A Quick Guide to Easing Pain in the Workplace & Beyond Shara Ogin Copyright Copyright 2017 by Shara Ogin. All rights reserved. No portion of this book may be reproduced or transmitted in any form, electronic or mechanical, without the written permission of the publisher. The information presented here is designed to help you to work and live a happier, healthier life. It is not intended as a substitute for any treatment or protocol that has been prescribed by your doctor. To access Feldenkrais Audio Lessons, please see: http://tinyurl.com/ycd9evez Acknowledgements I would like to bring many thanks to those who helped me with the completion of this book. It has been a budding lesson which I have learned over the years that I don’t have to do it alone. Good help is there right when you need it. All you have to do is spread your wings of intention and inspiration. It takes a team to bring an idea to fruition. And through community so much more is possible. A special thanks to My great editor: Peter Weverka Illustrations: Kat Williams Book Interior Design: Eric Lam Book Cover Design: Ashley Laughlin Special images: My beloved fiancé Frank Kuehnel Photographs: Laurel Doremus, PT & Kim McKee, PT Nutritional info: Luminalight.com Table of Contents Introduction i 1 The Pain Cycle for the Office Worker 1 2 Ergonomics 11 3 Finding Comfort with the Keyboard and Mouse 27 4 Finding Comfort with Your Laptop 31 5 Balancing the Towards vs. Away Personality 37 6 The Eyes 43 7 Posture 51 8 Sleep 61 9 Diet 69 10 Foam Roller Excercises 73 11 Nerve Stretching 79 12 Exercises for Relaxing the Neck and Jaw 85 13 Therapeutic Taping Techniques 93 14 Entering the Realm of the Pain Body 97 15 Easing Pain Quick Reference 101 Appendix: Workshops and Consultations 113 Introduction Are you tired of that old pain in the neck? The ache in your back? Or the familiar pain that radiates down to your hand? Do you feel more fatigued at the end of the workday than you should? Many people struggle at work with a sore neck, tight upper shoulders, and occasional lower back pain. They brush it off as no big deal. Many people think this pain is “normal”; some blame it on old age. But why live a life in pain when you could live a life of vitality? We know that when people feel good, their productivity and happiness in the workplace increases. For almost two decades, I have treated office-related overuse injuries. In my work as a Feldenkrais practitioner®, occupational therapist, and ergonomist, I have developed the ability to quickly determine the factors that contribute to pain states. I have discovered many techniques for alleviating and preventing pain. This book presents the wealth of my experience as a health practitioner. It suggests ways to treat pain and describes treatment modalities that have helped my clients lead pain-free lives at work and at home. Occupational and physical therapy are excellent approaches to pain management, particularly in cases that are acute or of relatively short duration. Through such therapies, one can learn what causes pain and learn techniques for preventing pain. A knowledge of body mechanics, stretching, and exercise programs can help relieve pain. So can modalities such as electrical stimulation, ultrasound, heat, and cold. Many therapy clients respond to a combination of rest, ergonomic adaptations, the healing effects of time, and physical therapy, but some patients face stubborn, obstinate pain that Introduction just won’t go away. My focus over the past few years has been on treating these chronic and atypical cases, the clients who do not improve with the usual treatment regimens. When pain becomes more chronic, it has a wider impact on all the cells of the nervous system. Movement patterns become more undifferentiated and synergistic. Joints become more rigid and contracted. The muscles and viscera of the body, which are normally engaged when fleeing or on the lookout for danger, become activated during normal day-to-day activities. This book focuses on physical pain. It offers clear-cut pain- management and prevention strategies. Whether your pain is acute or chronic, this book offers quick-tip solutions to get you back on your feet again, feeling well and vibrant. I consider myself a teacher, one who teaches people how to utilize their minds and bodies more efficiently. A therapist, friend, parent or teacher can show you how to sit, stand, and move in a bio- mechanically correct way, yet until the movements are subcorticalized — in other words, ingrained at a subconscious level — the changes will be very short lived. My mode of preference for this motor re-learning is called Feldenkrais. This method is named after Moshé Feldenkrais (1904- 1984), a Ukranian-born scientist and judo master who founded it. He developed the method while rehabilitating from a recurring knee injury, in order to successfully avoid getting the surgery his doctors insisted he have. The specific lessons I have chosen are all geared toward helping you to improve your ease and comfort when sitting for long periods of time in the workplace (and elsewhere). Some people report a lowering or decrease of their physical pain states after performing these lessons. When performing the lessons (from the audio CD or see http://tinyurl.com/ycd9evez for an instant download), lay on a yoga mat, rug or carpet in a quiet space where you won’t be interrupted for 35 minutes (approximately). Keep a small pillow or towel close by to support your head if needed. During the exercises one goal is to reduce muscular effort in order to increase your ability to feel. In addition to somatic movement lessons this book offers: • Low-cost solutions for how to set up your workstation. ii A Quick Guide to Easing Pain in the Workplace and Beyond • Tips to prevent the onset of repetitive strain injuries. • Treatment suggestions for pain, swelling, eyestrain, and headaches • Diet and fitness tips Use this book as a guide to help you figure out what office equipment is right for you. Good equipment is not enough. I can’t count the number of times I’ve seen people, with awkward postures and excessive effort, use top-of-the-line ergonomic chairs and keyboard equipment incorrectly. After you become familiar with what a good fit feels like, you can adjust even the most basic office equipment to meet your needs. Office equipment should be fit to meet your needs, not the other way around. The equipment should be adapted to your body; your body shouldn’t adapt to the equipment. Over the past several years, the clients I treat for repetitive strain injuries have been getting progressively younger. In the social media and Silicon Valley companies I visit, it concerns me how individuals in the post-college age group carry themselves at their computers. They often hunch over their laptops with their heads rounded forward. Although most large companies have sufficient ergonomic programs, the individuals who work in these companies don’t utilize the services — until they experience relentless pain. Once pain begins, it is extremely difficult to stop. And once habits of poor usage become established, they are extremely difficult to break. That’s why I encourage all my young clients to instill good postural habits from the start, before the pain sets in. Treating office-related injuries can be easy if caught early enough and treated properly. Simply by correcting the workplace setup and adjusting the bio-mechanical use of your body, your pain and discomfort can readily be alleviated. Take my hand and, together, let’s stop the pain in its tracks! iii The Pain Cycle for the Office Worker D uring a workday, the typical office worker spends 7 to 7.5 hours in front of the computer. The office worker performs on average 10,000 to 15,000 keystrokes, or 1,730 keystrokes per hour. Sitting at a desk and tapping the keyboard takes its toll. By the end of the day, micro-tearing occurs in the fibers of the tendons, ligaments, and muscles. Micro-tears are microscopic tears that occur in the connective tissues of the joints, tendons, and ligaments. Because these tears are so small, they don’t result in any noticeable pain or constriction of movement — not at first, anyway. In a healthy individual, micro-tears repair themselves overnight. The ligaments and tendons are firm and strong by the time the office worker returns to work next day. However, when muscles become overworked over a sustained period of time, a single night’s rest may not be sufficient for the fibers to heal. An inflammatory response can result around the frayed fibers. This inflammation can impede the proper conduction of blood. It can pinch nerves and obstruct the flow of lymph, the fluid in the body’s lymphatic system that contains infection-fighting white blood cells. Eventually, overworked muscles start to fatigue, which has a negative effect on posture. You may find yourself hunched and rounded forward over your desk. As your back rounds and your head protrudes The Pain Cycle for the Office Worker forward, the muscles on either side of your neck and spine have to work overtime to counterbalance this forward gravitational pull of the head. The ribs in front of the body become more compressed, constricting the organic flow of breath. Most office workers also perch forward in their chairs, which strains the stabilizing muscles of the lower back. These muscles have to work harder to keep the body erect and upright. The result of all this is even more muscle fatigue. The office worker has to adjust his posture more frequently due to discomfort. Eventually he begins to utilize different, smaller, less-efficient muscle groups. Now muscles made for one purpose are being used for another, which can eventually lead to pain. If the office worker is experiencing stresses from work, pressures from home, and other emotional difficulties, these contribute as well to his or her suboptimal posture. The pain cycle has begun. This chapter takes a hard look at the pain cycle, how it progresses, and what its consequences are. Compression of the Nerves Besides slouching and bending over, an office worker when fatigued may put more weight on his elbows, forearms, and wrists. Too much sustained pressure on these parts of the body can potentially lead to a compression injury of the nerves, tendons, or arteries. When nerves and tendons in the wrists are utilized repeatedly to type and move, especially in combination with poor postures and compression, this creates a double whammy. The person becomes even more susceptibility to injury. Compression combined with movement of the wrists and hands puts the office worker in double jeopardy because friction is created where the tendons and soft tissues rub together. As soft tissues become irritated, they swell, which puts even more pressure on the underlying structures. The pinching, binding, or tugging around the nerves of these regions can inhibit nerve conduction. Delayed nerve conduction and impingement, in turn, can result in numbness, tingling, burning, and an aching sensation. 2 A Quick Guide to Easing Pain in the Workplace and Beyond Pain Cycle Muscles Overused • Ligament & MM micro-tears • Increased calcification • Soft tissue impairments Difficulty Sleeping Postural Shifts • Slouched sitting • Decreased healing • Rounded shoulders, of micro tears & head & neck soft tissues • Increased resting on elbows, forearms & wrists Thalamus Alerted Increased Demands on • Pain suppressing • Smaller muscle groups hormones released • Tendons & nerves • Increased fear & anxiety Resisted Tendon Excursion Decreased Circulation • Muscles work harder • Less O2 supply & toxin removal • Fluid accumulation 3