Parents help ease the transition from summer fun to school routine. Just as important (but perhaps not quite as much fun) as shopping for the right back-to-school fashion, parents can encourage positive health and ergonomic practices that reduce their children’s risk for developing repetitive strain injuries.
Several years ago, a youngster was referred to our hand therapy clinic with classic and debilitating symptoms of Carpal Tunnel Syndrome (CTS). However, the physician, a generalist, was adamant that this young person did not have CTS as “16 year-olds do not develop these types of injuries”. This patient’s parents sought a second opinion. The patient was officially diagnosed with CTS upon physical examination with an orthopedic hand surgeon and nerve conduction examination, subsequently underwent surgical decompression of the nerve, and had a very successful recovery.
It is true that we don’t see many pre-teens and teenagers with symptoms of repetitive stress injury. The flexibility and rapid healing rate of children allow them to get away with much more than adults when it comes to the repetitive and forceful nature and awkward postures of physical activity that create symptoms.
Unfortunately, the increasing role of technology in our lives, across all age groups, can not be ignored. And formal classes in typing technique, posture and ergonomics are no longer offered in school as children begin using technology in their toddler years rather than learning to type in high school. It is important for adults to be aware of the risk factors and to teach good ergonomic principles and work practices to our children in order to help keep the next generation pain-free.
Kids, Computers & Repetitive Strain Injuries (RSIs)
- In a series of international studies, up to 60% of students across the globe reported eye-strain, neck & shoulder pain, wrist and back discomfort, headaches and fatigue. Symptoms were reported in children as young as in 4th grade.Repetitive strain injuries in children are highly correlated with the repetitive, awkward and prolonged postures they are using when they are working on computers or laptops.
- Most computer stations are designed for adults or lack the adjustability needed for children who display a wide range of body sizes and body growth rates.
- The portability of technology (e.g. laptop computers, video game players, mobile phones, iPads) allow for use in non-traditional settings and with non-traditional postures (for example, slouched in a couch or lying on a floor) that can increase the risk of injury.
General Guidelines to Promote Healthy Computing
- Provide children the skills to understand what is good for their bodies so they can make good choices for themselves.
- Teach healthy computer habits which can be carried into adulthood.
- Encourage physical activity. Children who exercised during breaks from computer use had fewer pain complaints then those who were sedentary.
- Encourage healthy habits including drinking plenty of water for tissue hydration and eating a variety of nutritious foods.
Computer Comfort & Ergonomics for Children
- Chairs should be adjustable allowing for easy changes for growing children or for various family members of different ages and sizes.
- The best chairs should have adjustability for chair seat height and depth. The back of the chair (providing lumbar support) should be able to be pushed forward. If the chair is not adjustable, use pillows or cushions to raise the child to the appropriate height or to support the back.
- Position the child so that the eyes are level with the top of the monitor screen. The monitor should be placed directly in front of the child at about an arm’s distance away (about 12-14 inches) to prevent eye and neck strain.
- Shorter legs should be supported on a footrest, sturdy box, or stack of stable books with hips, knees and ankles at about 90 degrees. There should be about 2 inches of clearance between the back of the child’s knee and the chair seat edge.
- Increase type font on the monitor so that it is clearly visible to the child so they don’t have to squint or lean forward to read the screen. The screen should be clean and the brightness and contrast adjusted for easiest reading.
- Reduce screen glare by placing the computer perpendicular to windows, having good room and task lighting, and, if necessary, using an anti-glare screen.
- Teach your child to look away from the screen after every 15 minutes or so of typing to ease eye-strain.
- Lower or remove chair arm rests so that child’s arms are loosely held at the side of the body, elbows bent at about 90 degrees, and the shoulders relaxed.
- Place the keyboard and mouse within easy reach of the child so they do not have to stretch the arms out to use them.
- Wrists should be flat and straight (in the neutral position) with fingers relaxed.
- Teach the child to use the lightest touch possible on the keyboard.
- Encourage the child to sit upright and not to twist, slouch or crouch in the chair while typing.
- Encourage a typing break of 5-10 minutes for every 30-40 minutes of typing. Preferably the break activity should be active. A timer can be used to help the child learn to monitor himself.