Ergonomics for Kids
How to Keep Your 10-Year-Old from Getting Carpal Tunnel Syndrome at Age 20

By Christina Elston

Watching your little darlings madly cutting down monsters with the Xbox, slouched at the keyboard earning "KinzCash" for their Webkinz, or repeatedly texting their BFF might give you plenty of concerns. Is that game too violent? What about online predators? And what do they charge for texting on my wireless plan, anyway?

What you might not be worried about is a little thing called "ergonomics." Technically, it\'s a discipline that matches the design of a device - for example, a computer console or a desk chair - to the needs of the user. On a practical level, it often refers to the discomfort - and even injuries - that result when someone spends long periods of time using something that doesn\'t fit them quite right. It\'s a term you\'re more likely to have heard in reference to your computer workstation than to your daughter\'s new iPhone. But as technological gadgets become small and friendly enough to squeeze into even the youngest kids\' lives, these issues increasingly impact children as well as adults.

Sources of Strain

Any activity performed repetitively without breaks, with incorrect posture or ill-fitted equipment puts kids at risk for repetitive-motion injuries, according to physical therapist Margot Miller, a spokesperson for the American Physical Therapy Association. "These activities often take place during a child\'s play time," Miller says, including video and computer game time. But these injuries can result from an improper fit between the child and the equipment, from habit or from lack of knowing a "better" way to perform the activity.

For younger kids, most ergonomic stress comes from using video games. In teens, it\'s a combination of video game and computer use, says Alan Hedge, Ph.D., director of the Human Factors and Ergonomics teaching and research programs at Cornell University.

While overloaded backpacks and book bags can certainly cause injury, they aren\'t the top concern for most kids, Hedge says. Children are likely to spend much more time at the keyboard or game console than they are lugging their books around. Some kids, he says, spend nearly 20 hours per week in front of one screen or another.

And while most ergonomics research to date has focused on the spine, kids\' high-tech activities present potential problems for the hands as well. The impact of gaming, computers and text messaging can add up. "You are using very small muscles on a highly repetitive basis," says Julia Greenwald, senior ergonomist at The Ergonomics Center of North Carolina, part of North Carolina State University.

The Damage Done

Kids\' tech-related injuries have become so prevalent, in fact, that one even has its own name: "Video Gamer\'s Thumb," a swelling at the base of the thumb due to overuse of video games. But there are other potential injuries as well - to the wrists, forearms and shoulders, resulting in tendonitis, bursitis or carpal tunnel syndrome, Miller notes.

Kids who report back pain from an early age are more likely to suffer injuries down the road - especially if they never learn proper posture and habits for computer use, gaming and texting, Greenwald says. "Part of it is education. Kids just don\'t think about it until something hurts."

Compounding the impact is the fact that kids\' spines change shape as they grow (from a \'C\' curve to the \'S\' curve we have as adults), and their bones are still hardening. Thus, the damage of ergonomic stress can be serious. Studies of young video gamers\' fingers have shown that because children\'s bones and cartilage are still developing, they can easily be deformed, Hedge says, adding that there\'s no easy way to remedy those deformities.

While there hasn\'t been an influx of children reporting carpal tunnel syndrome yet, that\'s likely because it takes years to develop, Hedge notes. People in the workplace are beginning to report carpal tunnel syndrome at younger and younger ages - as early as their 20s. "There\'s been a real forward shift in terms of the injuries that are occurring," he says, adding that a 20-year-old with carpal tunnel today likely began doing the damage at the keyboard or console around age 10.

Many people, he contends, don\'t take soft-tissue injuries like carpal tunnel seriously because they\'re not life-threatening. But repeat occurrences of the syndrome could mean permanent loss of use of the hand.

The Quick Fix

Fortunately, you don\'t need to ditch the Nintendo DS or spend thousands of dollars on a new computer desk and chair to keep your child in ergonomic health. The fixes for these problems can be fast and free.

Of the three factors involved in ergonomics injuries - effort, posture and exposure/repetition - the one you can address most effectively is exposure, Greenwald says. In other words, get the kids to take five.

"Set a timer for 30 minutes, and after 30 minutes they have to take a break," she advises. This means getting up, changing position and getting the blood flowing to the muscles so that they\'ll get an oxygen boost.

It also means finding an activity that\'s completely different from the one your child has been absorbed in. So if the fingers have been busy pressing game buttons, give those muscles and body parts a break: go outside and kick a ball around instead.

Get Your Game On

When gaming:

  • Take frequent breaks.
  • Hold the gamepad or joystick lightly, and try not to hit the keys too hard.
  • Use programmable features on the gamepad for repetitive actions.
  • Change positions frequently.
  • Hold the gamepad so that your wrists are unbent, and don\'t hunch forward toward the screen.

Because your child\'s "exposure" adds up over the course of the day, find out how much time she spends on a computer at school, and note what she is doing at home.

"Be in a position where you can manage the amount of time your child is spending," Hedge says. If you\'re uncertain, keep a diary. One of Hedge\'s colleagues added up his teenager\'s evening video game and homework time and determined that his son was spending a total of eight hours a day at one keyboard or another - outside of school hours.

Equipment and Bad Habits

Posture is another ergonomics issue that you can - and should - address. That often starts with making adjustments to your equipment:

  • Chairs are often uncomfortable for kids because the seat is too big, forcing the child to either slouch to rest his back against the seat back, or to sit with his feet sticking straight out.
    A kid-size chair is an ideal fix, but you can also modify what you already have by adding a pillow behind your child\'s back and a box or stool under his feet. "There are a lot of minor, cheap adjustments you can make," Greenwald says. "You don\'t have to spend a fortune for it."

  • Desk height can also be an issue if it forces your child to bend his wrist to use the mouse, causing the wrist to tire easily and be more prone to injury. A quick fix here is to use a wireless mouse and give the child a clipboard so that he can maneuver the mouse in his lap.
  • Think "adjustable" if you are setting up your workstation from scratch, or making a new purchase for an existing setup, Greenwald says. "One of the best investments you can make is a chair that goes up and down."
  • But you need to teach your child good habits as well. "Just having good equipment doesn\'t guarantee good posture either!" asserts Valerie Berg Rice, Ph.D., an ergonomics consultant and co-editor of the book Ergonomics for Children: Designing Products & Places for Toddlers to Teens.
  • Teach children about posture and the importance of taking breaks to prevent muscle fatigue and injuries. "There are software products that show proper posture and that will even come on at preprogrammed times and suggest a series of exercises before a child (or adult) resumes their work," Rice says.
  • When your child is using a hand-held device, such as a game controller, have him rest his arms and hands on a pillow or other surface on his lap, and keep his wrists straight, Miller advises. Have the child sit in an upright posture with the back supported and feet flat on the floor or a footstool. "No slouching," she says. "Take brief rest breaks every 20 minutes or so. Stretch the fingers by making a fist and straightening the fingers back out, and do shoulder rolls and shrugs to stretch the upper and mid-back and shoulder muscles."

Change Takes Time

Experts say it can take up to 21 days to change a habit, so any adjustments you make to your child\'s computer use and gaming will require some getting used to. Tackle just one or two issues at a time, especially if your child is younger, Greenwald says. "If you change too many things at once, it\'s overwhelming for them."

You may also have to encourage your child to complain. Yes, complain. That means telling your child to let you know if his neck, back or hands are feeling stiff, sore or simply uncomfortable. Discomfort is a precursor to injury.

"Teach children to recognize that when they feel discomfort, it\'s their body\'s way of telling them that they need to make a change!" Rice says.

The best teacher, of course, is a good example. "Tell your children why you are setting up your own workstation the way you are," she says. "Take breaks with them and exercise. Tell them how much better those breaks make you feel physically and mentally. Children learn so much through observation."


  • CU Ergo  - This site from Cornell University offers tips for parents, plus a link to software that teaches good computer ergonomics.
  • Healthy Computing 4 Kids  - This site, produced by an ergonomics consulting company, includes guidelines on proper use of backpacks, computers, gaming and mobile devices.
  • Move It!  - This site from New Zealand includes interactive games that teach kids how to move their bodies and stay comfortable when working on computers, gaming or at school.
Christina Elston is a health writer and senior editor for Dominion Parenting Media.