Home Office Ergonomics

January 10, 2022

The past 22 months has brought on some interesting and new injuries for many of you since your work stations have changed.  More of you are using computers and sitting far more than you have ever before.  Improper work stations can put strain on many parts of the body, including your neck, low back, wrists and even strain your eyes.  Now that many of you may be working from home again, I thought it would be a good ideato review some basic office ergonomic components that you can include in your home office setup.  

There are many components to your office setup to consider.  I will summarize the most common components that have been taken from the Canadian Centre for Occupational Safety website that can be found here.

Computer glasses:  For those of us with aging eyes, monitor spacing can largely affect our eyesight.  As we get past the age of 40, we begin to see changes in reading or seeing objects close to us.  This is the time when one may start wearing bifocals.  A computer screen falls into that in between distance, not so far away, but also not likely 6-12” from our face.  Using bifocals while on the computer can create some neck discomfort as the tendency is to tilt the head back to position the bifocal lens in the proper sight line to view the screen clearly.  Because the screen is a little further out then the bifocal range, the tendency will be to lean forward, thus creating more postural distortions, musculoskeletal tightness, headaches, and the list goes on.  If this is the case, you may be suffering from computer monitor syndrome and may need a more specific pair of glasses to account for the distance of the computer screen from your eye.  Speak with your eye specialist if you are having eye strain, vision problems or other head and neck symptoms to discuss adjusting or adding to your current eye prescription.  There are also other factors that may contribute to eye strain, like contrast and monitor colour which your eye specialist can assess.  

Monitor placement:  When we consider the placement of the monitor, there are two factors which need to be considered, the viewing angle and the viewing distance.  

The viewing angle is defined as the angle above or below the horizontal sight line of the viewer to the centre of the object that they are viewing, in this case the computer monitor.  A poor angle can lead to neck and shoulder strain.  Researchers agree that the eyes naturally have a straight forward and slightly downward eye cast.  The exact angle of downward cast is reported to be in the range of 15-30 degrees.  When the eyes look upwards above the horizontal line, the eyes will become fatigued.  This does not seem to be the case when looking downwards below 30 degrees, and thus some researchers have added another acceptable 15 degrees to the limits of downward gaze.  

The viewing distance is defined as the space between the viewer and the object being viewed, again in this case the computer monitor.  The closer the object, or the shorter viewing distance, can lead to eyestrain.  Viewing objects farther away don’t tend to lead to eyestrain, but can change the sharpness of the image.  Our eyes use the actions of accommodation and convergence to view objects close to us.  The eyes accommodate or adjust, to a closer object to keep it in focus by changing the shape of the lens inside the eye.  The action of convergence is the inward turning of the eyes (towards the nose) to focus on an image.  When the eyes have to focus on closer objects for prolonged periods of time, eyestrain will occur because it requires more muscular action to maintain focus.  Each of us will have a resting point of accommodation and a resting point of vergence, which is the distance where our eyes (if 20/20 vision or properly corrected vision) will not experience eyestrain.  Researchers have given a range of 40-70 cm of viewing distance where the majority of us will not experience eyestrain.  If there are constraints in space or the distance is too great to see images or text clearly, it is recommended to increase the font size or zoom in instead of creating a shorter viewing distance.  

Ergonomic chairs:  A chair becomes ergonomic when it fits the operator in terms of body size and workstation use; and meets the requirements to perform the tasks of the work.  There are several features to chairs which should be considered.  These include:

  • Adjustability

  • Seat height range

  • Back rest 

  • Seat height depth

  • Seat width

  • Seat angle

  • Seat surface

  • Armrests

  • Stability

We should also consider the desk height or workstation at which chair will be located and the type of flooring.  

The operator of the chair also needs to be able to easily adjust all of the features of the chair from a seated position.  When purchasing a new chair, look at several suitable chairs and try them out, as what may be great for one, doesn’t mean it will be great for another with different needs.   

Keyboard and Mouse:  There is no correct placement of a keyboard or mouse, but rather, a workstation that doesn’t cause excessive reaching or leaning of the body causing discomfort.  While using a mouse, one should maintain the wrists inline with their shoulders.

The mouse placement to the side of a large keyboard may lead to too much wrist lateral deviation or reach that requires more shoulder muscle tension and use.

When this is the case, switching to a smaller keyboard that doesn’t have the number pad on the right side may prevent the excessive wrist deviation or reach.  The use of a mouse platform and wrist support may also be used to help to maintain the wrist in a more supported and proper position.  Another option could include placing the mouse in between the keyboard and the operator to make use more comfortable and safe.  

Sit/Stand desks:  Many office workers are moving towards a sit/stand desk to vary their position throughout the workday.  Here are some considerations when setting up your sit/stand desk.

Maintain a neutral body position when both sitting and standing:

  • Hands, wrists, and forearms are straight, in-line and roughly parallel to the floor.

  • Head is level or bent slightly forward, forward facing, and balanced. Generally speaking, the head is in-line with the torso.

  • Erect or upright spine.

  • Shoulders are relaxed and upper arms hang normally at the side of the body.

  • Elbows stay close to the body and are bent between 90 and 120 degrees.

  • No twisting of the upper torso.

  • The in-line sight is between the horizontal and 30 degrees below the horizontal (i.e., when viewing the monitor, the monitor is at eye level or slightly below eye level).

When standing, also consider:

  • The platform height is approximately at your standing elbow position (e.g., your arms are in the same position as they would be if you were sitting).

  • The keyboard and mouse are aligned as you would when you are sitting.

  • The height of the monitor should still be between horizontal and 30 degrees below.

  • Wear supportive footwear.

  • Consider the use of an anti-fatigue mat, where appropriate.

  • Use a footrest when standing to help shift your weight as needed, or shift your weight from leg to leg occasionally.

  • Make sure that any cables, electrical access, storage of materials, and general layout do not make adjusting the desk difficult.

For further and more detailed information on the above ergonomic recommendations, please refer to the Canadian Centre for Occupational Health and Safety.  

If you require any further help with home office setup or related injuries, please be sure to discuss with us or book an appointment online by clicking here.  


Self care for acute spine pain

December 6, 2021

This is a topic we have discussed to some extent in previous articles, however, the need to review some of this information is due and it is always a good time of the year to discuss again due to the upcoming holiday time.  When you travel, or more importantly, when many businesses are closed for the holidays, you may find that you may be stuck to look after your acute back pain until things open up again.  And with the ever changing pandemic conditions, staying close to home may be the only ...

Continue reading...

Massage Therapist Needed

November 22, 2021

We have an exciting opportunity for someone to take over an existing RMT's active clients. MMD Chiropractic Health Centre has been in operation for over 10 years, with owner and chiropractor, Dr. Marnie Mabee D’Andrea treating patients for 20 years. Located next door to the Runner’s Den, athletes make up a large part of the practice. However, our clinic would be classified as a family practice as we see anything and everything dealing with the neuromusculoskeletal systems.

Dr. Marnie works...

Continue reading...

Is it a joint injury or disc injury?

November 8, 2021

When someone presents with low back pain, the diagnosis can be one of many things. Most commonly, the problem can be due to a lumbar spine joint injury, disc injury or a muscle strain. Less commonly, you can get low back pain from an infection like a urinary tract or kidney infection, bowel issues, uterine fibroids, ovarian cysts, tumors of the spine or spinal cord, or muscle tears, to name a few.

Let’s take a look at the symptoms of two of the most common low back pain sources, a joint in...

Continue reading...

Posterior Knee Pain

October 6, 2021

We have previously discussed knee pain, including in the last issue when we discussed the injuries to the medial side of the knee. Today we discuss the final area of the knee, the posterior knee. 

Let us first look at the anatomy of the posterior knee.

If we consider all the anatomical structures on the posterior side of the knee, we will find there are 7 muscles, 4 ligaments, 3 bones, 4 bursas, 2 mensicus, and multiple arteries, veins and nerves. There are also three surfaces of bone  li...

Continue reading...

Medial Knee Pain

April 12, 2021

In the last issue, we discussed the difference between Patellar tendinopathy vs Patellarfemoral pain.  This issue, we will continue to discuss knee injuries, but will focus on the medial side of the knee.  

Let us first look at the anatomy of the medial knee.  

If we consider all the anatomical structures on the medial side, or inside, of the knee, there are 9 muscles, 3 ligaments, 3 bones, 2 bursas, 1 mensicus, multiple arteries, veins and nerves and four surfaces lined with cartilage. All of ...

Continue reading...

Anterior knee pain: Patellofemoral Pain vs Patellar Tendinopathy

March 8, 2021

Anterior knee pain is a very common symptom in many musculoskeletal rehab or family practices.  In this article, we are going to look at the two most common conditions associated with anterior knee pain, Patellofemoral Pain (PFP) and Patellar Tendinopathy (PT) and address the differences in their respective symptoms and treatment options. 

The following chart shows a comparison of the clinical features of PFP vs PT.


Patellofemoral Pain

Patellar Tendinopat...

Continue reading...

We are Hiring!

February 7, 2021
We are currently looking for a Registered Massage Therapist and a Physiotherapist to join our team.  This is a difficult time in the world with the current pandemic.  Our clinic follows very stringent protocols for screening, cleaning and maintaining a high level of disinfection inorder to keep ourselves healthy, as well as our patients that are coming into our space. 

The successful candidate for massage therapy will be registered with CMTO and have atleast 2 years experience working in a cl...
Continue reading...

Staying Healthy at home: Part 3: Maintaining our Mental Health

February 3, 2021

In the past two issues of our Staying Healthy at Home series, we first discussed exercising from home with the equipment that is available to you.  In our last issue we discussed cutting the sugar from our diets to avoid insulin resistance and to cut down on the typical North American diet of high carbohydrate meals.  In this article, we will address our mental wellbeing. 

With the current pandemic situation we are limited in the activities we can do, people and family we can see and travel...

Continue reading...

Staying Healthy at home: Part 2: Cut the Sugar

January 12, 2021

In the last article, we talked about exercising at home and I provided ideas on how to do this with minimal equipment or items you likely already have at your disposal.  In this article, I want to address nutritional changes that you can make that only require small changes to your shopping lists and cooking habits.  In particular, I want to discuss reducing the sugar or carbohydrates in your diet as a starting point. 

A personal trainer that worked with us previously, had these little challen...
Continue reading...

Staying Health at home: Part 1 Exercise

December 8, 2020

We are not quite sure how much longer this pandemic is going to keep us out of the gyms, but it doesn’t mean we have to stop exercising.  There are several ways to exercise at home, we just have to be creative with what we have access to.  Here are some ideas of making the most of what you can do at home:

  • Safe space:  Ensure you have a space large enough for the length of your body with your arms out stretched in all directions.  Within this space, you can do many things to keep up your ca...

Continue reading...

Corrective Exercise: Part 3 in our Exercise and Movement series

April 15, 2020

unlock your potential and start moving vetter

In our last two newsletters we discussed both prehabilitation and then rehabilitation to help you make it through an injury.  Now let’s take a look at your overall motion and make sure you are moving well.  

There are many different screening methods that have been utilized during various medical evaluations, team tryouts, combines or sports training camps.  The evaluators of these screens take different information from them that may lead to a score of overall functioning, readiness t...

Continue reading...

Rehabilitation: Part 2 of our Exercise and Movement series

March 9, 2020

Rehabilitation - restoring back to normal after an injury

In our last article we discussed prehab and noted the difference with rehab.  To recap, by definition, Rehabilitation (according to Oxford dictionary) is "the action of restoring someone to health or normal life through training and therapy after imprisonment, addiction, or illness".  Prehabilitation can be defined as "the process of care, initiated before surgery, whereby patients’ physical, nutritional, medical and mental conditions are strengthened while waiting for surgery in order ...

Continue reading...

Prehabilitation:  Part 1 of our Exercise and Movement series

February 12, 2020

Prehabilitation is a newer buzz word that is used often in the healthcare industry, in particular, more amoungst physical therapy providers like chiropractors, physiotherapists, occupational therapists, athletic therapists, massage therapists and some orthopedic surgeons.  By definition, Rehabilitation (according to Oxford dictionary) is "the action of restoring someone to health or normal life through training and therapy after imprisonment, addiction, or illness".  Prehabilitation can be de...

Continue reading...

Common Fractures

December 29, 2019

The image above illustrates the various types of fractures that can occur.  The terms "Compound Fracture" is used to describe a fracture that breaks through the skin resulting in an open wound or also called an "Open fracture".  Many displaced fractures, meaning the two ends of the bone do not align, are Compound fractures.  The term "Simple fracture" refers to fractures that are "closed" or do not penetrate through the skin.  The terms in the image above are used to describe the fracture lin...

Continue reading...

How do I know if my low back pain is serious?

November 12, 2019

Believe it or not, this is not a common question.  Often, I find myself letting patients know the serious symptoms that may arise with a back injury so they are aware of what to look for.  I wonder sometimes if this scares people, but I know that in discussing this with patients they will be better prepared to recognize these symptoms and may not ignore the symptoms if and when they arise. 

One of the first signs or symptoms to look for is the presence of “saddle parathesia”.  This is n...

Continue reading...

What causes low back pain?

November 12, 2019

There are several sources of low back pain. 

To understand the symptoms of low back pain, we must be aware of all the anatomical structures and how they contribute to the movement of the spine.  These sources can be grouped into our “mechanical” sources of low back pain (LBP). 
There are other sources of LBP that tend to be secondary to another condition that we will also briefly discuss.  We will refer to this second group as “non-mechanical” sources. 

Mechanical Sources of Low Bac...

Continue reading...

Delayed Onset Muscle Soreness (DOMS)

November 7, 2019

When we use the term DOMS or Delayed Onset Muscle Soreness, we are referring to the post workout pain that tends to peak around the 24 to 48 hour mark.  We want to discuss the potential treatment for DOMS and recommendations for the prevention of this pain.  After reading a great, lengthy article on this subject by Paul Ingraham (painscience.com) , I will summarize some his points. 

How delayed is this muscle pain?  The muscle soreness can come on almost immediately post exercise, but tends ...

Continue reading...

Cold cream review

October 7, 2019
What is your cold cream of choice  for use on sore and ache muscles?  We had a fun little experiment on one of our Monday afternoon meetings where we each tried out the cold creams that either we sell in the clinic, or various other products that companies have sent samples to us to try out.  Here are the contenders:


Motion Medicine

Medistik solid 46%

Medistick spray 22%

After testing all five on each of our forearms, we rated each on smell, coldness, absorption rate, and leng...

Continue reading...

Proper Backpack fitting

August 13, 2019

As we prepare for the back to school season, let us remind you of how a backpack should be worn.  Remember the weight should be 15% of your body weight if you are older than 12.  Younger than 12, the backpack should only be 10% of your body weight.  If you have a scale at home, it is really easy to see how much your bag weighs.  Simply pack your backpack up for school with all the items you normally take with you and place it on the scale.  These rules also apply for all the other types of ba...

Continue reading...

Camping in Pain: Choosing Your Sleep System

July 9, 2019

Camping is a wonderful, age old summer tradition for outdoorsy Canadians. Something about natural landscapes and outdoor activities being good for your health. A road block for a lot of people can be pain. We know from the science that restriction of activities due to pain can lead to co-occuring mental health disorders like depression.

But it doesn't have to be that way.

It can be possible to adapt to pain while still doing what you love or even trying something new. When it comes to camping, ...

Continue reading...

Is your bike ready for summer? Summer Bike Tune Up.

June 6, 2019

The weather has been... well ok we won't talk too much about the weather as it has been raining a fair bit in the last while but I swear it can't rain all the time and when you catch those sunny days you will want your bike to be in ready-to-ride condition. A lot of people bring their trusty steeds up out of the basement between April and June to drop off at the local bike shop for tune ups but the truth is, a lot of the bikes only need a few small and simple adjustments that can be done at h...

Continue reading...

Range of Motion Training

May 9, 2019

 There is always a lot of talk about specific exercises for certain injuries or rehab protocols for different muscle groups.  One theory that has emerged in the last few years looks at the reason why many injuries happen, and that theory revolves around having an inaccurate range of motion. 

 The dancer above would not be able to move the way she does if she did not have full ankle planter flexion and toe flexion, knee flexion, hip flexion and extension, spinal extension, shoulder flexion, abd...

Continue reading...

Acute care for your Temporal Mandibular Joint Pain and Dysfunction

April 9, 2019
We have previously discussed Temporal Mandibular Joint (TMJ) Pain and Dysfunction in more detail (click here for previous article).  In this article, we want to review some acute care procedures you can do at home to help care for this problem.  

Finding Your TMJ

First, lets remind ourselves how to accurately feel where your TMJ is on our skull.  If you place your hands on the side of your face, just in front of your ear, your hand should be right over your TMJ (see diagram below).  To test if ...
Continue reading...

Tabata Workouts

March 2, 2019

Most people have one of two relationships with cardiovascular exercise... tolerate or hate. It's hard to refute the benefits of cardiovascular exercise for heart health. If you are in the hate category, Tabatas might be the right fit for you. Tabata exercises were created by Dr. Izumi Tabata, who researched new approaches to training the Japanese Olympic speed skating team. He created a 4 minute cardio workout that involves 20 seconds of work and 10 seconds of rest for 8 cycles. His research ...

Continue reading...

Spotlight on Women's Cardiac Health

February 26, 2019

March 8 is International Women’s Day and we decided to focus our newsletter on women’s heart health, an understudied, under-diagnosed and under-treated health concern for women. Though there have been incredible improvements in cardiovascular mortality rates in women, heart disease is still the leading cause of mortality in women. Regardless of age, women tend to die more frequently within 1 year of their first heart attack (at 26% vs men at 19%), and within 5 years, at 47% vs men at 36%,...

Continue reading...

Welcome to the gun show!

February 11, 2019

You guessed it!  The guns we are referring to are the biceps.  In this article, we will discuss proper motion, common injuries, exercises and things not to do at the gym! 

The biceps brachii have two muscle bellies and attach the shoulder to the elbow.  For those that would like to know more specific anatomy, the short head, attaches to the coracoid process of the scapula and the long head attaches to the supra glenoid tubercle of the scapula.  Together, both muscle bellies come together to ...

Continue reading...

Gout: Recognizing, Risk Factors and Treatment

December 5, 2018

Gout is an inflammatory arthritis caused by excess uric acid in the bloodstream.  The symptoms of gout arise due to uric acid crystals that are deposited in the joints and the body’s response to them.  The pain is often so intense, anything touching the joint involved, including clothing or socks, causes extreme pain.  The most common joint affected is the big toe, with patients often commenting that even their bedsheet hurts the toe.  As this is a potentially destructive joint disease, it ...

Continue reading...

Fall 2018

October 16, 2018

Continue reading...

Does weather really affect our joints?

October 11, 2018

How many times have you heard the statements "My ankle hurts more when rain is coming"?  Or cold weather brings ache joints.  Often we have an influx of acute neck or low back pain during a "change in seasons" period.  Is there some validity to the theory that changes in weather can bring changes in joint pain sensitivity or even pathology to joints.  Let us take a look at some of the literature on this theory.  

If you search for "joint pain and weather" in Google, the first listed website th...
Continue reading...