Feeling overwhelmed by work and home responsibilities? Having difficulty drawing the line between the two? Tired of trying to make dinner while answering work emails at the kitchen counter all while your cell phone is glued to your ear? Are your kids having trouble staying focused as they engage in school remotely? I hope that this blog can offer you some ideas for creating your own habits and routines in a context that will allow you to perform your absolute best in this new year.

Working during the pandemic, we have been required to adapt to many changes during the past months. One of these changes has been adapting treatments to focus on the results of individuals emerging from shelter in place orders. Many of you have had to make modifications to your daily lives including work and home routines and the contexts and environments they are performed in. Many have been working from home (WFH) as well as exercising at home as workplaces and gyms have been shut down. Although I am unaware of any definitive studies completed to date, the ramifications of these rapid lifestyle changes have not come without cost. We have observed increased levels of patients presenting with non-descript hand and arm pain and paresthesia’s.

During an initial evaluation or first meeting with patients, we typically ask questions about the nature of an illness or injury. We discuss activities that either exacerbate or improve pain. Additionally, we discuss daily habits, roles, routines and the environment or contexts where they are performed. Collaborating with the patient we strive to identify alternative solutions to maximize an individual’s ability to perform daily tasks and routines within the context of their current environment. A change I have recently observed is the patients' description of their environments and the contexts in which they are experiencing discomfort.

People are no longer leaving the house to go to work. Instead of a traditional workspace, people are working from makeshift office space in their home. Some of the descriptions I have heard include laptops on the kitchen table or (gasp) laptops on a coffee table or lap while seated on the couch. Physical activity (think step counts) has decreased as mobility requirements throughout the day have declined. In person meetings that required walking to a conference room or travelling to another building have been replaced with teleconferencing. Daily face to face communication regarding files and projects has been replaced with phone and email. With many gyms closed, people have lost the added outlet of physical activity and stress relief. Additionally, many are feeling the pressures of childcare tasks while performing work duties. School age children have lost their familiar routines both academically and socially. They are now faced with countless hours of remote learning with minimal breaks. Remember when we were concerned with the amount of “screen time” children were having? With the added responsibilities juggling multiple roles at once, many are struggling to complete daily activities efficiently.

As Occupational Therapists, we are trained to prescribe treatment plans involving activities to promote healing and provide recommendations for environmental modifications. These recommendations are designed to help individuals effectively fulfill their roles (as students, workers, care givers, home makers, fill in the blank here…) to their maximum potential within any limitations (physical or environmental) they may be currently experiencing. Where we may have previously recommended ergonomic devices and workstation set ups, we are now challenged to work with our patients to allay poor habits and biomechanics that are likely contributing to their symptoms.

Below are some suggestions to help you create new habits and routines. While WFH, schedule breaks into your day! Although this seems obvious, many of us fail to implement this simple task. Being hunched over a computer or laptop for extended periods of time causes repetitive micro trauma to the muscles and joints of your entire body! Designate an area of your home specifically as a workspace. Set a timer on your phone, put your computer to sleep and WALK AWAY. Taking just a 5-minute break to clear your mind and move your body can provide exponential benefits! With the limited change in environments (think work, home, gym, social settings), it can quickly become a habit to be constantly available to respond to a work email or take a call. Set boundaries and schedules and stick to them. You will find that you are more productive, and your body will thank you! Put your shoes on and walk to the end of your driveway. Stretch your arms over your head and behind your back. The simple task of putting on your coat and shoes will engage muscles that have been unused while you have been hunched over your work. Pay attention to your posture! While it may be tempting to use mobile devices to multitask work and home duties, this will likely contribute to increased stress both physically and mentally. Consider a wireless headset for those long conference calls as well as those virtual meetings. These will allow you to utilize a standing posture and possibly even allow you to perform some stretching and move around-all while saving your upper back and neck muscles! Consider using a posture trainer (amazon has many to choose from). Use a chair with good support or if unable to do this, use a back support so the front of the chair is not hitting the back of your knees. Make sure your feet are in full contact with the floor (or use a box or stack of copy paper under your feet) ensuring you have a stable base of support. This will decrease stress on your lower back and thighs. Regardless of where or what your work surface is, position your keyboard and mouse so they are at elbow height. Consider using a split keyboard to limit lateral wrist rotation and compression of your ulnar nerve. If you are experiencing pain on the back of your hand, a yolk splint or simply placing a pen under your index finger while typing may reduce compression on your radial nerve. Your elbows should be at a90-100-degree angle and your wrists should be straight. A worksurface that is too high can increase tension and cause discomfort in your upper back and shoulders. A work surface that is too low can cause you to slouch forward also causing discomfort in your upper back and shoulders. Your monitor should be at or just below eye level. You can use household items to reposition laptops, monitors and other office equipment.
In this time of unprecedented challenges, do the best you can with the things you have. Be kind to yourself and others. And remember, we are here to help you!