Version June 2024
| Problem | Remedy | |
| Desk-related | Keyboard/mouse too far from torso; causes repeated and prolonged shoulder flexion | Position keyboard closer and/or move chair closer to desk; elbows should align with trunk and rest at 90-degree angle. |
| Armrests too lateral; causes shoulder abduction and internal rotation | Position armrests closer to torso or avoid using armrests and keep elbows by side. | |
| Desk chair too low; causes thoracic flexion/slouching and shoulder flexion when typing or using mouse | Raise desk chair so hips are slightly above knees. This promotes more upright posture and allows elbows to be kept at 90 degrees of flexion when typing. | |
| Keyboard, mouse, or writing area to side of computer; leads to repetitive cross-body reaching (adduction) or lateral reaching (abduction) | Position monitor, keyboard, and mouse directly in front. When writing, use a clipboard or place paper/tablet as close to midline as possible. | |
| ADL-related | Movements with shoulder extension and internal rotation (eg, putting on belt, tucking in shirt) | Perform tasks slowly. When tucking in a shirt, rotate trunk in the direction you are tucking to reduce shoulder extension. |
| Taking off shirt by crossing arms, grabbing bottom, and lifting overhead | Remove one arm at a time, trying to keep arms out in front rather than to the side or overhead. | |
| Putting on bra | Position bra so a rear clasp is in front at breastbone, fasten, and then rotate. | |
| Crossing arms at rest; promotes shoulder internal rotation and scapular protraction | Position hands in pockets or clasped in the front of waist. | |
| Combination of horizontal adduction and internal rotation (eg, washing back); leads to impingement | Avoid reaching across your body to scrub the upper back; use a body brush with a long handle to reach those areas. | |
| Driving-related | Driving with one hand on top of steering wheel; can cause shoulder flexion and internal rotation | Drive with both hands on the steering wheel; position hands at 9 and 3 o'clock or below. |
| Reaching into back seat of car (especially to lift something) | Get out of the car and place or remove items on back seat. If you must reach into back seat, rotate trunk as much as possible before reaching. | |
| Putting on seatbelt; causes shoulder horizontal adduction and internal rotation | Rotate trunk and face towards direction of seatbelt. This reduces necessary shoulder motion. | |
| Work- and activity-related | Movements with repeated internal rotation of flexed shoulder (eg, raking leaves, using a screwdriver) | Take short breaks. This reduces likelihood of overuse injury. Shorten the range of motion and alternate sides with tasks such as raking. Keep elbows close to body during these tasks. Perform recommended stretching exercises during breaks. |
| Movements with internal rotation against resistance (eg, scrubbing countertops, washing windows) | Alternate arms; avoid using only dominant extremity. Perform small circular motions in both directions. Vary your movements: use up-down and side-to-side motions. | |
| Prolonged or repetitive overhead activity (eg, reaching up into cabinet, screwing in lightbulb, painting) | Use stepstool or ladder to reduce shoulder flexion. Take frequent, short breaks. Perform recommended stretching exercises during breaks. | |
| Sleep-related | Sleeping supine or prone with arm overhead | Avoid prone sleeping position if possible. While supine, avoid sleeping with arm overhead. |
| Sleeping on side with arm under the pillow | Thicker pillow improves cervical support and reduces tendency to put an arm under the pillow while sleeping. | |
| Childcare-related | Holding/nursing baby causes protraction of scapulae, rounded shoulders, and horizontal adduction and internal rotation of shoulder | Movement variation is key. Alternate between sitting and standing. Periodically switch arms if able. Use body wraps and harnesses to reduce stress on shoulders and arms. When sitting, use a chair with good back support or place a pillow behind your back to promote upright posture. Use additional pillows under your arm to take some of the weight of the baby. |
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