Online physiotherapy at xpertphysio: Office Ergonomics (Work laws or Work principles)

Online physiotherapy at xpertphysio: Office Ergonomics (Work laws or Work principles): Introduction Ergonomics( ergo=work, nomics=laws ) is the science of fitting job tasks, workstations, and equipment to individual workers. ...

Office Ergonomics (Work laws or Work principles)

Introduction

Ergonomics(ergo=work, nomics=laws) is the science of fitting job tasks, workstations, and equipment to individual workers. Ergonomics looks at all aspects of a job – from the design of tools, tasks, and equipment, to adequate lighting and how the overall workstation is set up. And, its principles can be applied everywhere – in the workplace, at home, and to recreational activities.

Good ergonomics (figure 1) have several things in common and they focus on:

·         Prevention of injuries

·         They are a component of a holistic approach to occupational safety and health, and

·         They can measure their value to the company through productivity gains, morale, and lower insurance costs.

A major benefit of good ergonomic design is:

·         Fewer musculoskeletal disorders

·         Lower incidence rates

·         Less absenteeism, and

·         Reduction in workers’ compensation premiums.

But, some of the intangible rewards you may not think about include:

·         Improved productivity

·         Less job turnover

·         Worker comfort, and

·         Greater job satisfaction.

Figure 1 office ergonomics (good posture)

Dangers of Desk Job

You don’t have to be an ergonomist to do an effective ergonomic assessment of your office workers. Although doing a job assessment for ergonomic risk factors in an office setting may not be quite the same as on the production floor, many of the same risks will show up in various job tasks throughout the workplace. Knowing what to look for will probably alert you to more risk factors than you anticipated finding. Almost everyone who works in an office setting spends a good portion of the day on the telephone or the computer, or both – jobs that make them prime targets for an assortment of ergonomic injuries. Awkward and static postures (figure 2), contact stress, and repetitive motions are prevalent among people who spend hours sitting at a desk or workstation, such as:

• The call center workers who spend eight hours talking on the telephone and

keyboarding at the same time.

• The computer programmer sitting for hours developing a new program.

• The administrative assistant reaching or stooping to file documents.

• Workers who spend majority of their day doing data entry.

And many other office jobs that result in wear and tear on the body over a long period of time.

Figure 2 office ergonomics (poor posture)

Awareness training

The trouble is, this wear and tear occurs so gradually that most people don’t realize what’s happening until they’re hurting. By then, the damage has been done. That’s why early reporting and intervention are essential. Awareness training that involves practicing good ergonomic techniques and recognizing the signs and symptoms of muscle stress before they become major problems is important. You may routinely include this type of training for workers on the production lines and on the shop floor, but never think of bringing it to those workers with sedentary jobs.

What are the ergonomic injuries around the office?

Musculoskeletal disorders can result in soreness, numbness and tingling; a limited range of motion; weakness; and tenderness and swelling. Common disorders that show up in people who work in office settings are generally classified as cumulative trauma disorders. These injuries are caused or aggravated by repetitive motions, sustained or awkward postures, and compression; and they result in aching, tenderness, and numbness. Cumulative disorders that are frequently diagnosed in office workers include:

• Tendonitis (inflammation), which occurs when a muscle or tendon is repeatedly tensed from overuse.

• Epicondylitis from overuse causes pain and tenderness in the elbow and forearm.

• Carpal tunnel syndrome caused by overuse, compresses and entraps the median nerve in the wrist, causing pain, tingling, and numbness in the hand and fingers.

Knowing the common workstation problems

When you’re doing assessments for ergonomic risk factors in office jobs, there are some common workstation problems you need to be aware of which can be easily and, in most cases, inexpensively corrected. Encourage employees to practice ergonomically sound techniques when you find the following conditions:

Wrist planting (figure 3)

• When wrists are idle, they often rest on the sharp edge of the desk, causing pressure points between the wrist and the desk and damage to nerve and blood vessels. Float the wrists, don’t press them on the edge of the desk.

• Use a wrist rest or support brace to keep the wrists in a neutral position.

• Remove jewelry from the wrist that uses the mouse.

• Do exercises about once an hour by gently shaking the wrists, fanning the fingers, and stretching the wrists by slowly pulling the fingers back or pushing them against a wall or edge of the desk.

Figure 3 wrist planting

Mousing wrist, hand, and finger stress

• Use a variety of key strokes to relieve some mouse work.

• Take your hand off the mouse when it’s not being used. Let the hand relax.

• Use a mouse that vibrates when it’s not moved for some time as a reminder to remove the hand.

• Switch the mouse hand.

• Use different type or style of mouse.

• Maintain a neutral wrist with some space underneath and float the whole forearm along with the mouse. This allows the larger muscles to contribute to the task.

Lower back pain

• Maintain a supportive posture by placing both feet on the floor.

• Sit slightly over the desk.

• Sit with the back straight, buttock bones on the chair.

• Shift your position frequently.

• Get up and move around hourly.

Neck and shoulder pain

• Check the monitor placement. The top of the screen should be slightly below eye level(refer e-book on forward head posture). The middle of the screen should be about six inches below eye level.

• Use a hard copy document holder. Position it close to and at the same height and viewing distances the monitor screen.

• Use a headset(for call centre workers). Don’t hold the phone between the head and shoulder.

• Check the desktop/keyboard tray height. Arms should be in a neutral position and not reaching up or down.

• Sit close enough to the desktop and keyboard.

• Be sure the chair armrests not too high or the mouse and keyboard elevated. Shoulder elevation can cause pain.

Summary

In short proper office ergonomics is the best way to improve productivity and make a good business. Also this keeps the employer and the employee in a state of stress free mind. Enjoy working!

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Long term Knee pain

Introduction

Long term knee joint pain, medically termed as chronic osteoarthritis is a common problem for most of the elder population. There are multiple reasons for the occurrence of this condition. Most of the people suffering from this condition are forced to live with pain and a make a lot of compromise in their social and personal activities. This produces a huge amount of stress in knee pain sufferers. When we look in to this issue with an intellectual eye, we can find some solution just by making people understand what their real problem is and how they have to deal with their pain, in short the article is aimed on creating a reasonable awareness on knee joint pain and not focused on any specific treatment.

Anatomy of knee joint (figure 1)

Figure 1 anatomy of knee joint

Let us have an idea of basic knee joint anatomy. Human knee joint is formed by three bones.

1.       Femur 

2.       Tibia 

3.       Patella

They are united by ligaments and muscles that give the joint, its integrity.

Capsule

The joint is covered by an articular capsule that acts as a protective covering. The synovial fluid placed inside the capsule lubricates the joint during its movement.

Bursae

These are fluid filled sacs and they are placed between the muscle tendon and bones. There are numerous bursae that surround the knee joint.

Cartilage

This is a thin elastic tissue placed between the bony ends for shock absorption and protection of bones from abnormal frictional forces. The cartilage has a tendency to wear over the years.

Muscles(figure 2)

The main muscle groups are quadriceps (front of thigh) and hamstrings (back of thigh). Any pain or inactivity following a period of immobilization decreases the activity and nutrition of the quadriceps muscle in particular, which leads to further problems.

Figure 2 Muscles of knee joint

Causes of knee joint pain

1.       Post traumatic knee pain (pain occurs after an injury)

2.       Ligament injuries

3.       Obesity

4.       Degeneration of joints (commonly called as osteoarthritis)

5.       Muscle imbalances

6.       Bursitis (injury leading to inflammation of bursae)

7.       Dislocation of the knee cap

What happens in the knee joint when an injury occurs?

When any abnormal force is encountered by the knee joint and the protection from the muscles and ligaments fail, the knee is injured. The initial reaction will be pain and swelling. Then the internal damage (fracture, ligament injury, prolonged abnormal or uneven stress to the knee joint etc.,) will be diagnosed and the knee joint will be treated for it. Now the pain gradually decreases and the person recovers from the injury. The muscles particularly the quadriceps will be weakened and its efficiency compromised. Usually quadriceps facilitation or strengthening program will be pursued to improve the function of quadriceps muscle and maintain full functional knee joint range of motion by improving flexibility of the hamstrings. This is the normal treatment program.

If there is treatment then why majority of people suffer from long term knee pain?

The main reason is early cessation of quadriceps rehabilitation.  First of all we have to understand that knee joint is a weight bearing joint and should be fully functional when a person walks. If the quadriceps muscle is mildly weak then it cannot efficiently pull the bones of leg when it contracts (see figure 2b). This will make the body’s weight fall unevenly through the joint and stress a particular point causing further strain to the knee joint and accentuate quadriceps weakness, further restricted joint range of motion and tightness of hamstrings. This cyclic reaction (figure 3) causes long term and uncontrollable knee pain.

Figure 3 vicious cycle of long term knee pain

Tips for knee pain sufferers

1.       Continue quadriceps exercise and hamstring flexibility till you attain full flexibility and strength following your injury.

How to test this?

a.       When you are sitting with your leg straight at the knee, you should be able to touch the floor with the back of your knee. This gives an impression of your knee flexibility.

b.      If you get knee buckling when you are standing or walking it indicates insufficient quadriceps strength.

c.       Lift your leg straight when you are lying. If you can’t hold your knee without a bend it indicates insufficient quadriceps strength.

d.      If you have any of the above you have to consult your physiotherapist for further management and rehabilitation.

2.       Avoid prolonged standing and single leg standing.

3.       Never carry heavy weight on one hand. The weight shift towards one side of the body may injure your knee further.

4.       When walking, use cane on the unaffected side hand if you have one sided knee pain.
     
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What is Online Physiotherapy

Introduction

Online physiotherapy, a relatively new service uses the recent improvement in technology that helps unite people around the globe in to a single unit. If a question is arised, “how online physiotherapy can help a person who is not around the clinician in real time?” The answer to this question can’t be explained in a single word or sentence. Instead it needs more understanding and explanation with examples as to how a patient is dealt by a physical therapist for his ailment. This article is intended to clear the doubt regarding online physical therapy.

What is physiotherapy?

Physical therapy is a health profession dealing with the physical ailments that occurs in any form, from painful condition to muscle imbalance, weakness etc. Here we have to understand, how the physical therapist deals with a patient. Let me explain it through some points.

·         First and foremost the science of biomechanics (body mechanics with calculations of energy expenditure and efficiency) is very important for a physiotherapist when he makes an assessment of a patient.

·         An injury happens when certain amount of force is applied in a disproportionate manner, it can be an external force (when we encounter something) or an internal force (happening inside us due to prolonged stressful posture or certain sudden explosion of movement).

·         The knowledge of biomechanics helps in understanding the pathology of an injury.

·         This can be executed through postural assessment and subjective history (how and in what circumstances the injury happened or what personal habit steered you towards this ailment).

·         Now when there is a clear understanding on how the injury happened, there should be a solution through advices and corrective exercises.  Next stage will be certain mobilizations and corrections done by the therapists.

·         In this I have explained what will be the scientific rationale in short terms. But in reality frequent reassessments and changes in exercises catering to individual needs should be considered.

Now let me explain the scientific rationale of online physiotherapy!

Online Physiotherapy

·         In an online therapy setup, when the individual, the client or the patient makes an access to the website, he or she will be prompted with intellectually designed assessment questionnaire.

·         The client will have to answer them with what happened to them when they had their injury or what type of lifestyle they follow.

·         These answers will give the therapist a thorough understanding of their clients biomechanics and pathomechanics (abnormal biomechanics).

·         Once a clear inference is obtained then a suitable plan of action can be easily devised.

·         Now the therapist will send a clear report, plan of action, regarding the patient along with appropriate exercises.

Schematic illustration on how online physiotherapy works

Exercises

All the exercises will be well illustrated and explained in an organized way. The exercises will be aimed on correcting muscle imbalances, improving strength, flexibility and self mobilization to relieve any stiffness. As there are thousands of exercises in our data that are proved to be efficient in correcting physical ailments, online physical therapy can address around eighty percent of all physical therapy conditions.

With all these exercises and frequent motivations the program can be headed towards success!

Advantages of Online Physical Therapy

·         The client has time to think on what has happened to him and explain the complete difficulty in his words as there is no rush.

·         The client can obtain a second opinion even if he or she is undergoing treatment in a real time setup.

·         Once a premium member the client will have a time of one month to work with his ailment and frequently clear his doubts in just one payment.

·         Can access the treatment from anywhere in the world at the comfort of home.

·         No need to drive and wait in a long que.
   
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UNDERSTANDING THE RELATION BETWEEN YOUR FOOTWEAR AND ANKLE-FOOT INJURIES

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Greetings to our reader!             The relation between footwear and ankle foot injuries is often overlooked. In reality, proper size and texture of each and every component of a footwear is essential to prevent injuries of the ankle, knee, hip and even the spine! This article includes:         • WHAT ARE THE ARCHES OF FOOT         • DIFFERENT TYPE OF ARCHES A PERSON MAY HAVE         • RELATION BETWEEN ARCH TYPE AND FOOT ALIGNMENT         • FOOT PLACEMENT ON WALKING         • THE LOW ARCH FOOT OR FLAT FOOT         • THE HIGH ARCHED FOOT         • SELECTING THE PROPER SHOE – THE MUST KNOW FACTS!         • KNOW THE TIME TO CHANGE YOUR SHOES What are the arches of foot              First we need to have a basic idea regarding the arrangement of foot bones. Look at the foot below, the line shows the arches of our foot. They are formed mainly by our bone alignment and some ligaments and muscles.

They are very significant in deciding our way of walking, running, climbing etc and how the forces are exerted to the muscles of our body by these activities. Hence it is vital to understand them when we select a footwear, footwear should satisfy the need of our foots’ arches efficiently. Different type of arches a person may have             Each person is unique and the normal arches vary among individuals. Let us get a general understanding of the type of arches through the below illustration.

Relation between arch type and foot alignment            Now let us learn about the relation between our individual arch type and what will be our foot alignment as a result of that type of arch. With this we should be able to, select the type of shoe we need according to our foot requirement. Look at the illustration below.

FOOT PLACEMENT ON WALKING Before I describe the above illustration, one has to understand the way we place our foot on standing or walking. When our foot strikes the ground initial contact is at the outside of our heel and then it is progressed to our ball of foot on the inner part of our foot. Pronation - inwardly rotating your foot (sole faces out or away from our body) Supination - outwardly rotating your foot (sole faces towards midline of body) The low arch foot or flat foot usually exhibits a great deal of pronation, landing on the outside of the heel and rolling inward excessively. To see if this is your problem, get your feet wet and walk (don't just stand) on a piece of paper. If you see the print of your entire foot including your arches, you are probably a pronator. The “pronators” tend to have flexible feet so this foot needs maximum stability and control. Avoid highly cushioned, highly flexible shoes. The high arched foot under pronates and does not absorb shock well. This type of foot may supinate or roll outward when running. To see if this is your problem, get your feet wet and walk (don't just stand) on a piece of paper. If you only see the print of your heel and the ball of your foot, you are probably a supinator. “Supinators” feet are more rigid and cannot absorb shock well. So this foot needs a highly cushioned sole with maximum shock absorption plus a great deal of flexibility to facilitate proper foot motion. Stay away from heavy motion control shoes that can make gait unstable and may even promote ankle injury. Selecting the proper shoe  SIZE        Don't select shoes by the size inside the shoe. The size your foot measures is your foot size. Sizes vary among shoe brands and styles. Judge the shoe by how it fits on your foot. Don't hesitate to try on a shoe in a size other than what measuring indicates. Don't assume that you know your current shoe size. Have both feet measured, as you stand, each time you buy your shoes (the size of your feet changes as your grow older). Most people have one foot larger than the other. Fit to the largest foot. SHAPE        Select a shoe that conforms as nearly as possible to the shape of your foot. The ball of the foot should fit at the widest part of the shoe. This is where the shoe is designed to flex. Women especially, should check this as they tend to be wider here relative to the heel. HEEL        The heel takes a large proportion of a person's weight. Unfortunately, the height of the heel is often determined by fashion, not by the needs of our feet. Ideally, the heel should have a broad base and the height should be no greater than 4cm. A wedge, which adds height to the heel, enhances the shoe's ability to absorb shock and reduces strains. While this may ease problems like achilles tendonitis, a shoe with a higher heel may feel less stable. Know the time to change your shoes     Place the shoe on a hard, flat surface and look at it from the rear. The entire upper part of the shoe should be centered and not leaning to the side or bowed to the side (inside or outside).    When looking from the rear of the shoe, the sole should rest level to the surface. If the shoe rocks side to side, replace it. For more info on this and your doubts related to physiotherapy log on to www.xpertphysio.com