Working from home has become increasingly common. Even prior to the COVID-19 pandemic, there was a sharp increase of remote work in many professions.
Occupational therapy has a long history in work and industry, and we know that certain jobs have more risks. Working from home does not inherently look dangerous, but it can pose physical, mental, and environmental challenges that people might not anticipate.
OccupationalTherapy.com presenter Sara Loesche, MS, OTR/L, CHT, teaches occupational therapists how to set up healthy workstations for themselves and the patients they serve.
“Setting up a healthy home office workstation is key and deserves conscious thought,” Loesche said. “It is also best to be proactive about this rather than after issues or discomfort arise.”
The following information is taken from Loesche’s OccupationalTherapy.com course Work from Wherever: Ergonomic Tips for A Safe & Healthy Workstation Set Up at Home.
Identify and Correct Common Work Station Risk Factors
Awkward and static posture
- Cradling phone between the shoulder and ear
- Wrist extension at the keyboard because of placement or keeping ‘feet’ of keyboard up
- Shoulders elevated or upper extremity “reaching” while keying or mousing
- Neck flexion, extension, or rotation to view monitor
- Lack of lumbar support or excess thoracic curvature, posterior pelvic tilt
- Crossing legs, sitting on legs, or other poor lower extremity position
Forces
- Finger flexors when keying
- Push or pull chair to get up or move at workstation
- Pinch or pull binders
- Stapler
Contact Stress
- Mouse pad
- Keyboard
- Armrests
- Chair at back of the knee
As desk height increases, the risk of contact stress increases.
Practice Neutral Postures
Neutral postures can alleviate the aforementioned risk factors. What is a neutral posture?
- Head straight, slight downward gaze
- Shoulders relaxed, slight protraction
- Elbows flexed (90-100 degrees)
- Wrists neutral
- Lower body supported
- Knee at hip level and not in contact with the chair
Examine the Big Three: Chair, Workstation, Monitor
The equipment in the office is referred to as the "big 3." This is a chair, a workstation (which includes the keyboard and mouse), and the monitor. Look at these three pieces of equipment and see if they can either promote or inhibit a safe, neutral posture.
Chair
- Explore the features:
- Is it adjustable?
- Does it have armrests? And if so, are they useful?
- Does it offer lumbar support?
- Create a neutral posture
- Lower extremity support:
- Do knees come in contact with the seat?
- Does it have a waterfall edge?
- Your feet NEED contact. Do you need a footrest?
- Add a cushion to increase the height or support back as needed.
Workstation
- Keyboard
- Do you have enough room?
- Do you have a neutral wrist?
- Pull closer as needed to avoid contact stress between and reduce tension in upper extremities.
- Mouse
- Consider the size of the mouse and hand; try different types to find the best fit.
- Place your mouse on the same surface as your keyboard.
- Be sure that the mousepad doesn’t increase contact stress with the wrist.
- A wireless mouse is recommended for increased freedom of positioning.
- Make sure jewelry isn’t getting in the way.
- Monitor
- Monitor should be positioned at eyebrow level and 18-30 inches from the eyes.
- Make sure your monitor is adjustable. Use a monitor riser or prop with a book if needed.
- If using a laptop, consider a separate monitor.
- Laptops
- Laptops are not meant for long-term use and violate most ergonomic design principles. If you choose to use your laptop as is, you are going to use a lot of small muscles in your wrist and hand. You are also not going to be in good neutral posture for the most part.
- An external keyboard and wireless mouse are recommended when possible.
Additional healthy home office recommendations include standing when possible and scheduling movement breaks.
Standing workstations can be set up at a countertop or even an ironing board. Standing for 20 minutes either each half hour or hour can reduce strain through the lower back.
The other thing you want to do is take breaks. This is just as important as deciding how your workstation is set up—you want to make a conscious effort to take a break from that workstation as well and get some movement.
Summary
- Try for neutral postures.
- Check the "big three."
- Make moving a habit.
- Small changes make a big impact.
Featured Presenter
Sara Loesche, MS, OTR/L, CHT. Sara is an occupational therapist and an Associate Professor at Thomas Jefferson University in the Occupational Therapy Assistant Studies Program. For the past 10 years, she has taught a course in information literacy as it applies to occupational therapy in both the academic and practice environments. This has led to presenting on the topic at both state and national conferences.