ERGONOMICSERGONOMICS

By By Raylene M. Blandino M.S., PARaylene M. Blandino M.S., PA--CC

ERGONOMICSERGONOMICS--What is it?What is it?

Derived from two Greek words:Derived from two Greek words:““NomoiNomoi”” meaning natural lawsmeaning natural laws““ErgonErgon”” meaning workmeaning workHence, Hence, ergonomistsergonomists study humanstudy humancapabilities in relationship to workcapabilities in relationship to workdemandsdemands

HistoryHistory

•• As early as 18As early as 18thth century doctors noted century doctors noted that workers who required to maintain that workers who required to maintain body positions for long periods of time body positions for long periods of time developed musculoskeletal problems.developed musculoskeletal problems.

•• Within last 20 years research has clearly Within last 20 years research has clearly established connections between certain established connections between certain job tasks and RSI or MSD.job tasks and RSI or MSD.

1)1) Static workStatic work: musculoskeletal effort : musculoskeletal effort required to hold a certain position, even required to hold a certain position, even a comfortable one.a comfortable one.Example: sit & work at computers; Example: sit & work at computers; keeping head and torso upright requires keeping head and torso upright requires small or great amounts of static work small or great amounts of static work depending on the efficiency of the body depending on the efficiency of the body positions we chose.positions we chose.

What two elements What two elements are at work?are at work?

Elements at work (cont)Elements at work (cont)

•• ForceForce: : amount of tension our muscles generateamount of tension our muscles generateExample: tilting your head forward or backward Example: tilting your head forward or backward from a neutral, vertical position from a neutral, vertical position quadruplesquadruples the the amount of force acting on your lower neck amount of force acting on your lower neck vertebraevertebrae

•• Increased force is d/t increase in muscular Increased force is d/t increase in muscular tension needed to support head in a tilted tension needed to support head in a tilted positionposition

3 Main Ergonomic Principles:3 Main Ergonomic Principles:

1.1. Work activities should permit worker to adopt Work activities should permit worker to adopt several different healthy and safe postures.several different healthy and safe postures.

2.2. Muscle forces should be done by the Muscle forces should be done by the largest largest appropriateappropriate muscle groups availablemuscle groups available

3.3. Work activities s/b performed with joints at Work activities s/b performed with joints at about midabout mid--point of their ROM (esp. point of their ROM (esp. head,trunk,UE)head,trunk,UE)

•• The average person working at a keyboard The average person working at a keyboard can perform 50,000 to 200,000 keystrokes can perform 50,000 to 200,000 keystrokes a daya day

•• Overexertion, falls & RMI are the most Overexertion, falls & RMI are the most common cause of workplace injurycommon cause of workplace injury

•• An average of 125,000 back injuries due to An average of 125,000 back injuries due to improper lifting each year.improper lifting each year.

•• Muscles overuse results in tiny tears in the Muscles overuse results in tiny tears in the muscles and scarring; these contribute to muscles and scarring; these contribute to inflammation and muscle stiffnessinflammation and muscle stiffness

FACTS

A Bit of A Bit of AnatomyAnatomy !!!!

•• Overuse and small repetitive movements Overuse and small repetitive movements ieie: : CTD, RSI, MSD disturb balance of muscles, CTD, RSI, MSD disturb balance of muscles, tendons, ligaments and nervestendons, ligaments and nerves

•• Brachial plexus: nerve group that supply muscles Brachial plexus: nerve group that supply muscles and skin of UE, course down side of front of and skin of UE, course down side of front of neck and become median, neck and become median, ulnarulnar and radial and radial nerves.nerves.

•• Nerves send signals to muscles to contractNerves send signals to muscles to contract•• When nerve compressed feel sensation When nerve compressed feel sensation

somewhere b/w point of compression and somewhere b/w point of compression and fingertipsfingertips

WhatWhat causes Nerve causes Nerve Compression or Compression or EntrapmentEntrapment??

1)1) Repeated motionsRepeated motions

2)2) Tight musclesTight muscles

3)3) Inflammation of surrounding tissuesInflammation of surrounding tissues

4)4) Misalignment of the nerveMisalignment of the nerve

What are 4 Common Nerve What are 4 Common Nerve injuries?injuries?

I.I. Thoracic Outlet Syndrome:Thoracic Outlet Syndrome: brachial brachial plexus compression d/t muscle plexus compression d/t muscle tightness side of neck from poor head tightness side of neck from poor head position or slumped posture. position or slumped posture. S/S/SxSx: numbness/tingling in hand, made : numbness/tingling in hand, made worse w/overhead activities or cradling worse w/overhead activities or cradling phone b/w ear and shoulderphone b/w ear and shoulder

Nerve injuries (cont)Nerve injuries (cont)

II.II. Radial tunnel syndrome:Radial tunnel syndrome: compressed compressed radial nerve @ outside of elbow d/t radial nerve @ outside of elbow d/t repetitive wrist & finger extension or repetitive wrist & finger extension or turning of forearmturning of forearmS/S/SxSx: Sensations from elbow to base of : Sensations from elbow to base of thumb w/ wrist weakness a common thumb w/ wrist weakness a common sxsx

Nerve injuries (cont)Nerve injuries (cont)

III.III. CubitalCubital tunnel syndrome:tunnel syndrome: ulnarulnar nerve nerve compression inside of the elbow d/t compression inside of the elbow d/t repetitive bending of elbow or repetitive bending of elbow or resting resting your elbowyour elbow on a hard surfaceon a hard surfaceS/S/SxSx: numbness or tingling and : numbness or tingling and inside of arm w/ tingling to ring & little inside of arm w/ tingling to ring & little fingersfingers

Nerve injuries (cont)Nerve injuries (cont)

IV.IV. Carpal tunnel syndrome:Carpal tunnel syndrome: compression of compression of median nerve at level of carpal tunnelmedian nerve at level of carpal tunnel

Where is carpal tunnel? Formed @ wrist by Where is carpal tunnel? Formed @ wrist by ligament over the carpal bones in handligament over the carpal bones in handS/S/SxSx: numbness or tingling in thumb, index, : numbness or tingling in thumb, index, or middle finger & or middle finger & ½½ of ring finger; often of ring finger; often awakened @ night by hand awakened @ night by hand ““falling asleepfalling asleep””SxSx increased by driving or attempting to hold increased by driving or attempting to hold objects; dropping objects is a common objects; dropping objects is a common complaintcomplaint

Tendons and TendonitisTendons and Tendonitis

•• Tendons are connective tissue that attach Tendons are connective tissue that attach muscle to bone; have little stretch or reboundmuscle to bone; have little stretch or rebound

•• Tendon overuse, static or prolonged Tendon overuse, static or prolonged position=inflammation or tendonitisposition=inflammation or tendonitis

•• Tendons of wrist & hand very small; @ high risk Tendons of wrist & hand very small; @ high risk for injury w/ overusefor injury w/ overuse

•• ““Tennis elbowTennis elbow”” or lateral or lateral epicondylitisepicondylitis affects affects finger extensorfinger extensor tendons outside of elbowtendons outside of elbow

•• ““GolferGolfer’’s elbows elbow”” or medical or medical epicondylitisepicondylitis affects affects finger flexor tendons inside of elbowfinger flexor tendons inside of elbow

What to do ??What to do ??

PREVENTPREVENT, , PREVENTPREVENT, , PREVENTPREVENT !!!!!!

a)a) Warm up & stretch before activities that are Warm up & stretch before activities that are repetitive, static or prolongedrepetitive, static or prolonged

b)b) Take Take frequent breaksfrequent breaks from ANY sustained from ANY sustained posture every 20posture every 20--30 minutes30 minutes

c)c) Respect painRespect pain-- positions or stop painful positions or stop painful activityactivity

d)d) Recognize early signs of inflammatory process, Recognize early signs of inflammatory process, & & txtx earlyearly

a)a) Maintain erect position of backMaintain erect position of back& neck w/ shoulders relaxed & neck w/ shoulders relaxed

b)b) Position equipment & work directly in front of Position equipment & work directly in front of and close to your major tasksand close to your major tasks

c)c) Keep upper arms close to the body, elbows 90Keep upper arms close to the body, elbows 90--100 degrees100 degrees

d)d) Keep feet flat on floor, upper body weight Keep feet flat on floor, upper body weight resting on resting on ““sits bonessits bones””

e)e) Wrists as neutral as possible; safe zone for wrist Wrists as neutral as possible; safe zone for wrist movement is 15 degrees in all directionsmovement is 15 degrees in all directions

Maintain Neutral Posture

f)f) Avoid bending neck forward for Avoid bending neck forward for prolonged periods of time (*remember prolonged periods of time (*remember quadruplequadruple the force); use a copy holderthe force); use a copy holder

g)g) Avoid static positions for prolonged time; Avoid static positions for prolonged time; muscles fatiguemuscles fatigue------MOVE to circulation!MOVE to circulation!

You talking to

me?

Modify Tasks:Modify Tasks:

a)a) Alternate activities frequently; rotate heavy Alternate activities frequently; rotate heavy &/or repetitive tasks w/ lighter less repetitive &/or repetitive tasks w/ lighter less repetitive ones.ones.

b)b) If If sxsx become worse become worse REASSESSREASSESS task setup & task setup & look for alternative methodslook for alternative methods

c)c) Avoid repetitive or prolonged grip activitiesAvoid repetitive or prolonged grip activitiesd)d) Avoid pinching w/ wrist in flexion or wrist Avoid pinching w/ wrist in flexion or wrist

deviation (bending to side)deviation (bending to side)e)e) Take Take frequent breaksfrequent breaks to stretch & rest handsto stretch & rest hands

•• Use the largest joints & muscles to do the jobUse the largest joints & muscles to do the job•• Use 2 hands to lift rather than one, even with Use 2 hands to lift rather than one, even with

light objects and tasks.light objects and tasks.•• Avoid lifting w/ the forearm in full Avoid lifting w/ the forearm in full pronationpronation

(palm down) or (palm down) or supinationsupination (palm up)(palm up)•• Slide or push & pull objects instead of liftingSlide or push & pull objects instead of lifting•• Keep reaching to a minimumKeep reaching to a minimum•• Carry objects close to body at waist levelCarry objects close to body at waist level

Body Mechanics

Correct & Incorrect TechniquesCorrect & Incorrect Techniques

Good and Bad of Good and Bad of ““TILTTILT””

ERGO REMINDERS from Stretchbreak.com

Practice Wellness at Work and Home !

Exercise RelaxationNutrition

Spirit

MindBody

MOVE

BREATHE

STRETCH

An ounce of Prevention is worth a An ounce of Prevention is worth a pound of cure !pound of cure !