Coders: Protect Your Most Valuable Asset—You!

Don’t let repetitive stress syndrome affect your personal well-being: Think ergonomics.

By Steve Gray, AOES, COSS
As an ergonomics specialist, I have worked with many coders regarding workplace injuries. Over the past 20 years, I have not seen another profession that requires more repetitive motion activities (e.g., continuous and repetitive keyboarding, mouse clicking, and 10-key activities) than those required of professional coders. As such, coders are at high risk for musculoskeletal ailments such as carpal tunnel, back and neck injuries, etc.

The upcoming transition to ICD-10 means two additional keystrokes for every code entered (as five-digit ICD-9 codes become seven-digit ICD-10 codes), which will only increase the repetitive nature of the job. Now, more than ever, it is important to become aware of how to protect yourself and stay injury-free.
Do you respond to your body’s signals before it’s too late? Take this quiz and find out:

When I feel back discomfort, I change positions.

o yes o no

When I feel back discomfort, I readjust my chair.

o yes o no

When I feel back discomfort, I stretch.

o yes o no

When I experience neck tightness or discomfort, I check my monitor height and distance.

o yes o no

When I have headaches, I check my monitor distance and display features.

o yes o no

When I experience shoulder/arm discomfort, I check to my workstation layout to make sure all of my work tools are close by.

o yes o no

If you answered “No” to any of these questions, it is time to pay attention to your body’s signals.

Ergonomic Essentials

Be Proactive: Listen to your body’s needs before you reach an alarming state. Your body will tip you off when there is something wrong with your work environment by sending pain signals to and from your brain. Do not disregard your body’s signals. Take proactive measures to protect yourself by following simple ergonomic guidelines developed to keep you healthy and productive.
Create a Comfortable Workspace: Keep your work area clean and clutter-free. Adequate workspace for your computer equipment and supplies is a must. Set up your workstation so that your most frequently used items are within your “comfort zone,” approximately a 20-inch radius. This will typically include your computer, keyboard, mouse, telephone, etc. Do not place items such as family photos and small mementos within your comfort zone area as you need this space reserved for your primary keyboarding, 10-key and mouse tasks, and reference books. Make sure you have space underneath the desk to freely move your legs.
If it is within your company’s policy, personalize your workstation with two or three small, “de-stress” personal items that are meaningful and bring a smile to your face. Stress causes your muscles to tense, which can make you more prone to injury; the more stress you feel, the lower your tolerance for pain.
If you work from home, have a designated desk and work area. Select an area in your home that is free from distractions and outside noises.
Alternate Between Sitting and Standing: A medical coder typically spends 80-90 percent of the day sitting. We humans were not designed to sit to this extent, and it’s hard on our backs, legs, and knees. Take short stretch breaks. Walk at lunch and during breaks. Relocate your printer or fax so that you have to walk to get to it. Practice “dynamic sitting” by stretching and moving around in your chair. If some of your tasks can be performed when standing, do so. Stretch your lower back by standing up and pulling each knee to your chest, holding that position for a few seconds.
Get a Good Chair: A properly fitted chair is one of the most vital components for creating a safe and comfortable work environment. Your chair seat should have the right depth and width for your size, and be built to accommodate your general body structure. Adjust the height of your chair so your feet rest flat on floor. It is even more important that your arms and shoulders be relaxed while keyboarding; raise your chair high enough to relax the upper body and use a footrest for lower body support, if necessary. Do not work in a posture with tensed or “shrugging” shoulders.
Lower back support should be provided by the lumbar area of the chair back through adjustments to the chair back angle and height adjustment. If you do not have lumbar adjustment on your chair, you can roll up a towel and place it on the back of your chair for support.
Check Your Monitor Location: Is your computer monitor positioned so your body and/or neck aren’t twisted when viewing the monitor? If you use dual monitors and they are used equally, set the monitors next to each other (forming a slight V angle) at the same height. If one monitor is used more than the other, position your most frequently used monitor directly in front of you and place your secondary monitor to the left or right.
Your eyes should be in line with a point on the screen approximately two or three inches below the top of the monitor. Sit back in your chair (i.e., slight recline) and hold your right arm out horizontally, your middle finger should almost touch the center of the screen. From that starting position you can then make minor changes to screen height and angle to suit your preferences and comfort.
Note: If you wear bifocals or progressive lenses, you may want to lower the monitor slightly to counteract bending your neck upward to view through the bottom bifocal part on your lens to avoid tilting your head back or craning your neck forward.
In future articles, we will discuss keyboard and mouse “do’s and don’ts,” including how to select and position a keyboard, how to minimize clicking, etc.

Steve Gray, AOES, COSS, of Innovative Ergonomic Solutions, Inc., has been practicing the science and art of ergonomics for over 18 years. He is a member of the management team at ERGOhealthy, an ergonomics services provider specializing in predicting and preventing work-related injuries and conducting remote-location and on-site ergonomic assessments to help people resolve issues with their work processes and workstation environments.


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