Asana means seat in Sanskrit (the ancient language of yoga). It also means any of the physical yoga postures. One of the original intents of the asana practice of yoga was to move the body in such a way to enable you to sit for long periods of time for meditation. The huge difference with the seat for most of us is that we are doing WAY more sitting than yoga or other types of movement, and while we are sitting we are focused on some type of work task while our posture goes by the wayside. For those times when sitting is unavoidable, we need to examine our sitting position to see if we can make it better and less a contributing factor to our posture and pain complaints.
The order of these steps assume that your desk is immovable, and you have the ability to either move your chair up and down or select a different chair. Also – this is only one view! If what you’re doing now works for you and you’re not in pain, don’t mess with it. Also, as with all internet advice, this won’t be applicable for 100% of people – in that case, the best thing to do is have someone look at you at your station (see #10).
The order of these steps assume that your desk is immovable, and you have the ability to either move your chair up and down or select a different chair. Also – this is only one view! If what you’re doing now works for you and you’re not in pain, don’t mess with it. Also, as with all internet advice, this won’t be applicable for 100% of people – in that case, the best thing to do is have someone look at you at your station (see #10).
Try looking at your set-up in this order and see if you can get some relief:
1. What’s the immovable piece – for most of us it’s our desk. We work around it.
2. Adjust your seat height for optimal wrist position. Our wrists were designed to be in slight extension for our fingers to work most efficiently. Your height relative to your keyboard and the shape of the keyboard will affect this. The flat laptop keyboard puts many people’s wrists flat or in too much flexion (palm toward forearm - 2a, 2b) which can lead to problems over time. If you do most of your work on a laptop, consider a separate USB keyboard and/or docking station. If that’s not an option, try to keep the heels of your hands a comfortable distance from the keys so that there’s a gentle dome under your hands (2c). Sometimes adjustable keyboard trays are a nice solution, but you have to take the scapula (next) into consideration.
2. Adjust your seat height for optimal wrist position. Our wrists were designed to be in slight extension for our fingers to work most efficiently. Your height relative to your keyboard and the shape of the keyboard will affect this. The flat laptop keyboard puts many people’s wrists flat or in too much flexion (palm toward forearm - 2a, 2b) which can lead to problems over time. If you do most of your work on a laptop, consider a separate USB keyboard and/or docking station. If that’s not an option, try to keep the heels of your hands a comfortable distance from the keys so that there’s a gentle dome under your hands (2c). Sometimes adjustable keyboard trays are a nice solution, but you have to take the scapula (next) into consideration.
3. Scapular position. Huh? This is THE MOST COMMON thing I have to talk to people about. It affects pain in the neck, back, shoulders, elbows, wrists…What we call the shoulder blade is actually the “spine of the scapula”. The scapula is a floating bone on the upper back that has 18 muscles that attach to it in all different directions to the spine, ribcage, upper arm and more. The scapula also forms the bony shoulder socket. Many people come into my clinic with one or both scapulas depressed. No, the scapula isn’t sad, it’s hanging out too low on the back. How can you tell? It’s best to have it assessed by a qualified physical therapist (ahem!) But a quick and dirty way to check is to look in the mirror with your shirt off. If your collar bones run straight across you probably have a depressed scapula. If it is depressed, it would likely LOVE to be supported at your desk. Try raising your arm rests. If your arm rests aren’t adjustable, you can tape a folded hand towel on top of them. If raising the arm rest causes shoulder pain, you may need some support from the armpits instead (so the upper arm bone isn’t jamming into the socket). This can be accomplished with stuffing a pillow under your armpits to get some lift – a huge relief for a lot of my patients (3).
4. Keep things close. Ideally your keyboard is close enough that your elbows come straight down from your shoulders like a plumb line. Your mouse should be as close as possible or part of the keyboard. Anything you handle frequently such as the phone should also be as close as possible. Consider a hands-free set for your phone - it may save your neck and shoulders. (avoid 4a!) Try to avoid repeated twisting of the neck or trunk while seated by keeping things in front of you. (4b) If you can’t keep everything in front of you, turn your whole chair so your spine stays aligned. Ideally your knees, front pelvic bones, shoulders and your eyes should be facing the same direction at all times.
5. Where are your feet? At this point, if you’re in the shorter legs club, your feet may not be touching the ground! Oops! STOP – don’t put your chair back down. Bring the ground up to your feet! You want your hips just a teeny bit higher than your knees, not so much so that the chair is digging into your thighs. You also want some breathing room between the end of the seat and the back of your knees (at least an inch or 2). Now, fill up the distance between your feet and the ground with a phone book, a ream of paper, riser, etc. (5) If you’re in the super tall club and your feet are on the ground with your knees above hips, see how high you need to adjust your seat to get your thighs more parallel and you may need to raise your keyboard by that same distance.
6. Check in with your thighs. If the seat digs into the back of your thighs, try tilting down the front of the seat a bit. If this is not an option, you may need something extra under your sit bones. A rolled hand towel in a U shape may work (6) or you can buy a foam seat wedge. If your seat is digging into the backs of your knees, you may need a shorter depth seat. If this is not an option, you can also sit more forward in your chair and not use the chair back – but this requires careful postural positioning to keep a healthy neutral position. Make sure both sit bones are parallel with the front of the seat so your pelvis and spine aren’t rotated. Make sure your knees are coming straight off your hips and not in or out at crazy angles. Some people prefer to have one foot slightly in front of the other because they feel more balanced or at ease – cool, but don’t tuck one foot way under your chair. Check to see that there’s even weight on each sit bone and you’re not leaning heavily to one side.
7. How does your back feel? Does it feel easy to sit up tall or does it feel like your spine is having to work too hard? Does it feel slouched? Does it feel overextended? Or does it feel just right? You can try rolling backwards and forward on your sit bones to find your best neutral pelvis position that will align your spine with gravity. Think about the pelvis like a bowl and you’re spilling it backward (7a) and forward (7b) until you settle in on what feels balanced and the least amount of effort to hold you up (7c). You can try this little trick periodically throughout the day to move a bit and make sure you’re still in that neutral gravity aligned position.
7. How does your back feel? Does it feel easy to sit up tall or does it feel like your spine is having to work too hard? Does it feel slouched? Does it feel overextended? Or does it feel just right? You can try rolling backwards and forward on your sit bones to find your best neutral pelvis position that will align your spine with gravity. Think about the pelvis like a bowl and you’re spilling it backward (7a) and forward (7b) until you settle in on what feels balanced and the least amount of effort to hold you up (7c). You can try this little trick periodically throughout the day to move a bit and make sure you’re still in that neutral gravity aligned position.
8. Where’s your head? The human head weighs 10-15lbs. Where it goes changes everything! Many people have too forward a head position (8a, 8b). To correct this, try to lift from nape of the neck (where a momma cat would grab her babies) and gently lift up and back to reset the head position. Sometimes the aforementioned pelvic rolling does that for you, sometimes not. Your ears should end up in line with your shoulders, which are in line with your elbows and hips. Have a coworker snap a pic from the side if you can’t tell. Your resting gaze should be slightly below the horizon at this point. If you can’t see your work, adjust your screen and any papers you need to see to where they fall in this line. Bifocals/transitions can create havoc for this. Many people end up sitting with their chin up and head forward trying to see out of the bottom half of their glasses (8c). If this is you – talk to your optometrist about it.
9. Consider alternatives. Did you have a hard time making some of the adjustments mentioned? You may just have a chair that doesn’t work for you. Most employers will cooperate with you to get you in the right set-up. Some can bring in a professional to help you set up your desk. Many will be willing to purchase a new chair, especially with a note from a medical professional. I am often asked about sitting on an exercise ball. This can work great for some, but make sure you choose a ball size that can get you in the positioning mentioned above (often a bigger ball than you think!). If you're on the short side, you may have to be able to lower your desk for sitting on a ball to be an option. Some people also enjoy converting to a standing station either as a full time solution, or as an option for changing position. There are adjustable height computer carts, stand up desks, treadmill desks, stationary bike desks…the possibilities are nearly endless!
10. Get professional help. Have you tried everything and you’re still having problems? Think your 6-16 hours a day of sitting may be contributing to your pain? (Maybe I’m a bit biased but…) A qualified physical therapist is a great option to look at both your ergonomic set-up for injury prevention purposes and/or as an adjunct to caring for an existing pain complaint or injury. Contact me for an inexpensive customized ergonomic evaluation via Skype, Facetime or email photos.
10. Get professional help. Have you tried everything and you’re still having problems? Think your 6-16 hours a day of sitting may be contributing to your pain? (Maybe I’m a bit biased but…) A qualified physical therapist is a great option to look at both your ergonomic set-up for injury prevention purposes and/or as an adjunct to caring for an existing pain complaint or injury. Contact me for an inexpensive customized ergonomic evaluation via Skype, Facetime or email photos.
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