Preventing Repetitive Motion Injuries at Computer Workstations

Executive Summary

Repetitive motion injuries can be some of the most expensive and debilitating injuries. It’s important that healthcare organizations, as employers, are appropriately addressing repetitive stress injuries in the workplace. Healthcare organizations must understand both their risk and how to help prevent their employees from sustaining such injuries. 

Recommended Actions 

• Consider implementing an occupational safety policy in your healthcare organization that addresses prevention of repetitive motion injuries.
• Encourage your employees to work on flexibility and strength to help prevent repetitive stress injuries. 
• Encourage employees to incorporate ergonomics into their workspaces by sharing the following tips and best practices.
• Repetitive motions on the job can cause repetitive strain or stress injuries to the musculoskeletal system. Appropriate controls can prevent these problems by using devices and techniques that are more in line with how a worker’s body naturally moves.

Injuries from repetitive motion can come in many different forms, including forceful heavy lifting, frequent pushing or pulling of objects, and prolonged awkward positions.

For repetitive strain injuries resulting from the same type of work for prolonged periods of time, encouraging breaks can be the best preventive measure. Employees who spend most of their day in front of a computer should follow the 20-20-20 rule: they should stop their work every 20 minutes and look at something 20 feet away for 20 seconds. In addition, employees involved in any sort of prolonged exposure to one task should take a break every two hours and perform the following exercises: 

• Head and neck stretch: Slowly turn your head to the left and hold it for three seconds. Slowly turn your head to the right and hold it for three seconds. Drop your chin gently toward your chest, and then tilt it back as far as you can. Repeat these steps five to ten times.
• Shoulder roll: Roll your shoulders forward and then backward using a circular motion.
• Upper back stretch: Grasp one arm below the elbow and pull gently towards the other shoulder. Hold this position for five seconds and then repeat with the other arm.
• Wrist wave: With your arms extended in front of you, raise and lower your hands several times.
• Finger stretch: Make fists with your hands and hold tight for one second, then spread your fingers wide for five seconds.

The placement and arrangement of equipment around the office can also reduce repetitive motion injuries. The following workstation measures can prevent long-term exposure to awkward positions and reduce repetitive stress injuries:

• Avoid reaching more than 18 inches for work items by keeping frequently used items within easy reach. Place input devices close to the keyboard and within comfortable reach with the arm close to the body and the wrist neutral. Ensure that there is sufficient space on the desk to prevent having to reach.
• Use minimum effective force to operate a hole punch, stapler, keyboard and similar equipment.
• Maintain space below the desk to permit changes to posture.
• Chairs should be padded, stable and mobile, and should swivel and allow operator movement. Adjust the backrest of a chair vertically so it supports the curvature of the lower back.
• Sharp desk edges can create contact stress on wrists. Padding or rounded desk edges can mitigate the impact. The support will also allow the user to type without bending the wrists.
• Place monitors directly in front of the user between 20 and 40 inches away. The top of the monitor should be at or below eye level, with the center of the monitor around 15 to 20 degrees below horizontal eye level.
• Make sure keyboards are easily accessible and comfortable. They should align with the user's posture. Adjust keyboard height to allow fingers to rest on the home row when the arm is to the side, elbow between 80 and 120 degrees, and the wrist straight. An alternative keyboard is likely to reduce awkward wrist posture.
• If standing for prolonged periods, stand with the torso upright to keep the natural curve of the spine in a comfortable position.

Employers can help employees achieve these safety measures by: 

• Assessing employees’ workstations, including their chair, keyboard, monitor and general work area to ensure compliance with the recommendations above.
• If needed, providing new equipment such as chairs with adjustable height and back, wrist pads and alternative keyboards.
• Finally, addressing employee complaints in a timely manner and providing resources they need will reduce the severity of repetitive motion strains in the long run.

Ultimately, micro-breaks and ergonomically well-designed workstations can have a dramatic impact on worker comfort by allowing employees to perform their tasks without strain while better maintaining their overall health and well-being.

Additional Resources

• Occupational Safety and Health Administration (OSHA) - Ergonomics
•  Human Factors and Ergonomics Society - Learning Center

Lessons Learned 

• Ensure that your healthcare organization has a process in place for employees to raise any workplace concerns or complaints.
• Ensure that your organization appropriately responds to employee complaints in a timely manner.
• Consider implementing occupational safety training that addresses repetitive motion injuries and prevention methods.

Potential Damages

Healthcare organizations that do not appropriately prevent repetitive motion injuries or that inappropriately respond to a repetitive strain injury could face a costly and time-consuming worker’s compensation lawsuit. Although relatively infrequent, the costs of these injuries to employers quickly add up.