Surfing in Shark-Infested Waters
Good, bad, and half-baked ergonomic advice
By Deborah Quilter
First published March 23, 1999

If you had back pain due to driving, would you consult your mechanic for advice? Would you expect a special cushion to cure your pinched nerve or crumbling disc? Worse, would you take medical advice from an Internet chat room?

Intelligent folks would do none of the above, yet people routinely look to questionable Web sites for ergonomic advice. I logged on to a random sampling of sites maintained by universities, companies that sell ergonomic products, and well-meaning amateurs who have repetitive strain injury (RSI) and wish to share their experiences, and the information I saw ranged from the sound to the silly. You may end up wishing you'd talked to an expert or a good doctor. If you do, remember to see a physician who understands RSI. After all, would you see your dentist for foot pain?

More Is Not Always Better

Finding useful ergonomic sites was frustrating to say the least. Some sites promise and don't deliver, while others overwhelm you with layers upon layers of links to muddle through before hitting the pertinent page – which don't always have decent content anyway. For example, the medical reference link on IBM's Healthy Computing site (www.pc.ibm.com/us/healthycomputing/vdt9-ergo.html) linked to an enormous, sprawling site providing general medical references (www.nashville.com/~gsnace/health_2.htm) with no readily apparent information about RSI.

What you really want is not just information but advice about what to do. But many of the sites I found mixed good advice with bad. Most of them impart the standard truisms about avoiding glare and positioning your monitor and keyboard, yet virtually all of these sites show graphics of workers sitting with their elbows and knees at right angles. This position is not advisable for two reasons. First, holding your elbows bent for long periods can injure the ulnar nerve – you can slightly reduce this risk by keeping your hands lower than your elbows (thereby reducing the stretch of the nerve) and frequently relaxing your hands by your side. Second, sitting with your hips and knees at the same level reduces the natural curve in your lower spine. It's better to have a chair with a pelvic tilt so your hips are slightly higher than your knees and your lumbar curve is maintained.

Elsewhere on the Net, more misinformation abounded. More than one site recommends a 15-minute break for every two hours of intense computer activity, à la the recommendations of NIOSH (National Institute for Occupational Safety and Health). This is not frequent enough; you need a five- to 10-minute break at least every 20 minutes. The sites also don't tell you to stop entirely if you are sore, and they rarely address the core problem, which is simply too much computer use. All it takes is an hour or two of computer use per day to put you in the danger zone.

In other cases, the advice is either too vague or too simplistic to be helpful. For example, some sites encourage good posture and technique – prevention essentials – but they don't describe how to do it. Learning correct posture can take months of training.

Similarly, IBM's Healthy Computing site (www.pc.ibm.com/us/healthycomputing/index.html) offers this solution to shoulder pain: "Worker is tense. Drop shoulders, hang arms loosely." Well, people can be tense for lots of reasons. Maybe they're worried about meeting their quota. Maybe they're in the middle of a divorce. In any case, if it were that easy for people to rid themselves of tension, valium wouldn't be a best-selling drug.

Blaming the Victim

The problem with the OSHA site is that its advice, though well-meaning, is hard to apply. For example, the site suggests asking workers which tasks cause them pain and what changes they think will make a difference. This sounds good in theory, but how many employers really want to hear workers' opinions, much less plan to act on them – especially if it involves spending money or lowering productivity? (Of course, sound ergonomics are supposed to lead to higher productivity due to fewer injuries and less time off work, but many employers don't – or can't – see that far ahead.) Moreover, OSHA's sound advice to "vary activities" and "take frequent breaks" doesn't acknowledge the reality that many jobs, such as graphic design, programming, and word processing, require nonstop computer use.

Similarly, the computer ergonomics page of the University of California at San Diego (www-ehs.ucsd.edu/vdtself.htm) skips straight to the wrong end of the productivity versus health debate. The page warns: "Computers are here to stay at the university... It [is] the responsibility of each computer operator to recognize the risks associated with using the appliance, and to take proactive, corrective measures now to reduce potential injuries. The university simply cannot afford to lose your productivity or continue to incur rapidly escalating costs associated with computer injuries."

While it's true that computer users must take responsibility for their own posture, pacing, and technique, the admonition about productivity accounts in great measure for the high rate of injury among computer users. It doesn't take great deductive powers to realize that if your job requires high productivity (i.e., long hours at the computer), the responsibility for your health shifts at least partly to the employer, whose productivity demands may exceed your work capacity. A much larger issue – the wide-scale use of computers in ever-increasing areas of our lives – must be addressed by society at large if we're going to curb this epidemic.

Sales Pitches in Sheep's Clothing

At other sites, ergonomic advice is coupled with product pitches. For example, Microsoft exhorts you not to cradle the phone with your shoulder (www.microsoft.com/magazine/nov1998/ergo/ergo.htm). These are wise words; cradling the phone can lead to neck injuries. But Microsoft quickly gets to the hard sell: "While you're here, check out the cool new Microsoft Cordless Phone." I'm not saying that suggestive selling is necessarily wrong, but the products should be at least ergonomically sound. Microsoft's Cordless Phone isn't; you'd be better off with a headset.

Surfing for Self-Help

Obviously, the Internet isn't an entirely useless resource for ergonomic information. A good place to start is the well-organized list of RSI support groups at www.tifaq.com/information/supportgroups.html. Before you go Web surfing, bear in mind that sitting in front of a computer, mouse in hand, is a high-risk activity, especially if you already have symptoms of RSI. It may be quicker (and safer) to browse through libraries and bookstores or to seek out trusted experts face-to-face.

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