How to Set Up a Comfortable Virtual Learning Workspace for Kids with Dr. Chad Adams

Podcast Transcript

Deanna Pogorelc:

Welcome to the Health Essentials podcast brought to you by Cleveland Clinic. I'm your host, Deanna Pogorelc. Now many kids are starting the school year virtually this year, which means there'll be spending more time on computers and tablets to get their schoolwork done. So to avoid aches and pains from sitting at a computer for long periods of time, kids should have a workspace at home that's comfortable and ergonomically friendly. Dr. Chad Adams is here today to give us some guidance on just how we should be setting that up. He's a chiropractor at Cleveland Clinic Center for Integrative Medicine. Welcome Dr. Adams. Thanks so much for being here with us.

Dr. Chad Adams:

So good to be with you.

Deanna Pogorelc:

Thank you. And to our viewers and listeners, please remember that this is for informational purposes only and is not intended to replace your own physician's advice. So Dr. Adams, why is it so important that we take the time and effort to set up a great workspace for our kids, that's comfortable and tailored to them and not just plop them at the kitchen table or at an adult desk that we have?

Dr. Chad Adams:

I think that's a really important question to answer. And as we kind of buckle down for some of the long-term nature of some homeschooling situations, it's important to know that kids' bodies as well as adult bodies are highly moldable. So one thing that I think is truly important for people to understand is the nature of the skeletal system and what we'll call the bio-flow. The definition of the bio flow is how the pieces and parts of us move in relation one to another, and how highly influenceable they are by gravitational forces, by positioning.

              So, one thing I'd like to explain is quite often, everybody is mostly familiar with braces on the teeth. Now why do braces work? Two very important principles, time and tension. And when we increase tension over time, we're able to take tissue like teeth and something that's very hard and mold it into a shape. Now, the tricky thing about our bodies is that we don't necessarily see that happening. So when we assume very poor postures for a long period of time, we can actually change the shape of the internal structures. There's an age old adage in the biological world that states, the structure governs the function. How something is shaped determines what it can do. So if we start messing around with the shape of something, ultimately what it can do is also going to change. So in a little tiny person, we think, "Oh, they're made of rubber, okay, we can throw them in these chairs, they can slouch, they can do these things. They're young, they can deal with it," when in fact this is the most important time of their lives to be truly aware of keeping that structural bio flow in check.

Deanna Pogorelc:

Great. So if kids don't have great posture or don't have a great set-up for working, are there either short or longterm effects that could come from what you just explained?

Dr. Chad Adams:

I believe, yes. Now as a clinician, I often see the down the road. We'll catch people at multiple different age groups, but what we do find is some similarities when we take these prolonged and fixed positions, something that I called the forced environment. The forced environment is the setting that we find ourselves interacting with. For example, your car is a forced environment. It was not built specifically for you, yet you put yourself into this every day and go where you're going. Your desk, your home, your countertops, are a standard height regardless of your height and how you interact with them. So we are forced as people to interact with these different environments. So the desk situation is no different. Whether you're in a school or at an office as a worker, what happens is we assume these prolonged and fixed positions for multiple periods of time throughout our lives.

              And what we find is when something doesn't move in the human body, remember the human body was designed to move. That is the only way that some of these articular pieces of anatomy, things like cartilage, things like ligaments, things like muscularity, they are fed by movement. So when we stop moving, we actually stop exchanging the nutrition to these different pieces of anatomy, and something that doesn't get fed, what happens to it? Ultimately, it's going to start to degenerate and that degeneration leads to some very bad things, as far as joint health, the discs in our spine, that can ultimately become irreversible if enough time passes.

Deanna Pogorelc:

Okay. So before we walk through some of the do's of how to set up a great workspace, let's talk about some of the don'ts. What are some of the common mistakes that you see with kids in their school set-ups?

Dr. Chad Adams:

I think the biggest thing is remembering that children, and your kids specifically, are not the same height as you. They generally come in smaller packages. So thinking that you can put them at the kitchen table or at the desk that you work at might be folly, in that again, that's a very forced environment. They may be leaning forward too far. They may be reaching for the computer or the keyboard. Now we're taking the regular forced environment and we're making it even more so, by trying to fit a smaller person into a larger type of scenario. So number one, having a conducive workspace is going to be the big thing. So the don'ts is, don't take a forced environment and make it even worse. And that's one of the things I think we'll get into is, is how can we creatively come up with some solutions to this? So if all you've got is that one desk or all you've got is that kitchen table, how can we tailor that to make it more specific for your best interest and your children's best interest as well?

Deanna Pogorelc:

Absolutely. So let's jump into that. Maybe we can start with, what should they be sitting on and how to choose a good place for them to sit?

Dr. Chad Adams:

Absolutely. So what we want to think about is, and I'm going to introduce one more concept that I think is important to remember: the elusive perfect posture is very difficult to find. So one thing to keep in mind is that there's our posture just like movement, should be variable. We should have that freedom to move. Our underlying theme during all of this is going to be movement. How can we still accomplish our task and stay focused, but remain fluid with our bio flow and able to move? So when we talk about posture, it should be variable.

              Now, another thing to understand is that is there a better posture for the task at hand? Absolutely. So what we were going to try to avoid is if I'm sitting on a chair and I have to focus my gaze at something, in this case, let's call it the monitor, I'm looking forward. So what we want to do is try to keep everything in a somewhat neutral state where I don't have to cast my head forward over my shoulders, where I don't have to cast my glance downward or too far upward. So with the head, we want to keep it at a somewhat neutral eye level that I can look forward, because as soon as ... one thing that people don't often consciously realize, is that your head will follow your eyes. So wherever my eyes track, it tends to pull my head in that direction. So as long as the eyes are cast forward, it will help keep my head on top of my shoulders, which is our next point of contact. The shoulders we want to remain somewhat upright and erect. So not too far forward to where now I'm leaning backwards, but I'm also not hunching and slouching forward.

              Now back to our previous conversation about posture being variable, would it be okay if I slouched for a little while? Sure. If it was just a little while and not all day. So my posture may change throughout the day and that's okay. But keeping in mind that any one position where we're locked into that position all day, can become very dangerous and over time will take its toll.

Deanna Pogorelc:

Yeah. And then what about typing? And the positioning of your arms when we're sitting at the computer all day, how should we navigate that?

Dr. Chad Adams:

So that the keyboard can be one of those things that can be a deal breaker, especially if all a family has is a laptop. The problem with a laptop is that the keyboard is affixed to the entire unit. So how do we navigate the keyboard and the monitor simultaneously? One thing that you might have to spend just a few dollars on, and one of the few things that I would recommend, is getting a wireless keyboard, a separate keyboard that you would be able to place your laptop up to that appropriate glance level or that eye level, and be able to work on the keyboard separately.

              Now that keyboard set-up and the arm set-up, is we want to think about a right angle, a 90 degree angle. So I'm bent at the elbows and I'm not reaching forward, so my arms are straight. So I don't want my hands clear out here and reaching for the desk. I want it within, if I can kind of turn to the side here, I want it within the reach. So the keyboard would be right here at the end of my hand. I'm not reaching forward and I'm not pulling back too much. So I keep this angle nice and even. Some support through here is always beneficial, so we don't want the wrist to pull up or come down too much as well. So keeping that nice right angle and keeping the keyboard within reach while maintaining that proper eye-level.

Deanna Pogorelc:

Okay. So then we would want to prop up the laptop on something that's laying around the house.

Dr. Chad Adams:

And it could be as simple as an extra cardboard box. It doesn't have to be fancy. It doesn't have to be a technical piece of equipment, whatever you ... an extra stool, some extra books that you have laying around, whatever you can do to get that up. Now, again, keep in mind, depending on the height of your desk, since the kids just aren't as tall, you may not need that much to actually get it up that high. So it's just going to be something very simple. You don't need to go out and spend a whole bunch of money on a standing desk or a variable workstation, home items are absolutely appropriate to use in this case.

Deanna Pogorelc:

Yeah. And speaking of home items, you talk about some of the adjustments if someone just has their adult desk and needs for a kid to be able to work there, what kind of props or what kind of things can they do to adjust that workspace so that it works for the child?

Dr. Chad Adams:

Sure. So when you think about the length of a seat, right? So where you actually place your bottom and sit into the seat, they're generally quite deep. And what children fall into is either they go all the way back and they end up pulling their knees to their chest, which might be okay to vary some of the movement of the legs, but again, we have to think about what's happening long-term for these little bodies being forced into these larger chairs. If they sit too far forward, well now they don't have any support through their spine to help them keep upright. And that can often, as the endurance of the spine wanes over the day, well, that's when they start poring over the desk and putting the hand on the head and really start forcing some of these other postures.

              So it's again, really simple. Find a couple of extra books, find some extra cushions, whatever you can do to help keep the back of the chair as close to their back as possible, so it can provide some support, but it's also that tactile reminder, as soon as I start to slouch, I'm going to feel it in the back of the chair. And I might straighten up a little bit. If I sink into that nice cushy desk chair or that, or if I've got my laptop on my lap, I might squeeze into that regular ottoman or that couch, the squishy couch, well, that's again where they're going to fall into those poor postures.

              So something that has a little bit firmer support through the back, that you can modulate simply with some pillows, with some books, with some other cushions, remember to keep that chair scoot forward towards the kitchen table or the desk so they're not reaching. And what we want to try to avoid is allowing any ... it's terribly ironic, we talk about the wiggles for kids, but we want to eliminate some of that wiggle room. So it just is a kind of a reminder to not deviate too far from that variable posture.

Deanna Pogorelc:

But if they're up on a chair that's a little bit higher, is it okay to have legs dangling? Or should we put something under there?

Dr. Chad Adams:

I think having the legs dangled periodically would be okay. However, yes, you bring up a wonderful point in that there should be some support to the legs or at least that option. Again, if we think variability, they're absolutely going to flow in and out of all of these postures all day long, depending on their interest level, their engagement level, the task at hand. So having a little stool there for some additional support.

              And again, we want to be mindful of the angles that that creates and the legs and knees should make a similar angle as that we talked about with the elbow in relation to the keyboard. So too high of a stool is going to prop their knees up into their chest, which could put some undue pressure through their bottoms. They're not going to last long there right? So now we, because of these postures, we might even create some more wiggles within them and decrease their attention span. So something that's nice and even, and again, you could vary that with some boxes, you could vary that with some cushions, something at home that's really easy to use is if you just have a ... if you have kids, you likely have a step stool for the sink. One of those might be just right for you

Deanna Pogorelc:

And back to your point about movement, is it okay for them to be getting up and sitting on the floor for a while or doing some work on the couch?

Dr. Chad Adams:

I think absolutely. So if we go back to our underlying theme, which is movement variability, now, of course the age range of the child and the task at hand is going to somewhat determine that. But if there is some flexibility, I think having a very systemic plan where, okay, I'm going to spend this long in the seated position, and then I might have them stand up and work for a little bit and oh now we might move to the floor, make a game of it. So their environment is constantly changing. Again, is there any perfect posture? It's very hard to find, but if they have that opportunity to change posture, would it be the end of the world if they worked from criss-cross applesauce, their legs crossed on the floor? Probably not. If they're there all day, okay, now we might have a different conversation.

              But if that is ebbing and flowing throughout the entirety of the day, I think that's absolutely appropriate and beneficial. I think one of the greatest problems with a school, in class structure, is that the desks are exactly the same size, no matter what size the child is. And here's that environment. And I think schools do a great job of interacting and moving throughout the classroom. But as the older we get notice, there are more prolonged and fixed positions. So this goes from your kindergartners up to your seniors in high school, they should absolutely be moving around like this.

Deanna Pogorelc:

Great. And if we are kind of locked in and focused on one task on the computer, how often should they be getting up and at least, shaking out and moving around a little?

Dr. Chad Adams:

Yeah, I think it's really easy to get lost in some work, even kids that get super hyper-focused on an engaging activity, they might be there for 35, 45, even an hour. I think it's important to allow that creativity to happen, but also to make sure that there's awareness of, okay, we need to change this environment. If it's at all possible, I think the maximum, even for adults is right around that 20 to 30 minute mark, some type of posture alterations should be made. So whether I go from a seated position to a standing, seated position to the floor, even if it's just disengagement completely, and now I look at something else in the room, I look at something further away. I cast my head and my eyes around the room so I'm not in this little blinder box of focused attention.

              It's to again, let the senses take in their surroundings and their environment. And if you did that, even for 30 seconds, it would not drastically have an impact on the focus, on the intention, on the task at hand, or even the longevity of a day. 30 seconds here and there just to reset the brain and the body done consistently goes a long way.

Deanna Pogorelc:

Along that line, are there any stretches or exercises or specific movement that kids can do to counter the effects of sitting for long periods of time?

Dr. Chad Adams:

Absolutely. And this doesn't have to be anything specific. There's no magical movement that, "Hey, do these things and they're guaranteed to improve." What I think what goes along with our theme is simply movement, but I want you to think in three dimensions. So rather than just looking side to side, well now I'm going to drop big circles, as big as circles as I can with my neck, and as big as circles as I can with my arms and my wrists and my knees and my fingers. And I'm going to try to include every single part of me. And you absolutely can do that in as little as 30 seconds. So when you think about movement, think about as large and as big and as expressive, three dimensional circles as possible.

              The other thing that we can do is involve the legs. So if you've been sitting for a long time, think about doing some very simple knee bends, deep knee bends. Now, kids are phenomenal at this. They're phenomenal at squatting down and getting on the floor. Have them do that. There was a very interesting study done out of Brazil called the Sit to Stand Test and something they determined was a person's ability to get onto the floor and then back off of the floor, had a direct relationship with mortality and some decreased longevity, depending on your inability to get on and off of the floor. That's one thing that we continue to marvel at with children is their ability, seemingly from any position, to get on and off the floor, I would have the kids do some type of exercise where they're doing that, interacting at different levels, getting up, getting down, because those are full body movements that really increase blood flow and that bio flow, how our pieces and parts of us move synergistically.

Deanna Pogorelc:

Yeah. That's great. What are some signs that a child's workspace isn't working for them or that something's not quite right? What are some things that parents might notice?

Dr. Chad Adams:

Yeah, I think kids, and depending on the age group, they're going to express discomfort and pain in different ways. My kids often don't say, "Hey, it hurts right here when I do this. And whenever I sit right here and have my arm like this, it really bothers this right here." They're generally not that specific about it. They're going to find that they're going to be a little bit more cranky. They're going to be a little less willing to engage with the activity. They might outwardly express "Actually, I just don't feel good." Those are good signs that there is some kind of physical discomfort, especially if you've checked off the other list of, okay, did they have enough to drink? Have they had enough to eat? Have they used the potty? If you check all those other things off, it's quite possibly related to some kind of positional engagement.

              If you notice them rubbing their eyes a lot, maybe the screen is too close, too far. Maybe they have some problems focusing on, depending on the platform that the school system is using, maybe the screen is not big enough, focused enough. So look for repetitive things like kneading the skin, so it's almost like as if they're trying to fix themselves. We have that innate thought process of, well, we may not know what's wrong, but we know where's something wrong. So if you see repetitive grabbing or pulling, or this kind of thing, there may be some additional strain on that bio flow on those bits of muscles and ligaments and tendons that prolonged and fixed positions can happen. And if you look around in your office environment, you're going to see adults do this as well. They'll sit back, put their hands over the eyes and the hands back here and rub through there. Those signs never go away. So you can notice those things in your children as well.

Deanna Pogorelc:

And lastly, if there's some complaint of pain or discomfort that doesn't go away by adjusting the computer screen or changing where they're sitting, what should the next step be for parents?

Dr. Chad Adams:

Do you know if it's possible, this is when you involve a professional. And whether it's a chiropractor, a physical therapist, a massage therapist, somebody in ergonomics that you might just need an objective third eye to say, "Hey, does this look right to you? We've done everything we can. And this seemingly is still causing some kind of problem." But this is where you bring in that third party that can objectively view this as is there something more sinister at work here? Does this require some type of intervention? Quite often it's a simple change of a structure. It's, simply reminding and somewhat training the person who's in this environment, "Oh, you just have to remember to sit up and remember, we have to move around and do this." So after you've done all in all your power, and this is something I tell my patients all the time, if ever the thought's crossed your brain or come out of your mouth, "I thought it would go away," if those words ever crossed your mind, that's when it's time to involve a professional.

Deanna Pogorelc:

Great. Well, thank you so much. Is there anything we didn't talk about that you think is really important to leave our viewers and listeners with?

Dr. Chad Adams:

I think we covered a lot of good things. Keep it simple. Remember movement is the underlying theme here. Try to move as much as possible, both in the environment and take those breaks. Make sure that the kids are up and out. If the weather is still holding to where it's good weather outside, let them run around the house real quick and get back to their class.

Deanna Pogorelc:

Great. Well, thank you so much for being here. And if you'd like to schedule an appointment with a Cleveland Clinic chiropractor, please call (216) 448-4325. To listen to more podcasts with our Cleveland Clinic experts, visit Cleveland clinic.org/hepodcast, or subscribe wherever you get your podcasts. And for more health tips, news, and information, follow us at Cleveland clinic on Facebook, Twitter, and Instagram. Thanks for joining us.