In part one released previously last month, I gave the definition of ergonomics. To review, here it is again. Definition of ergonomics is the study of people’s efficiency in their working environment or in this case, any environment where long term body positions are being held. There are 3 types: Physical, Cognitive and Organizational types of ergonomics. I will be focusing on the physical type.
As a Chiropractor, I see patients as they are. Patients may be in pain or looking to just optimize their wellbeing. In my Chiropractic patient histories, I not only ask about their posture (is it good, fair or poor), but their favourite ways to sleep. In some cases, I take it a little further by asking patients if they’re happy with their pillow and bed.
These questions help me understand where patients are in their wellness spectrum. This helps me figure out what type and how long of a Chiropractic treatment plan they will need. My priority is to just provide my Chiropractic patients with the best needed treatment, but to educate them on things they can improve on in order to keep, hold or stabilize their adjustments. I feel so strongly about this that I have my treatment philosophy in my logo – Correct, Stabilize, Maintain.
Back to the ergonomics I suggest to my Chiropractic patients. It should be easy to understand that the keys to proper ergonomics are supported posture (assisting the spine to keep the curves it was designed to have) and symmetry in posture.
Our bodies do much better when they are supported properly. All of our anatomy (muscle, tendon, ligament, bones even organs) is designed to function optimally “if” we support it. Yes, there is a level of compensation but for only so long until the alarms all of our bodies are designed with, sound off. Pain is one of those alarms. Longer we ignore pain, anatomy will start to change or adapt.
Sleeping
I ask patients if they sleep on their side, back, stomach, or a combination of. I further explain, that if you were to sleep on your stomach, it comes at a consequence. Your spine is designed to be symmetrical and likes to have its natural curves supported when in the same position for a long period of time, under stress or fatigue. Sleeping on your stomach means you must turn your head (if you want to breathe), if you raise one or both elbows above your shoulders, and then one knee higher than the other. Can you picture what that looks like? That is a twisted spine folks.
Some people like to say they sleep on their side but in all reality, they sleep in a twist. If both knees are touching the bed and you are on one shoulder, that is not on your side. That is a twisted sleeping posture. Another sleeping posture that will create issues over time.
I mentioned elbows above shoulders… this applies to side, back and stomach sleeping. When you raise your elbows above your shoulders, you activate the upper 2/3 of your Trapezius muscle. Then if you like that position for long periods of time, that soft tissue or muscle will start to conform to that length and add to the already present human issue of upper cross syndrome. We need the bottom 1/3 of Trapezius muscle to betoned / activated / facilitated / stimulated, not the upper 2/3.
I suggest a contoured pillow. I have my favourite on my practice website under recommended products. This pillow comes in different sizes for different shoulder widths and body frames. I measure patients in the office or there are measurement instructions on the Amazon page where the pillow is found. These contoured pillows need to be used the proper way. If you have a contoured pillow, just make sure you are using the right side of the pillow. Large side typically will be when you are on your side and small side when on your back. Notice there is no stomach sleeping option?
I also suggest body pillows when on your side. You can find body pillows anywhere but the important thing here is that knees need to have a slight bend in them and also be even with each other. This is where the body pillow helps. No one likes their knees touching so they will stagger them, well that creates pelvis issues and obliquity that your pelvis will learn to be normal. Especially if things are done often, that is raising your right knee above your other or vice versa. Other examples of this knee offset that can create pelvis issues are, crossing legs the same way all the time, wallets in the back pocket, leaning to one side when standing… The body pillow will also help you stomach sleepers stay on your side. Always preferred by your local Chiropractor. Does any of these sleeping postures or habits speak to you?
Lastly, sleeping on your back. With the right side up on that contoured pillow, you can use another pillow or that body pillow and put it under your knees creating a bend in them and putting your heels on the bed. This will help give some slack to those hamstring muscles and let your pelvis relax a little. This is a highly recommended position for those with chronic lower back pain.
Some other sleeping don’ts include fetal position sleeping or sleeping on the couch. There is no way to do this correctly. When sleeping on the couch, most people will not have their back supported, their head will have fallen forward or to the side, and their knees are uneven. Couches are not like beds. Beds are made for sleeping and couches are made for sitting. Seems obvious but Chiropractors see patients all the time after they have fallen asleep on the couch and now either have back or neck pain. Fetal positions when sleeping are bad because having your knees above your hips will cause the lower back to round which takes away the God-given curve that your joints and discs prefer, called your Lumbar Spine lordosis.
Standing
When it comes to standing, I discussed in part one the need to stand a little bit more when at a workstation. If you read it, you would know the ergonomic standard is 25 minutes sitting, 30 minutes standing and five minutes walking around.
So, when standing it is important to think symmetry once again. I call it tree-trunking. A tree trunk is meant to be solid and sturdy primarily to withstand the winds that will eventually blow. The things to think about would be feet at hips’ width apart and then squeeze your gluts. Then, doing the same thing with your core adding to the tree-trunking. That is done by drawing your bellybutton in toward your spine using muscle and not by sucking in using your breathe or inhaling.
By doing these three easy things, you can have more resilience and stability as you stand. It will definitely take some getting used to but as I tell my patients, remembering to do something 100 times a day for 30 days will create new habits. I even have rubber bracelets in my treatment rooms that say posture check, to help patients remember to check their posture more often and as much as possible.
Something else to think about when standing would be a pressure mat to stand on. This is a soft rubber mat that is about an inch to an inch and a half thick. This is especially important when standing on hard surfaces for long periods of time.
Those sit-stand workstations I mentioned in part one is a useful tool to help keep your monitor and keyboard/mouse in the best position (monitor at eye level and keyboard/mouse just in front of your belly).
When considering what I have discussed for both sitting and standing with working for larger companies, you can make a request for an ergonomic work study. An ergonomic work study is a four-hour observation by a certified ergonomist to see what special things you could benefit from at your workstation to improve your productivity and prevent any repetitive stress injuries.
So, when considering ergonomics and posture when sitting, sleeping or standing for long periods of time, make sure to continue to take the time to evaluate the things we discussed in these two blogs. What you may have learned will not only save you from unnecessary discomfort but most definitely will make your Chiropractor’s job a lot easier.
I hope you learned something today. Thanks for reading – and stay well. Dr. SJ