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We have an epidemic of bad posture (levels.io)
156 points by pieterhg on July 26, 2016 | hide | past | web | favorite | 146 comments

Lifting weights can help, but it can also cause more harm when your routine isn't properly balanced. Doing only bench press and military press lifts for upper body is going to be a chest/tricep push heavy routine.

If you're not balancing these pushes with pulls (chinups, pullups, rows, etc), it can promote issues like rolled shoulders, forward neck, weak traps, weak rhomboids or similar postural issues to those the author is trying to avoid in the first place. In fact, many lifters will add more pulls than pushes, because our day-to-day activities tend to be more push-oriented.

The point is, if you're going to lift, pick a beginner's routine designed by someone who knows what they're doing that has push/pull balance programmed in from the outset. Don't just pick a couple lifts that you enjoy and throw out the rest.

This. So much this. But even a cookie-cutter program can lead you down the wrong road because they assume that the person beginning the program is healthy. Most of the readers here spend our lives in globally flexed positions with abducted, elevated, and internally rotated shoulders and flexed, externally rotated hips. When we go to the gym, we need to train for the opposite. Training for global extension, especially emphasizing thoracic extension, is essential; it all starts and ends at the spine. External rotation at the shoulders is also important, as is scapular retraction and depression. Many keyboard users suffer from lengthened scapular adductors which (speaking from experience) may lead to anterior capsule impingement as the shoulder blades gradually 'wing' out farther and farther from the spine and force the glenohumeral joint forward. People like this (me) need to take extra care about how they train pressing.

The human body is a very complicated machine, but you have to start with the idea of a mechanical system. If the system isn't aligned properly (eg your posture sucks, you have a dysfunctional deep core, you're missing significant range of motion, etc) you have no business putting stress on the system. Weight training has a lot of benefits but most people end up just reinforcing their poor mechanics. When you grab a 5x5 off the Internet, you're basically betting that your body will automagically realign itself to normal (whatever that means) before you damage it beyond the point of recovery.

My advice- don't focus on moving weight, focus on moving correctly and use the weight as a tool to learn how. If you don't have a solid foundation in exercise fundamentals (your freshman football strength coach probably doesn't qualify), use a non-challenging weight while you learn. Also, start watching Dr. Kelly Starrett's videos.

Hey, you say "When we go to the gym, we need to train for the opposite" but then go into lots of terms that I don't understand.

Can you give a short "ELI5" list of popular exercises which should be avoided/limited with these posture issues, and which typical exercises would fill the lacking areas?

If you want an "out-of-the-box" routine that's simple and balanced, I'd recommend "stronglifts" [0]. To be sure, it's a very strength-centric routine, but you can very well dial it back to twice a week and complement it with a weekly run.

The reason I suggest this particular regimen is threefold:

1. it's simple

2. the "culture" of stronglifts focuses heavily on proper form

3. the exercises involved are compound (i.e. multi-join, multi-muscle-group) lifts, which reduce the risk of muscular imbalances.

[0] http://stronglifts.com/5x5/

I did CrossFit, got hurt. Tried again, got hurt. Final time, got hurt.

Did StrongLifts. Got gains. The only injuries came from my Krav Maga instructor. ;-)

I've been lifting on and off for the past 15 years. I'm currently doing stronglifts after a 4 year lull.

It is not for the beginner. Squats are difficult to do correctly and I spent about an hour watching videos before I attempted it with a personal trainer. Then I kept watching videos to improve form. It's not a simple exercise and it is easy to perform it wrong. Barbell rows are easier to learn but also easy to perform incorrectly. Bench press is pretty safe. Overhead press is pretty safe. Deadlift is worrisome but not so much at the low starting weights of the 5x5.

I would recommend watching a lot of youtube tutorials on how to do the exercises correctly. Do a complete warmup before lifting. Hire a personal trainer who is a weight lifter to make sure you're doing the exercises correctly. Then you can feel comfortable doing it on your own.

Squats really aren't that hard to learn on your own. There's no reason a level-headed beginner can't start squatting on his own.

If you have a mirror and you start with light weights, you can monitor yourself for form. Yes, there's a bit of due diligence involved, but it ain't exactly rocket science...

That having been said, the importance of doing all of these exercises with proper form cannot be overstated.

I recommend to use "ladder" technique instead of simple repeats, because it adjusts itself, so no need for app, spreadsheet, or personal trainer to calculate proper weights and number of repeats, moreover, it has lower risk of injure.

Start with x repeats, then count to 20, do x•2, count to 20, do x•3, ..., until you tired, e.g. x•5, count to 100, then do x•4, count to 20, do x•3, count to 20, do x•2, count to 20, do x repeats in row. X can be 1, 2, 3, 4, 5, etc., e.g. 5, sp, 10, sp, 15, sp, 20, lp, 15, sp, 10, sp, 5, lp, an another exercise...

Important NOTE: Each of downslope repeats must feel like top repeat, i.e. you should be equally tired for X•N, count to 100, X•N-1, count to 20, X•N-2, and so on. If you are not tired, then increase X or weight.

I don't dislike your suggestion in the least, but it's a bit disingenuous to suggest that a routine like StrongLifts requires an app, spreadsheet or trainer.

You just do 5 sets of 5 reps for a couple of exercises... that's really all there is to it.

So stronglifts is a slightly modified starting strength? I like it; I've been doing starting strength, but I can't do pull-ups very well so when I got to them I had to start with rows.

Yes, it's more or less the same thing. Potato-potahto, as far as I'm concerned.

>I can't do pull-ups very well

Funny it's the opposite for me. I can do pull-ups all day long but still struggle with bent-over rows to this day. TBH I don't really do rows anymore. I just hold a dumbbell between my thighs and do pull-ups.

At the risk of oversimplifying, and with an explicit warning that reading words is no substitute for working with a proper trainer who can plan a good programme, watch your movement live and correct mistakes immediately, and generally help you train safely and effectively...

Planning a good programme mostly isn't about specific exercises, except for avoiding a few that persist in popularity even though they're actually really bad for you. It's more about balancing so you don't focus too much on one area relative to another, and then you also need to use good form when you move so you really are recruiting the muscles you intend to without damaging anything else. If you don't balance your training well, or you train with bad form that has the same end result, a couple of things are likely to go wrong.

The first is if you have opposing muscle groups but train one side much more than the other, either through neglecting exercises on one side or through bad form so you're not getting the full benefit of the exercises you are doing. Barring injury, you'll still strengthen the muscles all right. However, you'll then find that instead of the muscles having a comfortable neutral position and supporting any nearby joints as they should, you permanently have the much stronger side pulling on everything. This makes you vulnerable to all kinds of injuries and complications. It also means that in the real world, your strength will be less useful in practice than it could be. (It's also potentially an underlying cause of bad posture, which I think is where we came in.)

There's no big secret to avoiding this. Just be careful to train both sides of an action reasonably evenly. If you're doing bench press to build up your chest, do some rows to build up your back as well. Shoulder press? Do some pull downs or chin-ups as well. Hitting your triceps? Don't forget your biceps. Be particularly careful with the legs, because so many exercises naturally use a pushing action, but big quads and weak hamstrings does not make for happy knees and hips.

A second very common mistake is to focus mostly or entirely on the bigger, stronger muscle groups. They look great all pumped up, and they do provide the majority of your practical strength. However, your body is also full of little muscles that co-ordinate and stabilise everything else, so you can deploy the strength of your major muscle groups efficiently and safely. If you don't train your supporting muscles to back up the big guns, then sooner or later all the extra power in your big guns is going to get put somewhere that can't handle it, again probably resulting in sprains, strains, or worse.

The best general advice I can offer to avoid this one is to try to focus on compound exercises and free weights for the most part. (A compound exercise just means one that uses multiple joints and muscles together at once. Almost any "big movement" exercise you see at the gym that isn't done with a machine partially controlling the weight/resistance is going to be a compound exercise.) If you use machines to isolate specific major muscle groups, you can really concentrate on building those up, but the machine is probably also lending support to the surrounding joints in a way that natural movement won't. Do that for most or all of your work-out and neglect other kinds of exercises and you'll build up the big muscles but neglect the stabilisers, and the first time you realise it may unfortunately be when you try to move something substantial in real life away from the gym and find you didn't have nearly as much functional strength as that nice increasing weight on the machine made you think you did.

I hope that helps with your question, but again I really can't stress enough how important it is to work with a good trainer, at least to start with, if you want to get into gym work. They're not just there for encouragement or to spot you on a heavy lift, they're also there to help you make the most of your work-out and get better results sooner just through training with a good combination of exercises and good performance when you do them. Finding the right trainer was one of the best life decisions I ever made.

I can only speak from personal experience:

Deadlift- My favorite, the king of lifts! When I say a globally flexed position I'm talking about the fetal position archetype. Next time you're sitting down just imagine transitioning from your seated posture to fetal position. The deadlift is the opposite of this- you start in a flexed position, and then stand up perfectly straight. Make sure to learn how to properly brace before attempting this movement, or really any movement under heavy load.

Bench Press- My back muscles that are in charge of pulling my shoulder blades back and down are stretched out, meaning that my shoulder blades are usually much further forward and up than they should be. When I bench press the tendency is for my shoulder blades to roll forward. When bench pressing, you're supposed to keep your shoulder blades pulled down towards your butt and as close to your spine as possible. This creates stability and room in the front of your shoulder. When I bench press, I have to put in extra effort and use a light load to make sure can I keep my shoulder blades in the right position. This forward rolling is also associated with activation of the internal rotator cuff, which is bad- your rotator cuff isn't meant to handle that much load. So it's also very important for me to use a close grip and keep my elbows close to my body, maybe a 15-20 degree angle at my armpit in the bottom position.

Squat- I'm missing a significant amount of internal rotation at the hip. Sit in a chair with your feet on the floor, then without changing the angle between your upper and lower leg rotate your right foot up and to the right. This is internal rotation. External would be putting your right foot on your left knee. Part of my restriction is due to a lifetime of poor habits, but part of it is due to my hip structure. Think of a dog with hip dysplasia. This, combined with a tight posterior chain, makes it impossible for me right now to squat without compromising in some way. I find that elevating my heels slightly (often I'll just stand with my heels on 5lb plates) and pointing my toes slightly out (10 degrees) creates more room in my hip, allowing me to achieve a parallel squat. The danger of this is that without your feet flat on the ground straight ahead, you aren't integrating your lower legs into the movement in a natural fashion. Make sure to keep your knees 'not in' so that your arch doesn't collapse. A collapsed arch not only bleeds power, but the accompanying inward movement of the knee (valgus) can cause ligament tears.

Pullup- The same issue I have with the bench press where my shoulders roll forward under high stress. I usually don't have any trouble maintaining form as long as I consciously think about keeping my back straight and pulling my elbows down and back, rather than my head up.

Just as a heads up, the adjustment of putting your heels on a 5lb plate is actually used to train depth in the squat. "Ass-to-grass" is the squat standard for weightlifting (i.e., like in a 3rd world squat, you should want to be able to sit down on your heels comfortably), and the idea is that squatting a bit higher weights than you can do without the heels elevated with the heels elevated trains that depth in the movement. Point being, eventually you might be able to get to just under parallel if you keep working on the heel-elevated squats!

Also, re toes slightly out, this is how you should squat, you shouldn't square up with the rack or keep your feet parallel, because (again, referencing the 3rd world squat) if you were to sit down on your heels, mobility permitting, you would basically have to have your toes slightly outward.


"Explain like i'm five"

What advice do you have for learning to move correctly with only bodyweight training, not lifting weights? I don't have access to a gym right now, but when I do have access later this year, I'd like for my body to be (closer to) properly aligned so I can start lifting weights again without reinforcing bad posture, etc.

(edit: I'm trying to ask the same question as the sister comment by PeterP)

Take a look at /r/bodyweightfitness: https://www.reddit.com/r/bodyweightfitness. They've put together a routine for beginners that is excellent: https://www.reddit.com/r/bodyweightfitness/wiki/kb/recommend...

No matter what: Lift heavy shit over your head properly, repeat, and you will get strong.

If you're looking for the README.md just going with StrongLifts works for a wide segment of people.

Lots of people have different opinions and systems of fitness but just keep that truth in mind.

All good advice. Are you familiar with sites like Nerd Fitness and GMB Fitness? They both focus on online self-driven instruction rather than in-person coaching, but each seems to offer an interesting angle on enhancement of physical movement, especially the latter.

Yep, getting a strong back (from pull type movements, as well as squats and deadlifts) has improved my posture more than anything else. Another to look into is weak/mis-firing glutes (from sitting all the time). Apparently planks (of a certain kind where you squeeze your glutes as well) help for that.


Totally agree!

I'm 6'4 and have always had issues with bad posture. Text-neck and bad eyesight go hand in hand, if you wear glasses Be sure your prescription is up to date! After using the same pair of glasses for three years and swapping them out the sheer amount of hunch eases out of my routine.

Keeping lower back muscles strengthened also helps. I've found rollerblading through my city and its trails to be an excellent low-impact cardio workout. A cheap pair of Bauers goes for 80$ at CanTire, and pairs perfectly with the Hackers Soundtrack (1,2,3) (because inline is dead right?).

Proper sized tools also help with RSI. Massive hands and small iPhones/chef knives destroy me. I've picked up some grips for my knives (I'm a chef) and a larger Android device and the cramps have disappeared. Raise surfaces that are routinely used, most surfaces ate meant for normal height workers, not giant lanklets.

Do you have any specific beginner's routines you'd recommend? I was doing 5x5, which has pulls in the form of barbell rows and deadlifts; I don't know if that's sufficient.

Always put technique first. Start with the basic compound lifts. These represent idealized human movement. Use light loads while you learn what proper technique feels like.

Deadlift- Be careful not to overdo this, especially when you're starting out

Squat- Overhead squat is probably the best variation to master, but goblet squat is probably the easiest


Bench Press



Bent-over Row

You should also challenge your cardiovascular system in some way, preferably one that physically moves your body through space.

In addition, I feel strongly that recreational lifters should always emphasize mechanical alignment and efficiency over force production. So set aside the time to address any movement restrictions, prioritizing those that interfere with your ability to perform the above movements. For instance, if you have 0 degrees of internal rotation at the hip, you aren't going to be able to squat correctly.

I agree. Spend a month or two (or more if you have severe mechanical restrictions) familiarizing yourself with the proper form for the major barbell lifts, and then put yourself through a beginner program such as Starting Strength [1] , accompanied with good nutrition[2] and HIIT to keep bodyfat in check.

On a side note, it's interesting to me that you singled out the deadlift, as I found the (back) squat the most challenging lift to master.

[1] - SS prescribes power cleans; I think most people will get more desirable results from rows

[2] - this varies significantly from person to person, and is probably the biggest challenge, as it's a huge inner game

> On a side note, it's interesting to me that you singled out the deadlift, as I found the (back) squat the most challenging lift to master.

I totally agree with you, I feel that the goblet squat, front squat, and eventually the overhead squat are much better for beginners because they emphasize good movement mechanics in a way that the back squat allows you to cheat on (until you end up at the chiropractor).

The reason I put deadlifts first on the list is that I truly believe it to be the most important lift to master- particularly for those who spend most of their time in globally flexed positions while sitting on the primary movers of the posterior chain. Plus, you can't deadlift and not develop bracing technique, which is IMO the most important thing a beginner can learn.

I don't think I agree about the OHS; I think it's a move that is better suited to aspiring Olympic lifters due to its complexity and application to the snatch, but I'll leave that argument to the Contrerases of the world.

Very much with you on bracing and its essence in deadlifting, though.

For specific beginner programs, GSLP and StrongLifts have always seemed like the two with the lowest barriers to entry of the ones I know about.

I would add weighted chin-ups to any beginner routine that doesn't have them, because I personally like to balance not only the push/pull muscles, but also in the horizontal and vertical planes.

You didn't ask, but my current routine consists of these core/compound lifts:

Workout A) * Bench Press (horizontal push) * Barbell Row (horizontal pull) * Squat (leg-driven push)

Workout B) * Overhead Press (vertical push) * Weighted Chin-Ups (vertical pull) * Deadlift (leg-driven pull)

Any lifts besides these are considered accessory and are only programmed in based on specific needs, e.g. weaknesses/imbalances/posture issues/aesthetic goals. If I can't tie an accessory back to a specific need, then it's just considered fuckarounditis and I eliminate it.

I rotate my rep scheme so I'm not always doing high weight / low rep, but sometimes low weight / high reps or medium weight / medium reps. I do this mostly to not get bored, but also because always doing high weight / low rep can get stressful. I'm probably sacrificing strength gains by slowing my progression down, but I'm okay with it.

Disclaimer: everyone's goals are different. I'm pushing 40 and my goals are to maintain a modest level of strength and overall fit appearance (only working out 3 days a week for < 90 minutes per session) and this is what works for me.

If one's goal is to be a powerlifter, fitness model, bodybuilder, etc. you most likely have to work harder and take your programming even further than I've taken mine.

You can always supplement the 5x5 routine with 3x8-10 (typically) accessory exercises with dumbbells.

In some cases dumbbells will give you a better range of motion and help develop smaller muscles.

Another common addition to 5x5 I've seen is adding a dedicated core day (weighted ab crunches, hanging leg raises, planks) Core is the 2nd most important part of doing pull exercises (after back)

> In some cases dumbbells will give you a better range of motion and help develop smaller muscles.

This has always smelled like broscience to me. I guess I'm just skeptical that someone unable to create stable positions with a fixed object (barbell) will have more success creating proper stable positions off of objects that move freely. Based on what I've seen in the gym, it looks like the barbell users usually end up 'collapsing' into stability... then again, most of what I see in the gym are meatheads using way more weight than they should be. Maybe it would be different if priority was given to proper mechanics rather than pressing till your eyeballs bleed.

>most of what I see in the gym are meatheads using way more weight than they should be.

What does that mean? If your goal is to get stronger you have to lift as much weight as possible. Obviously you don't want to hurt yourself, but the emphasis on perfect form over heavy weights is "broscience" if your goal is strength.

>I'm just skeptical that someone unable to create stable positions with a fixed object (barbell) will have more success creating proper stable positions off of objects that move freely.

The whole point is that it's more difficult to maintain stability with dumbells.

Let me clarify. A professional strength athlete will need to move lots of weight, and will occasionally need to compromise form and future health to get it done. That being said, look at the work Kelly Starrett has done with Mark Bell. Perfect form by definition results in the most efficient force production and transfer, and is therefore the most efficient way to increase strength. My understanding is that these days you rarely see elite power athletes compromise form in training, in the same way that you rarely see elite power athletes lifting their max load. My philosophy is that in training, a rep without proper form is a failed rep.

I prefer dumbbells to a regular benchpress, but it's largely because I don't have an exercise partner and I don't want to get trapped underneath a barbell if I can't lift it.

If you lift in a gym, one option is dragging a bench into a power rack [1]; this will allow you to bail using the safety bars. Another is to use an olympic bench station (if you have one) to hang the bar up onto a lower hook. If you can't even lift the bar, there's the option of benching without clips [2].

No need to miss out!

[1] : https://www.youtube.com/watch?v=Ru0scbx8DuI [2] : https://www.youtube.com/watch?v=XGkRDcMeSTY

The idea is that you have full range of motion when using a barbell or dumbbells compared to a machine that limits your range of motions to a very strict horizontal/vertical axis.

I like the reddit /r/bodyweightfitness recommended routine.

Yep. I could not fix my posture until I started lifting. And I mean compound barbell movements. Squat, deadlift, shoulder press, bench press and barbell rows. And then my posture just fixed itself.

Great to see I'm not the only one to discover this. Hopefully many more with poor posture will follow.

I had pretty bad RSI some years ago, to the point where I thought I wouldn't be able to program anymore. However, I got through it, and I don't have any pains today.

The key thing for me was starting to use a break program on my computer. Every 5 minutes I take a 10 seconds micro-break (let go of the mouse and keyboard). Every 45 minutes I take a 5 minute stretching break, and do 3 or 4 stretches.

That, together with a split keyboard (Goldtouch) and a pen-shaped mouse called Penclic. Both those are great for me. Almost all regular keyboards are terrible from an ergonomic standpoint (especially Apple's), not to mention laptop keyboards.

More details here: https://henrikwarne.com/2012/02/18/how-i-beat-rsi/

Forced break programs saved my wrists. I use AntiRSI on the Mac and WorkRave on anything else.

Rocking a GoldTouch split foldable keyboard, Apple Trackpad, and the Roost that levels mentioned in his post

I seem to recall hearing from my doctor that the micropause software simply made some people freeze up and wait, making it worse.

She suggested that it would just be better to get up and do something completely different for a time. I found that, while working at home, hanging out laundry worked wonders.

I've had a lot of people deride me and laugh at me for that single phrase, but not one of them suffered the pain of RSI. They probably wouldn't laugh so readily if they couldn't feed themselves - or open a locked door - for several months.

RSI stands for "repetitive strain injury": https://en.wikipedia.org/wiki/Repetitive_strain_injury

(for those of us who didn't just know this)

The article is a great starting point, but exercise in itself is not enough.

If you've worked for multiple years in a (seated) office setting, chances are you have tight muscles. Muscle tissue then gets glued together and stuff like forward rolled shoulders happens.

Now you go to a physical therapist with your neck or shoulder pain and he/she recommends you physical therapy. The problem is just, the area is too tight to react to the right kind of stimulus, so the trick is to first massage the area and then fix it with the right exercises.

Simple tools like a lacrosse ball (5 bucks) or a foam roller (10-20ish bucks) can work wonders IF used regularly and in the right fashion.

I've written about one part the issue here, called "text neck" https://bitehype.com/text-neck/ - I've also compiled some of these lessons into a free email course, where I dive into the topic a bit deeper: https://www.dailybitsof.com/courses/fix-your-posture

I hope that helps - open to any questions in that area (my expertise comes from years of injury/self experimentation, bunch of interviews with doctors, physical therapists and massage therapists as well as visits to sports clinics. Oh and of course interest).

>If you've worked for multiple years in a (seated) office setting

and an year ago, after more than 2 decades (not counting university and before) of sitting i started to work standing. Wonderful. Besides posture and better breathing position, gone away some issues that started to appear during recent years due to bad circulation when sitting.

This is a consequence of laptop usage. You should have your screen at eye height, sit in a chair with arms, and have wrist support. Before laptops took over, there was a lot of concern about keyboard ergonomics. That seems to have disappeared. You can't even get the Microsoft Natural Keyboard any more.

>You can't even get the Microsoft Natural Keyboard any more.

Wow, are they Out of stock temporarily or permanently?


EDIT: They still offer plenty of Ergonomic keyboards, but only wireless one it seems. (For instance: https://www.microsoftstore.com/store/msusa/en_US/pdp/Wireles... )

You've got 2 options at the moment I think:

Cheap MS Natural 4000: https://www.microsoft.com/accessories/en-us/products/keyboar... (rubber domes - actually I think the space bar is OK, but tends to be stiff until it's had a couple of weeks of use)

More expensive MS Sculpt Ergonomic: https://www.microsoft.com/accessories/en-us/products/keyboar... (scissor switches + clicky buttons for F keys and Esc)

Both are OK, I'd say. The 4000 has slightly nasty keyswitches, but in exchange it's got all the keys in traditional places. The Sculpt is nicer to type on, if you don't mind that sort of thing, but the non-standard keyboard layout leaves something to be desired.

(One note of caution: I've had 5 of the MS 4000s now, and the newest one, bought a month ago, has a much squishier, quieter key action - presumably a new recipe with improved cost-effectiveness. I don't think this is any worse than what was there already, but some might disagree...)

It's "out of stock" for business, but not for individuals?

It looks like Microsoft brought this back as a new model in black with fake chrome, unlike the old beige model. (Still has the crappy spacebar mechanism, though; the spacebar is huge but has to be pushed near its center.)

All the ergo adjustments in the world won't help you if you sit in one position all day long with one small set of muscles engaged while the rest are disengaged and slowly atrophying.

The best solution is touched on in the article, but it can't be overstated that actual exercise is the best preventative.

Easiest solution for an office worker is to just run up and own the stairwell a few times a day. I don't know how so many people just sit still all day, with a big lunch too, then wonder why they feel tired in the afternoons. Their only solution seems to be more garbage Keurig coffee!

One of the most frustrating things about working in New York is the ample amount of potential stairs to climb with almost every door locked from the stairwell.

The epidemic has long since spread to the west coast. The Seattle building I currently work in has some limited, well-defined accessible stairwells, but AFAICT the majority are one-way, emergency-only. I've worked in buildings as you describe: one-way, down-only. Sucks when you don't know this yet, think you'll take the stairs to the fourth floor only to discover that you need to climb all the way to the bottom then take an elevator up. Security? Yeah, maybe, but that's bare-minimum-to-meet-the-spec lazy security.

I can confirm that the Royal Bank building in Toronto is the same, so I wouldn't doubt that this is a malaise in much of this city's office space.

Hah, same issue in my building in NYC.

>I don't know how so many people just sit still all day, with a big lunch too, then wonder why they feel tired in the afternoons.

One of the best periods I had in college was when I used to wake up around 0430, work out at home, take a shower, have breakfast (oeufs au plat, escalope/steak, and half a liter of milk).

I'd spend the day feeling great even though I didn't have lunch hour, just four 1h30 lectures from 0800 to 1430 as opposed to 1st and 2nd years 0800-1120, 1300-1630, with 10 minute pauses between each two lectures.

Full of energy and feeling great the whole day.

We had a physical therapist come by the office and adjust everybodies chairs - the result was that sitting down hurt so badly I ended up standing all the time, that should be better than sitting down, and the best possible position for my back other than lying down.

My feet wanted to murder me the first week, and especially the first 3 days, but once you get over it I highly recommend doing so - I actually don't have a chair at my desk anymore.

Switching to a sit-stand desk is by far the best thing I've done: http://jakeseliger.com/2015/01/24/geekdesk-max-sit-stand-des....

The best bang for buck ergonomics device for me has been a monitor stand that is spring loaded for easy height adjustment and goes higher than a normal monitor stand.

You'll need one with a sit-stand desk anyway so I'd suggest getting one first. You need the monitor higher when standing to have correct posture.

The monitor stands that come bundled with monitors are way too low if stationed on the same tabletop as your keyboard.

Can you recommend said spring loaded stand? I've just ordered a Varidesk (it hasn't arrived yet) but monitor height is one of the things I am worried about being a tall guy.


This one (Ergotron LX Desk Mount LCD Monitor Arm, Tall Pole) has been working well for me for the last couple of years, in conjunction with a Conset sit/stand desk (also great). I got the Tall Pole version just to be on the safe side, and it gives a lot of flexibility on where you want to position and angle the monitor.

I can't give you a brand name or anything like that. I have one at home which I bought from a second hand office supply for peanuts and I didn't order the one I have at the office and it doesn't have any labels.

Just searching the Internet shows that there are dozens of manufacturers for these things and price ranges vary widely. You should have no problem finding one.

If you're a tall guy like I am, I'd go for the highest one I could find. I have it almost at the highest setting when sitting down and I wish it was higher when standing up.

It sounds great but I'm wondering, would this be accepted in any company?

I work at a Fortune 500 company, in an open office area. I was the first person to use a standing desk, by cobbling some cardboard boxes together. And then I was kind of a promoter, and also mentioned to the department chair: "By any reasonable measure, computer use is a workplace safety problem waiting to explode." In fact I goaded him into getting one for himself.

Since then, quite a few people have gotten a VariDesk, and if you ask, your boss will just tell you to get one from Amazon.

If you think programming is bad, CAD is even worse. So far as wrist fatigue goes, I was in pain within a few months of getting my first Apple Mac, and quickly learned all of the keyboard shortcuts so I could minimize mouse use. A side benefit is that using a keyboard shortcut instead of an icon doesn't require you to focus your eyes on the screen.

Second the motion on VariDesk; I have one and am entirely pleased with it. (No, I don't work for them or have any financial interest in their company.)

I'd love to see this happen at my company. Many of us have L-desks with cabinets and drawers. I see little, if any use, for them, and would rather some vertical space in a convertible desk like the VariDesk.

You "goaded" your department chair?

Yup. He and I have a good relationship, plus he's willing to entertain well meaning debate. When he says, "my door is open," it's for real.

But I told him, "long term computer use will kill you. Get a standing desk."

My coworkers just got some Ikea boxes and swap around from time to time between standing and sitting.


About eleven years ago I started having crippling RSI in my hands and wrists. I fit the typical patient... Type all day sitting at a desk.

Posted about it on Slashdot and someone told me to look up TMS. Changed my life. After years of problems it completely went away in weeks. After years of searching for ergonomic solutions it was bizarre that following TMS treatment cured it in weeks and now I don't do anything ergonomic and I have had no problems for over a decade.

More info... http://www.rsi.deas.harvard.edu/mb_what_is.html


Did you do specific exercises, or just read and re-read Sarno's books to make the concept stick?

It's probably not great for my wrists, but I particularly like the location of the built-in trackpad on my MacBook.

So instead of raising the laptop in a stand and getting an external keyboard and mouse, I use an external display (24" 4K) at an ergonomic height/distance and keep the built-in monitor as a secondary screen (for example, running the iOS simulator on the MacBook screen and Xcode full screen on the external display).

I arrange the screens so the built-in display is below the external one (i.e. the same arrangement as they are physically) and keep my dock on the left of the main display.

He's still not using an ergonomic keyboard. Typical keyboards require the user to press the key to the bottom to activate it, like pushing your finger into the desk. A mechanical keyboard switch activates halfway from the bottom, reducing the extra stress on your fingers.

Here's a collection of other RSI stories, along with other ergonomic information:


Fwiw, I was disabled for 8 years with RSI, and the best keyboard I've found, for me, is the Apple one displayed in this article. It has the lightest touch of any keyboard I've used except for actual touchpad style ergonomic keyboards, which can be worse, since they can be difficult to use and require static pressure - like the keyboard of the screen of a tablet. Not to mention being unobtainable.

There are a lot of switches. Reddit has a great guide:


There's a table with activation forces:

    MX Red		Linear		45cN
    MX Black		Linear		60cN
    MX Dark Grey		Linear		80cN
    MX Brown

I have a Kinesis Advantage keyboard, and it's awesome. I can use a million emacs key chords all day and it's painless for my pinkies.

The Kinesis Advantage has really helped me, along with a Kensington Expert Mouse (which is actually a trackball). I used to get pains all the way up my right arm and through both wrists, but now worst case is a slightly tired hand.

The Kinesis Advantage has MX Cherry Brown switches. It would be great to understand what makes this keyboard effective. How does an Ergodox compare, for instance? I've also got a Github page dedicated to ergonomic keyboards:


The lf version comes with red mx switches. It's not just the keys though, as the position of the keys helps immensely.

> Typical keyboards require the user to press the key to the bottom to activate it

For all I don't like about Apple, their aluminum keyboards are what I prefer and use, precisely for the reasons stated in the article, and to counter your claim, the Apple aluminum keyboard travel is very short, so it bottoms out much quicker and still gives a feel like a mechanical keyboard.

My claim was that you don't want to hit the bottom. If the bottom is "very short", isn't that worse? I don't know the numbers for Apple's keyboards? You activate after about 2mm on a typical mechanical keyboard. You hit bottom around 4mm, which of course, you don't want to do.

I use an ergodox infinity, the main things I like about it are the columnar layout (q->a->z are in a straight line), and I can use it at varying widths and angles. I mostly use it at about shoulder width, angled slightly outwards. I still use QWERTY but it's not been a problem.

Oh, he has my key feature for an ergonomic keyboard (and he forgot to mention it). It doesn't have a keypad. This alone helps lots of shoulder issues by reducing horizontal travel switching to the mouse.

On top of the exercises recommended in the article, I would also suggest "Band Pull-Aparts". These help undo some of the posture issues from working at a desk.

This is a good instructional video on them: https://www.youtube.com/watch?v=dd9VoT1BPAY

People aren't static. Many of us fidget quite a lot which does wonders for preventing RSI!

I once had an ergonomics consultant confirm that despite my ridiculously poor posture, my constant fidgeting did wonders for preventing RSI and other forms of strain that occur when you hold a single position for too long.

(Also I barely touch a mouse which probably helps.)

I did that too. Then I stopped because I saw it as a.. defect? And then I had to pick it up again :) It gives me some "exercise" while sitting. All the time when I really have to think hard I do it more. For sure there is a link there. Brain needs more blood, muscles deliver it?

> Make sure [the mouse is] wireless.

I disagree there — wireless mice & keyboards are terribly insecure.

Other than that, seems like some good advice here.

Ergonomics and security are different concerns; the best mechanism for addressing one, considered on its own, may be suboptimal from the perspective of the other.

True enough, but security is a sine qua non: a system must be sufficiently secure before one even begins to consider ergonomics or anything else.

I've found wired mice to be lighter. wireless can be heavy , depending on what kind of battery is used.

When I last used wireless mice they had two AA batteries and I found it a great relief to go back to a much lighter wired mouse. It hadn't occurred to me that newer battery tech might be lighter. Maybe I should take another look at wireless mice.

EDIT: The Logitech MX Master (a wireless mouse) weighs 145g including battery, and the M500 (corded) weighs 144g. That probably includes the cord, so the in-hand weight might be a little lower, but they're certainly close. Neato.

For people looking for a cheaper option than the roost stand, i can strongly recommend book stands like this:


It can fit literally any machine, won't break from a puny laptop under any circumstance, folds very flat so fits in most bags, and can bring the screen really high.

100% agree with this article - I also don't know how more people aren't in the chiropractor's office weekly. I went through a particularly intense period of working on my laptop and it resulted in a neck spasm so sever it was like daggers trying to move my neck.

The doctor prescribed Vicodin it was that bad. But only when I went in for a series of chiropractic sessions did I improve my neck at the source. Thankfully now I'm more aware of just how important it is to not crane the neck, and I catch myself if I do it for more than 15 minutes at a time.

It definitely is becoming an epidemic, and there needs to be a lot more public awareness around this. Not everyone can afford multiple chiro sessions a week for weeks at a time to correct something preventable!

> I also don't know how more people aren't in the chiropractor's office weekly

Maybe because there are no evidence that it's effective.


Chiropractors don't fall just into "straights" and "mixers", there are entire schools which focus on evidence-based biomechanic adjustments and others that get way more woo-woo about it with energy healing and whatnot.


That guy spent years being a chiropractor and while he acknowledges that the postulates of vertebral subluxation theory is implausible, he was also able to spend years helping people with spinal manipulations working as a chiropractor. It was only until recently that physical therapists began doing adjustments which began competing with chiropractics

Like with anything, there are good and bad actors and even a bad actor may help people even if their justification for why something is helping is fundamentally flawed.

Don't throw the baby out with the bathwater.

> That guy spent years being a chiropractor and while he acknowledges that the postulates of vertebral subluxation theory is implausible, he was also able to spend years helping people with spinal manipulations working as a chiropractor.

Did he help them or did he deliver placebos? "Most cases of back pain are self limiting, and spinal manipulation is not often more effective than other physical treatment modalities in affecting the final outcome."

> Like with anything, there are good and bad actors and even a bad actor may help people even if their justification for why something is helping is fundamentally flawed.

Is there actual science supporting the claims? Not the mechanism claims, which are clearly bullshit. Is there even any support in the science for the claims of effectiveness?

Effectiveness in treating what? And what do you mean when you say chiropractics?

You want a study on effectiveness in treating asthma or deafness, then it's probably not available.

Effectiveness in treating something like scoliiosis? Yep, there is a study for that[1]. How about headaches? Seems to be some positive research on it[2].

Now I'm no scientist or statistician and there are also studies point to non-effectiveness in things like lower back-pain[3], yet even that study acknowledges that it's difficult to ascertain since most chiropractic packages aren't limited to simply adjustments.

I find it interesting how many people denounce sweeping generalizations when it comes to programming paradigms and approaches to infrastructure and application development... yet still fall victim to it when it's a topic outside their domain.

We're still just talking about problem solving here, so how come it's not a matter of defining the problem and assessing each approach in context of that problem?

[1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259989/

[2] http://www.ncbi.nlm.nih.gov/pubmed/8775024

[3] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447290/

I keep reading that, and then I keep reading about people who actually had good experiences with chiropractors.

This thread here: https://www.reddit.com/r/videos/comments/4ug8vw/this_chiropr...

You can see a clear divide. It's far from the homeopathy agreement that it's bullshit. It also seems like most people arguing against chiropractors have never experienced even a good massage and its benefits.

> I keep reading that, and then I keep reading about people who actually had good experiences with chiropractors.

Many people had good experience with horoscope or homeopathy and so on... I think any reasonable discussion shouldn't be based on personal anecdotes but on serious scientific protocols.

> It's far from the homeopathy agreement that it's bullshit. It also seems like most people arguing against chiropractors have never experienced even a good massage and its benefits.

I'm certainly not saying that all manual therapies are bullshit. Chiropractic doesn't equate to manual therapy.

Oh Jesus. Take that elsewhere. Chiropractors make a big difference for plenty people. Also the practice dates back centuries before Dr. Palmer.

Without Chiropractors and PT's who incorporate it into their practice there'd be a lot more people on opiates.

I cannot get over this kind of unhelpful bullshit.

> make a big difference for plenty of people...

The plural of "anecdote" is not "data".

Maybe because of the baby whose neck was broken [1], 6-year old who had a stroke [2], and 30-year old killed [3], all at the hands of chiropractors.

[1] http://www.stuff.co.nz/world/australia/9223578/Chiropractor-...

[2] https://www.sciencebasedmedicine.org/chiropractic-manipulati...

[3] https://www.sciencebasedmedicine.org/stroke-death-from-chiro...

Yeah, I don't know why people get surgery considering perioperative mortality[1]

[1] https://en.wikipedia.org/wiki/Perioperative_mortality


Obviously people die all the time and the cause of death can be attributed to any number of activities that are otherwise beneficial to the vast majority of people who undertake them.

There is a difference between a surgery removing a brain tumor and someone jerking your neck left and right due to some neck pain.

True, but your bias is showing.

There is also a difference between anaesthetizing someone to slice them open for an elective hip procedure vs having someone analyze your biomechanics and work to correct that through subtle lowerback/hip adjustments and strengthening supporting muscles through various exercises.

We could spend days going back and forth like this but it really boils down to you us having different ideas of what we're talking about when we say "chiropractics". I get the sense you've either never been to one, or else you went to a shitty one.

Who brings their baby to a chiropractor?

People who don't know better. I would expect someone who claims to be a medical professional to know better.

How often do you find that a person with a low body-fat ratio with negative effects caused by bad posture? The people who I've seen with obvious problems caused by poor posture, like a hump or sore back or joints, are usually moderately to highly overweight. Kind of like how women with large breasts can have problems with soreness or neck humps. I suspect that it's not so much about good posture as it is about having a variety of postures throughout the day and not having bodyweight stressing one's joints. Granted, I have no scientific evidence for this. It's just from my own observations(and my own experience of being a former fat guy).

To supply a counter-point, I'm underweight, and I had sore wrists and lower back pain before I made my workspace ergonomic.

I'm a tall (1.86 m) and fit middle aged man. I have neck problems from using laptop or bad chair. I started to have lower back problems but I fixed them with a chair.

I realized nearly two years ago that almost all tall people in my office use external monitors and it clicked. The taller you are the worse the laptop ergonomy is. Human head weighs 4.5kg-5kg. If you have to bend your neck even a little bit your muscles have to do lot of static work. You can compensate by bending your back, tall people have to bend their back more.

My hypothesis is that short or fit people can get away more than tall or unfit, but things will show up after 20-30 years of bad posture for everyone.

> If you have to bend your neck even a little bit your muscles have to do lot of static work. You can compensate by bending your back, tall people have to bend their back more.

Or you could (with the right chair and foot rest) angle your seat instead of bending your back.

I don't see how you can fix things with just chair if you work with laptop that is in the table and your are tall.

External monitor and keyboard is must.

Me. I'm a skinny guy, and developed osteoarthritis in my neck due to years of intensive computer use (since 1981). The problem as explained by my physical therapist is sitting with a hunched neck. The acute symptom for me is a bout of pain running down my left arm and wrist, lasting several months before it goes away. This has happened twice. Second time, I switched to a standing desk.

As an aside, I don't goof off as much when I'm standing at my desk.

Skinny dude here who has had serious RSI/postural problems. Same for my boss. None of the research I did mentioned bodyweight as a cause for RSI.

My wife weights 43kg and she has pretty bad posture. She is developing a hunch at 35! In my limited knowledge, its because of weak muscles all over. She's been skinny all her life.

I'm looking in to what exercises she can do to get better.

It's worth checking her thyroid function:

"Some studies have related hypothyroidism to muscle dysfunction... Furthermore, studies ... demonstrated that thyroid hormone action on skeletal muscles affects mainly type-I muscle fibers, which promote slow contractions and are most prevalent in the postural muscles recruited during prolonged effort" [1]

Also, not sure where you are in the world but your doctor telling you your thyroid hormone levels are ok unfortunately may not necessarily mean they are ok... There is a controversy about reference ranges amongst experts [2], and I think it's wise to pay attention to that.

[1] http://www.scielo.br/pdf/abc/v87n3/en_a33v87n3.pdf

[2] http://www.ncbi.nlm.nih.gov/pubmed/16148345

Hmm thanks for the tip I'll look in to that for sure. Coincidentally, her thiroid levels are being monitored by her doctor after pregnancy. One of them was low if I remember correctly.

You're welcome, hope it works out.

BTW, I think this is also worth highlighting (from [1] above):

"Different metabolic changes, yet with similar consequences, may therefore be observed in both hypothyroid and hyperthyroid patients. In the first case, fatigue is directly related to deficient action of thyroid hormones. In the latter, however, the cause is mainly depletion of muscle energy substrate due to high metabolic demand."

I'll second this; after losing 50lbs, many health issues just went away. Adding in the the strength training (Rippetoe's SS:BBT), has just made me feel that much better.

fyi: a vertical mouse can help with lower arm issues. I swap between this and a normal one and simply varying the motion helped with my issues....

Thank you for this. I didn't even know vertical mice exist, but I've often remarked to myself how strange it feels to rotate my lower arm 45-90° to use the mouse. Purchased.

I have two slipped disks, sciatica, piriformis syndrome and I'm 6'3. Most work spaces are pure torture for me without my protocol:

* Yoga or daily stretching

* Walking (properly)

* Epidural steroid injections every six months (for the disks)

What would be better (for people who don't want to end up like me):

A) Don't do dumb shit with your body (obvi)

B) If facilities departments would stop buying torture devices just cuz that's what everyone's used to sitting in

#1 PSA.

I wonder what happens to all those bearded 20+year vets after all that neck carnage..scary..

so i just built one of these: http://www.latesthandmade.com/pvc-laptop-stand-diy-ideas/

And now EVERYONE in the office wants one. Best investment of the year. +Also fun to paint/customize them.


Pete Egoscue's book "Pain Free" is IMO, the best book for understanding correct posture and how to achieve it. https://www.amazon.com/Pain-Free-Revolutionary-Stopping-Chro...

Walking a few minutes every hour is a simple way to clear your head, be more productive, and save your posture.

By all means do that, but in the long run it is not enough. 8 hours of sitting isn't countered by walking for 1 hour. There are many good exercises you can do with little to no equipment, the recommended routine of /r/bodyweightfitness is a good place to start https://www.reddit.com/r/bodyweightfitness/wiki/kb/recommend...

An epidemic you say, doctor?

Mostly I liked how you reconciled your personal pains with your expert domain knowledge about human biomechanics and health to provide medical advice, even providing Googled images that unequivocally demonstrate your claim and truly the extent of this epidemic.

Sorry your arms hurt.

Does anyone have an idea why, according to the author, a mouse being wireless is so essential?

While I agree with many things in this article, I don't agree with a wireless mouse. The only (modest) advantage I can cite for a wireless mouse is reduced friction thanks to removing that slight tug you will get the cable.

The upsides for a wired mouse are:

* Zero lag. Wireless mice add a few milliseconds of lag.

* Zero charging. It's never out of charge because you forgot to dock it at the end of the day.

* Zero stuttering. Even the best wireless mice sometimes stutter.

To my mind, the most important things for a mouse are:

* Get a mouse with extra smooth gliding surfaces. Most good gaming mice qualify.

* Get a properly weighted mouse. Again, most gaming mice qualify.

* Get a proper mouse pad. A gaming mouse pad will usually provide the best surface.

* Make sure the cable has proper slack.

* Set your acceleration properly so that you don't need to reposition the mouse often. Again, a high-quality high-resolution mouse really helps here. A gaming mouse can help if it has a "sniper" mode allowing you to engage a high-precision mode to click small targets in your UI.

Ultimately, yes, what I am recommending is get a lot of gaming hardware to do work, but it's actually great.

I can't think of any reason why a wireless mouse would have an ergonomic benefit over a wired one. They are the same size, shape, and orientation, and any decrease in drag from the lack of a cord is more than offset by the increased weight of the batteries.

When I'm reading a web page or code, I occasionally stand or sit with my mouse in my hand and my arm relaxed at my side, or across my chest. It changes the extension of my arm considerably and sometimes makes things much more comfortable.

> Does anyone have an idea why, according to the author, a mouse being wireless is so essential?

I'm not sure why according to the author, but the advantages I can think of are:

(1) It allows more free repositioning to address ergonomic issues, and

(2) While this doesn't necessarily happen all the time, lots of times wired mice end up with the wires running in paths where they ocassionally provide more resistance to certain movements, which seems likely to have negative ergonomic consequences over time.

Yeah, it bothered me that the author didn't even give a rationale for it, just mentioned it and brushed it aside, much like his other recommendations that are "industry standard." I agree with the main point of the article, and good solutions are touched upon lightly, but it feels really shallow and very much single anecdote.

IMHO, it's because you can put it where you want, such as on a side table at arm height, rather than where the cable lets you.

The very biggest thing for me -- having started suffering from wrist pain about ten years ago -- was switching from QWERTY to Dvorak for typing. It was quite a lot of work, but the wrist pain completely disappeared and hasn't been back.

I had the Herman Miller Aeron chair for a decade, and I recently upgraded to the Embody from them. It's leagues better in the ergonomic department. So comfortable, and no back issues sitting for extremely long periods of time.

Good tips. I may add:

1. A second mouse for my other hand. Pick a corporate mouse because those are symmetric. Use it to browse the web when you are not really working.

2. A desk with a dull (chamfer) edge.

My solution is to use a lap desk. I have what is called an ePad which is going on 6 years old. I should probably replace it.

I limit my desk time to 3 hours a day.

Have someone tried BetterBack?

I purchased mine but still have not received it.

Yoga!!! Don't knock it till you've tried it.

I haven't read all the other comments so not sure if this has been mentioned already.

The modern concepts of posture may be wrong.

I have a curved butt to shoulder area. It makes me look somewhat duck like.

However, I never have any back aches etc.

I know of people who are straight as a plank, and complain constantly of aches and pains.

This TED talk will explain why curved is better than straight:


I disagree with his suggestions about keyboards and mice completely. It's not that simple. What helps the author might hurt someone else. I personally can't use a mouse or flat keyboard. Making these suggestions categorical destroys an otherwise good article.

Same here. While the author has a point about laptops as a workspace he fails to distinguish between generally accepted best practices and his personal opinion. I've yet to see any totally flat keyboard to be recommended as ergonomic.

This is a great write-up. Thanks for sharing.

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