Preventing Elbow Pain

Traumatic injuries may be unavoidable.  However, the risk of pain caused by stressful, forceful or repetitive activities can be controlled.  Sportsinjuryclinic.net offers nine tips to reduce the risk of elbow injuries related to sports.  I have modified these injury-prevention tips and applied them to the computer athlete or the desk jockey.

1.  Warm-up before working.  Warming-up increases the temperature of a muscle preparing it for work.  It also increases the oxygen and blood flow to a muscle enabling it to work more efficiently with less risk of injury.

Use of Heat & Cold to Relieve Repetitive Strain Pain

2. Make sure you are using good technique.  Sportsinjuryclinic.net provides tips for those playing sports.  For the computer athlete or the desk jockey, this means looking at your ergonomic set-up and work methods.  For example, avoid reaching forward for the mouse.  Place it at keyboard height with your arm relaxed at your side and your elbow at a 90 degree or slightly greater angle.  Keep the wrist neutral when using the mouse and manipulate the mouse through small elbow and shoulder movements rather than swiveling at the wrist.

Ergonomic ABCs

3.  Make sure that you have the correct equipment.  Again, in racket sports, this may mean having the correct racket size, grip size and string tension.  For the computer athlete or desk jockey, ergonomic equipment and an appropriately fitted ergonomic chair can help prevent pain.  Awkward positioning increases the stress on the body and makes the work that the body does less efficient, awkward and more prone to injury.

Top 10 Ergonomic Picks

4. Get a massage.  Whether for the athlete or the computer athlete, massage can help relax the arm muscles and break down any scar tissue and trigger points.  Massage along the length of the forearm muscles moving from the hand towards the elbow.  Knead the bulk of the forearm muscle below the elbow joint.  Plant two or three fingers from the opposite arm at the bony prominence of the elbow and perform small oscillating movements across the bone to improve blood supply to the location that the muscles insert on to the bone.

5. Strengthen.  Strengthening the forearm, upper arm and shoulder muscles takes some of the strain away from the elbow joint.

6. Wear a brace around the muscles just below the elbow. This can help by taking some of the pressure off the attachments at the elbow and distributing stress throughout the arm.   Sportsinjuryclinic.net explains the use and purpose of a clasp, support and sleeve.

7. Don't overtrain or suddenly change your training routine or daily activities.  For the computer athlete or desk jockey, a change in routine, new desk set-up, or special project requiring long hours to complete can have an impact on pain level.  If you notice an increase in arm fatigue or soreness, stretch often, use cold packs and take mini-breaks frequently. 

8. Stretch.  Stretching the muscles around the elbow keeps them flexible which helps to reduce the strain placed on the muscle attachments surrounding the joint.

9. Apply cold packs.    For the early stages of elbow pain, whether caused by a sports-related injury or a repetitive or cumulative injury from the keyboard, cold can help reduce inflammation and help relieve muscle pain and spasm.

 Marji Hajic is an Occupational Therapist and a Certified Hand Therapist practicing in Santa Barbara, California. For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.
 

Stretching for the Computer Athlete

People often sit in poor or awkward postures while working on the computer, playing on gaming systems, using a laptop, and even manipulating hand held electronic devices. These postures can cause stress to the body. Over time, these body stressors may develop into repetitive strain injuries such as carpal tunnel syndrome or tendinitis.

Stretching and strengthening programs can be instrumental in easing the rounded shoulder and forward head postures that develop from computer or desk activities. A recent study shows that stretching may not only improve flexibility but can also enhance performance making people stronger and increasing their endurance (Chronic Static Stretching Improves Exercise Performance; October 2007; Medicine & Science in Sports & Exercise).

The study also suggests that stretching is an important part of an exercise program for those who are out of shape or just beginning an exercise program.

Here are a few recommended stretches for the computer athlete –
(Stretches should never hurt. Stop if you have pain. Hold the stretch gently. Do not bounce).

• Stretch the Pecs
  
  Face a corner with the forearms resting against adjoining walls, hands placed at about ear height. Put one foot in front of the other. Gently lunge forward (bending the knee of the leg in front) keeping the back straight. As the chest presses forward towards the corner, you should feel a stretch through the chest muscles. Hold for a count of thirty. Repeat three to five times.
  
  (see picture at toneyourbones.com)
  
  
• Squeeze the Shoulder Blades
  Place your hands gently on the table in front of you. Leaving your hands on the table and keeping your shoulders relaxed, squeeze your shoulder blades together. Hold for a count of five. Repeat five times.
  (see picture at toneyourbones.com)
  
  
• Chin Tuck
  Begin in a good, relaxed posture. Slide your chin back as if you are trying to give yourself a double-chin. Look straight ahead and do not tip your head up or down. Hold for five seconds. Repeat 5 times.
  (see picture at silvafamilychiropractic.com, position 1)
  
  
• Head Tilt (Scalenes Stretch)
  Begin in a good, relaxed posture. Tilt the right ear to the right shoulder. Hold for ten seconds. Modify position by slightly rotating the head as if you are looking at the ceiling. Hold for ten seconds. Modify position again by slightly rotating as if you are looking down towards the floor. Hold for ten seconds. Bring the head back to the starting position. Repeat on the other side.
  (see picture at silvafamilychiropractic.com, positions 2, 3 and 4)
  
  
• Triceps Stretch
  Place the right hand on the left shoulder. Place the left hand on the right elbow. Push the elbow towards your chin as if you are reaching for an object behind your left shoulder. Hold for 30 seconds. Repeat 3-5 times. Then repeat on the other side.
  (see picture at adam.about.com)

Marji Hajic is an Occupational Therapist and a Certified Hand Therapist practicing in Santa Barbara, California. For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.

Helpful Products

Several programs are available that can cue you to take a break when working on the computer. These programs also provide stretching instructions and illustrations.

Helpful Resources

• ErgAerobics: Why does working @ my computer hurt so much?
  
• Yoga for Computer Users: Healthy Necks, Shoulders, Wrists, and Hands in the Postmodern Age

Mouse Bridge

A mouse bridge is a simple way of bringing the mouse in closer to your optimal work space while working at the computer.  Typically, people tend to reach forward or out away from the body for the mouse.  Because the keyboard tray may be too small to accommodate both the keyboard and the mouse, the mouse is often placed wherever space tends to be available, often to the far side of the keyboard or on a desk surface.  Using a mouse bridge can make mousing activity more comfortable and less stressful on the body.  Although the mouse bridge does cover the numerical keypad and prevents its use, the bridge can be easily moved for access to the keypad when necessary.

How Does A Mouse Bridge Work?

Ergonomically, the mouse converts the numerical keyboard pad into a mousing surface.  This eliminates some of the awkward reaching or the awkward wrist angles that occur during mousing activity and that can contribute to repetitive strain injuries such as tendinitis and carpal tunnel syndrome.

What is a Mouse Bridge?

A mouse bridge is simply a thin piece of plastic or metal with shallow legs that fits over the numerical pad of the keyboard.  Depending upon the type and shape of the keyboard, the style of this bridge may vary.

Who Needs to Use a Mouse Bridge?

Using a mouse bridge is the perfect ergonomic adaptation for those who have short keyboard trays that do not have a mouse tray attachment or for those who have limited desk space that places the mouse more than a half an arm’s reach away from the body during use.  It is also helpful for those who have placed the keyboard and the mouse at different working levels.

When Will a Mouse Bridge Work the Best?

The mouse bridge is appropriate for right-handed mousers who spend a majority of time at the computer using a mouse but who do not use the numerical pad section of the keyboard.   It can also be used by those who have distinct work tasks that use either the keyboard or the numerical pad at separate times. 

What Styles are Available?

• The Standard Mouse Bridge has legs that rest on the same surface as the keyboard (on the desk or the keyboard tray).  It is larger as it fits around the keyboard and is good for those who have a standard style keyboard. 
  
• The Flat Mouse Bridge is the smallest bridge.  It rests on the keyboard itself.  It can be used with the Microsoft Natural Keyboard or with pull-out keyboard trays with limited space availability. 
  
• A Rear Mouse Bridge has legs that can be adjusted (raised) for extra clearance for higher keyboards or if the keyboard has a cable at the right rear. 
  
• A side mouse bridge is also available for use with the Microsoft Natural Keyboard.

A Few More Tips

• When using an optical mouse, use a mouse bridge that is not transparent or place a mousing pad over the mouse bridge.
  
• A mousing pad on the mouse bridge may also help improve mouse movement (tracking) if needed or may help prevent the mouse from sliding if the bridge is slightly slanted.  Adjusting the legs on the mouse bridge or the slant of the keyboard tray can also help even the slope of the mousing surface.
  
• If the mouse bridge slides, use a non-slip padding material beneath the legs.
  
• If the mouse bridge is pressing on the keys of the keyboard, lower the legs of the keyboard so that it lies flatter.  Or you may need to look into a different mouse bridge such as the rear.

Marji Hajic is an Occupational Therapist and a Certified Hand Therapist practicing in Santa Barbara, California. For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.