Technology and Our Body

Technology and Our Body

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[ Music ] >> And good evening, welcome to this technology and our body webinar. So tonight we're going to discuss how to prevent and correct technology overuse injuries such as tech neck, smartphone hand pain, and more. Our speakers today are HSS Physiatrist, Dr. Jesse Charnoff, and HSS Physical Therapist, Anil Nandkumar. >> So we were given some sample questions that I'm going to read out and Anil and I are kind of going to go back and forth discussing our thoughts and things that we see regularly. The first question is; what are the most common technology overuse injuries that you see patients coming in with? What do you see, Anil, the most? >> Yeah, it's interesting because you know, now we're in such different environments both office use and home office use as well, so kind of seeing everything that has to relate to these types of technology use or ergonomics so you know, I'm seeing generalized neck pain, wrist pain, hand, low back, hips, knees and pretty much went through whole joint to the body there.

Mainly because you know, we're constantly in these different positions so you know, for the most part, it's generally neck pain. You know, we're at the computer, we're in front of our phones, a lot of wrist and elbow, I mean even shoulder pain too because we're kind of slouched over like this and in front of our devices. And so you know, unfortunately when patients come to see me especially, it's pretty, it's been going on for quite some time, you know, and how about yourself? Would you say the same? >> Yeah, I mean it's definitely increased I would say over the last year or so where I'm seeing a lot more patients who, they're just not walking at all during the day. They're getting up from their bedroom, they're walking 10 feet to their home office, sitting down and then getting up to eat dinner or something. You know? >> Sure.

>> So I think we're missing a lot of the exercise and the general TLC that we do naturally just by walking to the train and walking from the train to your office, getting lunch at the office, these things that you take for granted that now we're not doing, and instead we're loading the same joints for hours on end and what I'm seeing is a lot of overuse injuries, whether it's the texting thumb, cell phone elbow, tech neck, you know, all these things. But at the end of the day, it's really just overuse injury, that's what it comes down to. >> It's funny you say that because even, you know, some of my patients now, even if I see them virtually or I see them in then clinic, they ask them you know, what do you do for lunch, like during the day when you're at home, they're like you know, it's funny, like I when I was in the office I used to just take my lunch break, I used to go out, go get something or even go sit outside or you know with a friend or something like that. Now I just either order to my apartment or I just like quickly heat something up and then run back to another meeting.

So it's, you're totally right, it's like built into your day to just sit and sit and not move. >> Yeah and something I always tell patients for back pain in general is brisk walking is one of the ways, our disks, they don't have good nutrition so they have poor blood supply and they're very easily injured when they're starved you could say. So one way to hydrate and to feed your disks is to go for a brisk walk and that helps kind of bring in nutrition, help with blood supply. So regardless of kind of working from home, working from the office, I tell people, get up every 30-45 minutes, try to walk. But then when you're seeing these people who are totally starving themselves from this, you can kind of see how down the line, these injuries kind of crop up and we see the aftermath.

>> Sure. Absolutely. >> One other thing I thought that was interesting is I always do some research when we do some of these webinars and I was looking up some statistics so texting thumb was googled 100 thousand times per month in 2018, which is just, that's a lot. That was pretty surprising. And so I just think that this is something that really is affecting a lot of people is just pain from overuse injuries, whether it's new from working from home or you're using a new device that you have to use it for work and just kind of understanding that it is the overuse that is the issue and not necessarily the device or you know, something else. >> I think it's interesting that you know, I guess like when you and I were you know, in school and stuff like that, when you hear overuse injuries you're thinking about like kind of that weekend warrior kind of, you know, the tennis player constantly serving, quarterback throwing, anything like that. And then now it's like the overuse is really into your daily routine because we've kind of adapted our ways to you know, use those joints more and more.

>> Yeah, it's a lot of repetitive stuff. Alright, so I'm going to move on the next question. So the next question is; what's the best way to treat these types of technology overuse injuries such as tech neck, texting thumb, or wrist pain? >> Yeah, you know, I think it's tough because we, it's tough to treat them as a PT and I know for you too, because you're asking somebody to stop you know, their trigger and really that's part of their daily routine. So for us, you know, at least we would just find ways to modify those things in order to treat them properly. You know, I, my biggest anecdote that I tell patients all the time you know, they come in with a certain type of injury, they're always like you're telling me I have to stop doing this? No, but tell you this story and my favorite one is a famous basketball player had one of the best shooting percentages for years on end in the NBA, and then when the new phones started to come out and they started to get bigger and bigger, he actually, his percentages went down. And people asked him why, like what's going on? He was like I don't know, there's something wrong with my thumb, you know, and then over a course of time, they figured out, oh it's because you switched to a bigger phone and you're swiping across the screen trying to maneuver it.

And so once they kind of got that under control, modified it by having him have a smaller phone, you know, his actual percentage went back up again. Not saying that there's anything like a quick fix like that, but you know in our daily routine you know, what we tell patients is, you know, to really try to, just like you said, modify the things that you're doing. Get up every 30-45 minutes, maybe change the grip, get a new mouse, or work at your station to see if you can make it more ergonomically friendly. >> Yeah, no that's a great story.

>> From there then that's when we really tack on the PT things, the exercise things to build your strength back up and decrease your inflammation. >> Yeah, no, that story's great. But it's so true, because I'd say most of my patients, when it comes to stuff like this, were doing detective work, working backwards, like what changed and it's always nothing changed, it's, you know, it's rare that they come in and they tell you like oh, I got the new phone. But you kind of like go back and then you can oftentimes isolate one thing where they're like, actually I think it was around the time I got the new sneakers, or I got the tablet or my work gave me, instead of a laptop, they want me to do everything on the tablet.

So it is important to kind of be mindful of what you do during the day I would say more than anything else. I also tell people to switch hands so like most people will hold their phone in one hand and then just constantly do the same thing, so just make a conscientious decision to switch from your left to your right hand instead of typing with your thumb, try to type with one of your fingers. These are, they sound so simple, but it really does take that repetitive stress off of the joints and off of these tendons and it can make the difference. It's really hard obviously to completely stop doing some of these things, but it's just about being mindful and conscientious, and I've seen that make a big difference for a lot of people.

>> Absolutely. And you know, it truly, people ask me all the time like, can PT like actually work at this stuff, and you know, you know when I get the referrals from you guys too about these types of patients, I always tell them that it's going to be tough you know, it's not a quick fix and the reason is because again, we're asking you to break a habit. And so that's kind of the biggest obstacle but you know, over time just like you were saying, if you kind of modify things, break that habit every once in a while, then things do start to work and things do start to change. >> Yeah, I agree.

But the other thing I love about getting physical therapy involved and what I try to tell the patients is, you have to be able to tolerate the load, it's repetitive load, so if you can somehow get the muscle, the tendon to be stronger, just like you're training for a race, if you're holding a posture for 8 hours, you have to train for that. And getting, you know, that strength and that endurance more than anything else is where I think people get a lot of benefit. >> Absolutely. Good point.

>> Yeah. Alright, so next question they want us to go through here is; can you recommend any exercises or stretches to do for neck and back pain? Also for hand and wrist pain. >> Yeah, you know, there's so many of them out there. I think it really has to do on the patient specific you know, what they need, what their diagnosis kind of calls for. And then also like at least for the way I treat is to, if you can make something very accessible or tangible for a patient, they're more likely to do it, so you know, for instance, I'm sitting here at a desk, you know, I can very simply just put my hands right behind my head, open up the shoulder girdle here, open up your thoracic spine, and do a little bit of mobilization through it, right? Not hurting the neck because you're supporting it with your hands. And then simply like a lot of, I really feel like we hold tension you know, in certain places.

That being the low back and that being kind of like up here in your neck and in your upper traps. To simply just kind of just stretching out your upper traps by just bringing your head to one side, each way, is a good reliever for patients. But just like you said, these types of exercises is a very simple kind of, or a very specific way to just say, you know, just get up and move or break your, break the normal cycle that you're in right now, to kind of make sure that those joints don't stiffen up, those muscles don't stiffen up, so you don't have these types of injuries.

>> Yeah, it's hard to over simplify but I think those things are things I tell patients, you know, the masses because it can only help, what you showed. Movement, I would say is the biggest thing so whether you can just, the thing that I see a lot of times is people gradually getting more and more forward as the day goes on. And as the stress comes.

So just bringing the shoulders back like you said, and if there's, there's a million stretches and exercises online that you can see that will open you up, but that's really what it is, is just trying to reset your alignment so that everything is kind of back. And that takes a lot of stress off and can help with just discomfort and pain. >> For sure, and I think you know, for a lot of patients I tell them you know, you're walking, if you're in the city for instance, you're walking down the street, you're bound to look at yourself in the reflection of yourself in a store mirror, or store window, right and from there you can already see oh wait, my posture is not good, let me try to fix it as I walk down the street. Or just simply we're on all these Zoom calls now, right, so you can see it in your own posture. As I just said the word posture, I straightened myself back up too, so it's something that can be you know, constantly reminding, you don't have to put a mirror right at your desk to just see yourself, you'll find it in your day if you are paying attention to it. >> Yeah, no I definitely agree with that.

Alright, so moving on to the next question; if possible, what is the maximum amount of time per day we should spend on our phones, computers, phones or computers, to prevent overuse injuries? What would you say? >> Yeah just like anything, there's actually no time and I think you and I definitely agree on that, is the sense that, it's just about movement, right? It's about doing things the right way, making sure that you break that cycle or break a habit and just kind of get into things like that, and you know, ergonomics is key. If you're, whether you're a standing ergonomics, sitting ergonomics, or whatever you do for your work or repetitive stress, make sure that you're doing it the right way. >> Yeah, I couldn't agree more, I mean a lot of patients want that firm answer, so it's hard.

I mean I will tell people, don't sit for more than an hour, 45 minutes to an hour, try to get up. In terms of using a device, I don't think there's one number, I think it's about your endurance, what can you tolerate. Definitely use pain as a guide, you're not getting any awards for breaking through the pain. If you're feeling, if you're feeling discomfort or pain, change hands, change devices, try to get creative but it think just keep in mind that it is the repetition and the cumulative effect that often cause these problems, and keep that in mind when you're deciding how long to use a device.

>> For sure, and I will say that just like you said, the most frustrating thing about treating patients like this is the fact that they become frustrated at the sense that oh man, really, I was really hoping that there was one thing I could do or one quick fix in order for me to feel better. And it really is just about taking time and so with that being said, I'd like to ask you the next question because I, and that is really what are your top tips for workstation ergonomics in order to, you know, improve patient symptoms, especially while they're working at home? And then also you know, this is probably I think the hottest topic nowadays is are there any devices that you would recommend in order to improve someone's posture? >> Yeah, okay, that's a good question. Well, so the, I'd say the desk chair combo is essentially. So you want to have your eyes at the top of your screen.

I think a big mistake people make and it's no one's fault but so many people only have laptops these days and it's hard to get your laptop to a level where you're actually eye level with it and especially a lot of these makeshift offices so you have to have a desk that's high enough to accommodate that. If not, then a standing desk is also a great option. For a chair you want to have something that has good lumbar support, also could have some cervical support. You want to make sure that your back is firmly against the chair, you don't want to be sitting on the edge leaning forward. A big part of that also has to do with the volume, making sure that you have good audio, not that you're in a meeting and you're kind of creeping forward because you can't hear or you can't see. So I like a good size monitor that's eye level.

You want to keep your elbows about you know, at your side, bent at about 90 degrees. I use a 90/90 rule, so your knees also at about 90 degrees and your feet on the floor. And you basically, you go from a comfortable position and you make your station accommodate that. So I can't stress that enough, because I've seen just so many patients come in because they're like, oh, I started working from home, I do a lot of work on the couch, fast forward 3 months, problem. So you really don't have any support in that situation and you got to be careful. In terms of the gadgets and a lot of the postural things, I'm not a big fan, I think that using braces, it can be helpful in the short-term but you have to be careful because a lot of your supporting muscles tend to not fire and not work the way that we want them to, leading to some weakness down the road and it could kind of be a vicious cycle.

The one thing I really do like are standing desks, and they're not perfect, I'm not saying stand your enter work day, but it just allows you to be efficient and ergonomic so you know, if you can have a rising desk that you can sit, stand at times, sit, you can not only help you make sure the screen is eye level, but it can allow you to take some breaks while working. What about you? >> Absolutely, you know, full disclosure I asked you those two questions because you always answer them perfectly. Nothing to add to those, the only little thing that I would say in terms of the gadgets, because I completely agree with those things is that you know, a lot of times patients will be like I saw this on the internet, it looks great, I think I can incorporate this, and like what do you think about it? And I have the same answer as Dr. Charnoff, and then you know, to really overly simplify it to them, I just say; just think about it right now like, you know, like if you had a broken ankle right now, you would need crutches in order to walk but right now, you don't have a broken whatever, but you want to use a crutch for what reason? Right, and it's only because you want to just make yourself, you know, make it easier on yourself so basically you know, just try to break that habit, maybe modify your workstation and really use those muscles that need to be used. These muscles in particular are so unique because they have to be very strong and they have to have very good endurance too.

So there's only one way to do that, and you have to use them. >> Yeah, that's tough to kind of understand but that's so true. Okay, so can tech neck or texting hand pain lead to more serious injuries or conditions, especially if left untreated? >> Yeah. Absolutely, just like anything else, it can start by a simple tendonitis

or a simple pain here or there, and then by that you know, your body's going to start to avoid that or start to deviate in some way, then therefore degeneration happens and that happens time and time again. And that's when, you know, patients unfortunately come to see us. Right? And so it's just like you said, it's like working backwards, so you know, I absolutely you kind of, if once you start to see yourself slip a little bit, look at yourself in that Zoom call, you see those shoulders creep up, you know, that's a right away you should think about it and, let me try to fix that posture.

How about yourself? >> Yeah, you definitely want to be ahead of the ball. I think when we're talking about the spine particularly, you have to think about load and degenerative changes as kind of the curvature of your neck and your lower back changes, the ergonomically friendly posture that we're all born with, or most of us are born with, changes when that happens, the amount of load that goes through these disks and what we can tolerate changes as well, that's when you start losing some hydration in those disks, putting more load on the joints behind, causing these like little micro injuries which ultimately leads to micro instability and then you know, down the road is when we see them coming in and there's a lot of degenerative changes. So the earlier we can get ahead of this, definitely the better. And it's something that I think we're seeing more and more now with all the changes in our world.

>> Yeah, and I think you know, that kind of goes into our final question is like, you know, patients come to see us a lot of times when it's a little too late or you know, we're just getting on that really, I can't stand this type of thing anymore. And so you know, I mean for you, you know, when do you know it's a little too late? Or when do you really see those patients that come in and like Dr. Charnoff, I can't take this anymore. >> Yeah, I mean pain is obviously a big factor, intractable pain is always, is always an emergency for us. But I look for things like neurological changes, so weakness, issues with dexterity, those are all things that kind of alert me that I have to be a bit more aggressive and this is a very serious matter that, you know, I'm not going to just tell them, try these exercises and let's see if we can get through this with strengthening, I'm going to probably escalate it. Limitations in daily activity are definitely things that you know, alert me and should alright the patient that hey, my quality of life is really suffering, I want to do something about this.

But those other things, like weakness, issues with dexterity, balance problems, those are reasons for me like you got to see a doctor and the doctor has to be somewhat you know, aggressive in how they both diagnose and ultimately treat. >> Sure. Yeah, and I would also add like just simply [inaudible] patient, ask them all the time I'm like, how do you sleep at night? And usually when they say my sleep is disrupted or you know, I can't sleep throughout the night, I wake up multiple times throughout the night, can't find a good comfortable position. That's a big indicator for me like, you know, we got to do something about this right away. >> Yeah. It's amazing what people will tolerate and how modified they'll make their life because it's just, they have a schedule and things come up.

So, it's hard to you know, put yourself first but it's very important. >> Absolutely. >> Alright, I'm going to go through some of these Q and A questions, so Annalise wrote; at what point should someone go to physical therapy? I'm not injured and don't experience too much daily pain, but I wonder if I'm reaching my full potential. What do you think about that? >> Yeah, I think, I think there's always an option to go to physical therapy because a lot of our, at least when we want to see patients is kind of for preventative needs, so I think there are two kind of ways to actually seek PT, one is to you know, go to your physician and kind of express your needs, again, you don't have to be in pain or have to have an injury but I don't, you can simply say, I don't like the way like my posture is, I've seen it kind of degenerate over time, I want to fix that.

That's definitely a means to come to PT. Or as well there's a direct access route too, where we can treat you without a prescription and come in, assess you and treat you and things like that. So you know, long story short, you know, you know you need to come to PT when you yourself feel these types of things where it's like, I'm not sure if I'm 100% or I think I just need to be checked out, just so I can you know, have a good exercise program to modify my daily routine. >> Yeah, I agree completely.

I think also a lot of people, they put off the idea of going to PT because there is a fear of jumping back into exercising. But, or they may say I want to get back into you know, active lifestyle, go to the gym, but I just don't know where to start. So, I'll often tell my patients hey, you know, PT is a great starting point because they're going to ensure that you're doing it safely, you have realistic goals, and they're going to target things that can help you kind of move through those goals. So for me, it's a great starting point for a lot of patients, even before they're injured. >> Good point.

>> Okay, I have another question here, show your arms and where should they be when you're sitting. So for the arms, when you're sitting, I would just say you don't want your, you don't want your arms, your elbows to be high so that you're kind of scrunching your neck and you also don't want to be reaching down low. So you kind of want your arms to just fall at their side and where they're comfortably hanging is where you should have your elbow support and then you want to have your at about a 90 degree angle wherever it's comfortably sitting.

So I hope that helps that. And then there's a question about scoliosis fusion and hardware and whether or not you know, that changes our recommendations. It's really tough when we start getting into individual, individualized care. In general, the same recommendations hold true but it definitely could vary some of the recommendations depending on where and what was done.

So that could be a reason to have an evaluation with the physical therapist or a doctor and have them give some, you know, more detailed recommendations. What do you think, Anil? >> Yeah, just like you were saying before, you know, when you have, when those curvatures of your spine may not be anatomically you know, the norm, you know, the forces change in your body. Again, that doesn't mean that you know, you're doomed, it just means that we have to find ways to make sure that your body's at the most efficiency as possible.

>> Mm hmm. Okay, we have another question here; do you tend to see people that are very reliant on pain meds, if so, how do you approach this if you are under the impression they may be masking the issue? I mean in general I'm not seeing a lot of patients who are on chronic pain medication but I definitely see some. I try to get people to wean down because it's rare that I see a reason why you know, someone should have the chronic pain meds. There is obviously circumstances where it does apply but for me it's more about how can we get you functioning and doing things you want to do? You know, in a way that you're comfortable and you're enjoying life. So I kind of approach it with, in that regard, and sometimes I use addiction specialists and other pharmacological assistance to kind of do the safest way possible.

But in terms of masking the issue, it's kind of, it's a very complicated process and there's not just one approach, I'd say you got to kind of hit if from all angles. >> Alright, great, and while we were talking about ergonomics, I put a link in the chat just in case anybody has further questions on that or you want to see more. And could you guys speak a little bit on exercises for neck pain? Because I did see in the poll, like a good amount of people said they have neck pain as well as back pain and things like that. So exercises you can do and just you know, further ways to align your neck a little better. >> Yeah, like we kind of alluded to, a lot of times this is very patient specific based on the needs that a patient needs.

However, in generality I would just say that, just like Dr. Charnoff was saying, everything kind of comfortably stacked on your body is kind of the way you want to be while you're sitting at your desk or just in general, you know, one really good neck exercise that I do is something called the chin tuck, but you may have seen you know, on the internet or just your general treatment if you've had PT before. But it's pretty much about activating your deep neck muscles right in through here by retracting your chin and tucking downwards, okay, the biggest cue for that is to give yourself like a double chin, and then with that you're going to feel like a very strong muscle activation within the front of your deep neck flexor muscles and like almost like an intense stretch in the back of your neck. Because a lot of times, you know, patients when they're you know, texting or chronic computer use, they end up like this, you know, looking at the computer and then therefore this becomes elongated, okay, this becomes really shortened and so you want to kind of get out of that posture to be in the correct posture right there.

And then other things just like we talked about, just a gentle neck stretch to the side, that's usually one of the best ones, 9 out of 10 patients usually find relief from that. Because everyone is kind of constantly up here like this, but just like Dr. Charnoff said, anything like constant movement, getting up, changing position, is going to be just generally good for your entire spine, especially your low back. >> Yeah, I love the chin tuck, I think it's hard for people to understand but as you kind of come forward, the only way to see the screen or see someone you're talking to is to kind of prop your head up, so then your holding up your head with your neck extensor muscles and you're doing that for a long period of time.

Another stat I've found was tilting your head 30 degrees equals about 40 pounds of pressure or strain on your neck, 60 degrees is about 60 pounds of force. So you know we're naturally born, most of us, with this lordosis of the neck and that's how our neck dissipates force. By doing that chin tuck, you're coming back to that natural alignment and that really helps kind of get things back on track.

>> Alright, great. So I'm going to encourage everyone one more time, to put any questions in that Q and A button down there. While you guys are doing that, I'm going to punch up this quick quiz, you guys are going back just a little now. Just to see what you guys learned today and while we're doing that, can I ask both of you for any final, final pieces of information that you want to share with everyone? >> I think the biggest common theme here is you know, for these types of injuries it's about staying ahead of the curve, no pun intended, because we have the curves in the spine, but really just modifying you know, your workstation, your habits, whatever that may take in order to one, to complete the task that you need to and also to maintain a healthy spine, healthy body. And then you know, just very simply, more okay? We're kind of in a world where we stay stagnant because you know, we have occupational duties, family duties, whatever the case may be, you know, just try to get up, move around, so that way you can keep things, you know, moving.

You can keep things lubricated in your body and therefore you can disperse the force a little bit better. >> Yeah, for me I would just say, mindfulness is the most important thing. Like we go through our day so frequently on cruise control and hopefully this will just make you kind of wake up tomorrow and say huh, when I go to put my socks on I'm actually doing it really poor ergonomic form and then I realize every day when I go to breakfast after I put my clothes on, I feel kind of crumby. So there's just a million times in the day where you do something and you say, you do it on cruise control.

So being mindful and kind of understanding where your body is in space I think makes a really big difference. And especially when you're doing something for such a long period of time like working or you know, a hobby. So just be mindful and try to enjoy what you're doing. >> Alright, great. Thank you, guys. Let's see how everyone did.

Great job, I think you guys were studying beforehand. Alright, so I guess, do we have any more questions in the chat? Let's see. Someone said, do you have any go-to mobility exercises for the hip? >> Yeah, you know, besides the theme of movement, just simply standing up and kind of just going through circles of the hips or basically kind of bringing your hip up, rotating it back and around. You know, I like to do that about five times, and then you also come around the opposite direction too, the hip is a ball and socket joint so it moves in all different types of planes, so it can get very tight or very stagnant in the sense that, because you're sitting a lot or you know, doing one motion a lot, so a lot of times just by loosening up in a rotation manner you kind of loosen up the whole hip. I know the question is kind of like oh, the front of my hip gets kind of tight. Hip flexor stretching, that is definitely a good thing to do.

There's a bunch of different ways to stretch your hip flexors out there, you know, but at the same time, sometimes it gets a little bit tough to do that in let's say an office setting or you know, kind of like a you know, a setting where you need space or you need certain equipment, so that's why I recommend just kind of standing up and just simply just moving your hip around or swinging your hip around in a circular motion in both directions. >> Yeah, I agree, I mean there's a lot of ways you can approach it. I think motion is the most important thing. You also want to assess why do you need the range of motion, like why are you restricted. Are you actually restricted? A lot of people feel tight in the hip but it's actually, they might be hypermobile so you know, again, it's just understanding the cause and then kind of attacking it that way. >> Alright, I see somebody else said; where do you position your mouse on the desk.

I know you guys talked a little bit about arm positioning, do you have any opinions on the mouse? >> Yeah, so the mouse is also obviously a critical component. There's several different types of mice you could use but so, you kind of play with that in different underlying pathology will kind of steer you in one way or the other. But essentially if your elbow's at your side, you don't want to be overreaching. A common error that I'll see people doing is they may have the mouse on a higher level than the keyboard and they are contracting their rotator cuff muscles for hours on end doing this. And then you know, soon enough, they get pain in the shoulder and the scapula, the neck. So you want to again keep your elbows at your side, relax so that you're not engaging your shoulder or neck at all, but you're still using full range of your wrist, your hand, and your kind of rotating with internal and external rotation but in a relaxed manner.

>> Alright, and I see somebody else that I can't remember if you mentioned this, do you recommend those wrist cushion things? >> In certain instances they can be beneficial, particularly if you're noticing that you're having a lot of extends or like overuse where you're constantly kind of bringing your wrist up and you feel like you're engaging these muscles that cock your wrist up. So for the right person, it can be appropriate. I don't tell every patient to get something like that. That's more, you have a specific problem and we want to kind of offload that repetitive contraction. So I wouldn't necessarily say that's for the masses but can be implemented for the right patient. What do you think Anil? >> Yeah I completely agree, I think you know, just like anything, you really want to find the right reason you're doing it for.

And then also just like you know, you were saying, it's like can I keep my wrist at this position? Do I find myself constantly cocking it up this way throughout the day? You know, so again, we could use that wrist you know, mouse pad or whatever it is, you know, for maybe, maybe I'll use it for 30 minutes out of the day and try to wean off of it or something like that. Because I know, you know, you can easily fall into those bad habits when you have the desk there, you have the mouse there, and then you just constantly like this for you know, hours on end. >> Yeah, I agree. It's a good tool, don't get it hooked on it I'd say.

>> Yep. >> Alright, great. And I see someone else asking about, you know, they're noticing they're leaning into the screen, like you said not to do. Should I get a computer stand or should I get a blue light screen protector, I don't know if you guys opinions on that. >> I mean I think you know, if you're leaning into the screen like Dr. Charnoff was saying,

a lot of times it has to do with the volume issue so you're constantly creeping forward to almost hear, hear yourself better. Honestly, that's why I'm wearing these headphones right now so that way I don't do that. So maybe something as simple as using you know, headphones to [inaudible] that and then you know, with the blue light factor out there, there is a little bit of competing evidence between if blue light is a real thing or not. You know, I think you know, it really depends on your eyes too. You know, personally I need to wear glasses a lot of times when I'm staring at a screen for hours on end.

For this webinar I chose not to because it's not that long. But at the same time, if your eyes started to get that strain, you might want to think about that, for sure. >> Yeah, I think same thing.

It, the blue light is a more of a personal thing in my opinion. I would test it out, see if it works for you, if it does, go for it. For the monitor, that's more clear-cut in my mind, I would say you want it to be eye level so if you can get something that allows you to do that and have better ergonomics, I'm all about it.

If you're leaning forward it could be a volume issue, could be a visual issue, so it's a little small on your screen. It could just be your posture's not great and you got to address that with strengthening and kind of your chair, your whole setup. But definitely want you to ideally have the monitor, the top, your eye be at the top of the monitor and you're kind of starting from there. [ Music ]

2021-10-31 14:52

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