EBHSG - NOVEMBER 1996 MEETING NOTES

TOPIC: "REDUCING STRESS AT HOME AND IN THE WORKPLACE"

Leslie Wenz, a physical therapist, spoke at the November 12, 1996 meeting. 26 people attended this meeting, which was held in the Ball Auditorium at John Muir Medical Center from 7:30 to 9:00 PM.

Leslie specializes in orthopedics and ergonomics, and is especially interested in migraine headaches as her daughter suffers from them. To understand headache pain, one must look at anatomy, posture, and body mechanics, and practice self-management tools.

Anatomy:

The muscles and bones of the body form a shell, with blood vessels (arteries and veins) inside. Muscles run from the neck up to the head.

Identify your headache:

Most headache sufferers experience migraine or tension headaches, but some have both.

Symptoms of a migraine headache:

One-sided.

Experience bright spots, or blurred vision, before the pain sets in.

Occurs at the same time each week or month.

Physical activity makes the headache worse.

Symptoms of a tension headache:

Feels like a tight band around the head.

Pain in neck or shoulders.

Pain after activity.

Clenched jaw, or teeth grinding.

"It isn’t your brain that hurts when you have a headache."

Headache Triggers:

Shifts in body chemicals, such as hormones.

Certain foods and drinks.

Environmental stresses (muscle tension), such as poorly positioned equipment, poor posture and body mechanics, poor cardiovascular fitness, poor lighting.

Anatomy: Look at the whole body.

Anatomy of the spine: There are 33 vertebrae. There is a disc between each vertebra, which permits free motion.

Ligaments connect bone to bone.

Spinal cord—1/2" thick cable 18" long.

Nerves—send orders and information from the brain to the muscles.

There are over 400 muscles in the human body.

Good Posture:

Prevents headaches, dizziness.

Minimal strain and stress on muscles.

Prevents fatigue.

Promotes good circulation.

Develops body awareness.

Feels good.

Everyone’s curves are different. There are four areas of the spine: cervical, thoracic, lumbar, and sacral pelvic.

Good posture means your ears are over your shoulders, over hips, and over ankles. You have more movement with good posture. Leslie had us try different postures to demonstrate a neutral spine position.

Forward Head Posture:

"C" curve. The neck and upper back muscles work harder to hold the head steady. Your head weighs ten times as much when held in a head forward position.

Car Seats:

Many are angled downward, which causes one to slump when driving. Reduce the down-ward slope of the seat—make it more level and/or use a lumbar roll behind your back.

Watching TV:

Feet should be flat on the floor. Maintain a neutral spine position.

Sleeping:

Sleep on a firm mattress. Sleeping on your back is best. Use a pillow under your knees and around waist. Use a flat pillow for your head, and add extra support for your neck. Sleeping on your side is also preferable to sleeping on your stomach. Use a pillow between your knees and around waist. Support your head and neck—maybe use a double pillow. Put a hand towel in your pillowcase to support your neck. This is better than using a cervical pillow which is often too big.

Vacuuming:

Keep your arm at your side, and avoid twisting and bending.

"Good Body Mechanics is good posture in motion."

No forward head.

Reach up to shoulder height only—no higher.

Use a deep squat to pick up something.

Tighten your stomach muscles.

Pushing a heavy object is better than pulling it.

Use your leg muscles to do the heavy work.

Use your strongest muscles (whole body) rather than fingertips.

Tips to create a good workstation:

Adapt your chair to your body, not the other way around. The chair should have lumbar support, adjustable height, tilt forward (or use a wedge), and the seat should have enough depth and width. Your hips should be level with your knees, or higher.

Sitting at your workstation: Align your body an arms length from your PC, keep elbows under the shoulders, and wrists straight. Writing at your desk is forward work. Get close to the desk, and maintain a neutral spine position when reaching. For regular work, hold your hands at elbow height. For heavy, forceful work hold your hands 4" to 6" below the elbow, and for fine work, hold hands 4" to 6" above the elbow.

Standing: Use an anti-fatigue mat. Stand with one foot in front of the other.

Buy Spanko inner soles, to cushion your feet when standing for long periods.

When sitting in a recliner chair, support your back with a rolled-up towel.

Reading: Read at eye level.

Lighting:

Check for glare.

Add task lighting.

Block window light

Use anti-glare filter or hood over monitor.

Use maximum brightness without blurring.

Daily Routine:

Get up, slightly alter chair height. Every hour shrug your shoulders, shake hands,

focus on breathing.

Stress is a big issue—think positively. We have high workloads, high responsibilities, and low control. When under stress we exhibit the fight or flight response.

Some ways to relieve stress:

Sigh.

Use deep abdominal breathing.

Drink 8 glasses of water per day.

Don’t use alcohol, tobacco, or caffeine.

Leslie’s top ten things to reduce stress were presented, and are listed in the attached handout.

To relieve a migraine headache, you might try using a cold compress, shield your eyes, drink liquids.

For a tension headache, try massage (especially on the scalp) and moist heat.

Two exercises Leslie taught the group are the Forward Push (put fingertips on your forehead and press) and the Neck Press.

A second handout, also attached, presents a three-minute workout designed to reduce stress while sitting or standing at your workstation.

Keep fit—Exercise at least 20 minutes, three times each week. Weight control is essential.

When working, get up and move frequently (every 20-30 minutes), and do the 3-minute workout (at least some of it) every hour.

How to recognize if you are stressed:

Clenched teeth: Concentrate on relaxing the bottom jaw so your teeth don’t touch.

Grinding teeth.

Forward head posture: Get your ears back over your shoulders.

Cold, clammy hands.

Shallow breathing.

When sitting at your computer, follow these guidelines: Position your monitor so that the top of the screen hits the middle of your forehead. The top one-third of the screen is to be at eye level. Don’t use bifocals when looking at a PC.

For desk work (a forward task):

Sit close to your work.

Hinge from the hip.

Keep chin tucked.

Keeps hips higher than knees.

Keep spine straight.

Your hands should be 4" to 6" higher than your elbows.

Keep your ears over shoulders.

For an ergonomic evaluation of your workplace, call John Muir Physical Therapy, and ask for a "worksite assessment."

The important thing to remember is to adapt your worksite to your body, not the other way around.

When using a document holder, keep it at the same level as your eyes.

The notes provided above were taken by an EBHSG volunteer and have not been reviewed by the speaker for accuracy. If you have any questions regarding the notes, please contact the EBHSG.

The intention of the East Bay Headache Support Group is to provide information and resources. It does not provide medical advice, which should be obtained directly from a physician.