The Importance of Strength Training in Preventing Muscle-Related Neck and Shoulder Symptoms in Computer Workers
Neck and shoulder symptoms are very common, especially among working-age people, and the symptoms are often associated with the static load caused by computer work. The increased remote work due to the Covid-19 pandemic has further reduced physical activity for many people. This article discussed the importance of strength training in preventing muscle-related neck and shoulder symptoms in computer workers. Based on research results, strength training is the most effective way to prevent and manage muscle-related neck and shoulder symptoms.
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- Introduction
With the start of the Covid-19 pandemic in early 2020, remote work has increased globally. In 2017, only 2.9% of Americans and in 2015, only 2% of Europeans worked primarily from home. With the outbreak of the pandemic, remote work has become a normal way of working for millions of people in a very short time. (Wang et al. 2020, 2).
For most employees, remote work essentially means computer work. For many, the daily physical activity related to work, such as walking to and from work and taking breaks, has decreased due to the sudden increase in remote work. Due to the Covid-19 pandemic, indoor exercise opportunities have also decreased, but outdoor activities have increased. According to a survey conducted by Cabrita et al. (2021) in May-June 2020, 71% of respondents felt that their physical activity had changed, with 27% experiencing an increase and 44% a decrease in physical activity.
Computer work causes particular musculoskeletal symptoms in the neck and shoulder area. The symptoms are often described as pain, tightness, numbness, or tingling, and they can severely impair work ability or normal daily functioning. The prevalence of musculoskeletal symptoms in the neck, shoulders, arms, and lower back among computer workers ranges from 20-77%, with the neck and shoulder area being the most commonly affected region. (Turci et al. 2019, 466).
The static nature of computer work and the inactivity caused by remote work emphasize the need for effective preventive measures, especially for neck and shoulder symptoms. Certainly, every physiotherapist, naprapath, osteopath, masseur, or other healthcare professional working with musculoskeletal problems continuously encounters clients who report that remote work causes neck and shoulder pain, and almost without exception, clients think that the reason for the symptoms is a lack of stretching and/or poor working posture, i.e., poor work ergonomics. However, could paying attention to the strength of the muscles that maintain body posture lead to better results?
This article discusses, based on previous studies, the effects of static work on soft tissue symptoms, particularly in the neck and shoulder area, and the effect of strength training on symptom prevention.
- Methods
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This development task was carried out as a theoretical literature review. Material was searched from the PubMed and Google Scholar databases using the following keywords: static work, strength training, static muscle, computer work musculoskeletal disorders, myofascial pain syndrome, computer work statistics, covid 19 remote work, prolonged sitting musculoskeletal, musculoskeletal disorders prevention, office work strength training, and remote work sedentary.
To obtain up-to-date sources, the searches were limited to the last 10 years. The Finnish Institute of Occupational Health’s Ergonomics publication was also used as a source.
- Results
Neck and shoulder symptoms associated with computer work are particularly caused by prolonged sitting, static tension, forward-leaning neck posture, and repetitive movements. (Baker et al. 2018, 16; Mohammadipour et al. 2018, 331; Launis & Lehtelä 2011, 71).
According to Launis & Lehtelä (2011, 73, 76), static work often involves anaerobic muscle work, in which blood flow decreases as muscle tension and intramuscular pressure increase. This leads to a deficiency in the supply of nutrients and oxygen, as well as the accumulation of waste products in the muscle. The mismatch between the muscle’s blood demand and blood flow is greatest in static work. For continuous static force production (e.g., maintaining posture), the upper limit for a full workday (less than 8 hours) has been suggested to be only 2% of maximum force.
Myofascial pain syndrome (muscle fascial pain) is one of the most common causes of muscle pain in the neck and shoulder area, and it can develop in computer work involving visual and postural load. The usual symptoms include tightness, limited range of motion, weakness, and fatigue in the painful muscles, as well as sleep disturbances and autonomic nervous system dysfunctions. Dizziness and tinnitus may also occur in connection with cervical myofascial pain. The prevailing hypothesis for the development of the syndrome is local muscle hypoxia and an energy crisis that irritate the motor nerve endings, causing the neurotransmitter acetylcholine to leak into the synaptic cleft, causing the postsynaptic muscle fiber to contract. This mechanism creates a tight band and a trigger point in the muscle tissue where metabolites accumulate. Electrically dampened tension and thickening of muscle fibers at the neuromuscular junctions have been observed in these tight bands. (Partanen et al. 2010, 1921-1923).
While ergonomic instructions or ergonomic training do not appear to have a clear effect on neck and shoulder symptoms (Van Eerd et al. 2016, 65; Verhagen et al. 2013, 15), the perceived importance of ergonomics is nevertheless emphasized in both client discussions and media coverage of remote work.
In a systematic literature review by Van Eerd et al. (2016, 65), strength training was found to be the most effective factor in preventing and managing symptoms in the neck, shoulders, arms, and lower back. The content of exercise programs that produced positive results varied, for example, in terms of the time spent exercising and exercise frequency, but the unifying factors in all but one exercise program were the use of weights (e.g., kettlebells, dumbbells; one program used only body weight) and regular exercise.
Maestroni et al. (2020, 1439) recommend individualized training for older adults to achieve the positive effects of strength training, with major muscle groups trained using 1-2 multi-joint exercises for 2-3 sets, 2-3 times per week, at an intensity of 70-85% of one-repetition maximum, i.e., with significantly heavy loads.
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Physical performance training can be roughly divided into endurance and strength/power training. Endurance training has traditionally meant prolonged, low-load training, while strength training involves shorter, relatively high-load training. Strength training, among other things, increases muscle cross-sectional area, leads to neural adaptations that increase force production, and strengthens the body’s connective tissues. (Hughes et al. 2018, 1-2).
Maestroni et al. (2020, 1432) emphasize the difference between strengthening exercises and strength training, and that when referring to strength training and, for example, healthcare professionals instructing their clients, the number of repetitions and intensity should focus on the strength training range to achieve the desired effects.
Strength training has beneficial effects on various human tissues and aspects of health, including bones, muscles, cartilage, tendons, metabolic diseases, respiratory and cardiovascular diseases, dementia, sleep, depression, and, according to the latest research evidence, cancer. In terms of muscle-related symptoms, particularly important are the hormonal effects of strength training that promote muscle tissue health, the anti-inflammatory effect of increased muscle mass and decreased fat mass, and the effects of training on improving muscle energy metabolism (Maestroni et al. 2020, 1432, 1434).
- Discussion
Computer work emphasizes static muscle work and immobility, which generally impairs the body’s metabolism, reduces tissue growth stimuli, and makes the body’s movement patterns and loading more one-sided. In the neck and shoulder area, the muscle work required for supporting the arms and head, and insufficient muscle tissue metabolism, muscle weakness, and nerve conduction disturbances are particularly pronounced.
Stretching, massage, treatment with a massage gun, or treatment with cold/hot gels and other similar methods for the neck and shoulders can all be relaxing experiences, and as part of overall body maintenance, they have their place. However, these methods alone do not provide a longer-lasting, strengthening or maintaining effect against the detrimental effects of static work on muscles.
The mechanical and chemical stimuli caused by physical activity and strength training in muscle tissue create unique responses that promote and maintain, among other things, the body’s hormonal functions, energy metabolism, force production, nerve function, balance, overall functional capacity (especially in older adults), and protect against various diseases such as type 2 diabetes, cardiovascular diseases, and certain cancers.
In the prevention of muscle-related neck and shoulder symptoms, strength training plays a significant role by increasing muscle strength capacity, improving muscle blood circulation, composition, and innervation, as well as mobility. For example, the feeling of tightness in a muscle possibly caused by static postures does not usually alleviate as well by giving the body another static stimulus, i.e., static stretching, as by activating the muscles and the nervous system.
Better knowledge of load physiology among healthcare professionals, increased general media and public awareness of the benefits of strength training, and clearer recommendations on the content of strength training would be beneficial in helping to prevent musculoskeletal and, in particular, muscle-related neck and shoulder symptoms. In the future, research on the most effective and easily implementable strength training recommendations at the population level would be advantageous.
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