Musculoskeletal Disorders in Shorter People - II

Continued from the previous post.



Thus the possible and probable areas of stress in a short person (desk worker/housewives) would be :
  • Shoulders: leads to rounding and closed chest attitude. May have pain at terminal ranges associated with stiffness. 
  • Wrists: If working at odd angles, can complain of cramps, wrist pain or potentially develop symptoms suggestive of carpal tunnel syndrome (tingling in the fingers, commonly attributed to be coming from spine). 
  • Spine: Slouching with exaggeration of the upper dorsal kyphotic curvature, with a forward head attitude of the neck. 
  • Knees: Due to the need to sit with the legs tucked below the chair, rested on the chair base or sitting with the knees cross-legged to prevent them for dangling due to unavailability of foot rests 
  • Ankle and feet: If the user is sitting with feet supported only at the toes, then she is likely to experience cramps in the calf muscles, pain around the ankle and at the toe joints, which will experience hyper extension loads. 
  • The short female user may also be in a habit of using heels to compensate for the height and thus keep the feet in downward direction leading the shortening of the calf muscles and back pressure effects on the knee and spine. 
Solutions:

For desk work:
  • Raise the height of the chair so that the upper third of the screen is at eye level. 
  • Reduce the bulk of the chair by using pillows at the back and in the side such that there is not enough space to fall into poor posture. This will help in maintaining an erect posture 
  • Remove the armrests or don't use them. 
  • Keep the keyboard and mouse in the tray and get the tray as near to the body as possible. 
  • If keyboard tray option is not available then keep the keyboard in the lap on a pillow and the mouse on a side table raised to a level so that the elbow and shoulder are not under strain. 
  • The feet should be planted in front by using a heightened foot rest appropriate enough to keep the knees at the same or little higher level than the hips. 
Car driving:
  • Raise the chair height by keeping a pillow on the seat. 
  • take the seat as near as possible to the steering wheel 
  • Tilt the rear view mirror a little down so that one does not require to strain the neck. 
Housewives:
  • While working at the kitchen keep a stool or a platform in the entire length of the kitchen so as to have free movement and prevent tripping if there is a smaller length stool. 
  • Keep the height in a way that working on the kitchen platform produces minimal stress on the shoulders while stirring, lifting heavy objects and making chappatis. Do not raise the height so much that one will then require to bend to work on the platform and stress the back. 
  • Keep the objects in regular need in easily reachable distance. 
  • While sitting on the dining chair raise the height of the chair by keeping a pillow or two so that the shoulders are at good level to work. But the feet should be planted on a foot rest. 
  • For recreational purposes sit on a small chair so that the feet rest on the floor or on a regular chair but with feet planted on a foot rest. 
  • Narrow the depth and the width of the sitting surface if one is thin built so that slouching is discouraged. 
  • Always sit on a firm or cushioned hard surface so that getting in and out of the sitting surface remains stress free on the other joints of the body and on the back. 
The previous and this post tried to explain the various compromises a short person has to undertake and the areas of mechanical overload. They were specific for desk workers and housewives and the same principals can be extended to the environment existing in schools, colleges, at home, transport, talking to people, watching movies, dining in a restaurant and other similar situations.

In brief, one has to realize that the mechanical loads and stresses on the body parts occurring from the activities of daily living are an essential component in the development of musculoskeletal disorders. They have to be addressed with the help of tailor-made environmental changes (ergonomics) for a comprehensive rehabilitation.

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