4 Physical Therapy Keys to Workplace Wellness for New York City 

Workplace Injuries Requiring Physical Therapy: Sprains & Strains 

Sprains and strains are surprisingly common injuries that occur in typical hard working New York City office environments.    Back strains surface from extended sitting with poor posture, sudden twisting movements, or improper lifting of heavy boxes or equipment.  These ailments are typically recognized as lower back pain, muscle spasms, stiffness, or difficulty bending or standing upright.  

Neck strains also emerge from extended and continuous sitting, forward looking with head posture fixed directly at the screen (computer) in a workstation setting where the ergonomics have not been well sorted out and tailored for the employee. These ailments are typically recognized as neck pain, stiffness, headaches, pain radiating to the shoulders or upper back.

Wrist sprains and strains commonly result from repetitive typing or mouse use, leading to carpal tunnel syndrome or tendonitis.  These ailments are typically recognized as wrist pain, numbness or tingling in the fingers and or weakness in grip strength.  

Shoulder strains are generally caused from reaching for items on high shelves, carrying heavy bags, and or poor posture while typing. These ailments are typically recognized as shoulder pain, limited range of motion, difficulty lifting the arm.  

Ankle sprains are seen with trips and falls in the office that bring ankle pain, swelling, bruising, difficulty bearing weight. Knee strains often come from awkward positions under desks or repetitive stair use and something called “mouse elbow” (strain/tendonitis) can emerge with repetitive strain from using a keyboard.

Workplace Injuries Requiring Physical Therapy: Repetitive Strain Injuries from Office Work / Ergonomics

Repetitive Strain Injuries (RSI’s) develop gradually over time due to repetitive motions, awkward postures, and overuse of certain muscles and tendons.  Some of the most common RSIs we see in New York City office environments include:

Carpal Tunnel Syndrome, affecting the wrist and usually a result of compression of the median nerve in the wrist due to repetitive typing, mouse use, or other hand movements.  Typical symptoms are numbness, tingling, and pain in the hand and fingers, particularly at night.  

Tendonitis, which can affect any of the body’s approximately 4,000 tendons, but most commonly strikes in the wrists, elbows, or shoulders with pain, tenderness, and stiffness (often worse with movement).  The tendons become painful, tender or stiff once inflamed, which is usually due to repetitive motions or over use (typing, mouse clicking, etc).

Something called, “De Quervain’s Tenosynovitis” affects the tendons on the thumb side of the wrist, causing pain and swelling at the base of the thumb.  This injury is often triggered by repetitive gripping, pinching, or twisting motions, such as those used with a mouse or keyboard.

Lastly we also see “Thoracic Outlet Syndrome” which involves the compression of nerves and blood vessels in the space between the collarbone and first rib.  This injury can cause pain, numbness, and tingling in the neck, shoulder, arm, and hand, and is often due to poor posture and repetitive arm movements.

Workplace Injuries Requiring Physical Therapy: Back Pain from Office Work / Ergonomics

Back pain is another common ailment found in New York City workplaces, most often stemming from extended sitting and when coupled with poor posture (slouching, hunching forward, or leaning to one side strains back muscles, ligaments, and discs) places excessive pressure on the spine, discs, and muscles.  All of this of course can be exacerbated by poorly designed office chairs, fatigue and bad ergonomics (monitors too low or keyboards too high forcing awkward postures).  

Also contributing to back pain in the workplace are weak core muscles which are then unable to provide the needed support for the spine, leading to increased strain on the back and an elevated risk of injury. Core muscles become weak from years of living a sedentary lifestyle and insufficient exercise.  

Additionally, lifting heavy objects incorrectly, such as bending at the waist instead of using the legs, can strain back muscles and even cause disc herniation.  Lastly we can never dismiss how stress in and of itself can lead to muscle tension, including in the back, contributing to pain and stiffness.   A high-pressure work environment, long hours, and lack of work-life balance can be drivers to stress-related back pain.

Workplace Injuries Requiring Physical Therapy: Neck Pain from Office Work / Ergonomics

Neck pain is a common complaint in the workplace wellness and what we most commonly see in New York City offices is referred to as “Tech Neck”.  “Tech neck” is a repetitive strain injury caused by prolonged forward head posture when looking at devices. This generally produces muscle imbalances, stiffness, and pain from straining neck muscles and joints. Static postures (Tech neck) of holding the neck in the same fixed position for extended periods, even if seemingly “good” posture, can fatigue muscles and restrict blood flow, leading to pain and stiffness.  

This is commonly exacerbated by poor ergonomics, a computer workstation setup not tailored and aligned to the user including desk height, chair type, monitor placement, and keyboard/mouse positioning, – all which can force a person into awkward postures and strain the back.  Repetitive motions like constantly turning the head to look at documents or using a second screen can also strain neck muscles and tendons.   Lastly and it can never be noted too much, stress in and of itself can lead to muscle tension, particularly in the neck and shoulders, contributing to neck pain and headaches. 

Workplace Injuries Requiring Physical Therapy: Shoulder Injuries Acquired in Office Workplace / Ergonomics

Shoulder pain is a frequent complaint among office workers and  the most common culprit we see in New York City workplaces is poor posture (slouching, hunching forward, or rounding the shoulders) straining the muscles, tendons, and ligaments in the shoulder, leading to imbalances, stiffness, and pain. Poor posture is easily slipped into from prolonged sitting, fatigue, lack of awareness, and poorly positioned ergonomics.   An improperly set up workstation, including desk height, chair type, monitor placement, and keyboard/mouse positioning, can force the shoulders into awkward positions, leading to strain and pain.   Repetitive motions like typing, using a mouse, or reaching for objects overhead for items on shelves or in cabinets can also strain the muscles and tendons around the shoulder and rotator cuff, leading to inflammation and pain.   

What’s a Workplace Ergonomic Assessment?

As  physical therapists, we approach a workplace ergonomic assessment as essential for those who spend time at a desk with a computer and focus on preventing injury and optimizing the person’s well-being while working.   Here’s what you can expect in having us come to your workplace to perform an ergonomic assessment for workers:

Everything starts with information gathering centered on understanding a person’s work task while at a desk.  We’ll be very precise and want to know if the person engages in typing, mouse use, phone calls, writing, etc.   We’ll learn how much (time) during the course of a day goes to each task and we will want to see the devices (keyboard, mouse, phones, etc)  being used.   We’ll then ask about any existing pain points with respect to the neck, back, wrists, eyes and when does that pain generally occur?  We’ll also want to know if any breaks are taken, how often does the person stand up at all and or of any personal break strategies now being used. 

Observation comes next wherein through the lens of a physical therapist  we watch the musculoskeletal movements of the person at work noting posture and spinal alignment while engaging in each task.   We’ll observe details such as the demands on the neck, any stressing of the wrist, interaction with devices, observing lighting conditions and more.

If a person describes a pain point, we may engage in a physical assessment checking for neck, shoulder, back, and wrist mobility and any restrictions.   We’ll determine if key muscle groups have any imbalances or weaknesses (e.g., neck flexors/extensors, upper back, core, etc). If there are any specific concerns indicated we can perform tests for conditions (e.g., carpal tunnel).

Focus then turns to the desk-computer or ‘workstation’ setup.   Relative to the person, there’s basically a 6 point checklist to determine:  

1. Chair: Proper height, lumbar support, armrests adjusted correctly?
2. Desk: Appropriate height, enough legroom, keyboard tray if needed?
3. Monitor: Positioned at eye level, correct distance, minimal glare?
4. Keyboard/mouse: Close enough to avoid reaching, elbows at 90 degrees?
5. Phone: Headset use? Proper positioning to avoid neck strain?
6. Lighting: Adequate lighting to reduce eye strain? Glare reduction?

This completes the assessment and at this juncture with all this information gathered we’re able to offer advisory and education on:

• Posture correction: Provide specific guidance on seated posture, including head, neck, and back alignment.
• Ergonomic adjustments: Recommend adjustments to workstation setup based on the assessment.
• Movement and breaks: Prescribe specific exercises, stretches, and micro-breaks to counteract prolonged sitting.
• Equipment suggestions: Advise on ergonomic equipment (e.g., keyboard trays, alternative mice, monitor arms) if needed.
• Self-management strategies: Offer workers insights and tips on how to maintain good posture and prevent discomfort.

By conducting a thorough ergonomic assessment, we can help employees optimize their immediate work location, improve their posture, and reduce their risk of developing musculoskeletal problems (carpal tunnel, back pain, and neck strain)  and optimize their wellness so they are the best versions of themselves. 

Research indicates that multi-component interventions are most effective for improving ergonomics in the workplace. A multi-component physical therapy intervention means using a variety of techniques to address employee discomfort and improve their work environment. This includes individualized assessments of posture, movement, and workstation setup; hands-on treatment for muscle tension and pain; targeted exercises to improve strength and flexibility; and education on ergonomics and self-care. This comprehensive approach is exactly what Palmer Concierge Physical Therapy specializes in and aims to prevent injuries, reduce pain, and educate employees to actively participate in their own well-being, leading to a healthier and more productive workforce.

Consistent with the research, here are the key takeaways we want employers to know:

• No single solution: There’s no magic bullet (single solution) for preventing musculoskeletal disorders or boosting productivity through ergonomics.
• Comprehensive approach is key: Successful ergonomic interventions combine multiple elements, including workstation design, employee training, and ongoing support.
• Participatory ergonomics: Involving employees in the process, providing long-term follow-up, and making adjustments based on feedback are crucial.

Tailored interventions: Different work environments require different approaches.  For example, some employers have 2 monitors on their desk introducing a separate set of issues than an employee that only has 1 monitor at their desk.  Ergonomic interventions should be adapted to specific needs.