Tuesday, May 21, 2013


Please allow me to introduce myself, my name is Julie and I recently joined Duffy and Bracken, PT. I practiced as a physical therapist for 7 years in Seattle Washington before moving to Downtown NYC. One of my specialties in Seattle was workplace modification and 5-hour return to work testing. These included activities such as touring a sawmill to adjust a workstation to accommodate an injured shoulder patient to modifying the internal organization of a police car to accommodate a low back patient. While the average New Yorker I currently treat is not in an industrial occupation, workspace modification is no less important. You spend 8-10+ hours a day at your desk and the more efficiently you set it up, the less stress you will experience on your neck, back and arms.

Here is a little test – can you sit with your back straight and feet flat on the floor for 5 minutes without fidgeting or adjusting and without an increase in pain? If you cannot then your core musculature does not possess the endurance for an 8 hour day in a chair.

Ergonomics strives to keep your joints in a neutral position to minimize the stresses on the muscles and ligaments. People come in different sizes so no two desks should look alike. Here are some suggestions for easy adjustments to your desk:

Adjustable Chair
When you are sitting your knees should be bent at a 90-degree angle with your feet resting on the floor. If you are petite and can lower your desk this is ideal but most desks do not have modifiable heights. If your feet do not touch the floor, bring the floor up to your feet with a footrest or even a small box.

The end of your seat should reach to four finger lengths to the back of your knee. Any farther forward can pinch nerves in your leg and make it uncomfortable to sit. Legroom under your desk should be at least 60 cm to allow for easy foot movement.

The backrest should be adjusted so that there is a convex surface supporting your low back. (If your chair does not have this I would suggest an adjustable lumbar support, which we stock here at Duffy and Bracken).

The arm rests should be positioned so that your elbows are slightly forward and bent at near a 90-degree angle.

With Foot Rest
 I am asked a lot about therapy balls as chairs. While I think this is good for watching TV, spending 8 hours a day on a therapy ball requires a lot of core endurance. If you would like to sit on a ball at work I recommend keeping a chair nearby for when your back becomes fatigued.

When you are typing your wrist should be supported and your elbows should be at a 90-degree angle. Because your arm rests should also support you at a 90-degree elbow angle it sometimes comes in direct conflict with your keyboard. I would suggest table length arm rests (they are shorter and allow you to push your chair up to the desk) on your chair or none at all if you are mostly on the computer or writing while at your desk.

A traditional mouse used to control your cursor can add increased stress on your arm and shoulder because you have to elevate your arm for long periods of time. I recommend a trackball mouse. Your hand rests on the mouse and your thumb moves a roller ball that controls the cursor. They are inexpensive and your neck and shoulder will thank you.

Computer Screen
When you sit upright at your desk your eyes should be level with the top line of your screen. It is much easier for your eyes to track inferiorly without affecting your neck posture than it is for your eyes to track superiorly. If your computer screen is too high we tend to push our head forward and angle our head upwards, which tightens the back upper neck musculature. This is a good time to walk around your office and see your co-worker’s computer posture.

If you have a laptop it is harder to modify. I suggest putting it on a pedestal to raise the screen up and buying a wireless keyboard. 
Divide Your Desk Into Angles
Items that you use constantly should be within a radius of 50 cm – which means you do not have to reach far or rotate your body to grab them.  Items you use less can be a short reach away. 
Standing Desks
If you do a lot of reading you can make yourself a standing station at your desk. The optimal reading angle is with a 45-degree slanted desk and if you are writing the optimal angle for your elbows is with a 15-degree slanted desk. 

Unslanted Desk
Most importantly you need to get up and walk around to give your body breaks from being in one position. Most people become so engrossed in what they are doing that they forget so I propose setting your cell phone to go off every 1-2 hours. A 5-minute walk around your office will help clear your head and give your muscles a chance to relax.

If you have any further questions about how to modify your workstation or you want a professional to assess your sitting ability, please do not hesitate to see me here at Duffy and Bracken, PT.

Julie Garner, DPT, COMT, CCI

Monday, May 6, 2013

Strengthening Your Weak Link!

Kinesiology is the study of movement. It is what physical therapists are experts at. In kinesiology, a leg or an arm is often referred to as a "chain." The reason being is that a leg or an arm is comprised of parts with links, those links being joints. Muscles originate on a bone, cross a joint and anchor on another bone so it can stabilize and move a joint. So when we hear the expression, "a chain is only as strong as its weakest link," we could easily apply that idea to a human chain. That's a very important concept especially if you are an athlete. 

Aside from being a Physical Therapist, I have been an avid martial artist for a good 20 years. In that time I have suffered a nice bouquet of injuries; everything from a broken bone, to torn muscles in my mid back. After a four year hiatus, I recently joined a new martial arts school. I wanted to see how well prepared I was physically to go back into this very demanding activity so I had myself evaluated by Renuka Pinto (the supervising PT here at D and B) using the Functional Movement System (FMS). The FMS system, is a movement screen that is often used to assess an athletes' quality of movement by studying each kinetic chain. It can also be used on a non-athlete to evaluate how well they are functioning in their body in terms of movement. The individual scores are added together to create an overall final score. The FMS helps to identify not only the athletes limitations or weakness but also the compensations that cover up those weaknesses. The test takes about 20-30 minutes. It is broken up into subsections that look at very specific movement patterns. What's great about the FMS, is that not only does it identify these weaknesses, with each section, it will also give specific exercises to help improve the areas the athlete is weak in making it a very clear systematic approach.

By the end of the test, I had a good idea of where my weak links were. Renuka and her student (Karen), gave me exercises to improve my weakness and  enlightened me on my compensations. So not only will the FMS help refine whatever game you compete in, but more importantly, will help identify what injuries you are predisposed to. Whether you are a golfer that wants to improve that vital finite control in your swing, or you are an Ironman competitor that is looking to improve your endurance, the FMS will help you improve your practice and prevent injury so you can keep doing the game you love to do... So for all of you athletes out there that are preparing for an event or want to maximize your chances of preventing injuries I would highly recommend the FMS here at Duffy and Bracken. It is one of the many programs we offer to try to maximize how we can help you. If you are interested, ask anyone of us and we'd be happy to answer any questions. 
Happy Training!