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.
The Concept of Ergonomics
“Ergonomics is concerned with the ‘fit’ between the user, equipment and their environments.”1 This includes having properposture, which is a neutral position. The optimal body alignment will cause less strain on the muscles, joints, and spine. “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 Besides posture, equipment a patient uses in their environment matters in assisting with proper alignment.
The Basics of Proper Alignment
Carrying the proper backpack in the appropriately supportive method, with the proper weight, is something students can achieve. 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”.3
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”.4 Some people benefit from using exercise balls as their office chairs.5 Others have found success using standing desks or even half-kneeling desks.6