Chiropractic care is a beneficial treatment for many people; however, when people come home after their adjustments, go to their office, or perform other daily activities, they may be undoing the benefits of their treatments with poor ergonomics. Choosing the wrong position, chair, or desk can reduce the long-term effects of chiropractic adjustments. “Ergonomics is concerned with the ‘fit’ between the user, equipment and their environments.”1 This includes having proper posture, which is a neutral position. The optimal body alignment will cause less strain on the muscles, joints, and spine. The “head is balanced over the spine (ears over shoulders)…Shoulders are straight (shoulders over hips)…Thumbs point forward…Pelvis is tucked in (hips over knees)…Knees stay over the feet (when bending)…Heels are perpendicular to the ground.”2 Ergonomics benefit the whole body, preventing not only lower back pain but also optimizing circulation and breathing, keeping the bones in a proper alignment, reducing fatigue, and promoting confidence and a confident image. The fatigue is reduced because the body is using its muscles the most efficiently when everything is aligned and movement is easier. Poor posture can lead to chronic and even incurable diseases later in life.3 Besides posture, equipment a patient uses in their environment matters in assisting with proper alignment. Every part of life affects ergonomics, so it is important to optimize every aspect for proper posture and alignment.
The Basics of Proper Alignment
Carrying the proper backpack in the appropriately supportive method, with the proper weight, is something students can achieve. If the weight is unavoidable, such as textbooks for a student, taking a few items out and holding them in the arms will help reduce some of the weight. Backpacks with wider straps distribute the weight more evenly, and both straps should be worn on both shoulders at all times in order to avoid putting too much strain on one side. Backpacks with metal frames could provide more support, though that may make storage of the backpack more difficult. Core strength stabilizes the muscles and makes carrying heavy weight easier, though a backpack should not exceed more than 15% of the patient’s body weight. Backpacks with wheels remove the weight from the shoulder completely.4 Students and office workers should sit at an ergonomic desk, with the computer monitor at the right height and the chair positioned, with the proper lumbar support and height, for leg and knee alignment. Even a keyboard and mouse can be designed ergonomically. Some patients may benefit from orthotics, or special shoe inserts. There is an adage in chiropractic care that compares neck alignment with a banana: a banana is curved, and a neck should be too. Neither should be straightened out. This is a particular concern as people have turned to handheld devices and texting, which also causes neck and shoulder strain. A straight neck “squishes your spinal cord”.5
Ergonomic Positions and Office Furniture
The United States Department of Labor has many guidelines for office comfort and to reduce repetitive stress injuries (RSIs). Proper computer monitor distance is 20-40 inches away from the eye to the screen. The screen should be directly in front of the user, and not at an angle, with the top of the monitor at eye level. The keyboard should be at elbow level, wrists should not bend, and shoulders should be relaxed. There are also alternative keyboards available for greater comfort. The mouse also should be used in a neutral position, perhaps with a wrist rest. Desks should also be adjusted for the necessary height to accommodate the ergonomic computer positions, with foot rests for the user, if needed. The chair should have lumbar support and allow the user to “recline 15 degrees from the vertical”. The point of the guidelines is to reduce “awkward postures, such as extended arms…and raised shoulders”.6 Some people benefit from using an exercise ball as their office chair.7 Others have found success using standing desks or even half-kneeling desks.8 The United States Department of Labor’s Bureau of Labor Statistics has found that many injuries in the workplace were caused by musculoskeletal disorders like repetitive motion injuries and sprains. Literally, the repetition of daily workplace tasks creates stress which often leads to injuries in the back, neck, shoulders, and wrists as well as the onset of carpal tunnel syndrome in these areas. Poor office ergonomics and improper handling of tasks leads to these issues. While the best solution is to prevent these injuries before they occur, chiropractic care can treat many of these conditions after their onset. Chiropractic adjustments and manipulations will realign the areas of the body where improper posture and stress have caused injury. The body is unable to heal itself properly when it is misaligned. The chiropractor will also have suggestions for preventing further injury at work and at home as well as recommend exercises for strengthening and maintaining health in the affected areas.9