Ergonomics: How To Make a Desk Job Less Painful with Andrew Bang, DC

Podcast Transcript

John Horton:

Welcome to another Health Essentials Podcast. I'm John Horton, your host.

If sitting at a desk leaves you feeling achy, the reason why may be simple: You're doing it wrong.

It's estimated that up to 80% of office workers toil in bad ergonomic setups. This poor positioning can lead to chronic pain, unnecessary fatigue and even injuries over time. But if you arrange your desk just so, you can limit the physical toll an office job takes on your body. That's why we asked chiropractor Andrew Bang to join us today for a workstation design consult. Dr. Bang is one of the many experts at Cleveland Clinic who pop into our weekly podcast to help ease the aches of daily living. So with that in mind, let's see what tips he has to make our workdays a little more comfortable.

Welcome back to the podcast, Dr. Bang. Whenever you are with us, I know we're in for a high-energy chat loaded with info and probably a few laughs here and there.

Dr. Andrew Bang:

Oh, thank you. I appreciate being here.

John Horton:

Now, as a chiropractor, you see a lot of folks dealing with aches and pains. How many of those visits are connected to simple things, like a desk setup, that are off just enough to throw our bodies out of whack?

Dr. Andrew Bang:

Oh, OK. Well, I can give you a real-world experience right now. I don't know when you publish this podcast, but right now, we're just finishing March Madness. And I can't tell you how many people I walk around at work, at wherever, they're checking their brackets, they're watching a game and their head is like, they're looking down at their lap in their phone, their head is buried in their chest and their neck is just... I'm like, “Sit up!” I'm telling all these strangers to sit up. They're probably like, “Who the heck's this guy?”

So man, I see it all the time. Something as simple as March Madness. More people show up, “My neck's hurt. I don't know why.” They come into my office. That's it. It's little things we experience every single day like that are sitting at our computer all day long at work trying to finish up a project that brings on lots of aches and pains and brings people in to see me.

John Horton:

Well, and that's what we're going to try to tackle some of those little things that you mentioned there, and what we can do to address them. But I guess before we get into that, I want to take a moment to talk about ergonomics and define what the term really is. I mean, I think a lot of us, we use it, we say it, we're familiar with it, but I don't know if we could write out exactly what it means.

Dr. Andrew Bang:

Well, I mean, geez, I don't have the Webster's Dictionary definition, but essentially, ergonomics is just any activity you're doing, you're maximizing efficiency, and that's pretty much it. You're maximizing the body's efficiency and doing that activity. So when we talk about desk ergonomics, it's the work setup. It's using the least amount of energy of your body to do your job. When you're talking about working on a car or landscaping, there's best ergonomic practices for lifting, bending, twisting. You're using the best efficiency without getting injured in the process. So that's essentially what ergonomics is, and you apply it to any job or any task that you have in front of you.

John Horton:

That's a great way to just summarize it real quickly there. And I guess, so we know it's important, what happens if you don't pay attention to ergonomics and you ignore those efficiencies? What are the long-term health effects of doing that?

Dr. Andrew Bang:

Usually … OK, so short-term effects turn into the long terms. So the short terms are repetitive strain on specifically a muscle. So in the beginning, you get a lot of muscle pain, soreness. And when you have repeated muscle strain and soreness, that's when the joints start getting into play. And you get erosion of joints in certain ways — we call this osteoarthritis — and then that is where the long-term consequences of bad ergonomics come into play. You don't actually know it until it's too late and they go, “Oh, you need a knee or a shoulder replacement,” or “You have arthritis in your neck because you've been looking down for the last 20 years of your job at a computer screen.”

And so yeah, so it's a silent killer, unfortunately. You don't know it's bothering you because you just feel sore in the neck a little bit, but that, over time, is leading to some erosion and bad stuff to your joints, which then, that becomes a big problem and much harder to deal with than the easy aches and pains and doing it right the first time.

John Horton:

Yeah. It sounds like those early aches, that soreness that you might feel after, like I said, you're sitting there staring at your computer for a couple hours for a big project. And you do, you get that soreness. Sounds like that's just a warning sign that you got more pain coming later, man, if you don't do something to fix how you're sitting here.

Dr. Andrew Bang:

Oh, totally. I mean, think of it like that engine check light. “Hey, your oil's low. Hey, your tire pressure is low.” You can easily fix that. If you wait and you don't do anything about your oil, that's a big problem with the engine. If you wait on your tire and now you can't drive because your tire's flat — it's the same with our body. Aches, pains, headaches that come on from overwork, those are key indicators of, “I got to change what I'm doing.”

Oh, I have a lot of people, John, that come into my office … have you ever experienced this, where you feel like you need to crack your neck or crack your back? You ever?

John Horton:

All the time. Yeah, yeah.

Dr. Andrew Bang:

OK. This is a perfect real-world example. People feel that way because as your muscles … OK, when I'm sitting up, my muscles are doing a lot of the work, right? When they start to fatigue out as I shift into bad posture, now my joints and my bones take over holding up my heavy body. And when you have pressure on those joints for a long period of time, that sensation to crack them comes on.

So every joint, and most people crack just normally, you turn, you look, you stretch, you feel cracking. That's normal, that's OK. It's if you start doing that repeatedly, like every hour you're feeling like you need to crack your neck, that's a key indicator. That's your flashing dashboard light. “Hey, I got to change up my posture. My ergonomics is obviously off.” You don't need to be a specialist to know that. It's your sign. “Hey, I got to move and do something different.”

John Horton:

This affects you almost head to toe. I mean, if your ergonomics sitting at your desk are off, it's all over your body. What are some of the most common kinds of issues that you see people coming in with just from sitting at their desk? Where are they getting these pains?

Dr. Andrew Bang:

Well, it's easy to start at the head. Tension headaches are huge because they're the most common headaches that we experience, and they come on from muscular tension or stress. That could be like a big project you're stuck at your computer, and you're into the job or the video you're working on or the paper you're writing. And so, all that stress and bad posture now turns into a tension headache.

That can lead to neck pain. If you use a laptop and you're not using a separate mouse and your shoulders are crunched in to use the little pad on your keyboard, that can create shoulder pain. Low back pain's an easy one, hip pain. Sciatic stuff running down your leg because you sit too much. That leads to a syndrome we call “dead butt syndrome.” It's a funny name, but it makes a lot of sense.

John Horton:

[inaudible] name, yeah.

Dr. Andrew Bang:

It's a very funny name, but essentially, what it means is, when you don't activate a muscle, it gets weak. OK, have you ever seen someone take off a cast, they broke their arm and six weeks later, they take the cast off, their arm is tiny? Because they didn't use those muscles. Those muscles atrophied.

Well, if we don't walk enough, if we're sitting too much and we're driving, we're not getting our steps and we're not exercising, our butt muscles shrink, quite literally. And so now, when you do walk up and down stairs or go for a long distance of walk, your butt muscles, which holds you in place, they don't work as well. So now you get low back pain. Now you get sciatic pain, all because your rump is not nice and tight. So, that's a funny thing that comes from bad posture and bad ergonomics.

John Horton:

All right. You got to tighten those rumps up, so that's one of the keys.

Dr. Andrew Bang:

Tighten them up.

John Horton:

I tell you, I'm amazed, just because what you ran through there, you started it with the headaches and you went all the way down to the pain shooting down your legs. So I mean, it is literally head to toe, and all that's caused by just you sitting at your desk and putting your body in a bad spot.

Dr. Andrew Bang:

Yeah, for sure. Especially with office workers. But again, you can apply ergonomics. And again, you don't have to be a specialist. It's just a lot of rational thinking through, my job and what I do.

If I'm a landscaper, how do I sit on my lawnmower and how many hours in a row do I sit on it? When I lift this thing at my warehouse job, how am I positioning when I lift it? And am I repetitively lifting items or pushing super heavy things when I could use other stuff to help me do it with less force, more efficiency?

John Horton:

Well, and it's one of the things, like you said, if you do something repetitive, you're doing it over and over and over again. If you're doing it just off a little bit, there's a toll that you pay. And clearly, we want to avoid that toll, nobody likes paying the tolls.

So, let's start working on some solutions. And I'm guessing, since we're focusing here on desk jobs, it all starts with having some good posture when you're sitting at your desk. What should that look like as we're sitting in that chair?

Dr. Andrew Bang:

So when you're sitting in your chair, once you reposition your screen and everything, then you got to position your body to your screen, because you can't always control your desk height. Optimal world, you have full control of where your desk is, and you can sit and stand and switch that all throughout the day. Most of us have a fixed desk. OK?

So once you get your computer screen set, then you start building everything else around that.

Your computer, once you're finally sitting in a good posture, your eyes should be hitting the top third of the screen of the computer. So that means if I'm sitting here and I'm looking at the very top part of my screen, that means your monitor's too low because now, I have to look down to look at what I'm working at.

So, bring that screen up to where you're not looking at the middle of the screen, you're looking at the bottom portion of the top third of your screen. I know it's hard to describe, but…

John Horton:

Bottom portion of the top. So basically, you want to be looking a little over the halfway mark is where your eyes should be…

Dr. Andrew Bang:

Yes.

John Horton:

…just when you're sitting there.

Dr. Andrew Bang:

Thanks for explaining that.

John Horton:

OK. We were doing a lot of mathing, so I just wanted to… that's not my strong point.

Dr. Andrew Bang:

Me neither.

John Horton:

So, all right. It sounds like before we get to posture, we should get to getting the computer in the right spot.

Dr. Andrew Bang:

Because once you know that screen is there, then it's like, “OK, now my chair height…” Because OK, if I don't have my screen right, then I don't even know where to put my head, right?

So once I get my screen there, now my head is in perfect position. Now, it's like, “Where are my shoulders? Are they at 90-90?” Your shoulders and your elbow should be at 90 position. Your hip and your knee should be at a 90 position. That's like 90 degrees of motion is what I'm saying, so it's the most neutral position for those joints so they don't hurt.

John Horton:

Everything needs to be coordinated. You're getting your screen set, but that's not just alone a one-time thing. Your screen needs to be set for how your chair's set so that, like you said, your knees are at a 90-degree angle, your hip's at a 90-degree angle. You want to get all of this stuff lined up, so that way, you can be in the best position.

Dr. Andrew Bang:

Yeah, because then, if you're shorter than the average person with the chair was built for, you can now use a box to go under your feet so that your hips and knees can stay at that 90 position.

And then, if you're using a laptop primarily as your workstation from home, you're like, “Oh shoot, how am I going to get my screen up that high because now my keyboard's super high?” You can't be like reaching up to type, you got to get a separate keyboard and mouse so that your shoulders and elbows can be at that 90-90 position for your keyboard and you can move your screen and chair accordingly.

John Horton:

We went with the 90 you want for your knees, for your hips. It seems like every time we talk, you want your shoulders to be square and back and you want to avoid that hunch where we get into that gremlin mode, where we're sitting there and you get it all hunched up.

Dr. Andrew Bang:

Yeah, we call that like forward head posture. Your head is forward, your shoulders are rotated internally where you're collapsing in. Yeah, that's not good. That just leads to way more tension in the front of your chest and the front of your neck muscles, which then leads to a lot of neck pain and mid-back pain people experience.

And so, if your knees and hips are at 90, that means you get your spine into its normal S-curve because you're stacking it on top of each other. Shoulders are back and open, elbows and shoulders at your 90 position, and then your screen is nice and high so that your head is looking straightforward.

We've talked about this in lots of other podcasts, John, about the weight of your head. It's a bowling ball. It is like 10 to 12 pounds. Yours is probably 12 because you're really smart. Mine's probably like 11, I'm kind of smart.

But the point is, that bowling ball gets way heavier the farther it is from being over your shoulders. And some really smart doctor did some studies and found that, OK, 10 pounds of weight, if it's neutral, it's 10 pounds of pressure on your neck. If you look forward 15 degrees, it jumps to roughly like 25, 26 pounds. If you go 30 degrees, it's like 40-ish pounds, and it just keeps going up. It can get as high as 60 pounds of pressure on your neck and shoulders if you're like looking down in your lap. It's crazy.

John Horton:

Yeah, if you're holding a weight and you hold it straight up over your head, it feels one thing. But if you lean it out just a little bit, man, there's so much more tension on your shoulder and your arm. So it's like, yeah, it totally makes sense.

So, all of this sounds so easy when you talk about how you should sit, and it seems like, man, this is something we should all be doing, it should be like nothing. When you walk around the office and you see people sitting at their desk, how many people are in the correct position?

Dr. Andrew Bang:

Yeah, so, not many. And I think you're like, well, it's so easy. Why don't we all do it? Well, I think we start out usually with decent posture, but then fatigue sets in, and then you instantly start to slump or stoop or your head falls forward or whatever, or you cross your favorite leg, I always cross my right, over my left, etc.

You start creating these patterns because you're in the work and you're getting forgetful. So one of the biggest important parts of ergonomics is not only being in good posture while you're consciously aware of it, but also moving frequently so that you can remind yourself to get back in that good posture.

So, we were joking with one of the other gentlemen who's helping us film this, he has a 3-year-old, so he gets up a lot and runs around and chases him before he sits back down at his desk for a second. Right?

Not all of us have a 3-year-old at our side at work, but you need to create excuses for you to get up. And this could be like every Zoom meeting I have of the day, I'm going to stand and work and then have good ergonomics while I stand. Or I'm going to do walking meetings, I'm going to encourage wellness in my office and we're going to walk while we do our meetings.

Because then when you sit back down, you've not just sat all day while you're working on projects, sat during your Zoom meetings, sat during lunch, da, da, da, da, da. So now you can break up the day, but you have to be intentional.

You're going to say, “I'm going to eat lunch standing.” That's another easy way because everyone eats lunch or something. I'm going to drink my coffee standing, right? I'm going to have a small water bottle at work, so I get up to go to the water cooler, not the mega water bottle that I see people carrying around. It's like, what are you doing with all that water? Are you sharing it with half the office?

John Horton:

Well, if you're drinking all that, though, you should have to get up to go to the bathroom at least [inaudible].

Dr. Andrew Bang:

True, maybe that's their strategy.

John Horton:

So maybe that's where you get it.

What I'm hearing just from everything you said is even if you're in the absolute perfect ergonomic setup, you're sitting at your desk that way, it's not intended to be an eight-hour thing. I mean, it sounds like even being in the right setup, it's only right for a certain amount of time. If you stay in that setup too long, you start causing the same issues.

Dr. Andrew Bang:

Yeah. I've worked with some people who actually, they hate the word “perfect posture” or “perfect ergonomics” because in their mind, they believe it doesn't exist because, like you said, you spend, even in perfect posture, how long can you really hold that before your muscles fatigue, and now you're out of perfect posture?

Or just, our bodies are not meant to be static. You know, even while you're sleeping, you're unconscious, you may think you don't move, you still move. I can't remember right now, but there's a number of times you move per hour that everyone does, because our bodies do not like being static.

So that's a big take home from ergonomics, is you may have the perfect setup, but don't stop moving, ever. Keep moving, fidget.

John Horton:

Yeah. Well, yeah, you got to mix it up. Yeah, and I got to say, every time you're on, it seems like that is one of the central things we get to. And you always say that the whole “motion is lotion” thing.

You got to get up, you got to keep moving. Focus on doing whatever you're doing in the most efficient way possible, but make sure you're not stuck in that mode for hours at a time. You got to break it up.

Dr. Andrew Bang:

You're right. You got to be active, you got to be mobile, because every time you let a small injury now, like we talked about earlier, something small now can lead to something bigger down in the future if you're doing it repeatedly.

Repetitive tasks create problems that then turn into big problems down the line. So yes, set yourself in good ergonomics, but then make sure you're moving throughout the day to maintain those good ergonomics. You got to remind yourself.

Like, I know when I'm driving the car — this is another big one we haven't talked about, but similar to a desk setup, right? If I have a 20-minute commute both ways, which I do, it's like 22 minutes, where's my head?

If I'm tired at the end of the day, I usually find my head is stooped forward. So I use my headrest as a reminder. If I don't feel the headrest, “Oh, shoot,” I just push back and contract my muscles for a few minutes to remind myself.

I will reposition the seat. I don't always have it in the same position every time because I want different muscles to take turns working. So, sometimes I set my seat back a little bit and then upright about 10 minutes later, 20 minutes later. Or if it's a longer drive, well, my wife gets annoyed, I'm moving all over the place.

John Horton:

And that's so funny, because I got to say, I never reset my seat. And it's like, you feel like you get used to one thing. It sounds like maybe there's a little benefit in adjusting…

Dr. Andrew Bang:

…changing it up.

John Horton:

…your setup a bit here and there just to get a little variation.

Dr. Andrew Bang:

Totally. I have met — this is crazy — I met a couple of gentlemen who drive for a living, and they joke that they have in their center console where their elbow is, it's like worn out the leather or the cushioning.

And then, no joke, John, I look at their X-rays, and they have a curve, a scoliosis, but it's not like a true scoliosis that someone may get from birth or as they go through puberty, like they traditionally would. Theirs is a functional, or acquired, scoliosis from literally leaning while they drive.

And again, did that take time? Yeah, that took 20 years of driving, 25 years of driving. But that's just a good example of a small, simple, like, “Oh, I'm just leaning on the center console.”

So it's getting into the habit of, OK, if I leaned for 30 minutes to the right, let me lean to the left for 30 minutes onto the elbow rest of the door handle so that I can create some unique movements and avoid those repetitive things that my body hates.

John Horton:

Yeah. I love that story because I think all of us were guilty of maybe, you sit in a certain spot or you do something, and you can feel that it doesn't feel great and you go, “Ah, what's it going to do?”

And then you hear that 20 years in, it's like you've got a curvature in your bone. So, that really reinforces this notion that these little things, just the simple thing of how you're positioning yourself, can have just a dramatic impact on your overall health and how you feel, and heck, even your skeletal structure.

Dr. Andrew Bang:

Yeah, it really does.

John Horton:

So Dr. Bang, if somebody is looking at this, and all of a sudden, they're hearing this conversation and they're going, “Hmm, I think I'm feeling some of these aches,” what's just a first step or two that they should do to get things right?

Dr. Andrew Bang:

OK, that's a good question. I think that I would wonder — I wish we had some stats, maybe you can look it up — remember, your head's 12 pounds, mine's only 11, so you're smarter than I am — I wonder how many people work from home now in relation to like five years ago, 10 years ago. I would assume it's more.

John Horton:

A lot more. Yeah, I'll go with that. The 12 pounds will come up with that answer. I can dive a little deeper, but definitely a lot.

Dr. Andrew Bang:

So then it makes me think two things. First, it makes me think, I wonder how many of those have laptops only. And then, even if their company supplies them a desktop computer, do they supply them a decent chair or are they stuck at the kitchen table?

Right? It's like all those things that you normally show up to your workplace if you work at a computer all the time, they're going to have a nice desk, a chair for you, da, da, da, da. At home, I don't think you're getting those things. Maybe some companies are fantastic, but I don't know. I'm just making some wild assumptions.

That being said, if you're stuck with a laptop, it's so easy to then just literally go to the couch. There's so many people, literally, they come in, they don't know why they have back pain.

I'm talking to them and I go into this like, “Hey, tell me about your work setup.” “Oh, I work from home.” “Oh, that's cool. That's so fun. I'll never experience that because I have to go to an office.” And then we are BS-ing, and then all of a sudden, I find out that they love to sit on the couch.

“Oh, I sit on the couch to work.” And I'm like, “What?” So I'm like, “Where's your computer?” “In my lap,” and I'm like, “OK.”

John Horton:

Yeah. Which just seems the wrong place. You're automatically, you're looking down. There's nothing good that comes with…

Dr. Andrew Bang:

…nothing good.

John Horton:

Wow.

Dr. Andrew Bang:

So then, it's like, get your screen up high, like we talked about. Books, a box, whatever, get the computer screen up, bring in the wireless keyboard mouse, set up the screen, like we talked about earlier in the podcast.

Get everything set up. Even if you have a bad chair, it's not so much about the chair, it's about your positioning, right? So it's just like, get to the desk, get everything up.

That's the number one thing. The cheapest thing you can do is a wireless keyboard and a wireless mouse so you can set your shoulders and wrists the right way, and your elbows, and then you can move your screen so your head is perfectly positioned. If people just did that, man, that'd be huge.

And then, I think the next cheapest, most bang for your buck when it comes to feeling good with ergonomics is like we said earlier, avoiding sitting in one place, even in the best posture possible, for more than 45 minutes to an hour at a time. Right?

Yes, you can crank out an hour, it'd probably be fine, your muscles are probably resilient enough to handle that. You start going into that a little longer, you're going to get fatigued.

John Horton:

Yeah. Well, Dr. Bang, I think on that note, that sounds like a good sign that we should wrap this up because we have been sitting here for a while chatting.

So, I'm going to get up and move around, get another cup of coffee and we'll start getting that motion to get all those joints right. And then, I'm going to come back and I'm going to look at my desk set up and see if I'm doing it right, so…

Dr. Andrew Bang:

Awesome. Good, John.

John Horton:

I appreciate you coming in. Like I said, you always give us such useful tips and things that I really feel like we can use every day. And over time, it should make us feel a little better as we're walking around this earth.

Dr. Andrew Bang:

Yeah, I agree. It's not easy. It's not hard to do it, it's just a matter of remembering.

But that's why if you attach some of these newer things that I talked about, attach it to an existing habit you already do, like getting coffee, like going to the bathroom — if you say, “Every time I go to the bathroom, I'm going to switch my desk set up to standing or I'm going to do this, that or the other,” then it actually makes it simple and part of your daily life so it's not one more extra thing you got to think about.

Just make it part of a goal you already do and you can't fail and it will help you, and you'll be thanking yourself. In fact, you'll be thanking yourself because you won't be in my office.

John Horton:

Well, this is why I love having you on. You have tips right up until the last second. So, thanks again, Dr. Bang, and can't wait to have you back.

Dr. Andrew Bang:

Thanks, bye.

John Horton:

Don't underestimate the physical toll of a desk job and how your workstation setup can impact your overall health. Making a few small changes, like adjusting your chair or repositioning your computer monitor, can make a huge difference in how you feel every day. Give it a shot.

If you liked what you heard today, please hit the subscribe button and leave a comment to share your thoughts. Until next time, be well.

Speaker 3:

Thank you for listening to Health Essentials, brought to you by Cleveland Clinic and Cleveland Clinic Children's. To make sure you never miss an episode, subscribe wherever you get your podcasts or visit clevelandclinic.org/hepodcast. This podcast is for informational purposes only and is not intended to replace the advice of your own physician.