It’s strange thing to think that your elbow angle is possibly related to your neck pain. But, it’s true. Well, more specifically, it’s true in certain situations. Read on:
Neck pain is sometimes caused as a result of tension or spasm in the upper trapezius muscle. The upper trapezius muscles are the upper fibers of the large diamond shaped trapezius muscle that covers the back of your neck and middle back, illustrated below. As you can see, the upper fibers connect the neck and the shoulder, and it’s normally in the mid belly region of these upper fibers that people experience neck pain.
Why does your upper trapezius muscle become inflamed or go into spasm and create your neck pain?
Well, one common reason is because of stress (which can cause inflammation of the trapezius muscle in the absence of trigger points and muscle spasm).
Read my article about Stress and Neck Pain.
Another reason is because of fatigue of the upper trapezius muscle. When your upper trapezius muscle fibers are made to work under low loads for extended periods of time, they become fatigued and you are then likely to experience pain in the presence of spasm.
What causes the upper trapezius muscle to fatigue while you sit behind your computer and work?
There are a number of factors surrounding your computer workstation that can cause your upper trapezius muscle to fatigue and create neck pain for you.
Read my post on 4 Computer Monitor Positions that can Cause Neck Pain.
One of the least well known reasons to creating fatigue of your upper trapezius muscle and hence your neck pain, is the angle of your elbow while you work.
A very interesting study found that when you work on your keyboard and mouse, the angle that you keep your elbow at will determine the level of your upper trapezius muscle activity and your neck pain. Keeping the angle of your elbow greater than 90 degrees, helps to reduce the fatigue of the upper trapezius muscle fibers and reduces neck pain.
This elbow angle position is important when it comes to where you position your keyboard and mouse as you work at your desk. As I’ve mentioned before in other posts, your screen needs to be arms length away from you when you’re leaning backwards against your chair’s backrest. In contrast to a closer position of the computer monitor than most people tend to adopt, the keyboard and mouse need to be positioned further away and not too close to yourself.
As you sit and type and mouse, your elbow angle must be open (i.e. greater than 90 degrees and up to about 120 degrees). Working on a desktop computer, this elbow position may be more intuitive, however, be more aware of your elbow angle when you work on your laptop as well. People often work on laptops in constrained positions and places, with the laptop quite close to you. Learning how to setup your computer workstation correctly is important to help reduce or prevent the common aches and pains us modern workers experience.
Where do you position your keyboard and mouse when you work? And do you suffer from neck pain?
References:
Gawke J.C., Gorgievski M.J., van der Linden D. 2012. “Office Work and Complaints of the Arms, Neck and Shoulders: The Role of Job Characteristics, Muscular Tension and Need for Recovery.” Journal of Occupational Health 54: 323–330.
Bansevicius D., Westgaard R.H., Stiles T. 2001. “EMG activity and pain development in fibromyalgia patients exposed to mental stress of long duration.” Scandinavian Journal of Rheumatology 30 (2): 92-98.
Marcus M., Gerr F., Monteilh C., Ortiz D.J., Gentry E. et al. 2002. “A prospective study of computer users: II. Postural risk factors for musculoskeletal symptoms and disorders.” American Journal of Industrial Medicine 41: 236-249.
Neck pain is a common problem for at least 30-50% of the population at some point in their lives. Neck pain, however, isn’t the only problem that some people may encounter. Some people suffering from neck pain may also experience the bizarre phenomenon of feeling off balance or even falling over in association with their neck pain. Why is this?
If you are experiencing these added symptoms (and more – e.g. dizziness, problems with vision etc.), you would quite understandably be concerned that something more sinister might be at play. To rule this out, I highly recommend that you go see your doctor for further tests. This is especially important if you’ve recently been in any falls, car accidents, suffer from rheumatoid arthritis or any other systemic illness or cancer (to name just a few things that may contribute to structural weakness in the neck area – there are more things that can, but discussing this is not the point of this article).
Once you have been cleared of anything sinister, the question to ask is, why are you stumbling around, losing your balance or even falling over like a drunk person?
” Schematic of mammalian muscle spindle” by Neuromechanics under Licence in the Public Domain
There is a structure called a muscle spindle that is a key element in this phenomenon, which is found in an incredibly high density in the upper region of the neck (200 muscle spindles per gram of muscle in this area). It is also found in other parts of the body, but not in quite the high proportion that it occurs in the upper region of the neck (for example, there are only 16 muscle spindles per gram of muscle in the pincer muscle of the thumb).
The importance and function of the muscle spindle is that it detects changes in the length of the muscle fiber. This in turn helps the body part associated with those specific muscle spindles, to determine where it’s positioned in space. It also helps to set the resting tone (the resting degree of muscle contraction) of the muscle concerned as well as playing a protective function for the muscle. The protective function occurs through the feedback the muscle spindle provides when the muscle is overstretched, resulting in immediate contraction of the muscle to prevent overstretching and injury.
In the upper region of the neck, these muscle spindles play an enormous role in the postural control of your whole body and your overall ability to balance through their function in association with other systems found in the inner ear, eyes and central nervous system.
Something that we as therapists know, is that the whole body follows the head. In other words, if your head turns right, your body will follow and also lean towards that direction. Think about when you’re driving the car and you turn to look at something in the road, if you’re not careful, before you know it, your car too has veered off in that direction. This is all due to these muscle spindles in the upper region of the neck and their complex interaction with your other balance and positioning sensing systems in your inner ear, your eyes and your central nervous system.
I will always remember a knee patient I was rehabilitating years ago following his ACL surgery. He was absolutely useless at any balance exercise and made very poor progress despite practice. When I finally made him stand up straight to check his standing posture, I discovered that his resting position for his neck was tilted slightly to one side. To him, this felt absolutely normal and upright! Once I had corrected this so that he could sustain a proper upright standing posture, he found any balance exercises a whole lot easier and his rehabilitation, especially the balance and control elements, improved rapidly from there on out. This again illustrates the importance of these muscle spindles in the upper neck muscles!
So, one of the reasons your neck pain may be causing you to stumble, lose your balance or even fall over, is that you may have some malfunction of these upper neck muscle spindle fibers and their interaction with the associated balance and positioning sensing systems of your inner ear, eyes and central nervous system.
This can be due to a few things:
What can you do about it? Your OMT specialised Physiotherapist has a number of techniques to assist you. If you click on the link, you can find someone close to you to help.
References:
Guzman J., H. E.-J. (2008). A new conceptual model of neck pain linking onset, course and care: The bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Spine, 33(4S), S14-S23.
Guzman J., H. S.-J. (2009, February). Clinical practice implications of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Journal of Manipulative and Physiological Therapeutics, 32(2S), S227-S243.
J. Treleaven. (2008). Masterclass: Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Manual Therapy, 13, 2–11.
D. Falla. (2004). Masterclass: Unravelling the complexity of muscle impairment in chronic neck pain. Manual Therapy, 9, 125–133.
If you’ve been following my posts, you’re starting to realise that I keep harping on about how common neck pain is among office workers. During my pre-corporate practice days, lower back pain and knee injuries were the most common ailments I treated. Once I moved into the corporate environment though, I was totally amazed at the high incidence of neck pain I encountered.
There are various reasons for this high incidence of neck pain in an office environment. One large part is people’s posture while they work at their desks day in and day out (read my post on 4 monitor positions to cause neck pain). Another reasons for this higher incidence of neck pain is the high stress levels people are exposed to in the modern day office environment (read my post on stress and neck pain).
More and more computers are taking over and we’re working with less and less paper in our offices. A completely paperless office though, has not yet arrived for most of us. Does it really matter?
Who of you find yourself constantly referring to papers, writing on documents, capturing data from sheets and then working with the information on your computer as part of your job? I find this quite common among book keepers, data capturers, etc.
How does working between papers and a computer increase your risk of developing neck pain? There are a number of factors to consider in these scenarios.
Neck and lower back pain are such common complaints that we all know someone (if it’s not ourselves) who has experienced at least one of these complaints. There are many causes for neck or lower back pain. These can include different types of injuries, disease processes, genetic predispositions, and most importantly and commonly of all, our posture. Our posture at work and our posture at home and at play.
Our work posture is getting more and more attention, especially since the advances in technology have relegated most of us to work behind a computer for long hours each day. There are a host of things to consider in our work environment that can negatively affect our posture and cause our neck or lower back pain.
Part of my job is going around performing office ergonomics for people. One of the most common things I hear is people blaming their chair for their neck or lower back pain. Most often, however, this is not correct and the real culprit is the monitor and where it has been positioned on the desk. Luckily, this is a much cheaper and easier solution to the problem.
Your poor monitor position (read my post on 4 poor monitor positions that cause neck pain) is definitely one of the first places to look if you suffer from neck or lower back pain and you think your work posture is to blame. There are a number of factors to consider in relation to your monitor position, but one very important and neglected element is the correct monitor distance that your monitor is positioned away from you while you work.
If your monitor is positioned too far away from you, you will find yourself leaning forwards in order to see your screen better, creating all sorts of problems in your spine (especially in your neck and lower back) and over activating your shoulder muscles, all leading you down the path of aches and pains.
So what is the correct distance that you should place your monitor?
Generally, your monitor should be positioned a lot closer to yourself than you think it should. And if you don’t believe me, ask yourself why you keep leaning forwards when you work.
How do you determine the correct distance that you should position your monitor at? I call it the “Frankenstein” test.
Closer than you think? Give it a try and remember to keep leaning back against your chair’s backrest. Your backrest is there to help keep you in good posture while you work. A combination of those two factors (leaning back in your chair and having your monitor at the correct distance away from you) will go a long way to reduce your neck or lower back pain associated with poor working posture.
Who of you find that at the end of a day at work, your neck or shoulders are sore or aching? Neck pain is so common, that between 30-50% of the population will suffer from it at some point, and office workers are even more at risk of developing neck pain.
There are a number of reasons why neck pain is so common, particularly amongst office workers. Let’s look at a few of the reasons why:
The way that you sit at your desk and use your technology has a large impact on your physical posture and can either relieve or create neck or lower back pain. The posture that you sustain for extended periods of time will have a knock on effect on your muscles, joints, circulation of the blood, circulation of your nervous system and importantly, the ability of your lungs to expand and thus oxygenate your brain. Are you enabling all these systems to work well or are you compromising them through your posture and creating neck or lower back pain?
2. Not enough work breaks (Read this post about micro breaks in the work place)
When we work too long and too hard without breaking our work up into bite size chunks, we deplete our energy and our concentration levels and reduce our effectiveness, but, we also tire our bodies out more than we otherwise would that could lead us to developing neck or lower back pain. In fact, research has shown that a lack of micro breaks throughout the day results in a higher risk of developing aches and pains. Hmmm, who would’ve thought? and it’s the one thing I’ve noticed about South Africans – we don’t pace ourselves. This is really not good for our health.
3. Not enough movement throughout your day (view our ergonomic desk exercise software that will help you correct your computer ergonomics and perform desk exercises throughout your day)
Ah, who feels like moving when they’re tired? I must confess that I’ve had more than my fair share of couch potato moments. Not only that, most of us hate breaking our work rhythm when we’re on a roll. However, exercising regularly (on a daily basis or even once a day) is great for us in soooooo many ways. Moving helps relieve tension that has built up in our tissues. It also improves our circulation and helps protect us from aches and pains. It is good for stress relief and for our general health/cardiovascular system. Overall, if you are suffering from neck or lower back pain, exercise can help you reduce it.
An interesting thing I’ve noticed in my work is that even if someone has a really bad computer setup causing them to sit in an awful posture, if that person moves every hour, they invariably don’t get the aches and pains their colleagues who don’t move and sit in the same position do get.
Furthermore, moving throughout your day keeps your mind fresh and helps you perform better at your job. Taking active micro breaks is definitely worth considering in your work day!
4. And Stress!
Stress, stress, stress. The silent killer. The thing in our life that can take everything that’s good and run it down.
Researchers have discovered that working under time pressures and deadlines have a significant association with the development of neck pain. They’ve also shown that if you are being managed by someone who has a poor leadership style, you’re also more likely to suffer from muscular aches and pains. Eina!
And lastly, if you are experiencing psychosocial stress, you are also more likely than your peers to be experiencing neck and shoulder pain.
So, how can you help yourself?
Dealing with stress is not easy. It’s a process that requires learning new skills and looking at our life and situations in new and different ways. If you are suffering from stress, you owe it to yourself to find ways to reduce its detrimental affect on your life.
References
Ariens G.A.M., Bongers P.M., Hoogendoorn W.E., Houtman I.L.D., van der Wal G., van Mechelen W. 2001. “High quantitative job demands and low coworker support as risk factors for neck pain.” Spine 26 (17): 1896-1903
Bongers P.M., Ijmker S., van den Heuvel S., Blatter B.M. 2006. “Epidemiology of work related neck and upper limb problems: Psychosocial and personal risk factors (Part I) and effective interventions from a bio behavioural perspetive (Part II).” Journal of Occupational Rehabilitation 16: 279-302.
Gawke J.C., Gorgievski M.J., van der Linden D. 2012. “Office Work and Complaints of the Arms, Neck and Shoulders: The Role of Job Characteristics, Muscular Tension and Need for Recovery.” Journal of Occupational Health 54: 323–330.
Ferreira Jr M., Saldiva P.H.N. 2002. “computer-telephone interactive tasks: predictors of musculoskeletal disorders according to work analysis and workers’ perception.” Applied Ergonomics 33 (2): 147-153.
Fjell Y., Osterberg M., Alexanderson K., Karlqvist L., Bildt C. 2007. “Appraised leadership styles, psychosocial work factors, and musculoskeletal pain among public employees.” International Archive of Occupational and Environmental Health 81 (1): 19-30.
Which one are you? The painstaking 2 finger typer or the smug finger flying touch typer?
Who would’ve thought that typing at school would come in so handy? Or are you kicking yourself because as it turns out you never had the foresight to take typing as a subject when you had the chance?
Does it really matter if you can touch type or not? What are the implications for your health in the workplace? How does something so seemingly insignificant make such a difference?
I’ve written a number of posts on computer posture (click here to read about how your monitor position can cause neck pain) and neck pain (Click here to read about correcting a monitor positioned too far or too low on your desk causing neck pain). One thing I haven’t discussed is how touch typing (or not) can influence your neck pain.
As I mentioned previously, 30-50 % of people will suffer from neck pain and office workers are at a greater risk than others for developing neck pain. One of the reasons that neck pain is so common in the office environment is that people bend their neck too much in an office job. Research has shown that individuals who bend their neck for 70% or more during the day dramatically increase their risk of developing neck pain compared to their colleagues who don’t.
What are some of the reasons that cause people to bend their neck for too in an office environment?
When I go around to companies and perform office ergonomics, helping people to sit correctly at their computer workstations, sometimes correcting someone’s computer ergonomics is not enough to resolve the problem. If an employee constantly still develops neck pain despite having their computer workstation setup correctly (click here to view software to help you correct your computer ergonomics) , and neck injuries such as whiplash, or arthritis, or any systemic diseases which may cause neck pain are not clouding the picture, the reason why they may still be developing neck pain is possibly due to the fact that they are 2 finger typers, constantly looking down at their keyboard.
What is the solution when an inability to touch type is the problem? Simple, but it does require some effort. Learn how to type properly. There are a number of FREE online typing courses:
I’m sure there are more, just google it if you don’t like any of the one’s I’ve mentioned above. If you do use any of the above, I would appreciate feedback to help with the recommendation to others. Please post comments to this article.
Learning how to touch type will help you to keep working in a healthy body posture, reducing your need to bend your neck so often through the day and therefore reduce your risk of developing neck pain. Another bonus to learning to touch type is that the increased fluidity and speed of your new found typing skills will also help you to work faster which may also help reduce some of the deadline stress associated with your job. Stress in and of itself can also be a factor in your neck pain (read my post about stress and neck pain). A double bonus. Good luck and please let me know how it goes.
Reference:
Ariens G.A.M., B. P. (2001). Are neck flexionk, neck rotation, and sitting at work a risk for neck pain? Results of a prospective cohort study. Occupational and Environmental Medicine, 200-207.
Cagnie B., D. L. (2007, May). Individual and work related risk factors for neck pain among office workers: a cross sectional study. European Spine, 16(5), 679-686.
Guzman J., H. E.-J. (2008). A new conceptual model of neck pain linking onset, course and care: The bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Spine, 33(4S), S14-S23.
Guzman J., H. S.-J. (2009, February). Clinical practice implications of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Journal of Manipulative and Physiological Therapeutics, 32(2S), S227-S243.
So, you’ve discovered that your monitor (laptop, tablet or desktop computer screen) is positioned too low on your desk (read my post about 4 monitor positions that cause neck pain) causing you to bend your neck for too long, straining your neck. How can you go about correcting this and ease up the strain on your neck causing your neck pain?
Well, firstly, the changes to your monitor are entirely dependent on the type of technical device that you use. There are, however, certain principles that apply to all types of devices with a monitor that you might use that you need to be aware of in order to adjust your monitor correctly and reduce your neck pain.
3. You will need some assistive device to help raise your monitor to the correct height. Some desktop monitors have a built-in system that allows you to move the monitor up or down as desired, but most do not.
Let’s consider each scenario separately:
If You Use a Desktop Monitor
If you are using a normal, old fashioned desktop monitor, this will be one of the easier scenarios to raise your screen to the correct height. Just use books (it’s cheaper), a monitor raise or an adjustable monitor arm (check our our monitor raise and adjustable monitor arm in our shop).
If You Use a Laptop
People who use laptops sit in terrible postures unless they use a laptop raise (check out our laptop raise) or books to elevate the laptop monitor to eye level and use a second keyboard and mouse. Please ensure that you purchase a proper laptop raise that elevates the monitor sufficiently and doesn’t do a half job and leave you bending forwards over your machine. Alternatively, lower your chair until your monitor is at eye level as described above.
“Alu MacBook Desk shot” by David under Licence CC BY 2.0If You Use a Tablet
Tablets are an even greater ergonomic risk than laptops. Their screens are small and their keyboards laughable. If you’re crazy enough to use it like a working computer, you will have to get a tablet stand (and more than likely need to raise even that up on books to get it to the right height) as well as a second keyboard and mouse (check out our tablet stand).
This tablet raise/stand allows you to use your tablet like a computer, however, it will still need to be raised further on books etc to get the screen to eye level. In addition, you will also need a keyboard and mouse to allow for proper ergonomics and to avoid unnecessary back and neck pain.
Are you an office worker suffering with neck pain? If so, you’re not alone. Office workers are one of the population groups most at risk of developing neck pain, with an incidence of around 55% in some countries.
If you are an unfortunate office worker suffering from neck pain, is there something that you can do yourself to reduce or prevent your neck pain rather than popping pills or going to see your OMT trained Physiotherapist?
The answer is, yes, of course there is!
The first and simplest things that you need to consider is where your monitor is positioned in relation to yourself on your desk (check our our desktop software designed to help you correct your computer ergonomics). A poor monitor position is one of the most common reasons why office workers suffer from neck pain associated with poor posture. It’s happily also one of the easiest things for to change to help improve poor posture that could be causing your neck pain.
Consider the following 4 monitor position scenarios. Do you see yourself in any of them? All of these poor monitor positions are high risk postures for creating neck pain.
2. In this second scenario, your screen is positioned too high for you, causing you to raise your chin and compress the joints in the back of your neck causing you both neck pain and headaches. This monitor position will cause neck pain faster than any of the others and is one of the worst postures possible for a computer worker. This posture is common in people who are aware that a computer monitor often needs to be elevated, but are unaware of their own posture and what the correct position for one’s head and neck needs to be to prevent or reduce neck pain. Correct your position asap
3. Here, your screen is positioned too far away from you, causing you to lean forwards away from your backrest and poke your chin out. This posture will cause both headaches and neck pain. Read this post on correcting a monitor positioned too far away to help you correct this problem and reduce your neck pain.
4. In this last scenario, you are working a lot from notes/papers/files and don’t use a document holder. This means that you are looking down too often during the day and this constant bending of your neck puts you at a very high risk of developing neck pain.
Alternatively, you’re working a lot from notes and have positioned them on your desk between your keyboard and monitor causing you to push your monitor too far away and take a poking chin posture.
Both of these postures will create neck pain and possibly headaches.
I will write about how to correct these postures and position your monitor correctly in the near future, make sure you come back to find out how you can help yourself reduce your neck pain.
A ‘6-pack’ – the ultimate fit and healthy look! One of the most common ways to go about getting your awesome abs is to perform loads of sit ups. This must be one of the most common exercises performed in the gym, and judging by the photo below, in the armed forces as well (read my post on why your abs are important Part 1).
Most people are very careful about how they perform their sit ups to avoid straining their neck. If your abdominal muscles are weak, it’s not uncommon to assist your sit up by using your momentum, which then leads you to pull on your neck which may end up with you experiencing some neck stiffness or even neck pain. However, neck pain is not the only possible side effect from too many sit ups. Have sit up enthusiasts considered that too many sit ups may also be placing them at risk of developing lower back pain?
How’s that you ask? Lower back pain? Well, it’s like this: Your body is a complex setup of biomechanical levers. One of the most important levers is your spine. Sit ups work the front part of your spine, pulling it forwards. Counteracting this movement are the spinal extensor muscles. Are you working them as well? Are the forces acting on your spine balanced? (Read my post on how lower back pain works Part 1)
Do you know where your spinal extensor muscles are? If you refer to the image below, you can see how long these muscles are and how far they extend along the length of the spine. Are you performing any spinal extensor muscle exercises in the gym? Do you know how?
If the muscles acting around your spine are unbalanced and your abs/ ‘6 pack’ is over worked in relation to the spinal extensor muscles, this may cause a constant slumping/slouching affect on your spine. Too much bending of your spine will cause an increase in the compressive and shearing forces through your spine and especially on your spinal discs. This may lead to premature wear and tear on these spinal discs (spinal cushions), which are in and of themselves weak in resisting bending and turning forces of the spine, too much of which may lead to lower back pain. Some research puts the incidence of lower back pain due to injuries of the spinal disc at 65% of all incidence of lower back pain.
Furthermore, performing sit ups as a strengthening exercise for the abs/’6 Pack’ shows a lack of understanding for the real function of the rectus abdominus (click here to read more). Sit ups are therefore not really functional and are also a high risk exercise for developing lower back pain. What then would be a better exercise to strengthen your abs/ ‘6 Pack’/ Rectus abdominus functionally? And would there be a way to simultaneously exercise the spinal extensor muscles and ensure balance of your spinal lever? The answer is a resounding yes. Read my post on using the plank as an exercise for more information.
Feel free to leave a question or comment. I would love to hear from you.
Reference:
McGill S. (2010). Core Training: Evidence Translating to Better Performance and Injury Prevention. Strength and Conditioning Journal, 32 (3), 33-46.