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HR Update: Dealing with RSI in the workplace

HR Update: Dealing with RSI in the workplace


MARK WALKER:
My name is Mark Walker. I’d like to welcome you to this webinar, AbilityNet webinar and
we’re going to be looking at how you deal with RSI in the workplace. The session is due to last about 45 minutes
with about 30 minutes worth of presentation and then time for you ask questions. I’ll
answer any particular points you may have at the end. We’re going to be looking at several issues
today; we’re going to be explaining what an RSI is, what they might be and how the
better term for them is ‘work-related upper limb disorders’. We’re going to be looking at what causes
them, what is the impact, what adjustments can help in the workplace. We’ll be talking
about what sorts of equipment you’ve already got and the setup you already have and then
other specialist options that may require you to bring in other hardware or software. All the way through we’ll be offering top
tips and we’ll be picking up a couple of times on an issue to do with mobile working
and how mobile laptops, tablets and smartphones, how that’s impacting on RSI and the sort
of issues that you might need to start thinking about as the workplace begins to change. So, we’ve got three people on the call today;
Sarah, hello Sarah. Can you hear me? Are you there Sarah? SARAH IRVING:
Yes I can, yes. MARK WALKER:
Great. SARAH IRVING:
Sorry, I’m here. Can you hear me? MARK WALKER:
Yes. A bit louder, that would be great. And Robin, you’re there? ROBIN CHRISTOPHERSON:
I am. MARK WALKER:
Hello Robin. Sarah, could you say who you are and what you do for AbilityNet? SARAH IRVING:
Yes. I’m Sarah Irving and I’m a Senior Assessor at AbilityNet. I have degree in ergonomics
and I’ve been accessing workstations and workplaces since 1997. I currently work on a number of contracts
both for large organisations and one-off assessments for individuals and small companies and upper
limb disorders count for a large part of my work and are very commonplace in offices and
industrial settings. MARK WALKER:
Great. Thank you. And Robin, can you tell us a bit about your background? ROBIN CHRISTOPHERSON:
Yes, I’m head of Digital Inclusion at AbilityNet. I’ve been here for forever and set up the
Web Accessibility Team back in 2003, I think it was, and now I’ve moved on to more of
an advocacy role. Public speaking, that sort of thing. If anyone’s got an event where they would
like someone to speak about the empowering potential of technology and accessibility
then drop me a line. MARK WALKER:
Great. Actually, the picture we’ve got up for your Robin, is you’ve got a pair of
Google Glass on. I wonder whether you’ve stopped wandering around with that on now. Talking about the empowering nature of technology,
so you were talking about Glass is that something you’ve stopped eulogising about now that
they’ve-? ROBIN CHRISTOPHERSON:
Not necessarily. They haven’t really hit in the market in a commercial way. It’s
more that there are obviously there are thousands of wearables and we should probably do a webinar
on wearables at one stage but yes the Apple Watch is obviously just around the corner
and that promises to be very exciting for people with disabilities as well. MARK WALKER:
Great. Thank you. And I’m Mark Walker, I’m the Marketing
Manager. I host the webinars. We two have webinars every month, as a minimum, sometimes
more, looking at topics related to assisted technologies and disability and web accessibility
and so on. You can find more information on our website
at abilitynet.org.uk/webinars. The other thing to say is this particular webinar is being
recorded so you’ll be able to watch a version back later. The slides are already available for download
at slideshow.net/abilitynet that might be easier for you to follow them that way rather
than any other way. We won’t have any captions on today but we do do a transcript of the
video before we publish it, so there will be a captioned version available once we’ve
completed the session, within the next week or so. Now if you do have questions as we go along,
please do use the questions box. I will try and bring the questions into the session as
we go through but there is a question and answer session at the end as well. Very briefly about what AbilityNet does: we
help disabled people at work, at home, in education and on the web. We help them in
lots of different ways. We have services for workplace support which Sarah has just briefly
explained and we’ll be looking at again in a bit more detail. We provided all the accessibility testing
of the websites for the London 2012 Olympic Games and Paralympic Games. We also have tools
like ‘My Computer My Way’, which is on our website, a free tool for how identifying
how to adjust your computer, your laptop or your smartphone and we’ve just launched
the Tech4Good Awards, which we run with BT for this year. It’s in the fifth year now.
So a whole range of different activities that we’re involved in. So let’s look at repetitive strain injuries
in a bit more detail, some quite shocking facts that we picked up when we were pulling
this together, 8.3 million working days were lost due to musculoskeletal disorders in 2013/14.
Not all of those are RSIs necessarily. We’re going to talk about the definition of that
in a second. But a huge number of people are affected by repetitive strain injuries. We’re all broadly aware I think of what
the sensation is and what the impact is on people’s physical discomfort but it’s
estimated that 15.9 days of absence are lost from work for each person, who has these sorts
of conditions and as many as 15% to 25% of computer users throughout the world may have
experienced RSIs. We obviously particularly associate them with computer usage in the
modern workplace. There are other reasons, which we’ll look at about how an RSI may
arise. The HSC has estimated that three out of five
office workers in the UK have some symptoms of RSI and the TUC has estimated that everyday
six people in the UK leave their jobs due to an RSI. So we’re going to look a little
more at the impact but this is why RSI is a big issue. These are big numbers and there
are large proportions of people who are dealing with the symptoms. Sarah, I’m going to ask you to look in a
bit more detail now, when we started talking about RSIs you immediately said to me, “They’re
not really RSIs, they’re other things: they’re upper limb disorders.” Could you put this
in context for us and tell us a little more about how an ergonomist sees RSIs? SARAH IRVING:
Yes, sure. RSI is the term that was widely used previously and it then became realised
that not all of these injuries are of a repetitive nature, so a lot of other phrases were coined.
Different people used different ones, so it can get a bit confusing. So some people still refer to RSIs, other
people – upper limb disorders, work-related upper limb disorders. The Americans refer
to them as cumulative trauma disorders but they’re generally umbrella terms for a wide
range of different conditions. And they’re usually things that can be caused,
or made worse, by work. Although other activities such as sports, homework, housework, hobbies
may be involved and RSIs are common in jobs that do require some amount of repetition
of finger, arm and hand movements, also twisty movements, squeezing, hammering or pounding.
Things like pushing, pulling, lifting or reaching and repetition force, awkward postures and
insufficient recovery time can increase the risks. They can be seen usually in the upper
limbs, the neck and shoulders. MARK WALKER:
Great and obviously the symptoms of all of those particular conditions, we would probably
recognise these sorts of descriptions. Can you just talk us through how we know that
we’ve got it? Or what signs may there be that we need to start thinking about preventing
it? SARAH IRVING:
Yes. The first signs are things such as aches and pains, swellings, numbness, tingling,
stiffness. Also difficulty in movement, so limited movement. Obviously the earlier you
can catch these things the better, you can try and prevent them. It’s not too late
once you start feeling these symptoms, so yes, basically, if you’re already or your
employees are feeling any of these things then have a look at them as soon as possible
really. MARK WALKER:
Right and then you mentioned other conditions and obviously we have other words that we’re
used to hearing that may be connected to RSIs. Can you tell us a little bit about how these
are connected and how they’re similar? SARAH IRVING:
Yes. These are some of the most common ones; you see on the left the ones affecting the
hands and the wrist and the ones on the right are the upper limbs, shoulder and the arm.
We see most of these quite a lot of the time when we’re workplace assessing. I don’t
think… I can go through more if you want but if anybody wants to know what any specific
ones are at the end, I can let you know. But some RSIs such as tenosynovitis, carpal
tunnel syndrome – which is probably one you all may have heard of- they’re well
understood by doctors now, so they’re diagnosed pretty quickly but others have less distinct
symptoms and are still subject to some controversy, so basically they’re quite hard to diagnose. We’re going to have a look at carpal tunnel
syndrome now because that is the most common one. If you can change the slides, yes. So,
we see this quite a lot. Perhaps once a month, which is quite a lot, all of the assessors
perhaps see this once a month, probably more. The carpal tunnel is the area on the underside
of the wrist and repetitive movements of the hand, this can be typing or using a mouse,
can cause inflammation and that then leads to compression of the median nerve, and you
can see where the median nerve is on there. The median nerve supplies the thumb and that
side of the hand. If someone has symptoms in the thumb area, quite usually at the base
of the thumb or the first couple of fingers, it’s quite likely it’s carpal tunnel syndrome.
It can produce, again, numbness, tingling and pain in the first three fingers and the
thumb side of the hand and quite interestingly the symptoms often only occur at night to
start with, so you may be okay when you’re at work, you get home from work and you’ve
got an achy hand. Don’t ignore it, this is how it normally starts. It doesn’t normally
affect you at work to start with. It’s when you’re actually resting after your work
that the symptoms start to come out. So as I say, it’s very important to catch this
condition early as it can lead to swelling in the wrist area which then can lead to reduced
mobility of the fingers, hand and wrist. MARK WALKER:
Thank you very much and in terms of the impact, obviously, we can imagine that there’s discomfort
and physical pain, but Robin could you just talk to us a little bit about the broader
impact both for the individual and the organisation that RSIs are creating? We’ve looked at
the days lost and so on, but clearly, there’s a broader picture here. ROBIN CHRISTOPHERSON:
I think, I mean the first bullet point we’ve got here about ‘personal’, there is definite
personal impact. It’s an incredibly distressing condition, once it reaches a worrying level
of symptoms where people maybe haven’t flagged it beforehand and now they’re starting to
really worry about it and it’s particularly worrying for them because, you know, unlike
a bad back or a sore ankle or whatever it might be, it’s striking right at the tools
that they use to do their job so they get extremely worried about how they’re going
to be able carry on working. It’s a very high impact set of conditions for people that
are experiencing these symptoms. There’s obviously a productivity impact
on the organisation, as a whole. We saw some numbers in an earlier slide. The legal impact.
I mean, it is a legal requirement, there’s various bits of legislation and regulations
that mean that employers should be considering people and certainly taking it seriously when
they say that they are… They flag that they’ve got issues. There is an argument that you should be proactive
as an employer as well and you should be regularly asking your workforce about their general
health and being proactive and encouraging a climate where people can feel liberated
and confident that they can disclose any difficulties that they’re having. It will save a lot
of problems for people with RSI or work-related upper limb disorders further down the line. MARK WALKER:
Great. Thank you very much. Before we go any further, I’m just going
to launch a poll here. This is just a question to get some feedback from you. Have you ever
had…? Have you ever experienced any RSIs or RSI? We don’t know how common it is in
the workplace really. I think as Sarah said it’s got a label on it that some people
will attach but I think we’re all aware of some discomfort over work, particular muscles
and parts of our body could cause. It’s just interesting to see how many… I’ve
got most of you voted so far. I’m just going to do this quite quickly just to show you
actually. I’ve got 80/20 so far. 80%, 75% of people are saying yes, so that’s most
of you answered and you can just see that I’m just showing the results here and 73%
of people say they have. I’m just going to put up another poll. I’m
going to hide the results of that. What I’m interested in is why you’re here today and
what you’re interested in particularly knowing more about. So, there are a few options here
given that we know 75% of you say that you have some sort of personal experience of RSI,
are you interested today in dealing with your own RSI? Is it about supporting colleagues?
Do you need to know more about the adjustments that can help? Do you have concerns about
the legal risks? You can tick any of these boxes. So we’re interested in seeing what
your particular interest is and also if there’s anything not mentioned on there then please
do use the question box to mention anything that you’d like us to take account of or
a particular reason you’re here. We’ve got our slides set up to go through
all the various stuff I told you about but obviously if you can give us a pointer on
something, we can pick up on that. So I can see all of you have voted now, that’s
brilliant, thank you. I’ll close the poll and show you the results. You’ll see that
42% of people are interested in dealing with their own RSI, but far more of you – 67% want
to support colleagues, 75% want to understand the adjustments than can help and then there
is a number of you that are interested and concerned about legal risks. So the majority
of people are looking to help others in some role that might… I guess that might relate
to your role in an organisation or it may simply be that you’re working with your
colleagues and you want to support them. So let’s look at how we deal with RSIs,
that’s going to be the meat of the rest of what we do. We’re going to start by looking
at the most traditional setup of a computer with a keyboard and a mouse. And Sarah, I
think you’ve seen this every day, but this a real… This is where a lot of the problems
start really – it’s the average computer on the average desk. Can you tell us a bit
more about the sort of problems that arise because of this? Hello, Sarah? SARAH IRVING:
I was just waiting for you to remove the poll results that’s all. Quite often the traditional office workstation
setup doesn’t help. You can see a standard keyboard on this picture, obviously we sit…
Where we should sit central to the main keypad and this means that the mouse is pushed further
over to the right, if we’re talking about right-handed people here. So basically, it’s
not really designed that well. It means we have to reach further to our mouse, also,
some people are still using the old style mice with the ball underneath rather than
an optical mouse. These can lead to jerky movements when the ball is dirty. A wired
mouse can cause problems with the cable: it can be too short or it can get caught in other
items, again, which can cause jerky movements. So you can see, it can be very small, little
simple things that you probably wouldn’t think of that can cause this. Some problems
are caused by using corner or curved workstations. People don’t tend to sit central to the
curve which means they’re not actually sitting central to their keyboards and the screen.
Their body can get more support on one side than the other and the muscles can actually
grow differently. It’s much easier to sit straight at a rectangular desk, so if we’re
ever in a situation where we need to recommend a new desk for somebody, we quite often will
recommend a rectangular desk. It’s just so much easier to see if you’re sitting
straight on to all of your equipment. And we also see people who sit too low and
the majority of people we see sit too low and this causes a non-neutral upper body posture:
so the wrists are at the wrong angle, the arms are at the wrong angle and the sort of
thing. So, you know, it’s not all about money and about buying new equipment but you
know, changing the way you sit and using the things you already have can make a big difference. MARK WALKER:
Great, thank you Sarah. And you’ve got a picture which you shared with me here, which
I think is fantastic, of somebody struggling in the workplace for very obvious reasons. SARAH IRVING:
This is somebody I assessed many years ago, who’s left-handed and as you can see- I
hope you can see there- he’s using the mouse, which is placed on the right-hand side of
the keyboard, with his left hand and when I asked him why he was doing this his reply
was, “That was where the mouse was when I was given this desk.” And I have seen
several people since who are doing exactly the same thing. Or they’re sitting at a
desk where it was previously a left-handed mouse user, so the mouse has been placed to
the left of the keyboard and they’re right handed and they’re either trying to use
their left hand or they’re reaching across the keyboard, so you know, quite often these
things you think they’re obvious and they’re quite logical but sometimes it takes somebody
else to actually have a look and say, “You’re not doing this correctly.” MARK WALKER:
Yes and I think on ‘My Computer My Way’, we’ve got lots and lots of detailed changes
that you can make to your computer, to your mouse, to your keyboard and so on but one
of the most obvious ones, and it is something that people overlook, is that you can turn
a right-handed mouse into a left-handed mouse. It isn’t just about where it is but you
can change how the buttons work to work for different fingers in different ways, so they’re
very simple adjustments and I think this is looking at the top down level. This is really
the most obvious things about the most obvious pieces of equipment that you’ve probably
got on your desk. Again, if we look at the typical workstation,
we’ve got a picture that we’ve used before, I’ve highlighted a few issues on here, a
picture of a workstation. We call this one ‘the bad workstation’. Can you tell us
a bit about what the problems are that are on here that are going to inevitably exacerbate
or cause an RSI? SARAH IRVING:
Yes, I mean these are all problems that I see on a daily basis as well. You can see
the person’s actually sitting- you probably can’t see from this picture actually- that
they’re sitting a bit too low. So their arms aren’t going down to the keyboard;
they’re going straight ahead. The upper body is not in the neutral position. They’re
reaching to the keyboard… Reaching forward to the keyboard and also reaching to the side
to the mouse and that can cause problems in the upper body. Screen’s not placed in front
of the user, so it’s in the corner, which is quite often the way people traditionally
think- the screen needs to go in the corner of the desk- and it doesn’t. That causes
problems with the neck and even pressure on the neck nerves and muscles because the head’s
being turned to the side all the time and it can also be increased by the screen being
either too high or too low. Documents placed, you can see there’s a
red cross to the right of the hand, I think that’s supposed to represent a document
being placed to the side of the mouse. You can see that would be quite a turn for the
person to actually read that and that is quite a common problem and we also see people, particularly
in call centres, where they can push the keyboard back so it’s nearer towards the screen and
they put the document between themselves and the keyboard which also means they’re reaching
to the keyboard, which is a big no-no. MARK WALKER:
Alright, thank you. I think we’re covering a number of areas here. Just to reiterate
for people I think that you can work with what you’ve got. It may not be set up properly,
it may not be the equipment has been explained to you properly, it may be that the person
who’s using it isn’t using it in an appropriate way but it may well be that a huge number
of changes can be dealt with, with what you already have around you. Of course, we’ll come to in a minute, when
we’ll be looking at other specialist equipment like hardware, keyboards, mice. We’re going
to look at that in a little bit more detail. And there are other changes you can make to
the work pattern and we’re going to talk about the other things the employer can do
to support the employee this way. But I think from what you said Sarah, a huge part of what
you’re doing each day is using the equipment that’s there, not necessarily adding a huge
amount to the workspace for people. SARAH IRVING:
Yes, exactly. A lot of people that we assess they may have a bad back as well so we get
them a new chair but to do with the upper body, we’re quite often just educating them
in how they sit and their posture and how they can use the equipment they’ve got.
There’s not always a cost or any resources in time being required to do this. So the first thing really is to make sure
you hold and move the mouse correctly. We always ask people to show us how they move
the mouse. It’s very often incorrectly. Most people lean on the work station, hold
the mouse and just swivel at the wrist. This is incorrect. The wrist should stay still,
it should be in a neutral posture and the movement should come from the shoulder and
the arm. So it’s more like polishing your car or cleaning your windows and this is how
it should be to protect the wrist. So quite often when we see people with wrist problems,
we can see straight away they’re not holding or moving the mouse correctly, so that’s
something you can do for yourself. As I mentioned before, sitting at the correct
height – get the upper body posture correct, so your forearms are at least parallel with
the floor or preferably- I’ve done this for quite a few years- I’ve realised that
preferably, if they go down slightly to the keyboard and mouse, helps to keep a neutral
wrist. And it keeps the shoulders down and they’re not hunched up. The whole top of
the body is nice and relaxed, so you’re getting less stress and tension on your body. Again, move the mouse and the keyboard closer,
so we’ll look at some keyboards in a moment where you can do that, but get it right up
to your keyboard so it’s as close to you as possible and keep your keyboard so that
you can have your elbows by your waist – you don’t want to be reaching forward at all.
If you’re reaching forward to reach your keyboard you’re actually using the whole
of your upper body to type, which is a real waste of resources. You only need to use your
hands and wrist. The screen at the right height as I mentioned
before. Keep your neck neutral and also if you’re in a corner or curved workstation
or if you’re using the corner of a rectangular workstation, try and move everything central
where at least it’s central to the curve, so you’ve got the same supports. You should
have the same distance from the edge of one end of the keyboard to the edge of the desk
as the other end of the keyboard to the edge of the desk, so you’re getting the same
support on both sides. Keyboard shortcuts- I’m sure most people
know about those- that will reduce mouse use if you’re having a problem with your mouse
or even prevent it. Preventative that can be used for. Mark mentioned earlier ‘My Computer My Way’.
You can make your computer, Windows, the internet, applications, keyboard and the mouse suit
you and your needs so that’s something it’s worth having a look at and just getting yourself
sorted out and making sure you’re sitting properly. MARK WALKER:
Great thank you and we’re going to have a quick a look, as you said, about specialist
equipment. The first rider of course is that you provide,
when you go into the workplace, you provide samples for people to try things out and I
think we have to say from the start, there isn’t just one answer to this for one person
and I’m assuming that you spend a lot of your time getting people comfortable with
one or another of these solutions and making sure they try things out. SARAH IRVING:
Yes, we do. I mean I wouldn’t recommend you go and buy some different input device
without giving it a good go really. I mean obviously we can only let them try it shortly
in an assessment but we do say if it doesn’t help then call us back and we’ll try and
recommend the next thing, but it is good if someone has a problem with moving their mouse,
is to get all of the mice out and let them have a feel for them. So I wouldn’t recommend
you just sort of buy something online and hope that’s going to help. Obviously, this is only a limited list, there
are numerous things out there, probably way too many, so it’s quite hard choosing but
these are the ones I tend to recommend on a daily basis. The simple cheapest one is, of course, a wireless
mouse. No cable, easier to move, it’s not going to get caught up, so it’s not going
to cause those jerky movements. The vertical mouse, which is the middle one
at the bottom. So basically you’re holding the mouse in the most neutral wrist position
which is a handshake position and it eliminates forearm twisting, it supports the user’s
hand in an upright, neutral posture and encourages the whole arm movement that I was talking
about earlier. Bar mouse, the top right one, I do recommend
these an awful lot. There are many makes and models out there. They’re all slightly different
to each other but they work on the same principle. You can probably see if you’re not familiar
with them, there’s a bar running along the top. That’s actually what you use to move
the cursor. This sits between the keyboard and yourself which means your arms are more
neutral, you’re not reaching out to the sides. It also means if someone has a problem
with one hand, they can use the other hand or use both hands. You can literally use the
finger tips, the balls of the hand, the thumbs, anything you want to to the mouse and also
the bar does click and double-click. You’ve got buttons there as well but you can just
use the bar. So that’s pretty good. That’s quite helpful. So the arms are close to the
body and it eliminates the need to reach sideways. Bottom left is just an example of a trackball
mouse. As I say there are loads and loads out there on the market. You remain stationary
on the workstation and you control the cursor by moving the ball. Again, you can do this
with any finger, thumb or palm of the hand and it reduces strain on the wrist, the hands,
the arms and the shoulders. It’s good for conditions that inhibit clicking the mouse
and so is the bar mouse. It’s not particularly… I don’t recommend it for shoulder problems
because your hands remain stationary. I’m a great believer that if you’re moving your
arms then that’s good, they’re not remaining static, they don’t get ceased up if you’re
exercising them. So that’s good for that. Another good one you can see on there on the
bottom right is a HandShoe mouse. You can see it’s like a standard mouse. It comes
in different sizes and it sort of holds your hand quite naturally and it’s actually quite
comfortable to use. But again I wouldn’t recommend you start using any of them until
you know that’s the right thing for yourself. MARK WALKER:
Thank you. Quick question here about a trackpad, somebody has mentioned a particular one that
Apple does with a separate trackpad. What’s the ergonomist view of trackpads and separate
trackpads instead of a mouse? SARAH IRVING:
Do you mean a touchpad or a trackpad? MARK WALKER:
Yes you know, like the Mac one. I’ve got one actually, I don’t use it a great deal
but it’s the same as the trackpad from the computer it’s just it’s separate from
it. SARAH IRVING:
Yes, I know, yes. We do carry one of those around with us as well, not an Apple one,
but we do have one because there are…. I think in nearly 20 years of assessing, I’ve
only recommended one once and it’s because somebody used one at home and they couldn’t
then use a normal mouse. They are quite intensive on your fingers and
hands. Unless someone has a particular need or a particular problem where they can only
sort of do that movement that’s required on a touchpad, I wouldn’t recommend them.
It is quite intensive for your fingers which is why we say, “If you’re using a laptop
then try and use a separate keyboard and a separate mouse.” So not something I would
openly recommend but as I said, there may be cases of people where that is what is needed. MARK WALKER:
Great thank you. And then the keyboard. I’ve pulled up the pictures here of the keyboards
and again various choices. Could you quickly explain these weird gadgets? SARAH IRVING:
Yes. The one we recommend mostly is the top right, which is a compact keyboard. Basically
it’s a shorter keyboard without the number pad. You can probably see there, the number
pad is separate. These are good for when there’s not much
space or you haven’t got much space in front of you but they’re particularly good for
somebody who is quite intensively using the number pad. If, say if you’re right-handed,
you’re using a mouse, it’s very intensive, you’re obviously using your right hand for
the number pad which can be very intensive as well. We see a lot of people in banking
institutions and call centres, they basically… One of the only things they really use is
the number pad, and supply them with one of these they can then hopefully use the number
pad on the left-hand side. People find it a lot easier to adapt to using
a number pad with their left hand than they do to moving the standard mouse over to the
left. It’s something that we try and ask people to do, whether they do it afterwards,
I don’t know because we ___[0:30:28]. It would be good if they do. It’s just balancing
out really so you’re not doing everything with one hand. It takes the pressure off the
one hand. So that’s a good thing to use. It just gives you flexibility about where
you place things, you don’t particularly have to have it on the left hand side. If
you’re using the mouse more than the number pad, you can have the mouse in between the
keyboard and the number pad. So it gives you that choice of where you can use it. The second one is a split keyboard, so that’s
bottom left. You can see it can be pushed together or it can be split. When we’re
assessing, shall I say wider people, quite often it’s quite hard for them to place
their hands on the keyboard without sort of squeezing themselves in, so they can move
these to the side and have a more neutral keying posture. You can see there’s little
supports underneath that particular one. This is a particularly good one because it comes
with a number of different legs and stands, so you can actually you can have it flat on
the workstation and split or you can have it at different angles. It can, at different
angles, it can help to straighten the wrist and arms and it can align the shoulders to
achieve a neutral posture and the third one it’s an example of a Natural keyboard. You probably can’t see here, you can see
compared to the one above the keys are sort of positioned that the keypad is positioned
differently. It’s actually curved upwards as well which you can’t see from this photo
and it brings the keys closer to the fingers and the natural alignment of the hand. Again,
it allows you to work in a more neutral position. As I say, this isn’t the be-all and end-all.
There are other things available but these are the things that we recommend quite a lot,
most commonly. Again, I’d suggest you try them first of
all, particularly with the Natural keyboard, being a touch typist I’m unable to use that
because it just doesn’t feel right but some people love them. Going on to other equipment, so it’s not
all keyboards and mice, most common thing that I recommend is a palm support. That’s
in the middle there. That’s a bottom view imaging you had your hand on it. They’re
used with a standard mouse and they encourage correct wrist alignment. I think they’re
fantastic. I think everybody should be provided with one of these. It would actually be preventing
a lot of people getting wrist problems. You put the balls of the hand on it and then you
hold your mouse and you move the whole thing, the pad and the mouse. It comes with a shiny
mouse mat, so it’s quite easy to move, it doesn’t stick to the desk. What it does
is, it sort of holds your wrist neutral. It also gives you something to rest on but it
also means your carpal tunnel, which is the bit as you can see underneath that blue bit,
is not actually touching the desk. So there’s actually a gap between that part of your arm
and the desk. And it’s actually quite difficult to move a mouse, keeping your arm still and
just wriggling it at the wrist when you’re using one of these, so it actually encourages
the correct movement of the mouse. The other thing on the left are wrist supports.
They’re an example of wrist supports. Traditional wrist supports where you get a bar, I don’t
particularly recommend those because again you’re leaning on the carpal tunnel, so
if you do have one of those traditional non-bar ones, if you get a soft gel one it helps. These are Wrist Donuts. These attach to the
wrist and they’re particularly good if for somebody who has a problem in both wrists
or they need one of these for the mouse but they’re typing. It allows you to have them
on both wrists so your hands are at them same level, otherwise, you’d be a bit wonky using
the mouse and it protects you from the hard surface of the workstation as well. The third thing that we recommend quite a
lot is a document holder, on the right there. This is a document holder and it’s also
a writing slope which is what we tend to go for if people are writing notes as well as
looking at documents. And it sits between the keyboard and the screen, which means that
it’s directly in front of you, you’re not twisting to look at your documents, you’re
not pushing your keyboard forward to put the document between yourself and the keyboard
and you’re not putting the documents on the other side of the mouse. This one in particular,
the top falls down, so you when you’re not using the keyboard you can write notes on
it. It also makes everything closer to the eye as you can see it’s raised up from the
workstation. MARK WALKER:
Thanks Sarah. There’s a question about that middle picture, just to clarify that’s an
artist’s impression of something isn’t it? Just showing the mouse, where the mouse
would be. It’s actually the blue thing which is the rest for the palms. SARAH IRVING:
It’s the blue thing. It’s a plastic thing, it’s shaped like that, it’s padded. So
basically you’re looking through… Imagining this person is using it on a glass table and
you’re looking through from underneath and the shadow of this is trying to emulate where
the mouse goes. So it’s actually quite a natural position, you put the ball of the
thumb of your hand and the ball on the other side of your palm on to this. It sits quite
neatly and then your hands are in the right position to hold the mouse. They really are
good, I do recommend them for everybody. MARK WALKER:
Great. Thank you. SARAH IRVING:
This isn’t exhausted on all the other equipment you can get, but obviously we only have time
to look at the most common things. MARK WALKER:
Of course, yes. I’ve got a question about cubital tunnel syndrome. I don’t know whether
you know what that is but somebody is asking what mats would be recommended for someone
who had cubital tunnel syndrome. SARAH IRVING:
Right, again I wouldn’t particularly say a specific mouse and I would definitely not
do it without looking at somebody, going to assess somebody so I think really they need
to try out all the different mice, get a workstation assessment for them, so they can play around
with the different mice. Because you know, these symptoms, even the people with the carpal
tunnel syndrome, which as I said is the most common, they all prefer different mice. MARK WALKER:
Right. SARAH IRVING:
___[0:36:24] Sort of meant for a particular condition, because everyone’s symptoms are
slightly different, so I wouldn’t like to give you a suggestion because I don’t know
if it’s going to be right for that person, so sorry I can’t help more but they really
need to play around with it and try these mice or have a workstation assessment. MARK WALKER:
Sure. And somebody’s asking about where you can buy mice and palm supports. There
are lots of different places on the internet that you can go and look. We, when we were
preparing this, we were wandering around different suppliers’ sites I think the first thing to say is that there
are lots of different places to get any of these particular pieces of equipment and then
the second thing is to remember that what Sarah is saying that it’s really important
that you see this as something that you need to try and that each person will maybe find
different things more comfortable than others. Some suppliers will lend you things or you
can go and try them in workshops, in shops sorry, and what we do, what Sarah’s referring
to is that we do assessments in the workplace which people pay for through their employers
and when they do that they carry round a bag of stuff to show people and give them a try
and that’s when they actually get to try different types of mice and keyboards and
so on that the assessors will be carrying around with them. SARAH IRVING:
If I can add Mark, I think if you do get someone in to do a workstation assessment just check
with them beforehand that they do carry the kit around with them because I have known
people in the past that recommend things without getting people to try them and as Mark says,
you know, all of these ___[0:37:56] suppliers but they do have showrooms where you can try
things and quite often they do have two week trials for things so you can definitely try
them out. MARK WALKER:
Great thank you. SARAH IRVING:
Other changes that can help, so it’s not just equipment, something we recommend for
everybody we assess are micro-breaks. They’re not breaks as such, we recommend every 30
minutes or so, somebody changes their posture and just stops for a couple of seconds. You
can just count to 30, that’s all the time that is required. Most people can do that
in their job. I know in some call centres we work in they’re a bit funny about people
doing this but generally people can do micro-breaks so I suggest you stand up just shake it all
out, sit down, refocus the eyes that sort of thing because a rest is really good, just
changing that posture for a few seconds. Work patterns and job rotation, you know sort
of varying tasks that people do or just varying the tasks yourself. So if you’re doing something
pretty intensive, say a spreadsheet so you’re inputting lots of numbers, using the mouse
a lot, just split that up with sending an email or reading an email or making a telephone
call. Try and split jobs up so you’re not doing the same actions all of the time. Also learning to touch-type because this spreads
the load over the fingers. A lot of people we see are what we call two-finger typists,
I’ve even seen one-finger typists and this can put a lot of pressure on the fingers you’re
using so learning to touch-type is really, really good. You’ll get a lighter touch
on the keyboard and as I say it spreads the loads over the fingers. If somebody’s already got quite a bad problem
or is getting towards that way then obviously there is also speech detect software, so you
can actually dictate. This is quite good even if you haven’t got a really bad problem.
If you’ve got the facilities to use this and the time, you know, some big organisations
have copies of this, universal global copies of this, so it doesn’t involve any extra
money. It’s just the time involved in training and familiarising yourself and you can then
dictate your emails, your reports. It takes the strain off the fingers but you can also
control the computer with it so you’re not having to use the mouse as well. They’re
ways that you can do. The easiest one, the cheapest one is obviously the micro-break
so just make sure that you get up and have a break every 30 minutes. MARK WALKER:
Great, thank you. Just a final point here, I think, about changes
and adaptations. It’s just to pick up on this question about laptops, mobiles, tablets.
The way that we’re working is different. We are beginning to see iPads particularly
in the workplace, they’re considered to be very useful for all sorts of different
reasons because they’re so portable but of course they bring with some sort of inherent
problems in terms of ergonomics. Can you just briefly explain what you would suggest in
terms of the use of an iPad and any related technologies? ROBIN CHRISTOPHERSON:
Do you want me to pick up on that one Mark, sorry? MARK WALKER:
Yes, sorry Robin, thank you. ROBIN CHRISTOPHERSON:
Well, it does spell trouble really having a laptop as your main machine. You can’t
separate the screen. So having the screen at the right height level so that you’re
not looking down and putting pressure on the front of your neck, as Sarah mentioned earlier,
is incredibly problematic. Unless you have one of these fancy ones where you can detach
the screen, you really do need to raise up the laptop. I mean you could plug in separate
monitor but the best solution really is to raise up the laptop on a raiser as you can
see here, have an external keyboard, which are often better than the keyboards on the
laptops and an external mouse. A good ergonomic mouse, preferably, so that you can avoid using
that trackpad as your main pointing device as well and then you can achieve a much better,
sounder ergonomic positon. You can also see this iPad here, it’s on
a fancy stand. Sarah knows somebody who uses an iPad five days a week as their main computing
device working from home and if you’re doing that you’re typing off glass, there’s
no movement, there’s no travel on your fingers, which is much harsher a movement and it’s
going to give you more difficulties than a good responsive keyboard with nice travel.
So put the iPad up on a stand like this so that it’s more at eye height, so you’re
not looking down all the time and use a Bluetooth keyboard, a decent Bluetooth keyboard, for
example, so that you’re not typing on glass. MARK WALKER:
Great, thank you and final thing Sarah, just to look again at the perfect workplace- I
don’t think it’s the perfect work place but we had the bad one, this is the good one.
Just to reiterate, the head is up, the shoulders are relaxed, the hands are in line with the
forearms. The eyes are looking forward most of the time, the referencing material is easy
to look at and the monitor is approximately at eye height. I think those are…. You’ve
really underlined, I think, that the workplace needs to work for the individual and so the
equipment and the other specialist stuff we’ve been looking at, is really about people trying
things out and becoming comfortable and being more comfortable in the workplace, so. SARAH IRVING:
Yes. MARK WALKER:
Great. I’m moving on, quickly then, to other stuff because I think there are lots of other
things employers need to do. They have some sort of duty of care towards their staff and
so they need to be looking at other things, can you just briefly talk about the sort of
stuff… What sort of other adjustments that you have been recommending when you’ve been
working with an individual? Sarah this is your __[0:43:49]. SARAH IRVING:
Okay. I mentioned before task variation, task rotation – especially if people are data inputting,
allowing breaks. Temperature of the workspace can be quite important, if people have joint
and muscular problems, obviously when their hands are cold, their aches and pains are
exacerbated or when they’re hot they’re finding it difficult to grip things. Don’t issue a full keyboard, a standard
keyboard, unless they definitely need it. Have a think about getting in compact keyboards
and separate number pads. They’re not expensive these days. Take it seriously. Prevention is better than
cure. If somebody gets something like carpal tunnel syndrome, they’re probably going
to have it for life. I see people that have had operation after operation, treatment after
treatment, steroid injections, physio, everything, and the pain is still just as bad. It means
they can’t do things in their home life as well, they can’t carry their shopping,
their children that sort of thing. Training for employees and line mangers, so
training in how to use the equipment, health and safety, how to use the mouse properly.
Disability awareness training for line managers. So if you feel that your line manager is not
supportive enough, get them some disability awareness training or if you’re a manager
and you feel that you want to support people more, then this is a good thing. We recommend
this quite a lot. Maintain the information that you offer staff,
quite often the information on how to sit and how to do things, normally on a company’s
intranet, just sits there for years and gets forgotten about so just make sure that’s
up-to-date. Also monitor the sickness rates that relate to RSI because obviously this
can give you a picture of what’s happening. ROBIN CHRISTOPHERSON:
I probably want to add to what Sarah was saying earlier about how it can be a long-term condition.
I mean I’m a keyboard user because I can’t see so I don’t use the mouse at all but
being a very intensive keyboard user I got a very significant RSI-type condition about
a decade or so ago and luckily got it to the point, you know… Managed to catch it at
the point where it was something that could be turned round, completely 100% turned round,
although the symptoms were something very severe. So just to give people on the call heart,
just in case they suddenly felt that they were in the camp of long-term multiple surgery
route. Go to a physiotherapist, if you look for one that is a chartered physiotherapist,
a member of the Association of Chartered Physiotherapists or ACP, it’s really what you should be looking
for when choosing a physiotherapist and the exercises that they give you can turn round
some quite significant, even long-standing symptoms. So take heart and definitely go
down that route first. SARAH IRVING:
Yes I think if you want to help yourself then there are things you can do along those lines
Robin, but we do see a lot of people that feel that equipment is the only way they can
go forward. ROBIN CHRISTOPHERSON:
Absolutely. SARAH IRVING:
So a lot of it is doing things for yourself and just making sure you’re doing things
correctly and you’re taking advice. MARK WALKER:
Great, thank you. So just to wrap up, the first thing that really
came over to me when we were preparing all this is that one size doesn’t fit all, that
trying to deal with RSI is really about trying to deal with the individual circumstance,
looking at the workplace, looking at the individual’s needs, helping them try different options,
try different brands of different things – so you saw all the different types of mice that
you can get, all the different types of keyboard. This isn’t just one, “Oh here’s one
that’s really good, just use that.” The thing about having the numeric keypad on a
keyboard and making the keyboard wider, that’s a very simple thing that most of us will recognise
straight away from the standard setup. The micro-breaks thing and looking at how
you actually move around during the day and the sorts of responsibilities and roles that
you have in the organisation and whether they can be adjusted and equally if you’re looking
at this from the point of view of supporting other people, then it may not be the obvious
things that you need to look at, it may not be the mouse it may just be the work pattern
or the particular tasks that they’re being given and thinking about rotating those and
changing them regularly so that they don’t suffer the symptoms of doing the same thing
over and over again. And then there’s also, the final bit really
from our point of view is to underline that this is a personal solution and so you need
personal one-to-one support with that and the assessments that we provide really underline
how people need to try things out and give different things a try, different technologies
and solutions. I’ve just had somebody passing on a note
that Leonard Cheshire Disability offer bespoke disability equality training if anybody is
interested, so that’s Leonard Cheshire Disability, if you have a look at them they can offer
bespoke training relating to disability and equality. So, if you have any questions now, we have
a few minutes if you have anything in particular that you’d like us to cover. Use the question
box to ask anything that you think hasn’t been clear. Hopefully we’ve answered the
questions, I’ve been monitoring the questions as they come in and I’m hoping that we’ve
answered most of the questions. There is a question from somebody saying that
the keyboard was inverted which they spotted and turned one of the images around to make
it look right on the screen. The keyboard was inverted – well-spotted, Peter. Otherwise if you want to learn more about
how computers can help you in the workplace then we’ve got our next webinar on the 14th
April about controlling your computer with your voice which may well be one of the things
that people would recommend to do with RSIs if they’re having difficulty using the keyboard.
That’s on the 14th April. Next week, we’ve got accessible apps, Barclays
Mobile Banking app. We helped Barclays with their banking app. 12

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