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HOLDING YOURSELF FOR ANY LENGTH of time in any still position will negatively affect the health of your body. This is not limited to your work station. Holding smart phones, tablets and/or laptops in your lap causes you to look down for extended periods of time. This strains not only your neck, but your spine, shoulders, wrists, and more.

We healthcare providers are seeing the effect of this at such a degree that we’ve coined the term “iPosture” for people who are experiencing poor posture and pain as a result.

To combat “iPosture,” the first, most important prevention is movement. While you are standing or sitting for a prolonged period of time, the second key preventative behavior is keeping your spine neutral as much as possible. When looking at your smartphone (using it for its computer or texting capabilities, as opposed to using it as a phone), hold it high enough so that your neck remains neutral, not bent at an angle or bowed. In other words, hold your phone higher than your lap, ideally at eye level.

When working on your laptop, use it on a desktop or tabletop that allows your forearms to rest at about a 90 degree angle, parallel to the desktop, without slumping or hunching your shoulders. Despite the name, do not work with your laptop on your lap because you’re likely to hunch your shoulders and kink your neck to look downward too long.

Here is my posture advice for people who find themselves in front of a computer for extended periods of time. Follow these suggestions to set up your working space in a way that will to minimize problems caused by poor posture. Just remember to move every 20 minutes, no matter how proper your posture is.

Points 1-6 below are advisable for both seated and standing work stations:

1. Keep your chin tucked in and head back, so your ears are over your shoulders. Jutting your head forward causes your chin to tilt up so you can see what is in front of you. This posture causes compression to the posterior parts of your neck, including the discs between your cervical vertebrae, the nerve rootlets that run down your arms to your fingers, and strains your posterior neck muscles. The further your ears are in front of your plumb line (the center point of gravity), the more compression you cause. A deep slouch will even put pressure on your spinal cord (just minimally, but still, no pressure on your spinal cord can be good).

2. Your eyes are “lazy,” and like to tilt downward about 15 degrees. If your monitor is too high, you will end up tilting your chin up so that your eyes can tilt down. This results in compressing your posterior neck. So bring your monitor to the level such that when you tilt the monitor back 15 degrees, the eyes naturally look at the middle of the screen. Your screen should be able to tilt and swivel. The surface should be flicker free and reflection free.

3. It would be optimal to have a window to look out periodically to exercise your eyes. If you do not have a window to look out of, go to a window to look outside and focus on a distant object every time you leave your workstation. More on this in Chapter 8.

4. To ensure your wrist is in a neutral position, make sure your wrist is not flexed, and that the bottom of your wrist forms a straight, flat line from your forearm through the palm of your hand, as in the illustration below: as you’re looking down at your hand, the top of your hand should look like it is bent, tilting upward. In this position, the carpal tunnel will have more space for the median nerve traveling through it. If you do the opposite, as in the next illustration, having the straight line run along the top of your forearm, wrist, and hand, you will compress the carpal tunnel. This position is likely to cause irritation of the median nerve, which can result in carpal tunnel syndrome (pain and numbness in the palmar aspect of the wrist, thumb, index and middle fingers.)

5. Your mouse and keyboard need to be at a height to allow your elbows to be at 90 degrees at your sides, such that your lower arm is horizontal (parallel to the floor). A good chair will have an adjustable height to be able to make the adjustments needed for correct arm and leg positions. A good standing desk will have an adjustable height to allow for correct arm positions.

6. Keep your upper arm vertical, with your chest open and shoulders relaxed back and down. If you are standing, make sure your knees are soft and your feet are hip width apart. Wear comfortable shoes and stand on a thick, rubber mat.

Points 7- 12 are specific to seated work stations:

7. Your seat should be at a level so that your knees are 90 degrees and your feet are flat on the floor. For those who wear high heels, this is a good time to take them off (no one will see your feet under your desk). This is a good time to stretch your toes to help prevent bunions and hammer toes.

8. Make sure your low back is supported by a lumbar support pad in the chair or a lumbar support pillow. A good chair will have an adjustable back rest height and angle to provide you with proper support specific to your needs. Many shorter-than-average or taller-than-average people should look for chairs made specifically for their size. Remember, if you’re spending many hours a day in a chair, it’s worth the investment of having one that fits your body properly! If you are one to wear a wallet or store other items in your back pockets, make sure to take them out of your pockets while you’re sitting, to avoid a pelvic tilt that can throw your whole spine out over time.

9. The base of your chair needs to be solid (a five star base if it is mobile with wheels). Make sure the floor is level and flat. I have had patients come in with chronic back pain, only to discover that their treatments were not lasting because the floor at their work station was not level. If your floor isn’t level and you have to work to hold your rolling chair in place all day long, you will strain your back muscles unevenly, constantly pulling the spine out of alignment.

10. Do not sit crossed-legged, as doing so twists your pelvis causing additional strain to your spine. Crossed legs also interfere with your veins’ ability to pump blood back from your legs toward your heart, potentially increasing your risk of developing varicose veins.

11. Your desktop should be thin for maximum thigh space, with the keyboard in front of you.

12. Repeating the advice from the previous section of this book: be sure to move often! Get up out of your chair (preferably once an hour) and move around to get your blood flowing again. Even if you don’t have time or the ability to walk away from your desk, marching in place or doing some squats will be very helpful. Big movements like these will keep you mentally fresher throughout the day, allowing for more productivity in less time; easily making up for the little time it takes to perform such mini-exercises. Thinking again of office ergonomics, one way to ensure that you regularly move throughout your workday is to keep items far from your reach, so you have to stand up and move to get them

i. Place your printer in a different room, so every time you print something you have to get up and walk to get it.

ii. Position your phone out of reach, to remind yourself to get up and walk around while you talk on the phone.

iii. Store your tissue box, stapler, extra pens, and anything you reach for throughout the day just beyond your arm’s reach, so you have to get up and move to get these things when you need them.


On a side note: pregnant ladies should be especially attentive to moving throughout the day. They should also completely avoid sitting cross-legged. It is my observation that pregnant women who sit for prolonged periods of time tend to end up with their babies breach.

Sitting cross-legged adds increased pressure to your lower pelvic bowl, and that pressure would work against the baby dropping head down in the last weeks of pregnancy. Maybe there will be studies to prove this one day. For now, I advise pregnant women to avoid sitting cross-legged. Instead, they should sit with their knees apart and the buttock pressed out and back, so there is plenty of room for the baby to drop down, especially in the last weeks of pregnancy.

To learn more, check out my book “Top Seven Ways to Combat the Effects of Sitting: The Silent Killer”. Available on Amazon.

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