1. Ergonomics and Injury Prevention
Presented By Elmma Pena, DPT, CEAS
Alliance Occupational Medicine

2. AGENDA Repetitive Motion Injuries Consequences of Poor Posture
Optimal Work Station Adjustments
Upper Body Stretches
Back Injury Prevention and Proper Lifting Techniques
Back and Lower Body Strethes

3. REPETITIVE MOTION INJURIES

4. What is a Repetitive Mechanical Injury?
An injury that results from a continued repetitive motion without adequate periods of resting
Many symptoms:
Pain in the neck and shoulders
Pain in the forearms and elbow
Tingling in the hands
Headaches, etc.

5. Causes of Repetitive Motion Injuries
Force – pushing/pulling/gripping/pinching
Awkward posture – having a slouched posture
Repetition – continual typing/mousing, lifting, etc.
Contact Stress – resting forearms or wrists
affecting circulation

6. TYPICAL POSTURE AT YOUR WORKSTATION
Head moves forward
Shoulders begin to round
Slouched low back
Forearms/wrists rest on hard surfaces

7. POOR POSTURES

8. RESULTS OF POOR POSTURE HELD FOR EXTENDED PERIODS OF TIME
Decreased circulation of blood supply to muscles
Stress build-up in soft tissue
Structural Changes to Muscles
Tightness of muscles of chest and neck
Weakening of back and posterior shoulder muscles.

9. SOLUTIONS Optimal Work Station
Make adjustments to improve posture and relieve pressure
Take Micro Breaks (30-60 sec)
Stretch every hour to enhance circulation
Correct typing and use of hand tool techniques to lower injury risks

10. WORK STATION ADJUSTMENTS: CHAIR
Sit tall in chair with feet flat on floor
Lower seat so both hips and knees are bent to 90˚
Adjust back rest to lay flushed against your back, sitting upright
Elbows should be bent at the side of your body
No contact against armrests

11. WORK STATION ADJUSTMENTS: MONITOR
Eye Level:
When seated correctly and chin in neutral position, eyes should be looking at top 1/3 of computer screen
Exceptions
Bifocals –lower height of the monitor to where you are not nodding your chin when viewing the screen.

12. WORK STATION ADJUSTMENTS: PROPER DISTANCE
Monitor distance
Extend hand in front of your chest
Fingertip of middle finger should touch the screen

13. WORK STATION ADJUSTMENTS: DESK SETUP (ARIAL VIEW)

14. WORK STATION ADJUSTMENTS: KEYBOARD
Elbows bent to 90º, adjust keyboard height to slightly below hands
Float fingers over keyboard when typing
Maintain wrists in neutral alignment, avoiding excessive bending
Don’t rest hand/wrists on hard surfaces of desk or keyboard tray

15. WORK STATION ADJUSTMENTS: MOUSE
Hand should sit gently on top of mouse, centrally over neutral line with middle finger in the center
Bending of wrist should be avoided to prevent injury

17. INJURY PREVENTION

18. STRETCH BREAKS Every 30-60 min to reduce stressors
Stand up and stretch
Rotate stretches
Do your favorite more often!

19. Instructions For Stretching Exercises
Start the stretch gently, exploring the available motion.
Stay in the comfortable, pain free zone.
Do not bounce while stretching.
Release the stretch slowly, and wait for a few seconds
before the next stretch.

20. UPPER BODY STRECTHES

21. NECK SIDE BEND STRETCH
Begin in a comfortable seated or standing position
Move head to side towards you shoulder
Can increased stretch by gently pressing with hand
Hold for 30 sec.

22. LEVATOR SCAPULAE STRETCH
Place arm behind back at the waist
Move head diagonally toward collarbone.
Can increased stretch by gently pressing with hand
Hold for 30 sec.

23. SHOULDER ROLLS Sit/stand upright with arms at your side
Gently, move shoulders in a small circular motion both clockwise and counter clowckwise

24. UPPER BACK STRETCH Clasp you hands together in front of your body
Round your upper back as you push your shoulder blades out to the sides
Hold for 30 sec

25. POSTERIOR SHOULDER STRETCH
Begin standing or sitting tall
Reach arm across body, use the opposite hand to pull arm closer for a stretch
Hold stretch for 30 sec.

26. Wrist Extensor Stretch
Keeping elbow straight, grasp
left hand and slowly bend wrist
forward until you feel a gentle
stretch. You may curl your
fingers as necessary to increase
the stretch.
Hold seconds. Relax.
Repeat on the right side.

27. Wrist Flexor Stretch Keeping elbow straight,
grasp right hand and slowly
bend wrist back until you
feel a gentle stretch. KEEP
FINGERS POINTING
DOWNWARDS.
Hold seconds.
Repeat on the left side

28. Tendon Glides

29. BACK INJURY PREVENTION

30. LOAD PRESSURE

31. PROPER POSTURE Standing in one place Sitting/Driving
Rest foot on a stool or low box.
Switch feet often
Sitting/Driving
Sit with back fully against back rest/car seat
Feet should be flat on the floor

32. PREVENTING LOW BACK INJURY
Adjust workplace to the worker……not the worker to the workplace
Always be aware of you technique
Maintain “Neutral Spine”
Prolonged activity – alternate sitting or standing
Fatigue – take a small breaks
Heavy loads – use tools/machine when possible

33. PROPER LIFTING TECHNIQUES
Get Close
Brace your back.
Neutral Spine!
Look twice
Lift with your legs
Turn by stepping
Hold Close

34. BACK AND LOWER BODY STRETCHES

35. STANDING BACK BEND
Stand with at shoulder width apart, place palms on low back with fingers pointed down
Press your hips forward and begin to arch your torso backwards
Keep head looking forward
Hold for 5-10 sec

36. SEATED PIRIFORMIS STRETCH
Begin seated in chair
Cross leg over the other with ankle resting above the opposite knee
Keeping back straight, grab your shin and move towards your leg
Lean from your hips

37. STANDING HAMSRING STRETCH
Place heel on step or block
Keeping back straight, bend from the hip until you feel a stretch on the hamstring
Goal is not to touch toes
Hold for 30 sec

38. SEATED LOW BACK STRETCH
Begin sitting in chair with feet spread to hip width
Bend forward reaching toward your feet
Hold for 30 sec

39. WHAT ELSE CAN YOU DO TO STAY HEALTHY?
Exercise regularly & properly
Use proper work techniques
Eat nutritious meals
Get adequate sleep (7-8 hours)
Manage anxiety
Consult professionals as needed

40. Thank You Any Questions?
Presented by:
Elma Pena, DPT, CEAS
Alliance Occupational Medicine
315 South Abbott Ave., Milpitas
2737 Walsh Ave., Santa Clara
1901 Monterey Road, Ste 10, San Jose