Posture and Comfort

by Hugh Babington Smith

The manager and the employee’s posture

You can take a horse to water, but you can’t make it drink.

Anon

OK, so posture is important and affects our lives in a myriad of ways. As an employer, you understand your responsibilities and know what you should look for. But what can you do?

You can and should provide the right legal framework for postural health, including access to information, good equipment and training. By doing all this, you put employees in a position where you have fulfilled all your obligations and it is now their responsibility to get it right.

This is actually very logical. Employees have a legal duty to comply with company health and safety policy and regulations. They also have their own interests at heart and posture is one area where, by following advice, they will feel the benefit very personally.

But what approach can you take, and how might you – assuming you have good relations with them – advise employees?

Respect privacy

As any manager is likely to be aware, there is a fine and sometimes moving line between what the employer can know about the employee and what is not up for discussion – between the public and the private and personal. Crossing this line, whether intentionally or not, can lead to great distress and a break-down in the relationship between you and your employee.

Health is a matter of privacy, until it becomes of relevance to the employer. For instance, a person may have a disease that does not affect their work, in which case the employer has nothing to say on the matter. But if the disease leads to persistent absence, it becomes an employment matter. For more on this, see the topic on Attendance Management.

Posture is more than just a simple health matter. Because of the nature of posture and the links between the physical and the mental, it is very personal. It may also be affected by things that are not the business of the employer – a simple example might be a case where an employee has a slumped posture because a relation has recently died.

It follows that you have to be extremely careful when tackling matters of posture.

Perhaps the most obvious principle to apply is that of relevance – is the posture, or the need for an improvement in posture, relevant to the needs of the business? Can you express this need in such a way that the employee sees the relevance?

Sometimes this is easy – for example, when the company has to comply with legislation. In other cases, a more subtle approach may be needed. For instance, a minority may be happy to do something if they see that the majority has to do it as well.

Remember

There is a link between posture and performance: while the cause of poor posture may not be relevant to the business, the effect almost certainly is.

Ten management steps

Here are ten things you can do which will go a long way to helping an employee have good posture.

  1. Encourage movement. This may include purchasing equipment that does this (such as a sit/stand desk), as well as changing the office layout (putting the printer out of reach, for example) and their habits (such as encouraging periodic walking about, simple exercises and doses of fresh air). In cases where musculo-skeletal damage is suspected, legislation also encourages you to consider changing the employee from one job to another – though this carries other implications.
  2. Check when work station risk assessments were last done. If a particular employee has moved work station or their tasks have changed considerably, a new assessment is required. Even if it is simply a long time since the last assessments (say, a couple of years), consider having them done again. Remember the aim, though, which is to reduce the risks.
  3. Consider investing in some postural training by a properly qualified person. Understanding the causes of pain and discomfort is fundamental to doing something about them and is very effective in reducing risk.
  4. Provide information. The HSE is a rich source of pamphlets and advice – use them and anything else that helps, taking care that the advice is authoritative.
  5. If there is a problem and the work station risk assessment has not solved it, ask Health and Safety or HR to find some external professional postural advice.
  6. Try to get any problems solved on site. Sending people to a clinic will only partially elicit a work-related cause. Professional studies show that many doctors have little knowledge of occupational health and RSIs in particular.
  7. If on-site postural advice has still not solved the problem, then the cause could be outside the office (for example, an RSI from playing the piano for many hours after work). While it is in your interest to find the solution externally, clearly you will have to tread carefully. However, most people in pain will be willing to accept some intrusion into their private life provided it is tactful (a good investigation will require a detailed medical history). You could therefore suggest that professional advice is sought to cover life outside the office.
  8. If this has still not worked, there may be some underlying medical cause that needs a different approach.
  9. Be sympathetic to apparent problems, even (or particularly) if you do not have trouble yourself. Not being believed by the employer is a recipe for the breakdown of trust.
  10. The quicker you act, the more likely it is that future problems will be avoided. There is a wealth of evidence that shows that the more action is delayed, the longer the rehabilitation. In severe cases, this may be never.

Choosing a chair

Chair technology is advanced. However, companies still manage to choose chairs that look nice and cost a lot but do not have one or more of the essential adjustments.

The features of an ergonomically well designed chair are as follows:

  • The seat height is easily adjustable, with a pneumatic pedestal base
  • The backrest is easily adjustable to support the lumbar spine vertically (height) and horizontally (forward and backward) and is narrow enough so that the worker’s arms or torso do not strike it if rotation is required
  • The seat tilts forward and backward independently of the backrest – this feature is useful with fine detail work or office work
  • The seat edge is curved, to reduce pressure behind the knees
  • Enough space is provided between the back of the chair and the seat to accommodate the buttocks
  • The adjustable armrests (optional) are small and low enough to fit under the work surface and to support the back when the worker works close to the work surface
  • The base has five points to prevent the chair from tipping
  • The worker can make adjustments easily with one hand while seated
  • The upholstery fabric is comfortable, reduces heat transfer in warm climates and static electricity in cold weather, and is stain resistant or easily cleaned
  • Training is provided to ensure that workers are familiar with the features and adjustments of an optimally fitting chair.

An ergonomic chair, as with all ergonomic equipment, will not be effective unless it fits the worker properly. Workers must be trained to adjust the chair or equipment for proper fit and use.

Tip

It is often difficult to find a seat that tilts forward and backward independently of the armrest, but it is worth hunting for one as this is an extremely useful feature.

Ten point sitting

The following list is taken from a postural workshop and is presented here to help you, the manager. Most people will be able to do most things on the list, but to get the full benefit, it should be used as a reminder of training received. Read it in conjunction with the section after it – the four sitting positions.

Note that changing your posture often requires only minimal adjustments.

Don’t worry if it feels odd at first. Your brain has your ‘normal’ posture ingrained and needs to be reprogrammed! Persevere and you will achieve gradual change as your deep postural muscles get fitter and any initial teething pains recede.

  1. Sit with your feet and knees apart and with your feet under your knees (not under the chair), with the seat base slightly tilted forward and down.
  2. Your hip joints should be slightly higher than your knee joints.
  3. Roll your pelvis into the mid-position (the lower spine is gently curved forward).
  4. Sit tall, tip your trunk forwards and wriggle right into the back of the seat.
  5. Carry your chest actively and get the shoulder blades in contact with the back of the seat (just behind the vertical) by pushing gently with your feet into the floor.
  6. Relax your shoulders and let your upper arms hang vertically.
  7. The lower arms should be horizontal or wrists slightly lower than elbows when typing. This governs how high the chair seat should be.
  8. The wrists should be held in the mid-position in mid-air while typing.
  9. The top of the screen should be at eye height (depending on glasses, this may have to vary) in order to have head, chest and pelvis in one plane. The head is then in balance. Documents should be placed between screen and keyboard to avoid twisting.
  10. The mouse should be as close to the edge of the desk and the mid-line as possible and moved from elbow and shoulder not with wrist and fingers.

The four sitting positions

We are not always using the computer when we are at our desk. We may be writing notes, talking on the telephone, thinking or talking to someone else, so we cannot (and should not) always be striving to hold the computer operating position described in the previous section.

Below are the four basic sitting positions, all with the common rule of head, chest and pelvis in one plane.

1. Supported upright position

Use this when writing, reading at the desk and typing:

  • Trunk and back support about 5-10 degrees behind the vertical
  • Feet apart
  • Second toe, mid-ankle joint, mid-knee and mid-hip joint in one plane
  • Push buttocks as far back in seat as possible, while pelvis is upright
  • Lean back into upright back support, keeping pelvis, chest and head in one plane
  • Upper arms should be vertical, lower arms horizontal, and screen at eye level.

2. Active free sitting

Use as above, plus when your attention is in front rather than on the desk: for example, during computer work and conversations:

  • Trunk about 5-10 degrees forward inclined
  • Buttocks come forward slightly away from the back support
  • Foot and leg position as in No 1
  • Tip from the hip slightly forward and feel some weight going through your legs.

3. Supported reclined

Use when thinking, dreaming, talking on the telephone or reading on the screen:

  • Allow the backrest to go further back. This is only for thinking or reading, as you should not reach for the keyboard from this position.

4. The supported forward-inclined

Use this when writing by hand or reading papers on the desk:

  • Push your chair further away from the desk
  • Head, chest and pelvis in one plane
  • Tip forwards from the hip
  • Rest lower arms on desk while keeping shoulders away from ears!

What about that feet-on-the-desk position?

Funnily enough, if you can keep to the ‘head, chest and pelvis in one plane’ rule, this can be acceptable – at least posturally! And there are other positions, such as leaning forward onto the back of the reversed chair (only possible with some chairs), which may be fine, if one can keep to the one-plane rule.

The ten postural sins

The punishment for these is discomfort, pain, agony, damage, loss of work, loss of pleasure...

  1. Holding the phone between shoulder and ear
  2. Poking your head forwards
  3. Operating a mouse too far away and with only the fingers and wrist
  4. Curving the lower spine backwards with the chest sunk in
  5. Sitting on a chair with one leg crossed over the other
  6. Slouching and twisting to get something out of a bottom drawer
  7. Not taking a few deep relaxing breaths every so often
  8. Not moving
  9. Working without a break
  10. Not having a sense of humour.

Also see the page on Display Screen Equipment in the topic on Health & Safety.