Workplace ergonomic setup - PEER system

Follow the PEER system for maintaining a healthy work environment.

If you use the PEER checklist you will reduce muscle stress and enhance concentration and comfort. PEER reminds you to monitor and optimize your:

• Position

• Environment

• Exercise

• Rest

The following techniques are designed to help prevent conditions from developing. If you have had or currently are experiencing pain, numbness, tingling, weakness or any other debilitating symptoms, please consult your doctor.

POSITION

A major factor of muscle strain and ache is fatigue. When muscles are under constant contraction they tire very quickly. When a computer user leans forward the body becomes off-balance and back muscles have to constantly contract. By learning how to sit in balance you can significantly lessen the potential for fatigue and enjoy a more comfortable work position.

Positioning your body by finding your ‘balance point’

Place your feet flat on the floor with the ankles below and slightly behind the knees. Your head should be raised with the neck straight. Imagine a string connected to the top of your head, gently pulling upward. Most people tend to hold their heads forward, so try drawing the neck back and forward a few times to try finding the natural balance point. If you close your eyes and concentrate on the feelings in your neck while doing this, you will find a point where your neck naturally relaxes. Sometimes it feels like your head floats or lifts at the balance point.

The shoulders should be over the hips. Most people tend to lean forward when they cannot properly see the screen. Or they lean back in the chair. It is important to properly balance the body on the chair. Try to discover your natural balance point by first positioning your chair, then sit up straight with arms hanging down by the sides and close your eyes, concentrating on the feeling in your back and hips. Try to relax your back, relax your hips and allow your body to slowly sway forward and back in your chair. As you move forward and back you will feel your body naturally come to rest at your balance point. While still focusing on your balance point, raise your hands just over the keyboard as if you are about to type. Feel how your balance point shifts your body backward slightly. If necessary, sway back and forth and around again to find your balance point for typing. Do the same for your mouse position, your writing position, your phone use position and whatever other repetitive tasks you do in a typical day.

Setting up your chair

Sitting in your chair is a bit like sitting on a bicycle. You need to maintain your balance at all times. Keep your balance point in mind as you reposition your chair and repeat the balancing procedures as you make adjustments.

The seat of your chair should be tipped slightly forward. This will allow your pelvis to tilt forward and make it easier to keep your back straight and maintain your balance point. Adjust the height of your chair so that your hip joint is level or slightly higher than your knees and your feet are comfortably flat on the ground (or footrest). Your backrest should only be lightly touching the middle of your lower back. It should serve mainly as a gauge for when you are sitting up straight. Reposition your backrest after you find your balance point position.

Armrests are to be used to support the weight of your arms only. If you are leaning on them, your balance point will surely be upset. You should be able to relax the shoulders, upper and lower arms when the armrests are at the correct height.

Air filled or memory foam chair cushions are often quite good, however always try them for at least 20 minutes prior to purchasing as it takes a bit of use to discover any possible shortcomings of such products.

Using the keyboard

A palm down position is not ideal, as it requires contraction of a troublesome muscle on the front of the forearm called the pronator teres. A flat, straight keyboard forces you into a completely palm down position and is thus less than ideal. Try a split keyboard where the keypads are angled and raised so that the palms face in rather than down and the wrists are easier to keep straight. If you must use a flat keyboard, try tipping it away from you by slightly raising the side closest to you. This will help to keep the wrists straight while typing.

With all keyboards, ensure that your elbows are open more than 90 degrees by positioning your keyboard as low as possible. If your desk is very high, consider adding a keyboard shelf under the desk. Another option is to place the keyboard in your lap. Some people find this quite helpful for relaxing the arms and shoulders as well.

Practice breathing while you type. Some people hold their breath when they work, so try to be aware of your breathing pattern and practice long, slow, deep breaths in and out as you type.

Avoid pressure on the wrists. Try a wrist rest but don’t allow the crease of the wrist to rest on it while typing. It is only for resting the palms on when you are not typing.

For severe conditions where typing is not an option, consider voice recognition software that allows you to dictate rather than type. Many people find this software very useful but be aware that error correction will still be necessary and that it is a slower process than typing.

Using the mouse

The mouse or pointing device should be as close to your keyboard as possible. Reaching any distance to the side can create problems by throwing off the body’s balance and forces the contraction of upper arm and shoulder muscles. If you use an under-desk keyboard shelf, try to get the pointing device next to the keyboard on the shelf. If that is not possible, the next best alternative is to position it on the desktop directly in front of your elbow.

Keep your grip as light as possible. Be aware of when you are squeezing the mouse more than necessary and practice easing your grasp. Learning to let go of the mouse when you are not actively using it is also very important. Gripping the mouse unnecessarily (hovering) is very common and a very bad habit. This hovering activity creates excess muscle tension in the hand and forearm and can lead to premature fatigue.

If mousing is uncomfortable, try using a different pointing device. Trackballs, trackpads, a different style of mouse, or pen input (graphics tablets) may be more comfortable. Another option is to swap hands periodically to give your dominant hand a rest.

Using the phone

Use a headset whenever possible. Most people tend to tip their head when talking on the phone and thus create unnecessary tension in the neck. This tipping tendency is generally absent with headsets.

Never hold the phone to your ear with your shoulder, this is very stressful for your neck.

If you cannot use a headset, or hands-free device, swap the phone from one side to the other every couple of minutes, ideally before you experience tiredness in your arms.

Positioning your monitor

Your monitor should be directly in front of you with the center of the screen about 5 cm (2 inches) below eye level. Position your monitor at a distance that allows you to read the screen comfortably without having to lean forward. The general rule of thumb is to keep it at arm's length. If your vision is poor, consider a larger monitor or changing the screen resolution to make the text and images physically larger. You should not be any closer than 50 cm (20 inches) to the screen.

Maintain your balance point while reading the screen.

Using a laptop

Avoid prolonged use of a laptop. The biggest issue is that the keyboard and display are too close together. If you must use a laptop, take more frequent breaks and do more stretching before, during and after use.

A good setup for a laptop is with a laptop stand and external keyboard. By raising the display of the laptop, you can take the strain out of your neck. As you cannot use the laptop keyboard while it is in the stand, you will need to add an external keyboard and pointing device that you can then place in the optimal positions.

Another option is to use an external monitor or a docking station to get all the components in more appropriate places. If using the laptop track pad causes irritation, consider using a mouse or another pointing device that is more comfortable for you.

Vary your position

Try opening your knees out to the sides. This makes it easier to keep the back straight. However, make sure the feet stay under the knees or slightly behind them.

Put the keyboard in your lap for a while. This gives your arms a different angle to work from. If your knees are slightly lower than your hips, the keyboard will tip away naturally and provide a more appropriate wrist position.

Change chairs or try sitting on a large Swiss (Pilates) exercise ball. These are quite comfortable and force you to sit up straight as well as stimulate a more active use of your postural muscles.

Change the position of your chair by raising it a couple of centimeters (an inch) and adjusting the seat or backrest just a fraction. It is good to change your chair position on a regular basis (as long as you stay within the recommended range). Your body will appreciate even a very subtle change.

Resting your arms and elbows on the desk is actually okay for short periods, but not too much pressure! Only allow the weight of the arms to rest on the table and make sure that you do not upset your balance point. For short periods it is alright to lean back slightly on your backrest. Be aware that reclining or leaning back too far may force you to tilt your head down to see the screen.

ENVIRONMENT

Lighting

Avoid glare. Position your monitor to avoid glare on your screen from light sources or place a glare screen over the monitor. Generally your light source is best from the side and above. Glare may cause eye fatigue and eye strain.

Do not position your monitor directly in front of a window as the contrast in light from outside will cause your eyes to strain when viewing the monitor. Use soft or diffused lighting and set blinds or drapes to adjust the natural lighting to a comfortable level.
Use room lights and desk lights to illuminate your desktop work. Make sure that the lights have shades to deflect the light from directly shining on your eyes.

Air

Ensure the air is fresh. Open a window or put on a fan and move around frequently. Stagnant air will cause early fatigue.

Control the temperature. The ideal temperature is between 68 and 73 degrees F (20-23 degrees C). If the body is too hot, metabolism increases and thus the need for food and water also increases. If the body is too cold, the muscles will contract and relax quickly to produce heat. This is why we shiver. This also uses a lot of energy so food and water needs are again increased.

Breathe! When stressed or mentally very busy, most people will hold their breath or take shallow breaths. Oxygen is one of the main body fuels. The body goes into a kind of ‘low power mode’ when there is insufficient oxygen. Poor breathing habits cause less oxygen to be available to the brain, muscles and organs. Paying a bit of attention to how you breath and taking deep, slow breaths are key elements to maintaining energy levels and clarity of mind.

Food

Remember to eat. Keeping healthy snacks at hand will make it easier to refuel your body, but striking the right balance is key. Too many calories or snacks high in fat will pile on the pounds. Make good food choices.  An apple, orange or banana are great snacks.

Fluids

The body requires at least two liters of fluids a day. So keep a drink at hand. Spring water is a great choice.

Juices provide for fluid needs as well as containing vitamins and minerals. The natural sugars in fruit and vegetable juices are a source of energy as well. Be aware that packaged juices often contain added sugars, sweeteners, flavorings and preservatives, so read the labels carefully.

Coffee, black tea and alcohol are all diuretics and dehydrate the body. Drinking quantities of any of these should be balanced by another fluid source.

EXERCISE

General 

While working on the computer certainly uses your muscles, the particular motions are very slight and potentially unbalanced. Cardiovascular exercises will help to keep your heart, lungs and muscles in good order. The body needs to be worked to remain strong  and long periods of relative inactivity (like working at a computer) should be balanced by at least four 20-minute periods of sustained exercise per week. Speak to your doctor as individual needs will vary greatly.

Specific

Muscles on the front of the body, the ones that when contracted bring the body into fetal position, generally need to be stretched. Sitting at a computer hunched forward will mirror the fetal position and cause the muscles on the front of the body to shorten. The person who cannot stand up straight after working on their computer is a classic example of this. Doing regular stretches for these muscles as well as maintaining a balanced posture will help tremendously.

The opposing muscles on the back that open the body, generally need to be worked and strengthened. Standing up and walking around is a great way to do this. Specific exercises that will work these (extensor) muscles involve opening or straightening motions. Opening and spreading the fingers, straightening the elbow and lifting the arms over the head are a few examples.

Each person will have specific needs in relation to how they work, their daily stresses and personal strengths or weaknesses. Desk Doctor has been designed by a neurophysiologist to address these needs but it is also important to speak to your doctor prior to starting any exercises.

REST

Just as the body needs to move, it also needs rest. Rest is when your body refreshes itself, nourishes and heals. If this key element is not practiced, fatigue, tissue damage and a host of other disorders can ensue. It is best to take regular short periods of rest throughout the day. This way your body never has to wait too long before is gets refreshed. A minute break for every 20 minutes work is a good basic formula. More frequent breaks may be necessary for individuals who work very intensely or suffer from use-related issues. Make the most of breaks by taking another minute afterwards to do a stretch or exercise. 

Remember also to allow the mind’s focus to shift away from work during a rest. If the mind is still working, then it isn’t resting.