Audrey Kirchner is an MT/HDS as well as an online instructor who has worked online for decades.
Ergonomic Advice for MTs and Computer Users
The medical transcription profession has evolved over the years to become one of the most physically tasking positions you can secure. Why?
The repetitive nature of keyboarding has been shown to cause thousands upon thousands of cases of repetitive strain injury or RSI per year. Some people recover but some sadly do not.
Since the shift of medical records from paper charts to computerized medical records and the subsequent demise of transcription standards to a piecemeal environment, it has made it all the more demanding on transcriptionists...and on many other computer users across other industries as well.
The current method of payment for medical transcriptionists is almost always by the line and in today's market, that price per line has been generally cut in half. However, in order to make money, you have to keyboard so it is a catch 22.
Medical transcription is a great job as long as you understand the pitfalls and guard against the many repetitive stress related injuries that can put you on the sidelines—and in more ways than just your job!
Let's take a look at some sound ergonomic products that are especially vital to a medical transcriptionist but can also prove invaluable to anyone who makes their living on a computer.
Best Ergonomic Keyboards
Ergonomic keyboards come in all shapes and sizes. They also come in all price ranges.
These inventive keyboards can also take a very long time to get used to and one ergonomic keyboard might work for one individual while it may be a disaster for another.
Does an ergonomic keyboard have to be top-of-the-line or the highest priced keyboard to be effective? No!
Do you have to get used to an ergonomic keyboard and will it slow you down while you're learning it? You bet!
All that said, the most recommended way to introduce your hands and arms to an ergonomic keyboard is to start slow and also to start out on the economical side. While the caveat is usually true that you get what you pay for, starting out with the most high-end keyboard may have you screaming all the way to the bank if you end up not being able to use it.
Years ago, I tried one of the very first Microsoft ergonomic keyboards and as hard as I tried, I couldn't use it. It made my wrists and hands hurt more than before I started using it. The only thing I was ever able to figure out was that my hands are relatively small and the angle that the keyboard had my hands at felt uncomfortable from the beginning. It never got better. I ended up selling it to someone who was able to use it but it was a very expensive keyboard that I definitely did not get my return on.
The best advice is to try one that is relatively inexpensive and see how you tolerate it; or give one a trial run if a store is willing to let you do that and will allow a return if it doesn't work out. Graduate upwards in terms of more complicated ergonomic keyboards if you find that an ergonomic keyboard works for you!
Things to consider about ergonomics and keyboards in general:
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- Wrists should always be flat when typing or keyboarding.
- Keyboards should always be in front of you not to the side.
- Elbows should be close in to your body and shoulders relaxed.
- If an ergonomic keyboard changes any of these 3 things, it is not the one for you because it will give you problems down the road over time due to overuse in other muscles and tendons.
Also important to a medical transcriptionist or a chronic keyboarder is an adjustable or ergonomic keyboard tray. This allows you to adjust the keyboard to the elbow level or lower and also allows you to tilt your keyboard for more ease of use in keeping wrists flat.
Things to consider in an ergonomic keyboard tray:
- You still need knee clearance room so make sure the tray is the appropriate height.
- The tray needs to be able to hold the mouse and the keyboard side by side
- You should have room for a wrist rest.
- The tray should allow you to keep your keyboard at approximately the same angle as your forearm.
- Minimal vertical adjustment range for sitting is 22-28 inches from the floor.
Ergonomic Computer Mouse
Just as important as ergonomic keyboards is the ergonomics of the mouse we use for computer work, both for medical transcriptionists and for just everyday computer users.
Mouse injuries are one of the most common ailments for computer users and produce such maladies as thumb tendinitis or forearm tendinitis.
These are usually caused from positioning the mouse incorrectly but can also be accounted for by having the wrong type of mouse.
A commonly missed point about the computer mouse is that the mouse needs to be sized to fit the user's hand! I have relatively small hands and having to use a large mouse that is too big to fit my hand comfortably always flares up my thumb and wrist pain. I tend to buy the smallest mouse I can find because it is much easier for me to use quickly and I find that it reduces the stretching I have to do with fingers and wrist.
Tips for using a computer mouse ergonomically:
- The mouse should be at the same level and beside your keyboard.
- Repetitively using a mouse is just as damaging to muscles and tendons as keyboarding! This also applies to joysticks, pointing devices like touch pads, trackballs, etc.
- If at all possible, place the mouse on a keyboard tray next to the keyboard.
- Avoid any awkward positions to use the mouse or stretching your forearm excessively to move it around.
- Get a keyboard without a 10-key pad if necessary and replace with your mouse.
- Use a mouse wrist rest.
- Learn keyboard shortcuts and use the mouse less.
Ergonomic Chairs for People With Desk Jobs
If you consider that you will spend at least 8 hours per day in a chair while you are typing, the importance of having an ergonomic chair may become crystal clear instantly. If it doesn't, incurring your first back or leg injury because of sitting in a "regular" chair will definitely get your attention.
Sitting in and of itself for long periods of time is very hard on all the soft tissues of your body. If you add to that pressure points, dangling legs, or hunched postures, the possibilities for soft tissue injury are endless.
Poor ergonomics while working on the computer for medical transcriptionists or anyone doing repetitive computer work are common perpetrators of herniated disks, sciatica, and all sorts of various tendon and nerve damage ailments that are directly the result of keeping body parts in one position for long periods of time.
That said, having an ergonomically designed chair can provide computer users across the board with not only comfort but also the possibility of changing positions from time to time which is essential to avoid repetitive strain injuries.
Finding the chair that is just right is the rub. There are many chairs out there and many that claim to be the answer for everyone. There is more to it than that, however, because it all depends on the size of the person the chair is going to fit, and it also depends on how long the person's legs are or how short their arms are. There are many considerations in finding the perfect ergonomic chair for anyone and many should be tried before selecting "the" one.
The perfect ergonomic chair doesn't have to be the most expensive chair. It just has to be the right chair for the individual!
Ergonomic considerations and the computer chair:
- Adjustable height is essential so that you can raise and lower the seat height from time to time or if need be, to accommodate desk heights.
- Arm rests should be adjustable to several different positions to provide relief for elbows.
- The chair should fit the person so that the flat of your back is supported by the back of the chair. That means the chair cannot be too big because this forces you to lean out away from the back of the chair creating stress on your lower back.
- Most common chairs have a back that extends all the way up to the head although there are some unconventional chairs that have no back. Trial and error with the kind of chair that fits your needs is essential.
- Chairs that tilt back and allow you to flex backwards in it from time to time are great for keeping muscles from tightening up or becoming strained.
- Swivel is important to allow you to change positions easily without overstretching or reaching beyond your capability thus causing strain and stress.
- Some chairs have additional lumbar support pillows that you can inflate or you can implement the same by adding a small lumbar support pillow.
- Chair back vibrating or massage devices can be helpful for some people.
- Rolling chairs or floor mats are helpful in making your chair adjustable to exactly the proper distance from your desk.
How to Improve Your Foot Ergonomics While Sitting
Believe it or not, your feet can also benefit from ergonomic consideration, especially in a production environment that MTs find themselves in. Sitting all day long with your foot on a foot pedal can cause tendinitis in your toes or even in your foot and ankle.
How do you avoid that? I found long ago that a foot rest really helped prevent that on my job as my legs seemed to not quite fit where I put my chair. There needs to be a balance between having your hands at the proper height for your keyboard, and then your chair at the proper height to accommodate that.
However, you need to have your feet resting on either the floor or if that is not going to work perfectly, enter a foot rest!
I use a foot rest like the one below that you can toggle back and forth with your feet. There are many different varieties available so find one that works for you. With a platform one such as the one noted, you can use either foot (I switch back and forth all day long) and you can tilt the foot rest backward or forward in order to stretch tight tendons and muscles as you work, thus preventing strains and injury to your feet.
Movable Foot Rests Save Feet from Tendon & Muscle Injury
Computer Monitor Placement for Improved Ergonomics
Equally as important as keyboards, your mouse and your chair, knowing how to ergonomically place your monitor is essential to proper ergonomics for the medical transcriptionist or computer user.
I prefer flat screen monitors because they are easier to place and also lighter in weight.
Large screen monitors are obviously going to be more ergonomically sound simply because you can see them better and have less chance of positioning yourself incorrectly to be able to see what's on the screen.
Purchase the best monitor that you can afford in terms of visibility and also in terms of size. Over time, computer use is extremely debilitating on the body but it is also hard on the eyes. Having a large screen monitor can make the difference in being able to do your job quicker and better.
Ergonomic considerations for a computer monitor:
- Monitors should be directly in front of you and not to the side to avoid neck injuries.
- The top line of the screen should be at eye level or slightly below.
- This should be adjusted if you wear bifocals.
- Monitors should be perpendicular to the window.
- Use adjustments such as brightness, etc. to optimize your monitor's viewing area.
- Viewing distance should be 20-40 inches away.
- Increase the font size if you have a smaller monitor and have to strain to read it.
Perform Better with Ergonomic Adjustments to Your Workstation
In essence, ergonomics for medical transcriptionists and computer users are crucial to the performance of your job.
As the image here depicts, there are certain formulas that apply to all of us folks who make a living on our computer. Proper positioning at your computer for long periods of time can allow you to keyboard into the future indefinitely while neglecting ergonomics if you're a computer user can bench you.
Overuse syndromes are no laughing matter and can take months if not years to recover from. They can result in surgeries and injections into the long term and require the use of massive doses of anti-inflammatory medications.
In this case, an ounce of prevention is worth 100 pounds of cure. Ergonomics is the only way to properly address overuse syndromes which are particularly prevalent amongst medical transcriptionsts and heavy-duty computer users.
Investing in equipment and devices that circumvent these painful injuries is well worth the investment. However, realize that not every device will work for every single person and the key to ergonomics is making your work station comfortable for only you.
Finding the devices and equipment that are appropriate for you may take some time and some investment but it is well worth it to be able to continue your career pain free.
If you're stumped as to what devices are best for you, consider an ergonomics consultation. Physical therapists are also great sources of information when it comes to ergonomic possibilities for the individual. Many will come to your workplace whether it's at an office or in your home.
If you have more suggestions on ergonomics and the workplace especially for medical transcriptionsts and computer users, please leave your detailed comment below!
Learn More About Ergonomics and What Works Best for You!
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2011 Audrey Kirchner
Audrey Kirchner (author) from Washington on June 17, 2013:
Thanks for the input (and the visit) Angela~
Angela Kane from Las Vegas, Nevada on June 17, 2013:
Voted useful. Jobs that require you to sit all day can take a toll on your health and your body. The ergonomic product and device suggestions are great. Most only invest in a good chair forgetting about other useful tools such as keyboards, mouses and back pads.
brenda on May 08, 2012:
Your seating suggestions seem to ignore the use of a pedal when doing transcription. it makes it impossible to use the kneeling chairs, etc. any suggestions for that?
Audrey Kirchner (author) from Washington on February 25, 2011:
Crewman - Thanks for the good wishes - me, too. I generally wear them while I'm sleeping and them miraculously my tendons start to go ahhhh instead of screaming at me! Of course, it can be a hazard as I inevitably turn over in bed and clank Bob in the head with one of them...of course by accident!!
I love the netbook though because at least I can type in my lap - so less arm movement!! Now if I could just slow down and quit hitting keys and opening and closing the blasted program....always my problem though as I tend to speed through life with my eye on what's next! Love the netbook though and it has become my new best friend. My doc gets mad at me when I have to go in because he has his laptop and I have my netbook and I always say....'just a minute....have to finish this thought.... okay - now what were you saying?'
Crewman6 on February 25, 2011:
I had wondered; I do all mine on the netbook now,but I'm not fast enough to 'overpower' it. Sorry about the braces- I have a semi-permanent one for my knee, they can be a pain but overall really help. Hope this flare-up passes by quickly!
Audrey Kirchner (author) from Washington on February 24, 2011:
Katie - I'm so sorry - is she on the mend now? That is truly frightening...my mom has atrial fibrillation but refuses to take blood thinners even though they've warned her about strokes. It is no laughing matter! Sending you all my good thoughts and best karma!
Crewman - Totally on the netbook - in fact I almost stumble all over myself on that keyboard and sometimes have to inject a swear word here and there as I accidentally close the page I'm working on!! The only problem with netbooks for typing is that for my transcription job, they aren't 'powerful' enough - not enough speed, etc. After the last contest though, I kinda sorta flared up everything again so now I'm back to wearing my bionic braces to try to calm it down again. If only I could learn to type with my feet!
Crewman6 on February 23, 2011:
An excellent read, which I always expect from you. It's a fascinating look inside a non-standard career. I have a cousin who does this, honestly, I never knew how hard she worked.
Do you find your netbook keyboard better suited to the size of your hands than a full-size?
Katie McMurray from Ohio on February 23, 2011:
Great facts on medical devices. Sorry for being unavailable as of late. My Mom had a stroke, I flew outta here and haven't been on line till yesterday. She was in the hospital for six days, then moved to a rehab facility for 7 days now, 13 days in all. Love and Peace, Katie
Audrey Kirchner (author) from Washington on February 22, 2011:
Nell - Yes indeed, they have a lot of goofy looking keyboards out there but I've yet to find one that fits my little itty bitty hands! Can you imagine doing transcription for 8-10 hours per day and THEN writing the hubs? It is a little crazy and I wonder why my arms are aching!
BJ - I think that is it! You have the wrong mouse and once you rectify this problem, you will have no more mouse problems!
drbj and sherry from south Florida on February 22, 2011:
I dunno. I read your explicit instructions including: "The mouse should be at the same level and beside your keyboard."
I've tried and tried - honestly I have - but my mouse just won't stay put and keeps climbing over my keyboard. Maybe I should have bought the mouse at the computer store instead of the pet store. Nah, that can't be it.
Nell Rose from England on February 22, 2011:
Hi, Audrey, I had seen the chairs before but never knew about the keyboards, I do know the pain of back ache because of being on a pc all day though! at work we always had soft cushions for the wrists, it takes a bit of getting used to but is okay, great info, and how on earth have you managed to write all those hubs! lol
Audrey Kirchner (author) from Washington on February 22, 2011:
Yes, Darski - this is my 'real' job! I speak from the voice of experience when it comes to doing this for 35+ years....ouch - if you don't take care of yourself, it can be brutal! Thanks so much for the read!!
Darlene Sabella from Hello, my name is Toast and Jam, I live in the forest with my dog named Sam ... on February 21, 2011:
Great hub my friend, is this what you do for a living? Love your writing style, the photos and your outline. You are great and so is your hub, rate up love & peace darski