ROC Ergonomic Recommendations for Conditions Treated
| Diagnonis or Cause of Your Symptoms | What you should avoid in general: | What you should avoid in particular: | Therapy Advice: | Ergononomic Design: Work station Modification |
| Carpal Tunnel Syndrome | Rapid, often repeated finger movements; wrist deviation, either towards thumb or small finger or extreme bending or extending. | Wrist flexion and extension, pinching, gripping, vibrations between 10 and 60 Hz. | Median nerve glides; stretch flexors of digits, forearm and wrist. | Utilize ergonomic keyboards, that keep your wrist in neutral position and avoid ulnar deviation (wrist positioned toward small finger) |
| Cubital Tunnel Syndrome | Resting forearm or elbow on a sharp edge or hard surface. Elbow in flexion or bent while on phone | Resting forearm or elbow on a sharp edge or hard surface. Elbow flexion/bending greater than 90° for prolonged periods. | Maintain elbow posture at 30 to 70 degrees while performing daily or work tasks. Ulnar nerve glides | Utilize headsets or blue tooth for phone usage. Nighttimes extension positioning with splints or pillows. |
| Pronator Syndrome | Forearm Pronation (position with palm toward floor) | Rapid and forceful pronation or strong elbow and wrist flexion. | ||
| Thoracic Outlet Syndrome | Arm elevation, carrying | Shoulder flexion, arm prolonged reaching | Proper height of work station with shoulder position by side with elbow at 90° or <. | |
| Stenosing Tenosynovitis Wrist Ganglion DeQuervain’s Disease | Finger flexion, wrist deviation out of midline. | Ulnar deviation (wrist position toward small finger), dorsal and palmar flexion, radial deviation with firm grip | Wrist brace/ RICE | Avoid wrist positions direction toward the small finger for DeQuervain’s. |
| Trigger Finger or Thumb | Digit flexion | Flexion of metacarpalphalangeal (big) joint alone or with full fisting. | Focus on PIP and DIP flexion. | Blocking splint to block MP joint flexion |
| DeQuervain’s Syndrome | Combined forceful gripping and/or pinch combined with hard twisting of the wrist. | Combined forceful gripping and/or pinch combined with hard twisting of the wrist. | Grip without wrist ulnar deviation (avoid positioning wrist toward small finger). Lift with wrist in neutral. | Large diameter tools. Neutral wrist. |
| Lateral Epicondylitis | Abnormal tennis back hand. Picking up items with your palms facing the floor. | Wrist extension and pronation (palms towards the floor) Push Ups. Do not carry items with elbow by your side. | Scoop things up or lift with palms facing ceiling. Stretches for wrist and forearm extensors. | Tools with wrist in neutral and large diameter handles. |
| Medial Epicondylitis | Arm elevation above 45°, rounded shoulder posture. | Wrist flexion and supination (palm positioned toward ceiling) Pull-ups | Stretches for wrist and forearm flexors | Tools with wrist in neutral and large diameter handles. |
| Shoulder Tendonitis or Rotator Cuff Syndrome or Shoulder Impingement | Often repeated movements, particularly with force exertion; | Arm abduction with elbow elevation. | Rest and ice of the involved upper extremity. | Use a step stool to reach objects above eye level. |
| Neck Tension Syndrome | Static Head Posture | Prolonged static head/neck posture. | Cervical stretches and/or traction as medically prescribed and designed. Use cervical support for neutral positioning. | Work stations that prohibit poor cervical posture or twisting. Maintain neck in neutral position. |
| Ulnar Artery Aneurysms | Wrist flexion and extension | Avoid using heel of hand as a hammer. | Use gloves with padding | Soft protection for ulnar side of palm |
| Ulnar Nerve Entrapment at the wrist | Vibrations, tight grip, cold temperatures | Wrist flexion and extension, pressure on hypothenar eminence. | Use gloves with hypothenar eminence padding. | Padded tools or resting pads for the computer or mouse. |
| White Finger Vibration Syndrome | Hard surface in contact with skin; vibrations. Pounding and pushing with the heel of the hand. Avoid cold weather. | Vibrations between 40 and 125 Hz. Avoid cold weather | May benefit from warm mittens or gloves. | |
| Tendonitis | Frequent motions of digits, wrists, forearm, shoulder | Rest and ice of the involved area. Immobilization as needed. | ||
| IN GENERAL USE: Use large muscles, but infrequently and for short durations. Let wrists be in line with the forearm. Let shoulder and upper part of arm be relaxed. Let forearms be horizontal or more declined. | IN GENERAL DESIGN: Place work object properly. Perform job task properly. Use proper hand tools i.e. "bend in the tool, not the wrist." Round corners, pad edges or corners. Place work object at proper height. | |||
| Ergonomic Table for Web Page Rough Draft 7-20-2010 /business on maine/therapy | ||||
Office Ergonomics and Work Station Design
Work station ergonomics is the customization of a workstation so that it “fits” the user rather than the individual trying to fit into a “one size fits none” environment. Proper adjustments and simple modifications can minimize an individual’s risk of developing repetitive trauma conditions, neck strains or low back pain symptoms.
The key to properly fitting a workstation is ensuring that activities are done in proper body positions, whether standing or sitting. Awkward body positions will place increased stress on muscles and tendons to maintain the posture which in turn increases tension on the nerves and soft tissue structures ultimately requiring more energy to accomplish a task. Proper body postures reduce the force requirements placed on muscles, tendons, and nerves by placing the extremities and spine in the optimal anatomic position of function. Proper body posture minimizes gravitational pressure on the body and thereby demands less work by the muscles.
Sitting
Most people think of sitting as a resting position. In most situations the exact opposite is true because proper sitting demands good torso balance, leg position, neck posture and so on. Because sitting postures requires many body parts to work in concert, an individual who assumes an improper posture exerts considerably more strain on body tissues than occurs when standing. Backaches, headaches, muscle stiffness and soreness are common symptoms of an improper sitting posture.
Prolonged Over bending
Sitting in a forward bent or “hunched” position causes excessive strain on ligaments and muscles in the back and neck. It increases compression of our abdominal internal organs interfering with their normal function. This abnormal posture will usually cause lower back pain and muscle fatigue.
Prolonged extension of the arm and back
Prolonged sitting with the arms extended in a non-supported position can cause neck and shoulder pain.
Prolonged forward bending of the head
Sitting in an over bent posture with the head bent in a forward position will cause strain on the ligaments and muscles of the neck and shoulders resulting in stiffness and pain in the lower back.
Ideal Seating includes both proper body posture and work station management.
Please see below recommendations for body positioning and work station setup.
Body Positioning
- Head: Head & neck should be in line with your body with no tilting or rotation of the head.
- Back: Keep your back straight with shoulders stacked over hip. The low back should be supported at the lumbar curve with a lumbar roll.
- Eyes: The monitor height should be so that the top line of print is in line with your eyes as you look directly forward. (Mid-monitor height)
- Shoulders: Arms at the side, relaxed from your shoulders; close to your body.
- Elbows: Elbows close to your side in a relaxed manner. With keyboard use your elbows should be 90 degrees or lower. (see details instructions below on how to correctly setup your keyboard height at your individual work station.)
- Wrists: Held in a straight position (no bending backwards (extension) or forward (flexion).
- Lower Extremities: Hip and knees are both positioned at 90 of flexion.
- Feet: Both feet should be flat on the floor or on a foot-rest depending on height of the individual in relation to the chair and counter top.
Workstation
- Keyboard: is tilted to maintain neutral wrist position (calculation for keyboard height see below).
- Mouse: place an ergonomic mouse close to the keyboard or on a pull-out tray from the drop down adjustable shelf for the keyboard.
- Chair: the chair back needs a good lumbar support. The chair seat back must have soft edges and be at 5 inches from your knee bend. The chair height should be adjusted to allow the foot to be comfortably planted.
Keyboard monitoring
To achieve the ideal height of the keyboard you must first be in a proper-seated posture as described above. The keyboard height should be at the same level as your hands when your elbows are positioned at less than 90 degrees or lower of flexion. Check to make sure your wrists are straight and not bent forward or backward. If your fingers rest on the home row of the keyboard (left index on F and right index on J) and your wrists are straight, then the keyboard is positioned at the proper height (have someone measure this distance from the floor to obtain the exact measurement). Typically, to achieve the ideal keyboard height, the keyboard sits on a shelf or drawer that is mounted under the desktop. A wrist rest along the bottom edge of the keyboard can be used to rest the heel of the hands and place the wrist in a neutral position as well as to alleviate some of the stress on the shoulders and upper back because of the weight of the arms.
Do you accept therapy patient’s treated outside ROC? What do you need?
We do accept new patients from outside referrals. We need the followings:
- A prescription from your medical doctor.
- Your insurance information.
Please call (713) 520-1210. Our staff needs your insurance information to get authorization from your insurance carrier first, and then an appointment can be made for you.