November-December 2020 | Health

Office space

A physical therapist talks about how to avoid an achy neck, back pain and stiffness when you’re working from home

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Becky Gerber (left) with client Gretchen Hitchner. Photo by Lisa Helfert

In the Spring, Becky Gerber’s daughters, ages 11 and 14, sometimes wanted to do their school Zoom calls from bed or a beanbag chair, despite their mother’s advice. Gerber, a physical therapist who lives in Bethesda, says she didn’t argue about it too much, but by the fall she set up desks for her girls. “It’s not something we’ve had to deal with before,” she says. “We’re doing the best we can.”

From kitchen tables to comfy sofas, makeshift office spaces often are far from ergonomically correct. The result? Achy necks and lower back pain. And it’s not just adults who are vulnerable to the discomfort. Families are also trying to figure out the best setup for kids who are learning remotely. Proper posture is important, and long periods hunched over a computer can lead to stiffness. “My biggest advice is to move,” says Gerber, 44. Ideally, every half hour a person should spend 20 minutes sitting, eight minutes standing and two minutes moving, she says.

A physical therapist for 20 years, Gerber worked at an outpatient orthopedic clinic in Chevy Chase before going into practice on her own in 2017. Since then, she’s provided care to individuals in their homes or offices. For people with neck or back pain that can be traced to posture issues—often from sitting in front of a screen—she sometimes does soft tissue massage. Applying moist heat also can relax muscles and increase blood flow to speed healing, she says. Postural strengthening exercises and stretches, such as lying on your back and bringing one knee to the chest at a time, can help. Or, to relieve neck tension, she suggests gently stretching side to side by tilting each ear down toward the shoulder.

To fend off future aches, Gerber likes to evaluate a client’s workstation. The most common mistakes she sees are keyboards that are positioned too high and a lack of good lumbar support. Among her tips: Adjust your chair or keyboard so you don’t have to raise your arms to type and your hands are in a neutral position; align your computer monitor so it’s directly in front of you; keep your mouse close to your keyboard; use a chair with built-in lumbar support, or use a pillow or lumbar roll so your head is aligned over your shoulders and hips; keep your feet flat on the floor.

“I saw a patient in his office who was an attorney and working 60 to 70 hours a week. He had severe left-side neck pain, horrible headaches and was living on Advil,” Gerber says. “At his desk, one monitor was in front and one was to the left side, so he was looking to the left all the time. The chair was so low he had to reach his arms up to type. We raised his chair and got the proper position so his shoulders and elbows weren’t shrugged up. We set the timer for every half hour to walk around. He stuck to the pattern, and a week later he didn’t have to take any pain meds.”

In her own words…

Age matters

“Because kids have more flexibility and more water content in their tissues, they are not going to feel postural strain as quick as adults. As we age, there is a loss of disc height, and this degeneration can lead to nerve impingement, joint inflammation and pain. While still less common, the incidence of lower back and neck pain in children has been on the rise in recent years, which may be explained by increased time spent in front of screens.”

Break time

“The [MCPS] schedule for school online has breaks built in. At my house, those 15 minutes are not going to be watching YouTube. We have a dog that needs to be walked—even a quick spin around the block. Maybe a few sun salutations to stretch things out. Or kids might want to do the Renegade or a TikTok dance. You have to find something to make it fun.”

Proper posture

“Standing desks have a place, but you shouldn’t stand for eight hours a day. Even if you are standing, you still need to have good posture—standing up straight, your neck retracted. Still, that’s a static load on your hips, the soft tissue and the bones of your spine. Standing in one place can be bad if you are doing it for a long time.”

Forming connections

“I see my patients usually three times a week for one or two months and sometimes longer, depending on the diagnosis. It’s like visiting with a friend. I like being able to see somebody progress in a measurable way. Encouraging them and telling them they are going to work through it is a really important part.”

Take a seat

“I have a patient who is a writer recovering from a fall. She couldn’t sit for long periods. She was using a very old office chair that had belonged to her husband. We ordered her a new chair and adjusted [it] to be as high as it could so she could type correctly with her arms by her side. But then her feet were dangling. We got a stool to raise the floor to her. She didn’t have to buy a whole new desk. Now she’s able to sit at her desk comfortably and get things done.”