New habits are easiest to develop if you are in terrible pain but please don’t wait until then. Any discomfort indicates some damage has already been done. Work is not supposed to hurt. For the moment, set aside everything “they” say and follow these steps toward working in comfort. Learning what to wear, how to sit, how to adjust your chair and workstation components and how to use your work tools can make a significant difference in your work and health. The word “disease” comes from “dis” meaning “not” and “ease” meaning “comfortable.”

Remove anything that constricts or interferes
with natural posture and relaxation
Off they come: Short skirts that don’t cover the knees, heels higher than two inches, pants that are tight when you sit, non-stretch pants that function like a girdle, girdles, panty hose, tight shoes, large wallets in your back pockets, even long fingernails. That is the first thing you do at home when you want to get comfortable, isn’t it?

Sit on your sit bones
The muscles on the front and back of the body are at the right lengths to hold us upright in good alignment. Your sit bones are designed to be the weight bearing structure of your body. If you take the time to sit in balance on your sit bones, muscles can relax. You will also prevent the common muscle imbalances that lead to repetitive strain injury (forward head posture, rounded shoulders, weak, over-stretched back muscles, tight hip flexors, and tight hamstrings.)

To learn to sit on your sit bones, go to the Balance Center in Palo Alto and take their free introductory class. In the meantime, put your hand palm up under your tush and roll your pelvis up and down until you feel your fingertips getting pinched—those are the sit bones. Now hold your hands in front of you as if they are a fig leaf (especially appropriate if you have removed a lot of constricting clothing). As you sit, your fingertips should point between your legs and back that if your sit bones were headlights, they would point behind you instead of in front of you. Compare this posture with your regular sitting posture. You may feel more balanced, relaxed, and dynamic sitting on your sit bones.

How to Adjust Your Chair
Now that you are sitting comfortably, ignore your workstation and focus on your body’s center, alignment, and balance. Sitting in the best posture you can, adjust the chair around you to support and encourage your best posture. The controls are designed operate while you are sitting in the chair, so you can use them throughout the day to vary your position. If you have chronic postural imbalance (“bad posture”), sitting correctly may feel awkward at first. Start stretching, and give yourself time to adapt.

	While sitting in your chair, start feeling and looking around for levers, buttons, and latches to adjust your chair. Your chair may not offer all these control features.
	Adjust seat height so feet are on the ground with 60% of your weight is on your tush and thighs, 40 % on your feet.
	Adjust seat pan tilt to relieve any pressure on the back of your legs and to encourage neutral pelvic tilt.
	Set depth of seat 2-3" behind leg so you have as much support as possible under your leg without making contact with the chair as you stand up.
	Adjust back height & angle so chair conforms to you
	Adjust armrests to support arms at rest and out of the way when typing
	Adjust back tension so you are balanced and do not feel as though you are being pushed forward or are falling back.

Once you have adjusted your chair, you can design the rest of the workstation around you (telephone, writing tablet, files). Arrange your workstation so you can stay on top of your center of gravity while you work. You need to determine the right height for your work. Take a few minutes to consider these issues

	What are the work areas you need to do your job?
	What arrangement works best if you use multiple computers & monitors?
	Are you right or left handed, and need more work surface area on the right or left?
	Monitors have less external glare if set at right angles to windows.

Ideal Work Surface Heights
Determine the distance from the bottom of your elbow to the floor. Ideally, your writing/work surface is 1” higher to provide support for your arms while writing without compromising your head or trunk posture. Place the keyboard and mouse 1” lower so there is room to use the keyboard with wrists straight and fingers slightly curved. If it is 29" from the floor to the underside of your forearm (as shown by the blue arrow), use your keyboard on top of a 28" surface and use a writing surface that is 30" high.

Keyboard and Mouse Position:
Stay in the Zone
Do not rest your arms or wrists when typing. Center the keyboard typing area directly in front of you on a work surface or an adjustable keyboard tray. Place the mouse so your elbow is bent and close to your side, your shoulder is relaxed, and your wrist remains straight during mouse use.

Use a whiteboard kit or marker pens and a tissue box to evaluate your position. You are in a good position in your work zone and center of gravity if you can balance an eraser on your head, hold marker pens in your armpits, and place pens on your wrists so your middle finger lines up with the midline of your wrist while working.

If you do a lot of writing and a lot of computer use and are using the same work surface to do both, you can see by the guidelines above that you need two different surfaces. You can use separate surfaces for each activity or attach an adjustable keyboard tray to your current work surface if it is high enough to permit leg clearance. Most standard work surfaces are 28 - 30" while users really need heights ranging from 22 - 34".

You may be able to request an adjustable keyboard tray. Using an adjustable keyboard tray gives you the advantage of positioning the keyboard at the right height and with a negative or downward tilt away from you. A negative tilt helps keep your wrists straight in a neutral wrist position. You can also readjust your keyboard height as you readjust your chair or change shoe heights.

Another consideration is that keyboard trays increase the overall depth of the workstation. This is an advantage if it allows you to sit far enough away from your monitor, and leaves room to place a horizontal copyholder centered on the surface between the monitor and the keyboard tray. You can also angle the tray slightly to permit writing on a higher corner work surface. Increased workstation depth is a disadvantage as it takes up more floor space and places you farther away from the work tools on the work surface. If you have a corner work surface and move your phone and other work tools closer, that may not present a problem.

Monitor Distance and Height
Set your monitor right in front of you, not off to one side. Move it closer or nearer as long as you do not need to lean forward, push back, or stretch to see it well. Arms length is typically a good distance.

We spend most of our time 4” to 8” below the very top of the monitor. That area needs to be right in front of you. Place the monitor so you can maintain good neutral head and neck posture and open, upright trunk posture while you work.

Do not raise your chin or slide down in your chair to see your work. In fact, you may be slouching just to get in a better position to see your work. Use monitor risers or lower the monitor to the work surface to arrive at the right position. Raising your monitor instead of tilting it will improve your head and neck posture and reduce glare on the screen.

Glare also comes from the computer itself. Glare guards with a light tint can soften the glare from working on a computer all day, especially if you often work on white backgrounds doing email and word processing. If there are bring lights or sun above or near your computer, a monitor visor can block the light coming from the sides or top to improve visibility and reduce eyestrain. Clean your screen daily, and your keyboard and telephone buttons periodically so you can see more easily.


Arranging Work Tools
Work upright and in the zone. Move work materials in and out of your primary work zone. Avoid forward head posture, a common precursor to overuse or repetitive strain injury. Keep your chin tucked with your head on top of your shoulders like a golf ball on a tee. This is easier to do if you are sitting on your sit bones. Put papers you need while using the computer at midline on a slanted copyholder and between the keyboard and monitor. Do not turn or look down to work, and avoid working flat. Use copyholders for all reference materials.

Position your telephone so you can reach the controls while keeping your arm bent, especially during speakerphone use. Place the phone on your non-dominant side. Speakerphone use is acceptable if you keep the volume and your voice modulated and soft to avoid straining your voice and irritating your coworkers. Move the phone base as close to you as you can. Use a headset if you have frequent or lengthy telephone calls, particularly if you also take notes, use the computer, or handle reference materials at the same time.

Can you move around to your file cabinets and work surfaces easily while seated without pulling yourself along with your hands or bending forward and digging in with your heels? Chair mats provide a surface with less resistance so you can move your chair without straining your back or hands. Place file cabinets, boxes, and trashcans where they do not interfere with legs or normal relaxed posture. If you do a lot of handwriting or get cramps when you write by hand, use a fat pen or pencil so you don’t have to grip it so hard.

There are all kinds of mice and keyboards claiming to be “ergonomic.” Ergonomic means that it is a good match for you, so what might work well for someone with larger hands will be uncomfortable for a person with small hands. How do you know if you need an “ergonomic” keyboard or mouse and how to choose the one that is right for you?

Look down at your wrists next time you are typing in your neutral posture. With your elbows bent, you should be able to float over the keyboard and mouse without bending your wrists to the side like a windshield wiper. If you are bending your wrists, consider getting a keyboard like the Microsoft Natural Pro that is angled so you can reach the keys and mouse while you keep your wrists straight. Also, check to see if you are squeezing in toward your body at the junction of the arm and the trunk, the main thoroughfare for circulation. If you are, working at a computer is like trying to run a marathon with a tourniquet on your legs. If your wrist touches the work surface and is constricting or bending, consider a Contour mouse.

If you rest your elbows, forearms, or wrists on the wrist rest, table or chair while typing, all the work is being performed by hands rather than body, shoulder and arm muscles. Hand and finger muscles are small and have a limited blood supply. Use your mouse with the same large arm movements that you use when you wash your car or polish a table.

In summary, find your center, stay there (for no more than 30 minutes without moving), and bring the work in and out of it as needed. Check in with yourself often to see where you might be fixed or holding tension, or feeling pressure. Listen to your body and your self to get you where you want to go in every way possible.