Which is the Posture Right for me?

Is your posture RIGHT?
We have always been told to sit upright, keep our shoulders back & much more...to have good posture.
Our bodies have been subjected to varied stresses- long hours of sitting, backpack, carrying weights (hand bags, laptops, briefcases) on single shoulders, varied work related postures are some of them.
It's easy to say use good/correct postures when beginning an activity. How many of us pay attention to our postures once we are engrossed in said activities?
I am not going to tell you to this is the right posture & this is what you have to do. Each individual is unique & hence the right posture for them would be unique too.
The common doorway to good posture- Ergonomics
What is Ergonomics?
Simply put, ergonomics is fitting the job to the worker's abilities.
Ergonomics can be applied to all our daily activities too along with our professional lives. How? Most activities- personal & professional- use the same postures- Standing, Sitting, Forward Bending & Lying (Sleeping).

The Golden Rule: Change your posture every 15-20 minutes.
Standing Ergonomics:

• When standing, always maintain equal weight on both feet. Standing with uneven weight bearing places increased load on your spine & leads to low back pain & muscle imbalances.
• If standing for long, have a small stool (1-1.5inches height) & keep one foot on the stool. This reduces load on the spine. Alternate feet on the step.

Sitting Ergonomics:

• Most of our day is spent sitting- the curse of Sedentary Lifestyle.
• Sitting obliterates the low back curve as the pelvis tilts posteriorly. Along with flattening of the low back, there is increased curvature in the upper back & the neck moves forward- Causes low back & neck stiffness & pain, reduced movement of spine & overall poor posture.

Forward Bending/ Lifting:

• Bending forwards with knees straight places increased stress on the vertebral joints & intervertebral discs-can lead to Slip Disc.
• If you are lifting (for example) 10 pounds:
• Bending forwards with knees straight, the load taken by the spine is 10 times the weight being lifted; 10x10=100 pounds!!
• When, bending with your knees bent, the load on the spine equals the weight being lifted i.e. 10 pounds. This is because the weight is being taken by the leg musculature, mainly the Quadriceps, hence reducing the load on the spine.
• Remember to hold the weight being lifted close to your body.

Lying:

• If you sleep on your back, defer from using a pillow as it aggravates the forward head posture.
• If you sleep on your side, use a pillow(s) to maintain the distance between the neck & shoulder. Do not keep your hand(s) under your head as this causes forward neck bending. Keep a pillow between your bent knees.
• Avoid sleeping on your stomach as the neck is maintained in a rotated position & leads to muscle imbalances in the neck.
• The mattress you sleep on plays an important role for having good posture & also for getting a good night's rest. A firm mattress (coir) is the best choice (Goldilocks & the 3 bears).

Ergonomics for daily living is the easiest road to maintain the right posture while working & having fun. With these simple changes in your life, you can quit worrying about poor postures.

How to be comfortable in Labour

The anxiety of pregnancy followed by painful childbirth dogs most women. However, following a few easy steps and making adequate preparations can significantly make labour easy.

Fear of the unknown is one of the biggest factors that contributes to pain. Throughout labour, the woman, if not aware, will be anxious whether the developments in her body are normal or not, which is why it is important to tell women beforehand what to expect.

Everyone's labour is different, and pinpointing when it begins is not really possible. It's more of a process than a single event, when a number of changes in your body work together to help give birth.

In early labour, also called the latent phase you may feel: 

• Persistent low back or abdominal pain, usually accompanied by the crampy premenstrual feeling.
• A bloody show (a brownish or blood-tinged mucus discharge). If you pass the mucus plug that blocks the cervix, labour could be imminent or it could be several days away. But it's a sign that things are moving along.
• Painful contractions occurring at regular and increasingly shorter intervals and become longer and stronger in intensity.

How you feel in early labour depends on whether you've had a baby before, how you perceive and respond to pain, and how prepared you are for what labour may be like.

What should be done in early labour?

This will depend on what time of day it is, what you like doing and how you're feeling. Keeping calm & relaxed will help your labour to progress and help you cope with the contractions.
This could mean watching a favourite film, relaxing, or asking a friend or relative over to keep you company. You could alternate between walking and resting, or try taking a warm bath or shower to ease any aches & pains. If you can, try to get some rest to prepare you for the work ahead. 
During early labour, you may feel hungry so eat & drink if you feel like it. This will help to comfort you and help you to rest. 
Early labour is a good time to try out various positions & breathing techniques to see if they help you cope with the contractions.

How make yourself comfortable during labour?
One's posture tells a vivid story about the person's state of mind. When tensed, we tend to curl into a ball, like a new born baby. Our shoulders get hunched, we tuck are chin in, bend our elbows & pull in out arms. When pain is felt, we adopt a similar position.
Some of the strategies that can be used to relax during labour include:

• Postural Awareness
• Relaxation Posturing
• Visualization & Imagery
• Breathing Patterns
• Labour Positions
• Touch & Massage

Postural Awareness:
Being aware of your posture can be used when you are tensed or in pain. Relaxation can be obtained when consciuosly you move from a posture of pain to a posture of relaxation.
Relaxation Posturing:
Irrespective of which posture you choose, maximum relaxation can be obtained when the whole body is completely supported. This can be achieved by taking complete support from in the chosen position & with the use of pillows.
In Sitting-

Sit with complete back support, from buttocks to neck, arms resting on arm rests & feet on the floor. If your feet do not reach the floor, keep a pillow or a stool to place your feet on. Hips & knees both should be at 90 degrees.

Leaning forward, resting your head on a table is also a good posture for relaxing. Make sure the edge of the table is not pressing against the baby.

In Lying-

        

Visualization & Imagery:

Visualization & imagery is an technique which depends on your imagination. You can picture & relive a happy experience. Relive the sounds, touch, emotions & all sensations pertaining to that memory. If not, you can visualize a scenery-beach, mountains, the calm ocean, & experience the sounds of the waves/birds chirping/feeling of the wind on  our face/feel the sand between your toes etc.

Breathing Patterns:

Breathing Deeply increases the oxygen content in the body & induces relaxation on exhalation.

How To- Keeping your shoulders relaxed, take a deep breath in through your nose. On exhaling through your mouth, feel the tension leaving your body.

Labour Positions:
Adopting different positions is helpful in dealing with the contractions. Breathing techniques can be used in these positions. It is advisable to practice these positions from 7-8th month onwards, so that you can decide which positions are comfortable for you. Few of the commonly used positions are shown.

Above shown positions help in reducing low back ache ( No.3-All Fours/No.5-Squatting) during contractions & increases blood supply to the baby. The Squatting position (No. 5) helps the baby to descend and gets the head locked in the birth canal. The baby's head gets fixed in the right position, which helps during labour. However, make sure you consult an expert before engaging in this exercise.
The breathing patterns used to relax during contractions can be practiced in these positions.
Massage:
Massage in labour is a very personal thing. It is most important that whoever is giving the massage is sensitive to your changing needs- with regard to location, depth, technique & well supported positioning.
Back pain in early labour is commonly felt in the low back region & can intensify as labour progresses.

Performed usually with you sitting & leaning forwards on your hands. Using the heel of their hand, your partner can gently knead your low back & increase or decrease pressure according to your comfort.

Performed either in side lying or in the sitting position. Slow rhythmical stroking using fingertips from the neck to the tail bone, single or double handed, can relieve tension & induce relaxation. Can be performed over the spine or parallel to it. Pressure can become slightly deeper as the hands descend.

The lower half of the stomach is the most common site of pain. This massage can be done using fingertips of both hands.

Side to Side stroking over the area of pain, will give relief. Perform using fingertips/ palms of both hands.


We hope these tips have been useful to you to prepare for your labour. We would like to hear about your experience.


(Read about Breathing Patterns in How to Breathe during Labour)

Workspace Design & Ergonomics

We spend a lot of time sitting at our desks every day, and while it may not look like it, it can wreak havoc with our bodies.

Some of you may not realize how unfriendly your workspace is to your body, while many of you have already started experiencing aches & pains from an improperly set up desk. A number of different factors can cause injuries (yes, even at a desk), and they may not always be obvious—for example:

Slouching and keeping your shoulders tense can cause pinched nerves in your shoulders, but your wrists

If you haven't given a lot of thought to the comfort of your workspace, it's probably time to give it an ergonomic makeover. Here are the most important things you'll want to go through and change—both in your office hardware and in what you do when you're working.

For the purposes of this post, we're going to assume you're using a desktop PC & sitting desk.

What Your Hardware Needs to Do

Its not possible for most to go all out and build a custom ergonomic desk, so lets see the few essential changes around your workspace.
Here's where you want all your hardware positioned, and why:

Your Chair

People have been talking about ergonomic office chairs like uber expensive line for years now, but there's no need to go spend a bundle just to be comfortable. Nowadays, you can grab much more economical ergonomic chairs or even upgrade your old chair with some DIY ideas. Note that some things are DIYable; some are not. Here are the things you need to make sure your chair has:

• A comfortable cushion:
One of the most basic and obvious things you need is a comfortable place to sit. A hard chair isn't going to do any good; a proper office chair with a cushion is going to keep you much more comfortable. After all, you are spending hours in this chair. Breathable fabric is great too, if possible. 
• Arm rests: This is something you probably can't DIY, but you should have some arm rests on your chair for when you aren't actively typing. They should be low enough that your shoulders stay relaxed and your elbow bends at around a 90 degree angle. 
• Adjustable seat height: It's a lot easier to adjust your seat height than it is adjust your desk height. Step 1: Buttocks should fit snugly against the backrest. The edge of the seat should not press against the back of the knees.
  
  Step 2: Place feet flat on the floor and adjust the seat height till thighs gently slope downward while the feet remain flat on floor. You also want to have your arms at the height of the desk (or the part of the desk containing your keyboard or mouse).
  
• Adjustable back rest height: This is one of the first things to go in the cheaper office chairs. You should be able to adjust your chair's back rest not only up and down, but its angle as well. Generally, you want the angle to be pretty far forward to keep your posture up—the further back you put it, the more likely you'll be to slouch. You'll also want the back rest of your chair to have...
• Lumbar Support: You have probably heard this term a lot. Essentially, our backs are slightly curved inward, meaning the backs of our chairs shouldn't be directly vertical. Instead, they should support our lower backs by coming forward. Of course, you could just as easily strap a rolled-up towel or something similar on your chair, but you need that support if you don't want to mess up your spine. (Image)
• The ability to roll around: It's hard to DIY this particular feature, but a chair with wheels and the ability to swivel is actually more of a necessary feature than you may think. When you need to reach for items on your desk, you can put strain on your body—so widening the area you can easily reach (and see without turning your head) can do wonders. Always remember to swivel the chair using your feet & when reaching for items initiate movement with your hips rather than low back.

Your Desk

Just plopping your mouse, keyboard and monitor on your desk is not going to give you a healthy working setup. Here's how to make sure everything's set up in the right position.

• Mouse and Keyboard Placement:

Your mouse and keyboard should be as close together as possible, with the alphanumeric part of the keyboard centered on the desk. Pay attention to the keys, not the keyboard itself—most keyboards are asymmetrical, with the number pad on the right. Instead of putting the whole keyboard in the center of the desk, keep an eye on the "B" key. It should be directly in front of you and in the center of the desk (or, rather, where you'll be sitting at your desk).
Whether your desk has a sliding keyboard tray or not shouldn't be much of a problem, as you have both an adjustable seat (right?) that can put the keyboard and you can adjust your monitors in a myriad of ways (see below). If you do have a keyboard tray, make sure your mouse is on the tray with it, not on the desk itself. You want your keyboard and mouse to be at the height where using them causes your elbows to be bent at or near 90 degree angle, so you aren't bending your wrists to type.

• Monitor:

The monitors should be about an arm's length away from where you're sitting.
The trickier half of the equation is to eliminate glare on the monitors. While some monitors can tilt, many can't, and you're likely going to solve this problem with strategic lighting placement instead of monitor tweaks or an anti-glare screen.

• Desk Height:

Desk height should be appropriate according to your seat height, keyboard height, and monitor height of your setup, so you can double-check and make sure you've done everything right.

Accessories

The last thing you'll want to make sure of is that the most important objects at your desk are easily reachable. You shouldn't have to reach for anything often, so use the space you have to store the things you need frequent access to. Everything else can go in drawers. The swivelling and/or rolling chair helps with this: if your chair swivels, you have a larger space for which things are in direct reach.

You Need to Make an Effort

It doesn't matter how "ergonomic" your hardware may be, you still need to be pretty mindful of your body when you work or you'll never reap the benefits of your properly set up workspace. Here are the things you'll want to pay attention to every day to make sure you're being nice to your body.

Posture

If you've done everything right up until now, you're in a fairly good position: your keyboard is directly in front of you and the right level for a 90 degree bend in your elbows, and your monitor is at eye level so you shouldn't be craning your neck up or down to see. In addition, you should always make sure that:

You should be sitting up straight. What is important to remember is that, the curve in the low back has to be maintained. Two options are available:

1. Maintaining the curve using a towel roll/ round pillow.
2. If you have the option of inclining your seat, angle it to around 15 degrees. as long as your hips are above your knees the natural low back curve will be maintained, as seen in above picture.

Keep your elbows close to your body and keep your wrists straight. This means you can't be reaching for stuff, as I mentioned before—if you find your wrists or elbows aren't playing nice, it's probably because your mouse or keyboard is in the wrong position.
Keep your shoulders and back relaxed: tense shoulder and back muscles will cause all sorts of problems. Make sure they're relaxed, which is probably going to require you not using the armrests when you're typing. Your keyboard should already be at the right level where you don't need to use the armrests, even if it goes against your instincts.

Take Frequent Breaks

It's no secret that sitting in one place staring at the same screen all day is bad for you. You want to generally take at least a five minute break away from your screen every half hour to hour.

Follow the 20-20-20 Rule: Every 20 minutes, take 20 seconds to look away from your screen and at something 20 feet away from you.

Avoid Eye Strain

Taking those breaks will help your joints and your muscles, but also help relieve some of the eye strain you get staring at your computer all day. Minimizing glare with correct monitor placement will also help.

If your using Laptops

Angle the laptop to 30 degrees using an ergonomic stand & follow all the above mentioned tips.

Ideal Work Station Setup

These are but a few of the most important tips to creating a healthy, comfortable workspace. The above tricks may seem simple or inconsequential, but they'll make a world of difference. Got any of your own tips for an ergonomic workspace? Share them with us in the comments.

Ergonomics for Dentists- Ergodontics

Not many people look forward to visiting the dentist. And personally speaking, my vote lies with the majority.

Now my sweet tooth left me no option but to visit the dentist. As I lay down in the much dreaded patient's chair, I needed a distraction. Desperately! I tried to make myself comfortable in the chair but the posture I was in just aggravated my anxiety. :(

The procedure started, since my vocal chords were rendered useless, I was asked to signal with my hand if I had any pain. I signaled! But my dentist couldn't see my signal. Reason? he was bent over looking into my mouth!

That's when it struck me! The awkward posture the dentist was assuming for performing the task at hand. And I noticed how long he maintained that posture, without a break. His neck & upper back were bent & rotated for maximum view into the oral cavity. I also noticed how long he held his hands & fingers in the same position. The dentist sat back only after the procedure was completed.

This is when I started reading up about the role of ergonomics in dentistry & came up with quite a few ways dentists can avoid occupational hazards which they frequently face, especially musculo-skeletal disorders (MSDs) of the neck, back & hands.

Now the Commonest Posture adopted by the dentist is-

If right- handed, a right- forward leaning position i.e. right side bending (30 degrees), and twisting to the left (15 degrees) of the head, neck & trunk.
The combination of maintaining the above said posture for prolonged periods of time, minimal breaks & excessive patient load, dentists in India are extremely prone to MSDs.

What can be done to help this community of medical professionals?

A LOT!!

The main Aim is to maintain their spine in as neutral a position as possible. This can be achieved by adopting healthy work practices, using ergonomic equipment & instruments correctly & maintaining an active physical lifestyle.

The Golden Rule: ADJUST YOUR CHAIR FIRST!!

POSTURAL AWARENESS TECHNIQUES

Buttocks should fit snugly against the backrest. The edge of the seat should not press against the back of the knees.

Place feet flat on the floor and adjust the seat height till thighs gently slope downward while the feet remain flat on floor.

Two kinds of chairs can be used:

• If the tilt feature is available in the seat, angle it slightly forward up to 15 degrees to  increase the low back curve. This will place your hips slightly higher than your knees, which allows for closer positioning to the patient.
• Chairs without the tilt feature can be fitted with an ergonomic wedge-shaped cushion. If this cushion is not comfortable, you can instead attach the lumbar cushion to the backrest.
• Using a saddle-style operator stool also promotes the natural low back curve. This type of stool allows you to be closer to the patient when the patient chairs have thick backs and headrests.

Use of magnification Loupes- Reduce Strain on Neck & Upper Back:
Visualizing the oral cavity has always posed a challenge in dentistry.

The Use of Loupes Improves Posture:

1.Working with forward head posture of greater than 20 degrees for 70% of working time causes neck pain. Most dentists operate with a 300 Forward head for 85% of their working time. The prevalence of neck pain in dentists is around 70%!

2.The declination angle of the loupes should allow you to maintain less than 20 degrees of neck flexion.

3.Magnification of 2x will allow you to see the working field detail that is approximately identical to that you would see when hunching over the patient without scopes. Magnification greater than 2x provides enhanced visual detail but a smaller field of vision.

Important to Note: Improper adjustment/ selection of these magnification aids can worsen existing pain/ increase risk of injury.

Let the loupes do the work, not your back/ neck!

Lighting and Vision:

Lighting:

Prolonged visual strain leads to overall exhaustion.

Inadequate lighting also leads to contorted postures to view shadowed areas of the mouth.

Modifications:

1.Position the light parallel to your line of sight. For this the light has to be behind the your head.

2.Hand mirrors can be used to provide light intra- orally.

3.Fibre optics for hand pieces provide concentrated lighting to the operating field.

Vision:

Dental routine requires the use of normal-speed and high-speed drills.

Modifications:

Wear protective glasses which have hard plastic lenses and are designed like goggles or glasses with edges fitting against the skin. These offer complete security from sprays, droplets and solid bodies.

POSITIONING TECHNIQUES

Avoid static postures:

As seen earlier, spending long periods in one position increases your susceptibility to injury. So avoid holding one position for long.

Alternate between Standing and Sitting:

 

1.Standing uses different muscle groups than sitting. Alternating between the two positions lets one group of muscles rest, while the workload is shifted to another group of muscles.

2.If standing for a long period of time, rest one foot on a small stool or step, alternating feet; also alternate doing this with standing on both feet.

3.This is an effective tool in preventing injuries.

Reposition the feet:

Slight changes in foot position shifts the workload from one group of low back muscles to another, allowing the overworked tissues to recover.

Avoid twisting:
Individuals vary in size, shape, training, and experience.

• Operatory design plays an important part in how often you perform twisting movements during the workday.
• Ensure equipment and work areas allow flexibility.
• Move the position of the patient, rather than bending and twisting your body.
• Position instruments within easy reach. Keep the items used most frequently within a distance of about 20 inches (50 cm).
• Retrieve items with the closest hand, especially with rear delivery systems, to avoid twisting or reaching across the body.
• Use mobile carts for less commonly used equipment

Shoulder- Elbow Position:

Position the patient so that your

1.Shoulders are relaxed

2.Keep elbows and arms close to the body

3.Elbows are lower than your shoulders, at about 900 or less flexion

4.Keep your wrists at the same with or lower than your elbows

If your chair has armrests, adjust them to support your elbows so that the shoulders are relaxed. This decreases neck and shoulder fatigue.

When possible, use chair arms to support your upper arm or forearm when doing fine, precision work with your hands.

Wrist Position: 

 WRONG- The wrist is bent (flexed) while the fingers are being used.

RIGHT- Hold the wrist straight or in a slight extension.

Finger Position:

Tight Pinch Grip- The distal index finger joint is straight or hyperextended in a tight grip.

Use a more relaxed grip- The distal finger joint is slightly flexed in a relaxed grip.

Finger Rests:

Use a finger rest to stabilize your hand while operating.

Finger rest should be in the same arch & as close to the working area as possible.

Various types of finger rests:

 
 Finger rests also reduce muscle stress and prevent injury due to muscle fatigue.

PERIODIC BREAKS

• Take ‘Micro breaks’ in between patients for performing stretches.
• Frequently pausing can minimize fatigue and the risk of MSDs.
• Schedule patients so that you alternate between long, difficult cases and short, easier cases.

The most common reason for premature retirement from the dental profession is due to musculoskeletal disorders (particularly in the neck). Using the above mentioned ergonomic tips, dentists can increase their working efficiency.


As computers & smartphones/tablets also play an integral part in the ergonomics for dentists.