Functional ergonomics is the daily exercise program and instruction that is given to a client with regards to their everyday activity while keeping the functional neutral positions and postures in the correct alignment.
When we think of ergonomics, we often think of workplace evaluations and how we do our job. And that is one component of the instruction. However work is only one place in which we develop these patterns and restrictions. Patients must learn how to not only sit at a desk but also learn how to get in and out of that chair each time they get up. How about driving your car to and from your work and how the postural position of your commute contributes to the poor postural patterns.
We discuss sleep positions to minimize stress to the hips, lumbar, thoracic, and cervical areas all while keeping postural alignment neutral.
Proper support and position in the bed at the hips and waist, and in the cervical areas are key to minimizing stress to these areas no matter how good your mattress. The neck often needs special attention and the use of a postural pillow may be needed to assist in keeping the proper alignment.
Standing desks are one way in which clients are trying to minimize the effects of the seated position, however if you are standing in a torsional pattern with compensation, the standing position could be making your symptoms worse not better. Instruction is given for proper weight distribution in the LE’s and pelvic alignment to minimize these issues as well as further instruction in desk height and position to give good feedforward postural positions that promote neutrality.
The use of a laptop or phone versus the desktop provides its own postural challenges. Use of wireless keyboards, iPad holders, and supportive arm positions assist in keeping the cervical and lumbar spines in a state of relaxation and neutral positions without compensation. Specific instruction with both verbal and manual cues are utilized by your rehabilitation specialists to put you in a successful position to give you an opportunity to manage your posture with such activity.
Vision is such a vital role with the postural compensations and often is the driving force that leads to the inability to manage a neutral position. Placement of the monitor in the correct position is key to keeping a mid neck in neutral alignment however the most neutral position can be affected by a progressive lens or bi/trifocals. Several times the vision will drive the neck position in order to be able to focus on a screen and instead of being able to move the eyes, we simply move our entire head, usually in a non-favorable position that promotes loss of cervical lordosis and puts additions stress to the muscle of the cervical spine. Headaches and neck pain are promoted with these poor alignment and vision compensations as a result. Referral to your vision doctor may be needed to correct lenses so that the client can be successful at holding the proper position. For more difficult cases with vision, a neuro-opthamologist will need to evaluate further looking for midline shifts, anterior and posterior or left to right that could also play a role in the postural issues. Prisms will often be used to train the eyes and correct these compensation leading to less headaches and pain.
In the most difficult cases of facial pain and headaches, evaluation by a craniofacial specialist may be needed. Bite can play a crucial role in not being able to correct postural alignment, especially in the head and neck. If a client is not able to hold a corrected neutral position that the therapist is able to get them to and the vision is tested and is good with no issues, the bite may be the key component. Quick tests and specific questions direct us on the need for the specialist referral so as to get the client the assistance they need for long term management of their pain. Bite splints for day and night may be designed to assist the client and in more advanced cases, clients may require braces or other more advanced work to get the postural correction they need.
In summary, ergonomics is not the same as it was 20 years ago and the need for a therapist trained in postural restorative therapy and functional biomechanical- ergonomics is a must if one is really interested in correcting their posture and treating the cause of the pain, not just the symptoms.
Contact our therapist should you have any questions regarding your ergonomic assessment.
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