Wrist stretches for the keyboard worker & carpal tunnel

Do you find yourself with issues in the hands, wrist, or arms during a long shift at the computer? As with any repetitive stress issues, taking breaks and stretching are important. How do we stretch, though? Some areas are less easy to figure out than others. Here we will focus on the wrist.

Again, I'd like to preface with the fact that I'm not an expert in this department, and to trust your body. When stretching any part of the body, take it very slow at first until you know your limits. 

Also note that bouncing stretches are not good. This is where you take it to the stretching end point and bounce back & forth ala cheesy 80s workout videos. This can cause tissue damage as you're forcefully pushing past your natural level of flexibility. You want to take it to where it feels like a good stretch without pain. Hold it here for 3-5 deep breaths, and back out from the stretch at any time. You may only last through a breath or two before it's too intense and that's okay. Many of these areas have not been stretched much and I cannot stress enough to take it slow and listen to the signals your body is giving you.

1. One-arm assisted wrist stretch:

• Note that the image above is a person with high flexibility. This one can be very intense - don't overdo it!
• Sit in a chair with your feet flat on the floor. Extend your right arm out in frong of your right shoulder with your palm facing up. Use your left hand to gently pull your fingers toward you.
• Slowly let go of your right hand and turn your hand so your palm faces down. Using your left hand, gently pull your fingers toward you and hold for five deep breaths. Then release and repeat these two stretches with the left arm.
• If it's feeling okay, repeat both stretches two times on each wrist, and then shake out your hands to release your wrists. Allow your wrist and arms to fully relax for a few moments and adjust.

2. Palm-to-palm wrist stretch

• If either of this cause you pain, back out until there isn't pain, or just plain stop. If the pain is in the wrist, you may have some cramped space in your carpal tunnel.
• Sit in a chair with your feet flat on the floor. Bring the backs of your hands together in front of your chest, so your thumbs are pointing in. Press them together, and lower your elbows slightly to increase the stretch. Hold for five deep breaths.
• Then turn your hands around so your palms are touching, with your thumbs pointing away from you. Press every fingertip and the base of your palms together firmly, again lowering your elbows slightly to increase the sensations. Stay for five deep breaths.
• Repeat these two stretches for a total of three times. Then shake out your hands to release your wrists.

3. Hand on the wall stretch

• Positioning of your hand relative to your body affects the stretch - if your hand is further behind you than your body it will create a more intense stretch that reaches up through your pecs.
• Place the palm flat against a wall with all five fingers spread. Fully extend the arm and take several deep breaths. Slowly turn your head towards the opposite side and take another deep breath. Hold the stretch and return your head forward.

If you're looking for relief for general computer posture including shoulders, neck, and back: look up brugger relief position. It's a great exercise that is easy to do.

Sitting posture: at the desk

There is so much that could be going wrong with sitting posture, it's hard to know where to start.

I would like to preface these posts with a reminder that I am no expert in this, and some of this information may not ring true for you and your body. Any posture that isn't your natural posture will feel odd, so keep that in mind but ultimately trust your body and the signals it's sending you. Just focus on one adjustment at a time.

Other things to keep in mind: variety! There is no one sitting posture that's going to be perfect and comfortable for an 8 hour shift in a chair. It's important to stay mobile, and to take breaks. So many people take breaks from work without getting out of their chair. It's easy to hop on facebook instead of giving your body a break. If possible, get out of your chair every hour even just for 20 or 30 seconds. Walk around, do some light stretching, jog in place, do whatever you can to get your body mobile. We are designed to be mobile.

Head & neck: I might even recommend having eye level closer to the middle of your monitor - especially if it doesn't tilt up. It's very common to have a monitor be much lower than eye level. Put something under your monitor so that your neck does not need to be constantly bent forward. Phone books, reams of printer paper, sturdy boxes or other books... Doesn't need to be fancy. If you have pain or issues with the back of your neck and upper shoulders, this minor adjustment could be huge.

If you find yourself leaning your head forward to see what's on the monitor, adjust something that allows the screen to be visible while keeping your head neutral. For each inch your head moves forward, it multiplies the weight of your head. I mean this quite literally: if your head is 3 inches forward, your head is 3x as heavy as far as your neck muscles are concerned. Your neck does not need this added stress! A good baseline is having the monitor at arm's reach, like your fingertips could barely touch the screen. If vision is a problem for this, try a larger resolution on your monitor.

Shoulders & Arms: It's important to have arm support. As picture above, you want your shoulders relaxed down and back. The keyword here is relaxed. I have spent much time trying to correct my posture via using muscular effort to pull my shoulders back. This doesn't really help, and just creates its own problems. It's likely your arms are not able to relax back to an ideal position, but that's where massage and especially structural work comes in to help.

You want your elbows bent, forearms fairly parallel to the ground. The arms should not be reaching out to meet the keyboard. Ideally the keyboard would be quite close to the core of your body, but it's not easy to find a desk that actually accomplishes this. If you suffer from pain in the shoulder blade/scapula area (do you get those knots between your shoulder blades and your spine?), raise your awareness of how often your arms are reaching out to type or use the mouse. Having your arms reaching out for long periods of time puts excess strain on the musculature here. Think about keeping your elbows close to your body.

Right side = front side of your body

Back & Spine: It's important to understand the natural curvature of the spine here. Take note that the person would be facing to the right in the above picture. There is a light hunchback-esque curve in the shoulder/upper back region. This curve is exaggerated by a vast majority of our seating choices. Your back shouldn't be a straight rod, but you also shouldn't be sitting in what's basically the fetal position. All that to say, don't overdo it when trying to keep your head above your shoulders - there is a bit of natural curve here. When your monitor is too low and you have to bend your neck forward, you're taking away from the cervical curve here.

Lastly, the lumbar curve. This is important. So many chairs, including the one I'm sitting in right now, don't have proper lumbar support. You want to have your back and butt against the back of your chair. Unfortunately, a lot of chairs aren't shaped properly and this is uncomfortable. Many times, the base of the chair is so long that you feet can't reach the ground, or the actual shape of the back of the chair just doesn't fit. Make up for the lack of lumbar support with a small folded pillow, or one like this. There are a lot of lumbar supports for chairs out there. Find one that works for you.

 If your legs can't comfortably reach the ground, use whatever you can as a foot rest - a bucket, more phone books, whatever!

Now lets address the concept of 'sitting up straight.' Many of us, myself included, imagine sitting at a perfect 90 degree angle as perfect posture. It's much healthier to be leaned back somewhat. We're talking 100-120 degree, just a slightly obtuse angle. Putting all your body weight directly through your spinal column puts too much weight on the vertebral discs. Sources say that a 135 degree angle produces the least strain on the discs. This may cause you to be sliding out of your seat or just downright uncomfortable though. There is no one sitting posture that will be perfect. We're not designed to sit in a chair for 8 hours in a row.

Here's an article on the leaning back idea: http://news.bbc.co.uk/2/hi/health/6187080.stm

Legs, Hips & Feet: Keep your feet flat on the floor. This one is hard, I know. I like to rest my feet under my chair (on the legs of the chair seems comfy right?). This can contribute to an anterior (forward) pelvic tilt. Low back pain a common issue for you? Tight quads? Raise your awareness of what you do with your legs at your desk - it may help! You want your feet close to being directly under your knees (90 degree angle) or a little further forward. Having your ankles at a bit of an obtuse angle should be alright. I've read that you should have your knees a little lower than your hips. I'm not entirely sure why. I could see why they shouldn't be above your hips though.

Don't cross your legs for long periods of time (again, variety is key!). I'm guilty of this one as well. It can affect circulation, and it can attribute to unilateral (one-sided) tilts or rotations of the pelvis. This can surface in so many different ways. When your pelvis isn't sitting right, any part of your spine can be affected. I tend to cross my legs at the ankles when sitting, and I suspect it attributes to my tight IT bands (outside of legs) and tight deep hip muscles.

Speaking of hips, another important thing is to not have your legs spread too widely either. This can affect the lumbar curve in the spine, as well as various leg muscles, namely the deep hip muscles. You're holding them in a shortened position and if you do this long enough, the body adjusts and figures you don't need as much length in there. Google some piriformis stretches if this is an issue for you. I try to stretch my hips every day (just take it slow and don't do a 'bounce' stretch, hold it still and controlled). It's quite helpful for me!

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Like all disciplines and practices, good posture takes time. The hardest part is the awareness. Try sticky notes on your monitor or in the car, try computer/phone reminders, whatever you can to keep reminding yourself. You're changing neural pathways and you're not going to do it in one day. Think about your brain like a wheat field - your habits are these pathways you've gone through hundreds and thousands of times. The path is quite tread, quite comfortable. It takes mindfulness, effort, and energy to trudge through the tall wheat grass that has not been traversed. Each time it will get incrementally easier. Eventually, if you force yourself down this path enough, it will become the new standard path and you will no longer have to think about it.

Here are some resources for ergonomics & ergonomic office furniture:

General:

http://www.ors.od.nih.gov/sr/dohs/HealthAndSafety/Ergonomics/ErgonomicEquipment/Pages/officeequip.aspx

Custom chairs:

http://www.ergo4me.com/index.php

Posture itself (book/podcast I intend to check out!):

http://stopchasingpain.podbean.com/2013/03/19/new-rules-of-posture-with-mary-bond/

It's hard to see if something will work for you ergonomically if you are buying it online. I recommend finding something you can try out in person.