Special Report

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Computers haverevolutionized education and the workplace, and many people are doingan excellent job of teaching students to use computers. However,there has been far too little attention paid to the dangers ofRepetitive Strain Injury (RSI) among children and young adults whouse computers extensively. There are simple safety skills andunderstandings that can be easily incorporated into computerinstruction, and this article will provide some suggestions about howto help students understand the dangers of computer use and preventRSI's.

RSI's can take many forms.Carpal tunnel syndrome is one that everybody has heard of, but thereare many other specific injuries that can result from repetitivestrain. For my purpose here, the details aren't important. What d'esmatter is that RSI's can be extremely painful and incapacitating, andyet there are simple precautions that will reduce the risk factorsfor RSI's.

RSI's can lead toexcruciating pain and the inability to work at the computer or evendo many simple daily-life tasks such as turning door knobs or openingbottles of milk. Here are excerpts from two letters (from an Internetnewslist) by young people who have experienced RSI's:

As one of those kids who'salways been into computers &emdash; my first was an Apple II+ when Iwas four &emdash; I wish someone had shown me about proper typingposture. Sixteen years later, it's coming back to haunt me, and Iknow I'm not the only one. I wonder how long it will take beforepeople start noticing that significant numbers of people my age canno longer do the things they've been doing all their life.

Since the surgery I lost agreat deal of strength and the pain just seems to travel higher andhigher up my arm, leaving it feeling constantly sore and heavy. Atfirst my hand and fingers didn't fall asleep that often, but my thumbalways had a burning sensation. As time g'es by, though, the numbnessis becoming more familiar. And the pain almost never g'es away anymore. The things that seemed so simple at one time in my life are nowdifficult, which leaves me frustrated and extremely depressed. I am26 years old and RSI has now taken over my life, which is very, verydepressing. I cry constantly because it has robbed me of doing thingswith ease. My life is now centered around my injury. I am told that Imust resign [from my job] or end up being permanentlydisabled.

Body AwarenessTraining

So what steps can be takento help protect students against RSI's? Body awareness training isthe foundation for computer safety. Body awareness training teachespeople to: (1) notice and feel their bodies as they engage in varioustasks; (2) experience and understand principles of relaxation,balance and movement efficiency; and (3) discover the most economicaland strain-free ways of accomplishing movement tasks and setting upworkstations.

Observe children sittingat their desks and using computers. What do you see? Are the chairsand the desks the right height, or do the children have to reach toofar or too high to the keyboard? Are the children resting theirwrists against the sharp edge of the desk? Are the children sittingin a relaxed, balanced, comfortable manner, or are they all twistedup or hunched over? Are the children tense with excitement orrelaxed? Do the children take rest and movement breaks, or are theyglued to the screen for long periods of time?

Observe a computer lab.Are the students given adequate instruction in proper posture andrelaxation for computer work? Are they taught about movement breaks?Are they taught how to set up a workstation to minimize physicalstrain? These subjects are crucial and, actually, quite simple, butthey do take specific instruction.

Perhaps it seems that theright ways to sit and work should be obvious to anyone and thatinstruction in something as basic and common as sitting isunnecessary. Perhaps it seems that good equipment would be enough toget people to sit and work properly and that providing good equipmentwould make body awareness training unnecessary.

However, instruction inhow to use the body really is necessary. Most of us have inefficientand awkward patterns of posture and movement which pose a risk whenwe engage in an intense task like computer use for long periods oftime. And good equipment supports the body in moving well but willnot compel people to move well if they don't already do so.

A MovementExperiment

What is body awarenesstraining? Let's try a simple movement experiment to see how bodyawareness training functions and what kinds of information about thebody need to be taught.

Sit on a flat-bottomedchair, far enough forward that your back isn't against the back rest.Slump down. Let your back get round and your chest cave in. Howcomfortable is that? Notice how the compression of your rib cageconstricts your breathing. If you sit this way on a wonderful chair,you will still be uncomfortable.

Staying slumped, raiseyour arms in front of you and move them around. Perhaps you canpretend to conduct an orchestra. Notice how the constriction of thechest and shoulders interferes with free movement of the arms. If yousit this way on an excellent chair and type with this strain in yourarms, you will be uncomfortable, and eventually you may incur somephysical damage.

What is comfort? Comfortis the balanced, relaxed, energized anatomically natural use of thehuman body. The body is designed to be a self-supporting unit, andsitting at a computer d'es not have to be as hard as most people makeit. Through an understanding of the way the legs and pelvis provide afoundation for the spinal column, head and arms, we can arrive at agood sitting posture.

Sit up straight from theslump. How did you do that? Most people believe that straightening upfrom a slump is accomplished by throwing the shoulders back,straightening the back and elevating the chest. Try thatdeliberately, and notice that that creates tension in the muscles ofthe back. In reality, sitting up is done by rolling the pelvis intoposition below the spinal column, thereby bringing the spinal columnto a position of easy balance on the pelvis. You can feel this foryourself.

Slump again, and noticethat when you slump, your pelvis rolls backward, the stack ofvertebrae has no foundation on which to rest, and it curves and fallsdown. (The pelvis can be thought of as a bowl which contains theguts, and "backward" is the direction in which the bowl would rotateto spill out the guts behind the body.) Notice also that when youslump, your pubic symphysis (the bone in the front of your pelvisjust above your genitals) points upward.

Now, simply roll yourpubic symphysis forward so that it points down toward the floor.Notice that when you roll your pelvis forward, you bring the spinalcolumn into an upright position and move up to an erect sittingposition. Rather than using (and straining) the muscles along theback to sit up, this pelvic movement calls into play deep coremuscles (the iliacus and the psoas muscles), which are much strongerand more efficient for maintaining erect sitting. (Some peopleinitially find this rolling movement unfamiliar or difficult toachieve.)

Once the spinal column isbalanced on top of the pelvis this way, it takes very little musculareffort to hold it there, and the posture is stable and strong. Inthis well-supported position, you can let go of unneeded tension andeffort. You can relax your muscles and sit and work comfortably. Bycontrast, sitting up "straight" by tensing the back will creatediscomfort and strain. Sit up in the new way and move your armsaround. Most people experience that then the pelvis and spinal columnare balanced, and the shoulder girdle and arms move with moreefficiency and ease. In practical terms, this means that arm and neckstrain in keyboarding will be reduced considerably.

Here is a simple hint forsignificantly improving comfort at the computer. Once you havelearned how to balance the torso atop the pelvis, you can reduce themuscular effort that even that takes. Sitting on a chair with a flatseat pan, roll up a bath towel, and wedge it in under your tail bone.Let your two sitbones (ischial tuberosities) still rest on the chair,but put the towel roll under your tail bone. The towel will act as awedge to keep your pelvis rolled forward into the proper position,and you will feel support all the way up your back. Pelvic supportrather than lumbar support is the real key to comfortablesitting.

PracticalKnowledge

I once conducted ademonstration of body awareness training for my computer users group,and the person who volunteered for the demonstration of propersitting posture happened to be wearing a TENS unit (an electricalgadget for interfering with nerve transmission of extreme chronicpain). Once I helped her into the position of comfortable balance,she exclaimed with great surprise that the simple cafeteria chair shewas sitting on felt better than the $600 ergonomic chair she hadtried out just the day before. The chair didn't feel better. She feltbetter on the chair. That was the secret.

The point of describingthis movement experiment is to indicate the content and the processof body awareness training and its necessity. It is important torealize that effective body use is not something we can take forgranted or assume people have. Through miseducation and misuse,people have learned to move in ways that are awkward, strain-filledand damaging yet seem normal and right. Students need to be taughthow to use their bodies well. Otherwise, they will hurtthemselves.

It is also not enough tosimply have good equipment. Without understanding and being able toachieve proper pelvis/spinal column balance, students will stillslump or sit too tense on whatever chair they may use, however goodthe chair may be. Students have to learn to use their bodiesappropriately to make best use of their workstationequipment.

Moreover, if students dounderstand principles of proper body use, then most equipment will beadequate or can easily be arranged to be adequate. For example,inexpensive chairs and tables will work well if pillows and footrestsare used to help the students fit the equipment to their bodies. Butthey must be able to feel what their bodies need in order todetermine what adjustments to make to their equipment.

Body awareness training iscost effective. Rather than needing new and expensive equipment,people who truly know their own bodies can use inexpensive aids tohelp customize workstations. The issue of cost is always important,for both schools and parents, and body awareness training can solvesafety problems with a minimal outlay.

ComputerSafety

There are three primaryelements to be examined in safety training for computer users: (1)body awareness; (2) movement breaks; and (3) workstation setup anduse. For reasons of space, I have confined myself in this article toone brief example of the process of body awarenesstraining.

The first and most basicelement of computer safety is body awareness. Students must be ableto feel and understand the functioning of each body component, fromthe legs to the eyes, so that they can detect strain and nip it inthe bud. The alternative to early awareness is to wait until physicalinjuries occur to realize that strain must have been present forquite a while.

The second element isproper movement breaks. Even the best work position on the bestequipment should not be maintained for too long. The body is designedfor movement &emdash; not for static work. Students need to learn totake rest and movement breaks in order to prevent fatigue and strain.There are three kinds of movement breaks to consider. The first andmost important is a brief, five-second movement break at the keyboardevery ten minutes. That will be enough to maintain relaxation andprevent stiffness. In addition, a five to ten minute movement breakaway from the computer each hour will be very important. And helpfulbut not necessary would be a 20 minute stretching session at homeonce a day to prepare the body for computer work.

The third element isequipment choice, workstation setup and task analysis. Students needto be able to feel what equipment will be comfortable and effectiveduring long hours at the computer. They need to be able to feel howdifferent ways of positioning the equipment affect the body. Theyhave to understand how to position the keyboard, mouse, monitor,graphics pad, external drives, books and so on. Students also have tounderstand the physical differences between the various kinds oftasks involved in computer use &emdash; from graphic design or textentry to programming or computer games &emdash; and be able to set upand use their workstations accordingly.

All of this is really alot simpler than it sounds at first, and it is not hard to teach. Itwould be easy to slip the various aspects of body awareness traininginto computer instruction in a way that would take minimal time andyet provide students with the basics of work safety education. Thereare so many positive uses of computers in education, but we owe it toour children to teach them how to keep themselves safe as they useand enjoy computers.

Note:For information on ordering Paul Linden's book, Compute in Comfort:Body Awareness Training: A Day-to-Day Guide to Pain-Free Computing,contact the author directly via e-mail.

Paul Linden is aspecialist in body and movement awareness education, and his workfocuses on the interplay between self-exploration and effectiveaction. He holds his Ph.D. in Physical Education, is an instructor ofthe Feldenkrais Method, holds black belts in Aikido and Karate, andis the developer of Being In Movement training. His teaching focuseson the application of body and movement awareness education to suchtopics as stress management, conflict resolution, performanceenhancement and work safety.

E-mail: paullinden@aol.com

This article originally appeared in the 08/01/1998 issue of THE Journal.

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