Kids, computers and RSI

With children using computers ever more at home and at school, Ann Thomson, Director of the RSI and Overuse Injury Association of the ACT, has some important information for parents and tips for avoiding injury.

Would you be surprised to learn that even young children are reporting musculoskeletal pain related to computer use? According to an international team of experts, one in five Australian children reported soreness at least monthly and the soreness reported was not trivial in nature. One in four had to limit their activities, one in ten took medication and one in twenty sought professional health advice.

Unfortunately, computer use can involve poor posture, long hours of sitting and repetitive activity. None of these is good for health. As computers become a bigger part of education and children’s lives generally from primary school right up to high school, these factors can lead to muscular pain at a very early age.

One American study of 212 primary and secondary students found that many of them were experiencing physical discomfort which they attributed to computer use. For example, 30% of the children reported computer-related wrist pain and another 15%, back pain.

There are a number of key factors behind the increase in overuse injuries in children. One is simply that computers are often not set up properly for kids' young bodies. Another is a lack of evidence-based guidelines and education around safe computer use.

A quality education program in safer computer use can be really effective in preventing injury. For example, a recent study in Johannesburg found that educating a group of adolescent students about correct ergonomics and computer use resulted in a significant decrease in muscle pain. After a six-month period of working with the students on correct computer use, the prevalence of musculoskeletal pain reduced from 43% to 18%. Ultimately the study found that simply educating students about correct posture and computer use can result in a significant reduction in musculoskeletal pain.

Dr Leon Straker from Curtin University has long been concerned about computer-related musculoskeletal injuries in children. In a recent paper entitled "Young Children and Screen Time: It Is Time to Consider Healthy Bodies As Well As Healthy Minds", he says: "we urge all authorities developing guidelines for wise use of information technology by children to adequately consider the long-term physical health aspects of this interaction.”

He suggests that guidelines should include “practical advice to parents and others responsible for care of children on how to minimise potential negative physical health outcomes. For example, the advice could include statements on ensuring that children are adequately encouraged to actively play and not sit for prolonged periods in flexed posture engaged with a screen."

Reducing your child’s risk of RSI

There are relatively simple things you can do to reduce the risk of harm from your child's computer use.

Limit computer time

It's really important to limit the amount of time spent at the computer, ideally taking an active break every 30-60 minutes. It is also important to encourage micropauses – taking 30 second breaks every three to 15 minutes – as this has been found to be even more effective than taking long breaks every hour or so.

Mix it up

It is also helpful to switch between different types of tasks (e.g. data entry, reading, intensive tasks) as they apply different types of stress to the body. Increased neck pain is found in children who primarily use the mouse when using the computer and mouse use has also been associated with musculoskeletal pain in adults. Keyboards allow more body movement but often involve more awkward wrist positions so a mixture of the two is recommended. Using motion sensor technologies which require more active movements should also be strongly encouraged (e.g. using a Wii rather than other gaming devices).

Focus on posture

Good posture is vital when it comes to preventing musculoskeletal pain in both children and adults. One of the best ways to improve posture is good workspace design. If the child’s workstation is set up awkwardly and includes things like furniture that doesn't provide proper back support, as is the case in many schools, then it is difficult to avoid discomfort and pain while using the computer.

The chair is a good place to start if you’re looking to improve your child’s workstation, as many chairs provided in schools are just unsuitable for computer work. The distance from the chair to the ground should be the same as the distance from the underside of the thigh at the knees to the soles of the feet. Adjustable height chairs can be very helpful in achieving this, especially if different people use the same workstation.

Backrests are also recommended as they are thought to reduce spinal loading and leaning against a backrest can also help with retaining the lumbar curve. That said, no backrest is better than a bad one as children without backrests tend to adopt better posture.

When it comes to the monitor, it's important to have it at the right height: the top of the monitor should be at eye-level or up to 45° below that. If your child is using a desk that other people use, it is extremely unlikely that these requirements will be met, so for safe computer use, your child should have their own desk suited to their size. And the set-up will need to change as your child grows!

Forearm support

How your desk is set up is also important as this can reduce strain on your arms, shoulders and wrists. Having forearm support is vital and your child's keyboard and mouse should be pushed back so that they can comfortably rest their forearms while they type. The mouse should also be adjusted for the child’s size. Smaller mice with a lower clicking force both help performance and reduce stress on the wrist. To avoid compromising spinal posture, try to have the desk slightly below elbow height.

Choose the right device for school

Provide your child with a relatively light notebook if you can and when transporting it, use a backpack with two comfortable straps to minimize discomfort. And when it comes to notebooks or laptops, it's better to have an external mouse and keyboard.

Two things to teach your kids

It’s vital to teach children to respond to discomfort. Many children will ignore symptoms because of limited self-awareness and will not address issues in the same way that an adult would. So it is important to teach your child to notice whether they are in pain or discomfort and make them aware that this is not just a part of computing that should be ignored.

Secondly, teach your children touch-typing, which has been associated with lower stress on the wrists.

As computers become a greater part of our lives, both at work and home, it's essential to learn how to use them safely. As parents, we need to encourage our schools to provide a safe computing environment – and also make sure we provide one ourselves!

For more information on child-safe computing, see the RSI and Overuse Injury Association website:

The Association is Australia's only support group for people with RSI and is a non-profit charity funded by the ACT Health Directorate.

This article appeared in ParentACTion, Term 2, 2016. See other past editions of our quarterly magazine.