As all of us have started working from home for long periods of time, it is more important than ever to adjust your home workstation to prevent unwanted strain and injury. The neck, back, wrists, and eyes can become painful or irritated even after one day, and with prolonged work in an improper desk setup can cause severe inflammation. Here is some information to determine if your home setup is appropriate for you along with exercises to keep you mobile throughout the day.

Ergonomic Tips for Setting Up Home Work Space

• Avoid doing any work in bed or on a sofa.
• Make sure your chair and table/desk height are appropriate and that you are not hunched over.
• Adjust the monitor to arm’s length away to reduce strain on eye. The top of your screen should be at eye level. If you need to use a laptop, place it on a kickstand or books to raise the screen to eye level.
• If you are using two monitors, your body should be in the middle of the two screens
• Make sure the elbows are bent at 90 degrees
• Make sure the keyboard is placed in a position to protect wrists from being in extended position for too long.
• When using a mouse, move from elbow not shoulder to reduce overuse injury.
• Avoid resting your wrists on the desk surface as this can cause a painful condition called carpal tunnel syndrome. There are mousepads with built in wrist bumpers, but you can consider placing a rolled up hand towel to remind yourself to keep them elevated.
• When using a phone, use a headset or headphones.
• Your feet should rest comfortably on the ground. If not, then use a footrest or reams of paper
• If you have a standing desk, be sure to wear comfortable and supportive shoes. You can even stand on a yoga mat to reduce strain on the arches of your feet, as they will be supporting your weight for several hours throughout the day.

Take Breaks and Stretch Often

• Get up every hour and take breaks to walk around house, get a snack, stay hydrated, and chat with family.
• Stretching exercises have been designed to warm up muscles, improve flexibility and help prevent soft-tissue injuries. Stretches should be brief, no longer than five min in duration to complete.
• Stretching should not cause pain or discomfort. In general, you want to stretch your body parts in the direction opposite to the positions while working.
• Low Back Stretch: While standing, place both of your hands on your low back. Slowly bend backwards as far as is comfortable. Do not extend the neck to prevent straining the muscles around the neck.  Hold for five seconds then return to upright posture.  Repeat five times.
• Overhead Stretch: Reach above your head by stretching your arms up and interlocking your fingers.  Hold for five seconds, repeat five times.
• Shoulder Circles: Raise both shoulders up as far as possible toward your ears. Now make shoulder circles bringing shoulders backward, downward, forward and upward again.  Perform ten times in one direction, repeat ten times in opposite direction
• Neck Side Bend: Tilt your head sideways, pulling your ear towards shoulder.  Hold for five seconds and repeat three times on each side
• Neck Rotation: Turn your head as if looking over the shoulder, return to center.  Repeat to other side.  Hold for five seconds and repeat three times on each side.
• Wrist Stretch: Extend your arm in front with palm facing down, with your opposite hand, bend your wrist downwards until you feel a comfortable stretch. Hold for five seconds.  Repeat with palm up. Repeat in the other arm.

Lighting Tips

• The light source near your workspace should be positioned ideally at a 45 degree angle from the eyes
• Avoid having windows or bright lights behind the computer screen.
• Adjust the brightness and contrast of monitor to suit the environment. Reduce the brightness of screens (computer, phones, or tablet) at night before bedtime.
• Workers over fifty years old often require twice as much light to complete tasks comfortably.

Preventing Eye Strain

• 20/20/20 rule. Every twenty minutes, look at a point twenty feet away for twenty seconds.  This allows the eyes to stretch out muscles and reduce eyestrain.
• Use natural tears and blink often. When we stare at computer screens for long periods of time, we naturally stop blinking, which is how our eyes normally stay moist.  Blinking and using natural saline tear drops can help soothe your eyes and feel less tired.  Applying a washcloth moistened with warm water, with gentle pressure over the eyes can also be effective.

Take some time to make sure you feel comfortable in your workspace and not try to “make do” with your current setup.   You may find this could improve your productivity and prevent injuries.

Vitamin D is a necessary vitamin that we get from certain foods, such as fortified dairy, eggs, and sardines.  Some scientists believe that low levels of this vitamin can contribute to anxiety and depression, and reduce our immune systems putting us at risk for colds/flus that many of us experience in the winter months.  Ever wonder why we feel more energetic in the summertime?  We need approximately 15 minutes of exposure to the sun to activate this vitamin.  If you aren’t exposed to the sun for this amount of time, your levels will certainly be low.

Nursing home residents almost always have chronically low levels of vitamin D as they are indoors for much of the day.     Glass blocks the rays of sun needed for us to process vitamin D, so even sitting in a sunny windowsill is not adequate.  COVID19 has ravaged nursing homes, and low levels of vitamin D, while not the immediate cause, still could have contributed to its spread and severe symptoms.

Right now, most of us are not likely to be getting adequate amounts of sun each day due to isolation restrictions or being forced to stay home if we do have COVID19.  I recommend taking a supplement with 1000 IU of Vitamin D3 per day during this time.  Be sure to take it with food as it is a fat soluble vitamin and preferably in the morning.  Take a walk whenever it is sunny (while maintaining at least 6 foot distance from others AND I would recommend wearing a mask).

We are in an unprecedented medical situation in the US right now.  COVID-19 is seeping into every town.  Our country has vastly underestimated the power of the coronavirus.  Unlike the flu or other cold viruses, after infecting people COVID-19 can manifest with mild symptoms at first.  Most people think it’s just a “head cold” or allergies, so they may not feel the need to stay home but during this time they can spread it to other people with even a handshake.  Over a few days, these people can become ill in varying degrees ranging from flu-like symptoms to shortness of breath requiring them to be on a ventilator.

You may think “I couldn’t possibly have the coronavirus, I feel fine”, but if you infect others, they may have severe complications which could land them in the hospital and add more stress to the already overwhelmed healthcare system.  Many hospital across the nation are experiencing unprecedented number of patients, many of whom require ventilators to help them breathe.

Right now, to help your fellow Americans and all of mankind, PLEASE STAY HOME AS MUCH AS POSSIBLE.  Do not go to buy groceries more than necessary, wash your hands and clean all common surfaces in your environment (door handles, faucets, etc.).  Here are some other tips to help stay safe if you do go outside your home.

As you may have heard, we are having a global health crisis caused by a virus known as COVID-19.  This virus in the Corona-virus family is thought to be spread by human to human contact, mainly from respiratory droplets and possibly also from urine and feces.  The main routes of entry into our body is through our mouth, nose, and eyes.

Here are some steps that you can take to protect yourself from infections during this time:

• Wash your hands!  Make sure you wash with soap and warm water.  The proper duration of an effective hand cleaning is about the time it takes to sing the “Happy Birthday” song twice.  This so so important, especially before eating or touching your face.
• Limit unnecessary bodily contact with other people.  In times like these, we should be reducing kissing/hugging/handshakes as these can easily transmit viruses.  Try other forms of greeting such as bowing, “namaste” with hands together, and waving.  I recommend placing hand sanitizers in by the doorway in your home, to remind yourself to use it after you entering.
• Avoid touching things that many other people have touched with your bare hands.  If you do, wash your hands or use hand sanitizer afterwards.  Door knobs, restaurant menus, toilet flushers, subway poles, airline arm rests/tray tables/seat belt buckles, and pens at banks are some examples.
• Get adequate rest each night.  Your immune system needs adequate rest to be strong enough.  Here are ways to get better sleep.  If you need discipline, set up your phone alarm to ring at a certain time each night.  When the alarm rings, all electronic devices and lights must be turned off and you must get ready to go to bed.
• If you are flying on an airplane, here are tips to stay healthy.
• Get your flu shot if you have not gotten one this season (after Sept 2019).  No, it’s not too late!  We are still at the tail end of a very bad flu season.  Flu symptoms and COVID-19 are almost identical.  If you get the flu, you may panic and think you have COVD-19.  Also, the flu could worsen your immune system and make you more likely infected by other germs afterwards.
• If you are over 65, get your pneumonia shots (Prevnar-13 and Pneumovax 23).
• Eat a balanced diet with plenty of different colored fruits and vegetables.  Each color represents a different vitamin.
• Exercise regularly, in moderation.  Exercise can mobilize white blood cells, which are like policemen in the body, to different parts of the body.  Don’t over-stress your body with intense workouts as that could actually reduce your immune function.
• Prioritize sleep.  This is so important!  Sleep is really one of the most important ways our immune system gets stronger.
• Avoid extreme dieting/excessive weight loss.  I am a big proponent of trying to reach your goal BMI, however this is not the right time to be losing too much weight.  If you do get infected with COVID-19 and you have fevers and loss of appetite you will likely lose weight and that could be harmful if your weight is already on the lighter side.
• Don’t smoke or vape.  All respiratory illnesses are worsened with any type of inflammation caused by these chemicals in the lungs.
• Avoid touching your face with unclean hands.  If you feel an itch that you must scratch on your face, use a clean tissue.
• Stay hydrated and moisturize.  When your nasal passages dry out, it can cause cracking and irritation which allows viruses into our body.  Just as you would apply lip balm to your lips in the winter, put a tiny amount of vaseline around your nostrils to keep them moist.
• Reduce stress, meditate.  When your body is stressed out, the immune system function is reduced.  Try to do some meditation, and take your mind away from fearful thoughts.  Avoid watching or reading too much of the news stories, as some of them can be false or paint the worse case scenario.
• Laugh, interact with friends and family (perhaps virtually, depending on the recommendations about acceptable distance at the time you read this).  A positive outlook can certainly improve immune function.
• Wear glasses.  If you normally wear contacts, change to glasses.  If you don’t wear glasses, consider using a “blank” set of glasses. Ideally the larger the frame size, the better.  The eyes are a way for germs to enter our body, by having a barrier, you can reduce droplets from getting in contact with your eye.  Also, wearing glasses can be a reminder not to rub your eyes or touch your face.
• Postpone elective surgeries, avoid going to medical offices if not absolutely necessary.  Many doctors offices now have the capability to do “virtual video visits” where you can speak with you health care provider over video chat.  You really don’t want to be sitting in a waiting room with many other sick people right now.  Be sure not to touch the waiting room magazines!
• Make sure your chronic medical conditions are under control.  For example, if you have diabetes, make sure your sugar levels are controlled.  If you have high blood pressure, make sure you are monitoring your blood pressure closely at home.  If not, you may need to adjust your medications or diet.  Check in with your medical provider (ideally through a virtual video visit and not in-person), and ask to review your conditions, medications, and symptoms.
• If the weather is nice, plan gatherings outdoors.   Open spaces are not conducive for viruses to spread from person to person.  The wind current would disperse particles far and wide.  If you must gather indoors, open the windows to allow for fresh air to circulate.  Avoid gathering in tight spaces.  The recommended distance for ideal protection is a six foot radius.  For social events, consider patios, terraces, or backyards.
• Take Vitamin D3 1000 IU’s per day.  Some studies have shown a correlation between low levels of Vitamin D and reduced immune function.  Vitamin D is usually activated by our body from sun exposure.  During the cold and dark winter months, we are more likely to get sick with the flu and cold viruses because of this.  If you do have a sunny day, go for a walk for at least 10 minutes, that is another way to get adequate Vitamin D.
• Do not take Vitamin C.  There has been no benefit shown for this vitamin in relation to preventing colds/flus.  In fact, taking excessive Vitamin C can cause kidney stones and other health issues such as heartburn and stomach ulcers.
• Humidify your home.  Dry air leads to skin and nose irritation.  Here are ways to get more moisture in your home.
• Moisturize your face, especially your nasal passages and skin on your face.  When your skin gets dry, it cracks and creates openings for viruses to enter.  Use a warm moist towel to add extra moisture to your skin.
• Make ginger tea and drink daily.  In traditional Chinese medicine, ginger boosts “Yang” energy which can improve immune functioning during winter months.  Simmering ginger tea on the stove will also add humidity to your home.
• Hydrate, hydrate, hydrate!  Drink enough water/tea/soup.  Your urine should be clear and almost colorless. If it is apple juice or tea colored, you are not well hydrated.
• Wipe down your electronic devices regularly.  Our phones and tablets can be quite filthy considering how many times we handle them each day and lay them down on all surfaces.  Keep a bottle of glass cleaner spray and paper towels on the counter and remember to clean your devices.
• Wash your clothes after coming in from outside.  This is more important for shirts as your sleeves are more likely to get contaminated compared to your pants.
• Clean your phone.  We often forget that we touch our phone so many times in a day.
• Don’t panic!  Anxiety worsens our immune system function.  Just use your common sense.  Do not let the fear of the virus overwhelm you or make you feel isolated.  Use other forms of electronic communication to stay in touch with loved ones.  Try to continue doing things you normally would, with just a few extra precautions.