Thoughts Have the Power to Create or Eliminate Body TensionPosted: January 31, 2023 Filed under: Breathing/respiration, CBT, cognitive behavior therapy, computer, emotions, ergonomics, healing, health, Neck and shoulder discomfort, Pain/discomfort, posture, stress management, Uncategorized | Tags: Alexander Technique, mind-body connection 3 Comments
By Tami Bulmash republished from: Medium-Body Wisdom
Photo by Jonathan Borba on Unsplash
The mind and body have long been regarded and treated as separate entities, yet this distinction does little to promote holistic health. Understanding the direct relationship between thoughts and body tension can illustrate how the mind and body either work dysfunctionally through separation, or optimally as a unit.
Mental and physical aren’t separate entities
Stress and pain existed long before the coronavirus, though it was highlighted during this isolating era. In the height of the pandemic nearly eight in 10 American adults cited COVID-19 as a significant stressor. Though it may no longer be front page news, the aftermath of COVID still lingers. Its toll on mental health continues to impact children and adults alike. The shift to remote work was appealing at first, but later created a more pervasive sedentary lifestyle. Now the concern has shifted to an emerging pandemic of back pain.
Yet, there is nothing novel about body tension brought forth by stressful thinking. In 2014, the American Institute of Stress reported 77 percent of people regularly experience physical symptoms caused by stress. Moreover, the findings of a 2018 Gallup poll suggest 55 percent of Americans report feeling stressed for a large part of their day. This is compounded by the American Academy of Orthopaedic Surgeons finding one in two Americans have a musculoskeletal condition. Discerning between mental and physical stress is becoming increasingly obscure.
While the mind and body have long been regarded and treated as separate entities, this distinction does little to promote holistic health. Understanding the direct relationship between thoughts and tension can illustrate how the mind and body either work dysfunctionally through separation, or optimally as a unit. What’s more, viewing the body as a whole being — in thought and activity — can promote better habits which eliminate tension.
The link between stress and pain
Dividing the self into parts is common practice in the Western world. Expressions such as “I’m mentally exhausted” vs. “I’m physically exhausted” provoke differing self-reflections. However, the psycho-physical relationship is evident in the tension stimulated by either thought. For example, sitting in front of a computer necessitates both thought and action. Viewing content on a screen lends itself to a reaction from behind the screen. This response can be minimal and inconsequential, or it can be subtle, yet critical.
Repeatedly engaging in certain thinking habits like, “I have to get this done and fast” are often reflected in forms of body tension such as stiff fingers at the keyboard, a clenched jaw after a meeting, or tense neck at the end of the day. These unconscious responses are common and have a pervasive effect.
The prevalence of technology has led to a plethora of occupational ailments, now referred to as technology diseases. These include carpal tunnel syndrome, mouse shoulder, and cervical pain syndrome and occur because of excessive work at the computer — especially keyboard and mouse usage. According to the book, TechStress-How Technology is Hijacking our Lives, Strategies for Coping and Pragmatic Ergonomics, by Drs. Erik Peper, Richard Harvey and Nancy Faass, 45 million people suffer from tension headaches, carpal tunnel, and back injuries linked to computer use and more than 30 percent of North Americans who work at a computer develop a muscle strain injury every year.
Pushing through mental tasks is reflected in the physical
Dr. Peper, a biofeedback expert and Professor of Holistic Health at San Francisco State University, gives an illustration of the mind-body connection in relation to pain. His example requires the use of a computer mouse while trying to complete difficult mental tasks. He asks me to hold the mouse in my dominant hand and draw with it the last letter of an address. Then continue to go backward with each letter of the street name, making sure the letter height is only one-half of an inch. He tells me to perform the task as quickly as possible. As I’m drawing the address backwards trying to recall the letters and their order, Dr. Peper commands, “Do it quicker, quicker, quicker! Don’t make a mistake! Quicker, quicker, quicker!”
These commands reflect the endless to-do lists that pile up throughout the day and the stress associated with their efficacy and timely completion. While enacting this task, Dr. Peper asks me, “Are you tightening your shoulders? Are you tightening your trunk? Are you raising your shoulders possibly holding all this tension? If you are like most people who do this task, you did all of that and you were totally unaware. We are usually really unaware of our body posture.”
I have spent the past 20 years practicing the Alexander Technique, a method used to improve postural health. At its core the technique is about observation and utilizing psycho-physical awareness to stop repeating harmful habits. Dr. Peper’s words resonate because becoming aware of unconscious responses isn’t easy. Most people are completely unaware of the relationship between mind-body habits and how they contribute to stress-related pain.
Posture affects mood and energy levels
Posture is often thought of as a pose — most notably being associated with “sitting up straight”. Yet the health implications of good posture extend far beyond any held position. The agility and movement which are evident in good posture exemplify the mind-body connection.
It is well-known that feeling depressed has been linked to having less subjective energy. The American Psychiatric Association listed a variety of symptoms connected to depression including feeling sad or having a depressed mood, loss of interest in activities once enjoyed, and loss of energy or increased fatigue. While the treatment of depression hasn’t traditionally considered the role of posture in informing mood, researchers have started exploring this relationship.
A study by Dr. Peper and Dr. I-Mei Lin examined the subjective energy levels of university students and their corresponding expression of depression. Participants who walked in a slouched position reported lower energy levels and higher self-rated depression scores. In contrast, when those participants walked in a pattern of opposite arm and leg skipping, they experienced an increase in energy, allowing a positive mindset to ensue.
As mentioned in the study, the mind-body relationship is a two-way street: mind to body and body to mind. If thoughts are manifested in the way one holds their body, the inverse would also be true. Namely, changing the way one carries their body would also influence their thinking and subsequent mood. If stopping certain habits — such as walking in a slumped posture — could have a positive impact on mood and well-being, perhaps it’s worth exploring the mind-body relationship even further.
Supporting the mind-body connection
One of the best ways to improve the mind-body connection is through awareness. The more present you are in your activities, the more unified the relation becomes. Give yourself a couple of minutes to connect your thoughts with what you are doing at the moment.
Begin With Grounding
If you are sitting down, imagine coloring in the space of your whole body with an imaginary marker. Begin with your feet planted on the floor. Start to outline the footprints of your feet and then color in the bottom and top of each foot. Take your time. Fill in all the space. See if you discover new parts of your feet — like the spaces between your toes. Continue up through your ankles and toward your calves. Pay attention to the entire limb (front and back). Work your way upward through the knee and then the upper leg. See if you can find your sit bones along the way to the torso. Explore new joints — such as the hip joint.
Lengthen Your Body Through Thought
Continue up while circling the front and back of the torso. Extend the awareness of your thoughts through your shoulders. Allow for an exploration of the arms — noting the joints such as the elbows, wrists and fingers. Pay attention to their length and mobility. Come back up through the arms. Extend up through the shoulders again, this time noting the passage through the chest and neck. Observe the length and space within your entire being. Journey up to the head and travel around its circumference. Imagine filling your head space with air. Picture the wholeness of your head from top to bottom and side to side.
This two-minute mind-body meditation allows you to feel the full extent of the space your body takes up. It is a way to awaken the senses and include them in conscious thinking. This helps generate awareness in how to engage the mind-body relationship optimally. The next time you try it, use a visual aid like an anatomy diagram of the whole body. This can also introduce new parts and spaces of the body you may not have thought of before. However, don’t rely on the diagram each time, as it can pull away your attention from the mind-body meditation. Instead, use it as a reference or guide every once in a while.
Learn from other cultures
In Western cultures, it is common practice to divvy up musculoskeletal ailments into an array of categories such as tension headaches, tension neck syndrome, or mechanical back syndrome. For instance, in countries like the U.S., it is normal to seek a specialist for each area of concern — like a neurologist for a migraine, an orthopedist for neck strain, or chiropractors for back pain. In contrast, Eastern lifestyles have historically taken a more holistic approach to treating (and healing) their patients.
An article by Dr. Cecilia Chan, Professor of Social Sciences at the University of Hong Kong, explains how the Eastern philosophies of Buddhism, Taoism and traditional Chinese medicine adopt a holistic approach to the healing of an individual. Rather than diagnose and treat with medication, Chan and her colleagues explore health through the harmony and balance of the body-mind-spirit as a whole.
Because basic biology clearly delineates how the human head is attached to the body, it seems fitting that the entire being be regarded as a unit. By recognizing the relationship between thought stressors and their manifestation in the physical body, awareness is elevated. This, in turn, can prevent mindlessly engaging in harmful patterns that lead to stress and pain. Combating tension is possible through the realization of how thoughts — whether they are emotional or task oriented — directly impact the body as a whole.
This excerpt from Taro Gold’s book, Open Your Mind, Open Your Life: A Book of Eastern Wisdom, cites Mahatma Gandhi’s famous quote which beautifully elucidates the mind-body connection:
Keep your thoughts positive, because your thoughts become your words.
Keep your words positive, because your words become your behavior.
Keep your behavior positive, because your behavior becomes your habits.
Keep your habits positive, because your habits become your values.
Keep your values positive, because your values become your destiny.
Referring to the mind and body as separate entities perpetuates a disconnect in the being as a whole. This is why distinguishing the mental from the physical further exacerbates the notion that the two don’t work together as an indivisible unit. Understanding the relationship between stress and tension begins through the awareness of habits.
There are recurrent thinking habits like “I’ve got to get this done now” and their unconscious counterparts that become visible through posture. The unknown habits are the ones which accrue over time and often appear seemingly out of nowhere — in the form of tension or pain. Modern culture is quick to treat symptoms, such as those related to excessive technology use. However, a holistic approach to addressing the underlying issue would examine how stress and pain work hand in hand. Once the thoughts change, so will the tension.
Biofeedback, posture and breath: Tools for healthPosted: December 1, 2022 Filed under: ADHD, behavior, biofeedback, Breathing/respiration, CBT, cognitive behavior therapy, computer, digital devices, education, emotions, ergonomics, Evolutionary perspective, Exercise/movement, healing, health, laptops, mindfulness, Neck and shoulder discomfort, Pain/discomfort, posture, relaxation, screen fatigue, self-healing, stress management, Uncategorized, vision, zoom fatigue 1 Comment
Two recent presentations that that provide concepts and pragmatic skills to improve health and well being.
How changing your breathing and posture can change your life.
In-depth podcast in which Dr. Abby Metcalf, producer of Relationships made easy, interviews Dr. Erik Peper. He discusses how changing your posture and how you breathe may result in major improvement with issues such as anxiety, depression, ADHD, chronic pain, and even insomnia! In the presentation he explain how this works and shares practical tools to make the changes you want in your life.
How to cope with TechStress
A wide ranging discussing between Dr. Russel Jaffe and Dr Erik that explores the power of biofeedback, self-healing strategies and how to cope with tech-stress.
These concepts are also explored in the book, TechStress-How Technology is Hijacking our Lives, Strategies for Coping and Pragmatic Ergonomics. You may find this book useful as we spend so much time working online. The book describes the impacts personal technology on our physical and emotional well-being. More importantly, “Tech Stress” provides all of the basic tools to be able not only to survive in this new world but also thrive in it.
Gonzalez, D. (2022). Ways to improve your posture at home.
Reversing Pandemic-Related Increases in Back PainPosted: August 30, 2022 Filed under: behavior, Breathing/respiration, digital devices, ergonomics, Exercise/movement, health, laptops, Neck and shoulder discomfort, Pain/discomfort, posture, relaxation, self-healing, stress management, Uncategorized | Tags: back pain 1 Comment
By: Chris Graf
Reproduced by permission from: https://www.paintreatmentdirectory.com/posts/reversing-pandemic-related-increases-in-back-pain
Back pain increased significantly during the pandemic
Google searches for the words “back pain” reached an all-time high in January 2022. In a Harris Poll in September 2021, 56% of respondents said they had chronic pain, up from about 30% before the pandemic. There are probably multiple reasons for the uptick in pain in general and back pain in particular related to COVID, including added stress and ongoing symptoms of long COVID. Poor posture while working at home is another likely contributor.
Back pain and Ergonomics
According to Dr. Erik Peper, co-author of Tech Stress: How Technology is Hijacking Our Lives, Strategies for Coping, and Pragmatic Ergonomics, It is likely that poor ergonomics in the home office are partially to blame for the apparent rise in back pain. “With COVID, ergonomics have become a disaster—especially with people who use laptops.” Peper, an internationally known expert in biofeedback and Professor of Holistic Health Studies at San Francisco State University, said that it is “almost impossible” to sit correctly when using a laptop. “In order for the hands to be at the correct level for the keyboard, the head must be tilted down. The more the head tilts forward, the most stress that is placed on the cervical spine,” he said, noting that the arms will no longer be in the proper position if the laptop is placed on a stand to raise it to eye level.
For laptop users, Peper recommends using either an external monitor or external keyboard. When using an external keyboard, a laptop stand can be used to elevate the screen to the proper eye level. University of California at Berkeley recommends other tips for ergonomic laptop positioning.
When using both laptops and desktops, attention should be focused on proper sitting posture. Ergonomic chairs are only part of the equation when it comes to achieving proper posture.
“A good chair only gives you the opportunity to sit correctly,” Peper said. The goal is to achieve anterior pelvic tilt by having the seat pan slightly lower in the front that in the back. He recommends using a seat insert or cushion to achieve proper positioning (see figure 1).
Figure 1. A small pillow or rolled up towel can be placed behind the back at kidney level in order to keep the spine slightly arched (see figure 2).
Figure 2. Sitting Disease: Cause of Back Pain and Much More
According to Peper, people who spend extended periods of time at their computers are at risk of developing sitting disease—a condition of increased sedentary behavior associated with adverse health effects. A study that appeared in the American Journal of Preventative Medicine found that prolonged sitting was associated with an increased risk of 34 chronic diseases and conditions including chronic back and musculoskeletal pain. According to the study, “Being seated alters the activation patterns of multiple weight-bearing muscles and, therefore, excessive desk use is associated with adverse back curvature, back pain and upper extremity problems such as carpel tunnel syndrome.”
To Avoid Back Pain, Don’t Slouch!
Sitting for prolonged periods of time can cause back, neck, arm, and leg pain, but slouching is even worse and can damage spinal structures. “Most people slouch at computer, and when you slouch, our spine becomes more like the letter C, our abdomen is compressed, the diaphragm goes up which causes us to shallow breathe in our upper chest,” Peper said. “That impacts our back and digestion and many other things.”
According to Peper, slouching can also impact our mood. “Slouching is the posture associated with depression and low energy. That posture collapse may evoke negative and hopeless emotions. If I sit up and look up, I have less of that. I can have more positive and uplifting thinking.”
Peper recommends a simple device to help people improve their posture. Called an Upright Go, it attaches to the neck and provides vibrational feedback when slouching occurs. “Every time it starts buzzing, it’s a reminder to stop slouching and to get up, wiggle, and move,” he said. “We have published some studies on it, but I have no investment in the company.”
Peper’s 4 Basic Tips for Avoiding Back Pain and Other Sitting Diseases:
#1 Get Up and Move
“Rule one is to take many breaks—wiggle and move,” he said. “People are unaware that they slightly raise their shoulders and their arm goes slightly forward—in their mousing especially. By the end of the day, they feel stiffness in their shoulders or back. So, you need to take many wiggly breaks. Get up from your chair every 15 minutes.”
Use Stretch Break or one of the other apps that remind people to get up out of their chairs and stretch.
Walk around while on the phone and wear a headset to improve posture while on the phone.
For back pain, skip in place or lift the right arm at the same time as the left knee followed by the left arm and right knee–exercises that cause a diagonal stretch along the back.
#2 Just Breathe
- “Learn to practice lower breathing,” Peper said. “When you sit, you are forced to breath higher in your chest. You want to practice slow diaphragmatic breathing. Breathe deeply and slowly to restore a natural rhythm. Take three deep breaths, inhaling for five seconds, then exhale very slowly for six seconds.” For more instructions on slower diaphragmatic breathing visit Peper’s blog on the subject.
#3 Take Visual Breaks:
- Our blinking rate significantly decreases while looking at a screen, which contributes to eye strain. To relax the eyes, look at the far distance. “Looking out into the distance disrupts constant near-focus muscle tension in the eyes,” he said. By looking into the distance, near-focus muscle tension in the eyes is disrupted.
- If you have children, make sure they are taking frequent visual breaks from their screens. According to Peper, there has been a 20 percent increase in myopia (nearsightedness) in young children as a result of COVID-related distance learning. “The eyes are being formed and shaped during childhood, and if you only focus on the screen, that changes the muscle structure of our eyes over time leading to more myopia.”
#4 Pay Attention to Ergonomics
- “If you are working on a desktop, the top of screen should be at eyebrow level,” Peper said. “Your feet should be on the ground, and the angle of the knees should be about 110 degrees. You should feel support in mid back and low back and be able to sit, lean back, and be comfortable.”
- Peper recommends adjustable sit/stand desks and regularly alternating between sitting and standing.
For more specific guidance on ergonomics for prolonged sitting, UCLA School of Medicine offers detailed guidelines. And don’t forget to check out Dr. Peper’s book on ergonomics as well as his blog, The Peper Perspective, where you can use the search feature to help you find exactly what you are looking for.
But in the meantime, Dr. Peper said, “It’s time for you to get up and wiggle!”
Find a Provider Who Can Help with Back Pain
Christine Graf is a freelance writer who lives in Ballston Lake, New York. She is a regular contributor to several publications and has written extensively about health, mental health, and entrepreneurship.
A breath of fresh air: Breathing and posture to optimize healthPosted: April 3, 2022 Filed under: behavior, Breathing/respiration, CBT, cognitive behavior therapy, emotions, ergonomics, Exercise/movement, health, mindfulness, Neck and shoulder discomfort, Pain/discomfort, posture, self-healing, stress management, Uncategorized | Tags: respiration Leave a comment
Most people breathe 22,000 breaths per day. We tend to breathe more rapidly when stressed, anxious or in pain. While a slower diaphragmatic breathing supports recovery and regeneration. We usually become aware of our dysfunctional breathing when there are problems such as nasal congestion, allergies, asthma, emphysema, or breathlessness during exertion. Optimal breathing is much more than the absence of symptoms and is influenced by posture. Dysfunctional posture and breathing are cofactors in illness. We often do not realize that posture and breathing affect our thoughts and emotions and that our thoughts and emotions affect our posture and breathing. Watch the video, A breath of fresh air: Breathing and posture to optimize health, that was recorded for the 2022 Virtual Ergonomics Summit.
Resolving a chronic headache with posture feedback and breathingPosted: January 4, 2022 Filed under: behavior, Breathing/respiration, computer, digital devices, ergonomics, health, laptops, Neck and shoulder discomfort, Pain/discomfort, posture, relaxation, self-healing, stress management, Uncategorized | Tags: Desktop feedback app, headache, migraine 11 Comments
|Adapted from Peper, E., Covell, A., & Matzembacker, N. (2021). How a chronic headache condition became resolved with one session of breathing and posture coaching. NeuroRegulation, 8(4), 194–197. https://doi.org/10.15540/nr.8.4.194|
This blog describes the process by which a 32 year old woman student’s chronic headaches that she had since age eighteen was resolved in a single coaching session. The student suffered two or three headache per week a week which initially began when she was eighteen after using digital devices and encouraged her to slouch as she looked down. Although she describes herself as healthy, she reported having high level of anxiety and occasional depression. She self-medicated with 2 to 10 Excedrin tablets a week. It is possible that the chronic headaches could partially be triggered by caffeine withdrawal which get resolved by taking more Excedrins (Greben et al., 1980) since Excedrin contains 65 mg of caffeine as well as 250 mg of Acetaminophen which can be harmful to liver function (Bauer et al., 2021).
The behavioral coaching intervention
During the first day in class, the student approached the instructor and she shared that she had a severe headache. During their conversation, the instructor noticed that she was breathing in her chest without abdominal movement, her shoulders were held tight, her posture slightly slouched and her hands were cold. As she was unaware of her body responses, the instructor offered to guide her through some practices that may be useful to reduce her headache. The same strategies could also be useful for the other students in the class; since, headaches, anxiety, zoom fatigue, neck and shoulder tension, abdominal discomfort, and vision problems are common and have increased as people spent more time in front of screens (Charles et al., 2021; Ahmed et al., 2021; Bauer, 2021; Kuehn, 2021; Peper et al., 2021 ).
These symptoms may occur because of bad posture, neck and shoulder tension, shallow chest breathing, stress and social isolation (Elizagaray-Garcia et al., 2020; Schulman, 2002). When people become aware of their dysfunctional somatic patterns and change their posture, breathing pattern, internal language and implement stress management techniques, they often report a reduction in symptoms such as irritable bowel syndrome, acid reflux, neck and shoulder tension, or anxiety (Peper et al, 2017a; Peper et al, 2016a). Sometimes, a single coaching session can be sufficient to improve health.
Working hypothesis: The headaches were most likely tension headaches and not migraines and may be the result of chronic neck and shoulder tension which was maintained during chest breathing and the slouched head forward body posture. If she could change her posture, relax her neck and shoulders, and breathe diaphragmatically so that the lower abdomen widen during inhalation, most likely her shoulder and neck tension would decrease. Therefore, by changing posture from a slouched to upright position combined with slower diaphragmatic breathing, the muscle tension would be reduced and the headaches would decrease.
Breathing and posture changes
She was encouraged to sit upright so that the abdomen had space to expand (Peper et al., 2020). In addition, she needed to loosen the clothing around her waist to provide room for her abdomen to expand during inhalation instead of her chest lifting (MacHose & Peper, 1991). Allowing abdominal expansion can be challenging for many paticipants since they are self-conscious about their body image, as well holding their stomach in as an unconscious learned response to avoid pain after having had abdominal surgery, or as an automatic protective response to threat (Peper et al., 2015). The upright position also allowed her to sit tall and erect in which the back of head reaches upward towards the ceiling while relaxing and feeling gravity pulling her shoulders downward and at the same time relaxing her hips and legs.
With guided verbal and tactile coaching, she learned to master slower diaphragmatic breathing in which she gently and slowly exhaled by making a sound of pssssssst (exhaling through pursed lips) which tends to activate the transverse and oblique abdominal muscles and slightly tighten the pelvic floor muscles so that her lower abdomen would slightly constrict at the end of the exhalation (Peper et al., 2016). Then, by allowing the lower abdomen and pelvic floor relax so that the abdomen could expand in 360 degrees, inhalation occurred.
While practicing the slower breathing in this relaxed upright position, she was instructed to sense/imagine feeling a flow of down and through her arms and out her hands as she exhaled (as if the air could flow through straws down her arms). After a few minutes, she felt her headache decrease and noticed that her hands had warmed. After this short coaching intervention, she went back to her seat in class and continued to practice the relaxed effortless breathing while sitting upright and allowing her shoulders to melt downward.
The use of muscle feedback to demonstrate residual covert muscle tension
During class session, she volunteered to have her trapezius muscle monitored with electromyography (EMG). The EMG indicated that her muscles were slightly tense even though she reported feeling relaxed. With a few minutes of EMG biofeedback exploration, she discovered that she could relax her shoulder muscles by feeling them being heavy and melting.
Implementing home practice with a posture app
As part of the class homework, she was assigned a self-study for two weeks with the posture feedback app, Dario Desktop. The app uses the computer/laptop camera to monitor posture and provides visual feedback in a small window on the computer screen and/or an auditory signal each time she slouches as shown in Figure 1.
Figure 1. Posture feedback to signal to participant that the person is slouching.
To observe the effect of the posture breathing training, she monitored her symptoms for three days without feedback and then installed the posture feedback application on her laptop to provide feedback whenever she slouched. The posture feedback reminded her to practice better posture during the day while working on her computer and also do a few stretches or shift to standing when using the computer for an extended period of time. Each time the feedback signal indicated she slouched, she would sit up and change her posture, breathe lower and slower and relax her shoulders.
She also monitored what factors triggered the slouching. In additionally, she added daily reminders to her phone to remind her of her posture and to stretch and stand after each hour of studying. After two weeks she recorded her symptoms for three days for the post assessment without posture feedback.
The chronic headache condition which had been present for fourteen years disappeared and she has not used any medication since the first day of class. She reported after two weeks that her shoulder and back discomfort/pain, depression, anxiety and lack of motivation decreased as shown in Figure 2. At the fourteen week follow up, she continues to have no headaches and has not used any medication.
Figure 2. Changes in symptoms after implementing posture feedback for two weeks.
She used the desktop posture app every time she opened her laptop at home as often as 3-5 times per day (roughly 2-6 hours).In addition, when she felt beginning of discomfort or thought she should take medication, she would adjust her posture and breathe. While using the app, she identified numerous factors that were associated with slouching as shown in Figure 3.
Figure 3. Behaviors associated with slouching.
The decrease in depression, anxiety and increase in motivation may be the direct result of posture change; since, a slouched position tends to increase hopeless, helpless and powerless thoughts while the upright position tends to increase subjective felt energy and easier access to empowering and positive thoughts (Peper et al., 2017b; Veenstra et al., 2017; Wilson & Peper, 2004; Tsai et al., 2016). Most likely, a major factor that contributed to the elimination of her headaches was that she implemented changes in her behavior. One major factor was using posture feedback tool at home to remind her to sit tall and relax her shoulders while practicing slower diaphragmatic breathing. As she noted, “Although it was distracting to be reminded all the time about my posture, it did decrease my neck pain. With the pain reduction, I was able to sit at the computer longer and felt more motivated.”
The combination of slower lower abdominal breathing with the upright posture reversed her protective/defensive body position (tightening the muscle in the lower abdomen and pelvic floor and pressing the knees together while curling the shoulder forward for protection). The upright posture creates a position of empowerment and trust by which the lower abdomen could expand which supported health and regeneration. In addition, the upright posture allowed easier access to positive thoughts and reduced recall of hopeless, powerless, defeated memories. It is also possible that caffeine withdrawal was a co-factor in evoking headaches (Küçer, 2010). By eliminating the medication containing caffeine, she also eliminated the triggering of the caffeine withdrawal headaches.
This case example suggests that health care providers first rule out any pathology and then teach behavioral self-healing strategies that the clients can implement instead of immediately prescribing medications. These interventions could include slower and lower diaphragmatic breathing, upright posture feedback, muscle biofeedback training, hear rate variability training, stress management, cognitive behavior therapy and facilitating health promoting lifestyles modifications such as regular sleep, exercise and healthier diet. When students implement these behavioral changes as part of a five week self-healing program, many report significant decreases in symptoms such as headaches, anxiety, neck and shoulder pain, and gastrointestinal distress (Peper et al., 2016a).
Watch April Covell describe her experience with the self-healing approach to eliminate her chronic headaches.
See the following blogs for additional instructions how to breathe diaphragmatically.
Ahmed, S., Akter, R., Pokhrel, N. et al. (2021). Prevalence of text neck syndrome and SMS thumb among smartphone users in college-going students: a cross-sectional survey study. J Public Health (Berl.) 29, 411–416. https://doi.org/10.1007/s10389-019-01139-4
Bauer, A.Z., Swan, S.H., Kriebel, D. et al. (2021). Paracetamol use during pregnancy — a call for precautionary action. Nat Rev Endocrinol . https://doi.org/10.1038/s41574-021-00553-7
Charles, N. E., Strong, S. J., Burns, L. C., Bullerjahn, M. R., & Serafine, K. M. (2021). Increased mood disorder symptoms, perceived stress, and alcohol use among college students during the COVID-19 pandemic. Psychiatry research, 296, 113706. https://doi.org/10.1016/j.psychres.2021.113706
Elizagaray-Garcia, I., Beltran-Alacreu, H., Angulo-Díaz, S., Garrigós-Pedrón, M., Gil-Martínez, A. (2020). Chronic Primary Headache Subjects Have Greater Forward Head Posture than Asymptomatic and Episodic Primary Headache Sufferers: Systematic Review and Meta-analysis. Pain Med, 21(10):2465-2480. https://doi.org/10.1093/pm/pnaa235
Greden, J.F., Victor, B.S., Fontaine, P., & Lubetsky, M. (1980). Caffeine-Withdrawal Headache: A Clinical Profile. Psychosomatics, 21(5), 411-413, 417-418. https://doi.org/10.1016/S0033-3182(80)73670-8
Küçer, N. (2010). The relationship between daily caffeine consumption and withdrawal symptoms: a questionnaire-based study. Turk J Med Sci, 40(1), 105-108. https://doi.org/10.3906/sag-0809-26
Kuehn, B.M. (2021). Increase in Myopia Reported Among Children During COVID-19 Lockdown. JAMA, 326(11),999. https://doi.org/10.1001/jama.2021.14475
MacHose, M. & Peper, E. (1991). The effect of clothing on inhalation volume. Biofeedback and Self-Regulation 16, 261–265 (1991). https://doi.org/10.1007/BF01000020
Peper, E., Booiman, A., Lin, I-M, Harvey, R., & Mitose, J. (2016). Abdominal SEMG Feedback for Diaphragmatic Breathing: A Methodological Note. Biofeedback. 44(1), 42-49. https://doi.org/10.5298/1081-5937-44.1.03
Peper, E., Gilbert, C.D., Harvey, R. & Lin, I-M. (2015). Did you ask about abdominal surgery or injury? A learned disuse risk factor for breathing dysfunction. Biofeedback. 34(4), 173-179. https://doi.org/10.5298/1081-5937-43.4.06
Peper, E., Lin, I-M., Harvey, R., & Perez, J. (2017b). How posture affects memory recall and mood. Biofeedback. 45 (2), 36-41. https://doi.org/10.5298/1081-5937-45.2.01
Peper, E., Mason, L., Harvey, R., Wolski, L, & Torres, J. (2020). Can acid reflux be reduced by breathing? Townsend Letters-The Examiner of Alternative Medicine, 445/446, 44-47. https://www.townsendletter.com/article/445-6-acid-reflux-reduced-by-breathing/
Peper, E., Mason, L., Huey, C. (2017a). Healing irritable bowel syndrome with diaphragmatic breathing. Biofeedback. (45-4). https://doi.org/10.5298/1081-5937-45.4.04
Peper, E., Miceli, B., & Harvey, R. (2016a). Educational Model for Self-healing: Eliminating a Chronic Migraine with Electromyography, Autogenic Training, Posture, and Mindfulness. Biofeedback, 44(3), 130–137. https://doi.org/10.5298/1081-5937-44.3.03
Peper, E., Wilson, V., Martin, M., Rosegard, E., & Harvey, R. (2021). Avoid Zoom fatigue, be present and learn. NeuroRegulation, 8(1), 47–56. https://doi.org/10.15540/nr.8.1.47
Schulman, E.A. (2002). Breath-holding, head pressure, and hot water: an effective treatment for migraine headache. Headache, 42(10), 1048-50. https://doi.org/10.1046/j.1526-4610.2002.02237.x
Tsai, H. Y., Peper, E., & Lin, I. M.* (2016). EEG patterns under positive/negative body postures and emotion recall tasks. NeuroRegulation, 3(1), 23-27. https://doi.org/10.15540/nr.3.1.23
Veenstra, L., Schneider, I.K., & Koole, S.L. (2017). Embodied mood regulation: the impact of body posture on mood recovery, negative thoughts, and mood-congruent recall. Cogntion and Emotion, 31(7), 1361-1376. https://doi.org/10.1080/02699931.2016.1225003
Wilson, V.E. and Peper, E. (2004). The effects of upright and slumped postures on the generation of positive and negative thoughts. Applied Psychophysiology and Biofeedback, 29(3), 189–195. https://doi.org/10.1023/b:apbi.0000039057.32963.34
Get Well & Stay Well: Technology’s effect on our mind and body with Wayne Jonas, MD and Erik Peper, PhDPosted: December 3, 2021 Filed under: behavior, computer, ergonomics, health, laptops, Neck and shoulder discomfort, Pain/discomfort, posture, screen fatigue, stress management, zoom fatigue Leave a comment
Enjoy the conversations, Get Well & Stay Well, with Wayne Jonas, MD, Former Director NIH Office of Alternative Medicine, and Erik Peper, PhD of San Francisco State University (SFSU) recorded November 30, 2021. They discuss technology’s effect on our mind and body and holistic approaches to managing stress and pain from chronic illness. Have patience when you watch the video–it takes 5 seconds for the program to begin. Click on the link to watch: https://fb.watch/9Cbkw9GZw8/
For more information, see the following blogs:
Addicted to your phone? How to separate from your phone for a healthy lifestylePosted: September 21, 2021 Filed under: behavior, computer, digital devices, education, ergonomics, Evolutionary perspective, Exercise/movement, health, Neck and shoulder discomfort, posture, vision, zoom fatigue 2 Comments
Erik Peper, PhD and Monica Almendras
Our evolutionary traps with technology
Maintaining and optimizing health at the computer means re-envisioning our relationship with technology—and reclaiming health, happiness, and sanity in a plugged-in world. We have the ability to control everything from our mobile phones without needing to get up from our seat. Work, social life and online learning all involve the mobile phone or some type of smart devices.
A convenient little device that is supposed to simplify our lives has actually trapped us into a vicious cycle of relying on it for every single thing we must do. We spend most of our day being exposed to digital displays on our smartphones, computers, gaming consoles, and other digital devices, immersing ourselves in the content we are viewing. From work related emails or tasks, to spending our free time looking at the screen for texting, playing games, and updating social media sites on a play-by-play of what we are eating, wearing, and doing. We click on one hyperlink after the other and create a vicious cycle trapped for hours until we realize we need to move. We are unaware how much time has frittered away without actually doing anything productive and then, we realize we have wasted another day. Below are some recent estimates of ‘daily active user’ minutes per day that uses a screen.
- Facebook about an hour per day
- Instagram just under an hour per day
- Texting about 45 minutes per day
- Internet browsing, about 45 minutes per day
- Snapchat, about 30 minutes per day
- Twitter, about 25 minutes per day
Adolescents and college students interact with media for over 40 hours per week, or around 6 hours per day. That is a lot of hours spent on staring at the screen, which it is almost impossible not to be distracted by the digital screen. In time, we rehearse a variety of physical body postures as well as a variety of cognitive and behavioral states that impact our physical, mental, emotional, and social health. The powerful audiovisual formats override our desires to do something different, that some of us become enslaved to streaming videos, playing virtual games, or texting. We then tell ourselves that the task that needs to be done, will be finished later. That later becomes never by the end of the day, since the ongoing visual and auditory notifications from our apps interrupt and/or capture our attention. This difficulty to turn away from visual or auditory stimuli roots in our survival instincts.
Each time visual or auditory stimuli occur, we automatically check it out and see if it is a friend or foe, safety or danger. It is such an automatic response that we are unaware are reacting. The good news is that we all have experienced this compelling effect. Even when we are waiting for a response and the notifications has not arrived, we may anticipate or project that there may be new information on our social media accounts, and sometimes we become disappointed when the interval between notification is long. As one student said, “Don’t worry, they’ll respond. It’s only been 30 seconds”. Anticipating responses from the media can interrupt what we are otherwise doing. Rather than finishing our work or task, we continuously check for updates on social media, even though we probably know that there are no new important messages to which we would have to respond right away.
Unfortunately, some forms of social media interactions also lead to a form of social isolation, loneliness–sometimes called phoneliness (Christodoulou, G., Majmundar, A., Chou, C-P, & Pentz, M.A., 2020; Kardaras, 2017). Digital content requires the individual to respond to the digital stimuli, without being aware of the many verbal and nonverbal communication cues (facial expressions, gestures, tone of voice, eye contact, body language, posture, touch, etc.) that are part of social communication (Remland, 2016). It is no wonder that more and more adolescents experience anxiety, depression, loneliness, and attention deficit disorders with a constant ‘digital diet’ that some have suggested that include not only media, but junk food as well.
In my class survey of 99 college students, 85% reported experiencing anxiety, 48% neck and should tension, and 41% abdominal discomfort.
We are not saying to avoid the beneficial parts of the digital age. Instead, it should be used in moderation and to be aware of how some material and digital platforms prey upon our evolutionary survival mechanisms. Unfortunately, most people -especially children- have not evolved skills to counter the negative impacts of some types of media exposure. Parental control and societal policies may be needed to mitigate the damage and enhance the benefits of the digital age.
Zoom Fatigue- How to reduce it and configure your brain for better learning
Zoom became the preferred platform for academic teaching and learning for synchronous education during the pandemic. Thus, students and faculty have been sitting and looking at the screen for hours end. While looking at the screen, the viewers were often distracted by events in their environment, notifications from their mobile phones, social media triggers, and emails; which promoted multitasking (Solis, 2019). These digital distractions cause people to respond to twice as many devices with half of our attention- a process labeled semi-tasking’ -meaning getting twice as much done and half as well.
We now check our phones an average of 96 times a day – that is once every 10 minutes and an increase of 20% as compared to two years ago (Asurion Research, 2019). Those who do media multitasking such as texting while doing a task perform significantly worse on memory tasks than those who are not multitasking (Madore et al., 2020). Multitasking is negatively correlated with school performance (Giunchiglia et al, 2018). The best way to reduce multitasking is to turn off all notifications (e.g., email, texts, and social media) and let people know that you will look at the notifications and then respond in a predetermined time, so that you will not be interrupted while working or studying.
When students from San Francisco State University in the United States chose to implement a behavior change to monitor mobile phone and media use and reduce the addictive behavior during a five-week self-healing project, many reported a significant improvement of health and performance. For example one student reported that when she reduced her mobile phone use, her stress level equally decreased as shown in Fig 1 (Peper et al, 2021).
Figure 1. Example of student changing mobile phone use and corresponding decrease in subjective stress level. Reproduced by permission from Peper et al. (2021).
During this class project, many students observed that the continuous responding to notifications and social media affected their health and productivity. As one student reported,
The discovery of the time I wasted giving into distractions was increasing my anxiety, increasing my depression and making me feel completely inadequate. In the five-week period, I cut my cell phone usage by over half, from 32.5 hours to exactly 15 hours and used some of the time to do an early morning run in the park. Rediscovering this time makes me feel like my possibilities are endless. I can go to work full time, take online night courses reaching towards my goal of a higher degree, plus complete all my homework, take care of the house and chores, cook all my meals, and add reading a book for fun! –22-year-old College Student
Numerous students reported that it was much easier to be distracted and multitask, check social media accounts or respond to emails and texts than during face-to-face classroom sessions as illustrated by two student comments from San Francisco State University.
“Now that we are forced to stay at home, it’s hard to find time by myself, for myself, time to study, and or time to get away. It’s easy to get distracted and go a bit stir-crazy.”
“I find that online learning is more difficult for me because it’s harder for me to stay concentrated all day just looking at the screen.”
Students often reported that they had more difficulty remembering the material presented during synchronous presentations. Most likely, the passivity while watching Zoom presentations affected the encoding and consolidation of new material into retrievable long-term memory. The presented material was rapidly forgotten when the next screen image or advertisement appeared and competed with the course instructor for the student’s attention. We hypothesize that the many hours of watching TV and streaming videos have conditioned people to sit and take in information passively, while discouraging them to respond or initiate action (Mander, 1978; Mărchidan, 2019).
To reduce the deleterious impact of media use, China has placed time limits on cellphone use, gaming, and social media use for children. On February 2021 Chinese children were banned from taking their mobile phones into school, on August 2021 Children under 18 were banned from playing video games during the week and their play was restricted to just one hour on Fridays, weekends and holidays, and beginning on September 20, 2021 children under 14 who have been authenticated using their real name can access Douyin, the Chinese version of Tik Tok, for maximum of 40 minutes a day between the hours of 6:00 and 22:00.
Ways to avoid Zoom
Say goodnight to your phone
It is common for people to use their mobile phone before going to bed, and then end up having difficult falling asleep. The screen emits blue light that sends a signal to your brain that says it is daytime instead of night. This causes your body to suppress the production of the melatonin hormone, which tells your body that it is time to sleep. Reading or watching content also contributes, since it stimulates your mind and emotions and thereby promote wakefulness (Bravo, 2020). Implement sleep hygiene and stop using your phone or watching screens 30-minutes before going to bed for a better night’s sleep.
Maintaining a healthy vision
We increase near visual stress and the risk of developing myopia when we predominantly look at nearby surfaces. We do not realize that eyes muscles can only relax when looking at the far distance. For young children, the constant near vision remodels the shape of eye and the child will likely develop near sightedness. The solutions are remarkably simple. Respect your evolutionary background and allow your eyes to spontaneously alternate between looking at near and far objects while being upright (Schneider, 2016; Peper, 2021; Peper, Harvey & Faass, 2020).
Interrupt sitting disease
We sit for the majority of the day while looking at screens that is a significant risk factor for diabetes, cardiovascular disease, depression and anxiety (Matthews et al., 2012; Smith et al., 2020). Interrupt sitting by getting up every 30 minutes and do a few stretches. You will tend to feel less sleepy, less discomfort and more productive. As one of our participants reported that when he got up, moved and exercised every 30 minutes at the end of the day he felt less tired. As he stated, “There is life after five”, which meant he had energy to do other activities after working at the computer the whole day. While working time flies and it is challenging to get up every 30 minutes. Thus, install a free app on your computer that reminds you to get up and move such as StretchBreak (www.stretchbreak.com).
Use slouching as a cue to change
Posture affects thoughts and emotions as well as, vice versa. When stressed or worried (e.g., school performance, job security, family conflict, undefined symptoms, or financial insecurity), our bodies tend to respond by slightly collapsing and shifting into a protective position. When we collapse/slouch, we are more at risk to:
- Feel helpless (Riskind & Gotay, 1982).
- Feel powerless (Westfeld & Beresford, 1982; Cuddy, 2012).
- Recall and being more captured by negative memories (Peper, Lin, Harvey, & Perez, 2017; Tsai, Peper, & Lin, 2016),
- Experience cognitive difficulty (Peper, Harvey, Mason, & Lin, 2018).
When stressed, anxious or depressed, it is challenging to change. The negative feelings, thoughts and worries continue to undermine the practice of reframing the experience more positively. Our recent study found that a simple technique, that integrates posture with breathing and reframing, rapidly reduces anxiety, stress, and negative self-talk (Peper, Harvey, Hamiel, 2019). When you are captured by helpless defeated thoughts and slouch, use the thought or posture as the trigger to take change. The moment you are aware of the thoughts or slouched posture, sit up straight, look up, take a slow large diaphragmatic breath and only then think about reframing the problem positively (Peper, Harvey, Hamiel, 2019).
When we are upright and look up, we are more likely to:
- Have more energy (Peper & Lin, 2012).
- Feel stronger (Peper, Booiman, Lin, & Harvey, 2016).
- Find it easier to do cognitive activity (Peper, Harvey, Mason, & Lin, 2018).
- Feel more confident and empowered (Cuddy, 2012).
- Recall more positive autobiographical memories (Michalak, Mischnat,& Teismann, 2014).
The challenge is that we are usually unaware we have begun to slouch. A very useful solution is to use a posture feedback device to remind us, such as the UpRight Go (https://www.uprightpose.com/). This simple device and app signals you when you slouch. The device attaches to your neck and connects with blue tooth to your cellphone. After calibrating, it provides vibrational feedback on your neck each time you slouch. When participants use the vibration feedback to become aware of what is going on and interrupt their slouch by stretching and sitting up, they report a significant decrease in symptoms and an increase in productivity. As one student reported: “Having immediate feedback on my posture helped me to be more aware of my body and helped me to link my posture to my emotions. Before using the tracker, doing this was very difficult for me. It not only helped my posture but my awareness of my mental state as well.”
 Adapted from the book by Erik Peper, Richard Harvey and Nancy Faass, TechStress-How Technology is Hijacking our Lives, Strategies for Coping and Pragmatic Ergonomics, North Atlantic Press. https://www.penguinrandomhouse.com/books/232119/tech-stress-by-erik-peper-phd/
 Correspondence should be addressed to:
Erik Peper, Ph.D., Institute for Holistic Healing Studies/Department of Recreation, Parks, Tourism and Holistic Health, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA 94132 COVID-19 mailing address: 2236 Derby Street, Berkeley, CA 94705 Email: email@example.com web: www.biofeedbackhealth.org blog: www.peperperspective.com
Rest Rusts: Increase dynamic movement to improve healthPosted: September 16, 2021 Filed under: behavior, computer, ergonomics, Evolutionary perspective, Exercise/movement, health, laptops, Neck and shoulder discomfort, Pain/discomfort, posture, screen fatigue, zoom fatigue | Tags: dynamic movement, static postures 2 Comments
In hunting and gathering cultures, alternating movement patterns was part of living and essential for health. This shift from dynamic movement to static or awkward positions is illustrated in Figure 1.
Figure 1. The shift from dynamic movement to immobility and near vision as illustrated by the Hadzabe men in Tanzania returning from a hunt to our modern immobilized work and pleasure positions (Reproduced by permission from Peper, Harvey & Faass, 2020).
Dynamic movement promotes blood and lymph circulation and reduces static pressures. At present times our work and leisure activities increase immobility and static positions as we predominantly have shifted to a sitting immobilized position. This significantly increases musculoskeletal discomfort, cardiovascular disease, diabetes etc. The importance of movement as a factor to enhance health is illustrated in the recent findings of 2110 middle aged participants who were followed up for ten years. Those who took approximately 7000 steps per day or more experienced significantly lower mortality rates compared with participants taking fewer than 7000 steps per day (Paluch et al., 2021). Just having the head forward while looking at the cellphone significantly increases the forces on the muscles holding the head up as illustrated in Figure 2.
Figure 2. The head-forward position puts as much as sixty pounds of pressure on the neck muscles and spine (reproduced by permission from Dr. Kenneth Hansaraj, 2014).
For background and recommendations on what how to reduce static positions, look at our book, TechStress-How technology is hijacking our lives, strategies for coping and pragmatic ergonomics. and the superb article, Static postures are harmful – dynamic postures at work are key to musculoskeletal health, published by the European Agency for Safety and Health at Work (EU-OSHA, Sept 16, 2021) and reproduced below.
Static postures are harmful – dynamic postures at work are key to musculoskeletal health
Our bodies are built for movement – it’s a central part of maintaining a healthy musculoskeletal system and the less we move, the more chance we have of developing health issues including musculoskeletal disorders (MSDs), type 2 diabetes, cardiovascular disease, cancer and more. However, the negative effects of sedentary work can be mitigated by paying attention to the postures we adopt when we work.
Whether workers are standing or seated while working, maintaining a good ergonomic posture is essential when it comes to preventing MSDs. Poor or awkward postures put unnecessary strain on the musculoskeletal system and, over time, can cause the deterioration of muscle fibres and joints.
Poor or awkward postures include those which involve parts of the body not being in their natural position. More muscular effort is needed to maintain unnatural postures, which increases the energy used by the body and can cause fatigue, discomfort and pain. Unnatural postures also put strain on tendons, ligaments and nerves, which increases the risk of injury. For example, the risk of neck pain increases when the neck is rotated more than 45 degrees for more than 25% of the working day.
These postures, including slouching, rotation of the forearms, or prolonged periods of sitting or standing in the same spot, can cause pain in the lower back and upper limbs. The risk increases when combined with repetitive work, static muscle load, or the need to apply force or reach. And even natural or good postures maintained for any length of time become uncomfortable and eventually painful. Everyone has experienced stiffness after being in the same position for any length of time.
What do we mean by ‘good posture’?
For workers, especially those in sedentary jobs such as office work, factory work or driving, it is important to recognise and adopt good postures. A good posture should be comfortable and allow the joints to be naturally aligned. The segments of our body can be divided into three cross-sectional anatomical planes: the sagittal plane, which concerns bending forwards and backwards; the frontal plane, which concerns bending sideways; and finally the transverse plane, which refers to rotation or twisting of the body parts. A good posture is one that ensures that all three of these planes are set at neutral positions as much as possible, in that the worker is not leaning backwards, forwards or to any particular side, and their limbs and torso are not rotated or twisted. Adopting neutral postures will help to lessen the strain on the worker’s muscles, tendons and skeletal system, and reduces the risk of them causing or aggravating an MSD.
In practice, workers can consider the following checklist to ensure that they’re standing or sitting in a neutral position:
- Keep the neck vertical and the back in an upright position.
- Ensure the elbows are below the chest and avoid having to reach excessively.
- Keep the shoulders relaxed and use back and arm rests where possible and ensure that they are adjusted to the size and shape of the worker.
- Avoid rotating the forearms or excessively moving the wrists.
- Ensure that any work tools can be held comfortably, and that clothing doesn’t restrain or prevent movement.
- Allow room to comfortably move the legs and feet and avoid frequent kneeling or squatting.
- Ensure that long periods of standing or sitting in the same posture can be broken up.
Employers can assist workers in adopting good postures by communicating checklists such as this one, and by promoting physical activity where possible, encouraging the fair rotation of tasks between employees to avoid them consistently making repetitive movements, and ensuring that workers have the capacity to take regular breaks.
Why our next posture is the best posture
However, maintaining a good posture at all times is not enough to reduce the risk of MSDs, and can even be harmful. Static postures, even if ergonomic, are still a risk factor if over-used. Our body requires movement and variety, which is why the best approach is to use a variety of ergonomic postures in rotation, breaking up long periods of static working with stretching, exercise, and movement. This is known as adopting ‘dynamic positions’.
It is important not only for workers who spend much of their day seated, but also for workers who primarily stand – such as factory workers in assembly lines. In both cases, sitting and standing are not opposites. The opposite of both is movement. Changing postures between sitting and standing is not sufficient for any worker – the working environment must still offer ways of varying their postures and incorporating movement into their daily working routines. What’s more, if standing work cannot be avoided, workers do not need lots of space in order to adopt dynamic positions in a healthy way. Blood flow propulsion mechanisms can still work correctly even if the worker is only moving around in one square metre. However it is still the case that they should have a break after 30 minutes of standing.
Work should therefore not only facilitate good postures, but ensure that good, ergonomic postures are also dynamic. Switching between sitting, standing and moving while ensuring that the musculoskeletal frame is not under any unnecessary tension can help sedentary workers avoid the onset of MSDs and other health problems. For more information visit the priority area on sedentary work.
EU-OSHA. (September 16, 2021). Static postures are harmful – dynamic postures at work are key to musculoskeletal health. https://healthy-workplaces.eu/en/media-centre/news/static-postures-are-harmful-dynamic-postures-work-are-key-musculoskeletal-health?
Hansraj, K. K. (2014). Assessment of Stresses in the Cervical Spine Caused by Posture and Position of the Head. Surgical Technology International, 25, 277–79. https://pubmed.ncbi.nlm.nih.gov/25393825/
Paluch, A.E., Gabriel, K.P., Fulton, J.E., et al.(2021). Steps per Day and All-Cause Mortality in Middle-aged Adults in the Coronary Artery Risk Development in Young Adults Study. JAMA Netw Open, 4(9):e2124516. https://doi.org/10.1001/jamanetworkopen.2021.24516
Peper, E., Harvey, R. & Faass, N. (2020). TechStress-How Technology is Hijacking our Lives, Strategies for Coping and Pragmatic Ergonomics. Berkeley: North Atlantic books. https://www.penguinrandomhouse.com/books/232119/tech-stress-by-erik-peper-phd/
Are you encouraging your child to get into accidents or even blind when growing up?Posted: May 12, 2021 Filed under: ADHD, behavior, computer, education, ergonomics, Evolutionary perspective, Exercise/movement, laptops, Neck and shoulder discomfort, posture, screen fatigue, Uncategorized, vision | Tags: glaucoma, myopia, nearsightedness, palming 3 Comments
Erik Peper and Meir Schneider
Adapted in part from: TechStress-How Technology is Hijacking our Lives, Strategies for Coping and Pragmatic Ergonomics by Erik Peper, Richard Harvey and Nancy Faass
As a young child I laid on the couch and I read one book after the other. Hours would pass as I was drawn into the stories. By the age of 12 I was so nearsighted that I had to wear glasses. When my son started to learn to read, I asked him to look away at the far distance after reading a page. Even today at age 34, he continues this habit of looking away for a moment at the distance after reading or writing a page. He is a voracious reader and a novelist of speculative fiction. His vision is perfect. –Erik Peper
How come people in preliterate, hunting and gatherer, and agricultural societies tend to have better vision and very low rates of nearsightedness (Cordain et al, 2003)? The same appear true for people today who spent much of their childhood outdoors as compared to those who predominantly stay indoors. On the other hand, how come 85% of teenagers in Singapore are myopic (neasighted) and how come in the United States myopia rate have increased for children from 25% in the 1970s to 42% in 2000s (Bressler, 2020; Min, 2019)?
Why should you worry that your child may become nearsighted since it is easy correct with contacts or glasses? Sadly, in numerous cases, children with compromised vision and who have difficulty reading the blackboard may be labeled disruptive or having learning disability. The vision problems can only be corrected if the parents are aware of the vision problem (see https://www.covd.org/page/symptoms for symptoms that may be related to vision problems). In addition, glasses may be stigmatizing and children may not want to wear glasses because of vanity or the fear of being bullied.
The recent epidemic of near sightedness is paritally a result of disrespecting our evolutionary survival patterns that allowed us to survive and thrive. Throughout human history, people continuously alternated by looking nearby and at the distance. When looking up close, the extraocular muscles contract to converge the eyes and the ciliary muscles around the lens contract to increase the curvature of the lens so that the scene is in focus on the retina — this muscle tension creates near visual stress.
The shift from alternating between far and near vision to predominantly near vision and immobility
Figure 2. The traditional culture of Hdzabe men in Tanzania returning from a hunt. Notice how upright they walk and look at the far distance as compared to young people today who slouch and look predominantly at nearby screens.
Experience the effect of near visual stress.
Bring your arm in front of you and point your thumb up. Look at your thumb on the stretched out arm. Keep focusing on the thumb and slow bring the thumb four inches from your nose. Keep focusing on the thumb for a half minute. Drop the arm to the side, and look outside at the far distance.
What did you experience? Almost everyone reports feeling tension in the eyes and a sense of pressure inside around and behind their eyes. When looking at the distance, the tension slowly dissipates. For some the tension is released immediately while for others it may take many minutes before the tension disappears especially if one is older. Many adults experience that after working at the computer, their distant vision is more fuzzy and that it takes a while to return to normal clarity.
When the eyes focus at the distance, the ciliary muscles around lens relaxes so that the lens can flatten and the extra ocular muscles relax so that the eyes can diverge and objects in the distance are in focus. Healthy vision is the alternation between near and far focus– an automatic process by which the muscles of the eyes tightening and relax/regenerate.
Use develops structure and structure limits use
If we predominantly look at nearby surfaces, we increase near visual stress and the risk of developing myopia. As children grow, the use of their eyes will change the shape of the eyeball so that the muscles will have to contract less to keep the visual object into focus. If the eyes predominantly look at near objects, books, cellphones, tablets, toys, and walls in a room where there is little opportunity to look at the far distance, the eye ball will elongate and the child will more likely become near sighted. Over the last thirty year and escalated during COVID’s reside-in-place policies, children spent more and more time indoors while looking at screens and nearby walls in their rooms. Predominantly focusing on nearby objects starts even earlier as parents provide screens to baby and toddlers to distract and entertain them. The constant near vision remodels the shape of eye and the child will likely develop near sightedness.
Health risks of sightedness and focusing predominantly upon nearby objects
- Increased risk of get into an accident as we have reduced peripheral vision. In earlier times if you were walking in jungle, you would not survive without being aware of your peripheral vision. Any small visual change could indicate the possible presence food or predator, friend or foe. Now we focus predominantly centrally and are less aware of our periphery. Observe how your peripheral awareness decreases when you bring your nose to the screen to see more clearly. When outside and focusing close up the risk of accidents (tripping, being hit by cars, bumping into people and objects) significantly increases as shown in figure 3 and illustrated in the video clip.
Pedestrian accidents (head forward with loss of peripheral vision)
Figure 3. Injuries caused by cell phone use per year since the introduction of the smartphone (graphic from Peper, Harvey and Faass,2020; data source: Povolatskly et al., 2020).
- Myopia increases the risk of eye disorder. The risk for glaucoma, one the leading causes of blindness, is doubled (Susanna, De Moraes, Cioffi, & Ritch, R. 2015). The excessive tension around the eyes and ciliary muscles around the lens can interfere with the outflow of the excess fluids of the aqueous humour through the schlemm canal and may compromise the production of the aqueous humour fluid. These canals are complex vascular structures that maintains fluid pressure balance within the anterior segment of the eye. When the normal outflow is hindered it would contribute to elevated intraocular pressure and create high tension glaucoma (Andrés-Guerrero, García-Feijoo, & Konstas, 2017). Myopia also increases the risk for retinal detachment and tears, macular degeneration and cataract. (Williams & Hammond, 2019).
By learning to relax the muscles around the lens, eye and face and sensing a feeling of soft eyes, the restriction around the schlemm canals is reduced and the fluids can drain out easier and is one possible approach to reverse glaucoma (Dada et al., 2018; Peper, Pelletier & Tandy, 1979).
- Increase in neck and upper back compression when the person cranes their head forward or looks down while reading books/articles, looking at a cellphone or a laptop screen, This often results in an increase of back, neck and shoulder pain as well as headaches (Harvey, Peper, Booiman, Heredia Cedillo, & Villagomez, 2018; Hansraj, 2014).
- Decrease in subjective energy and increase in helpless, hopeless, powerless and defeated thoughts when the person habitually looks down in a slouched position (Peper, Booiman, Lin, & Harvey, 2016; Peper, Lin, Harvey, & Perez, 2017).
WHAT CAN YOU DO?
The solutions are remarkable simple. Respect your evolutionary background and allow your eyes to spontaneously alternate between looking at near and far objects while being upright (Schneider, 2016; Peper, 2021; Peper, Harvey & Faass, 2020).
For yourself and your child
- Let children play outside so that they automatically look far and near.
- When teaching children to read have them look at the distance at the end of every paragraph or page to relax the eyes.
- Limit screen time and alternate with outdoor activities
- Every 15 to 20 minutes take a vision break when reading or watching screens. Get up, wiggle around, move your neck and shoulders, and look out the window at the far distance.
- When looking at digital screens, look away every few minutes. As you look away, close your eyes for a moment and as you are exhaling gently open your eyes.
- Practice palming and relaxing the eyes. For detailed guidance and instruction see the YouTube video by Meir Schneider.
Create healthy eye programs in schools and work
- Arrange 30 minute lesson plans and in between each lesson plan take a vision and movement breaks. Have children get up from their desks and move around. If possible have them look out the window or go outside and describe the furthest object they can see such as the shape of clouds, roof line or details of the top of trees.
- Teach young children as they are learning reading and math to look away at the distance after reading a paragraph or finishing a math problem.
- Teach palming for children.
- During recess have students play games that integrate coordination with vision such as ball games.
- Episodically, have students close their eyes, breathe diaphragmatically and then as they exhale slowly open their eyes and look for a moment at the world with sleepy/dreamy eyes.
- Whenever using screen use every opportunity to look away at the distance and for a moment close your eyes and relax your neck and shoulders.
BOOKS TO OPTIMIZE VISION AND TRANSFORM TECHSTRESS INTO TECHHEALTH
Vision for Life, Revised Edition: Ten Steps to Natural Eyesight Improvement by Meir Schneider.
TechStress-How Technology is Hijacking our Lives, Strategies for Coping and Pragmatic Ergonomics by Erik Peper, Richard Harvey and Nancy Faass
YOUTUBE PRESENTATION, Transforming Tech Stress into Tech Health.
ADDITIONAL BLOGS THAT FOCUS ON RESOLVING EYES STREAN AND TECHSTRESS
Andrés-Guerrero, V., García-Feijoo, J., & Konstas, A.G. (2017). Targeting Schlemm’s Canal in the Medical Therapy of Glaucoma: Current and Future Considerations. Adv Ther, 34(5), 1049-1069.
Bressler, N.M. (2020). Reducing the Progression of Myopia. JAMA, 324(6), 558–559.
Chen, S. J., Lu, P., Zhang, W. F., & Lu, J. H. (2012). High myopia as a risk factor in primary open angle glaucoma. International journal of ophthalmology, 5(6), 750–753.
Cordain, L., Eaton, S.B., Miller, J. B., Lindeberg, S., & Jensen, C. (2003). An evolutionary analysis of the aetiology and pathogenesis of juvenile‐onset myopia. Acta Ophthalmologica Scandinavica, 80(2), 125-135.
Dada, T., Mittal, D., Mohanty, K., Faiq, M.A., Bhat, M.A., Yadav, R.K., Sihota, R., Sidhu, T,, Velpandian, T., Kalaivani, M., Pandey, R.M., Gao, Y., Sabel, B,A., & Dada, R. (2018). Mindfulness Meditation Reduces Intraocular Pressure, Lowers Stress Biomarkers and Modulates Gene Expression in Glaucoma: A Randomized Controlled Trial. J Glaucoma, 27(12), 1061-1067.
Hansraj, K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical Technology International, 25, 277–279.
Harvey, R., Peper, E., Booiman, A., Heredia Cedillo, A., & Villagomez, E. (2018). The effect of head and neck position on head rotation, cervical muscle tension and symptoms. Biofeedback. 46(3), 65–71.
Min, L.P. (2019). Speech by Dr. Lam Pin Min, Senior Minister of State for Health, Singapore, at the opening of the Sangapore National Eye Centre’s Myopia Center, 16 August, 2019.
Peper, E. (2021). Resolve eyestrain and screen fatigue. Well Being Journal, 30(1), 24-28.
Peper, E., Booiman, A., Lin, I.M., & Harvey, R. (2016). Increase strength and mood with posture. Biofeedback. 44(2), 66–72.
Peper, E., Harvey, R. & Faass, N. (2020). TechStress: How Technology is Hijacking Our Lives, Strategies for Coping, and Pragmatic Ergonomics. Berkeley: North Atlantic Books.
Peper, E., Lin, I-M., Harvey, R., & Perez, J. (2017). How posture affects memory recall and mood. Biofeedback.45 (2), 36-41.
Peper E., Pelletier K.R., Tandy B. (1979) Biofeedback Training: Holistic and Transpersonal Frontiers. In: Peper E., Ancoli S., Quinn M. (eds) Mind/Body Integration. Springer, Boston, MA.
Povolotskiy, R., Gupta, N., Leverant, A. B., Kandinov, A., & Paskhover, B. (2020). Head and Neck Injuries Associated With Cell Phone Use. JAMA Otolaryngology–Head & Neck Surgery, 146(2), 122-127.
Schneider, M. (2016). Vision for Life, Revised Edition: Ten Steps to Natural Eyesight Improvement. Berkeley, CA: North Atlantic Books.
Schneider, M. (2019). YouTube video Free Webinar by Meir Schneider: May 6, 2019.
Susanna, R., Jr, De Moraes, C. G., Cioffi, G. A., & Ritch, R. (2015). Why Do People (Still) Go Blind from Glaucoma?. Translational vision science & technology, 4(2), 1.
Williams, K., & Hammond, C. (2019). High myopia and its risks. Community eye health, 32(105), 5–6.
Tips to Reduce Zoom FatiguePosted: November 15, 2020 Filed under: behavior, computer, digital devices, ergonomics, Exercise/movement, health, laptops, Neck and shoulder discomfort, Pain/discomfort, self-healing, stress management, Uncategorized, vision 1 Comment
Adapted from the book, TechStress: How Technology
is Hijacking our Lives, Strategies for Coping and Pragmatic Ergonomics, by Erik Peper, Richard Harvey and Nancy Faass.
Peper, E., Harvey, R., & Faass, N. (2020), TechStress-How Technology is Hijacking our Lives, Strategies for Coping and Pragmatic Ergonomics. Berkeley, CA: North Atlantic Books.