Valerie Hunter, Physical Therapist, Providence St. Joseph Medical Center answers a few questions shared by the TAG community.

What are good exercises for prevention and endurance for back?

To help the back, exercises for flexibility and strengthening of the core trunk and pelvic muscles are always best. Pilates is a good source for core strengthening. You want your abdominals strong, your gluteals strong and your back and legs flexible.

An issue I’m having is that when I draw, I prefer to be pretty close up and leaning to the Cintiq, but every ergonomic visual I see has the artists in an upright straight position in their chair. Is there a good balance for this? (I am also very short)

I found most of the pics of the Cintiq not so good also. Choosing a chair that has a seat tilt for forward lean might be helpful to position you closer to your monitor. You also might need a foot support to allow you the height your need while still supporting your feet.

My desk at home was built a bit too tall for my height, so I end up angling my arms so my elbows are at a downward angle from my wrists, and I end up wresting my wrists on the desk itself. Any solutions you might suggest?

If you have enough leg space to raise your seat and use a foot support under your feet, that might work. If the desk is up on legs, consider cutting them down.

I find that with my Cintiq, I have to choose between taking care of my arm, or my neck and back. If I have my Cintiq down, my arm is neutral but I lean down putting strain on my neck and back. If I have the Cintiq up, I’m sitting up straight but my arm is not neutral. Any suggested solutions?

It is important to be close to the screen to reduce reach but to have the screen angled between 45 to 65 degrees, not straight up, and considering a chair with a forward seat tilt option.

I’m a bit of a mess from accidents over the years. I had neck surgery last year and wrist surgery a few years ago. It helped but working at a computer really exacerbates the pain. I have a great workspace at home and at work with a Cintiq arm and a great chair already. I also have a timer so I get up every hour, exercises and have a foam roller. Do you have any other suggestions, tools or exercise recommendations for someone with neck injuries? How frequent to you recommend doing stretches for your wrists throughout the day?

It sounds like you have made some good adjustments already. I like people to take breaks from sitting a little more often, say each 30 minutes for a minute or so, I think doing stretches a couple of times is usually enough as you can over stretch and have pain. You have a complex group of health concerns and might want to consider a physical therapist working with you to address the whole picture.

How thick does the pen have to be in centimeters? Does it depend on hand and finger size?

I would say 1.5 to 2cm but there is no perfect width as hand size does make a difference. It can help to try out a few Office Depot type pens for comfort of width to help you choose the best wacom.

What a great substitute for lentils? Would play dough work good?

I find playdough a bit sticky, smelly. I do really like the lentils and they are easy to find. Theraputty can also be fun (somewhat like silly putty) and I recommend medium soft.

What if you are only 5′ tall and there are not any chairs that give me any support- I’m too short to sit all the way against the back of the chair, even with an added ergonomic lumbar and back cushion.

This is always a bit of a challenge but you might consider a seat insert that includes both back and chair seat, and would probably need a foot riser.

Would it be alright to stack monitors vertically?

Vertically poses a challenge to looking up and down constantly but if you can get used to using your eyes to look up and down, not your head it might work.

Does it matter how your keyboard is positioned? I’ve heard negative tilt is better – is this true? If so, how can I reproduce negative tilt on a flat surface?

Flat to negative is recommended but if on a solid desk, you can place a riser under the front of the keyboard. Just be sure you are sitting high enough to keep the downward slope from your elbows. Otherwise, a pullout tilt tray might work.

What if we lack a desk and chair? What are other drawing position that is better for our backs?

Consider standing using a counter top such as in the kitchen.

Do you have any specific recommendations when using Cintiq in a horizontal position? I find that my neck starts to hurt after a while.

It really needs to be positioned on a support that allows for proper tilt. Check with Human Resources.

Any advice on mouse usage? I find it most comfortable when alternating between an upright and a regular mouse. Is that a good practice?

Alternating your mouse is fine. It allows for a change of hand stress.

My right side seems to be very tight. Even the muscles near my ribs, shoulder and neck. Any recommended exercises? Strengtheners? Equipment? Yoga?

First, stand and move around more often to be less tight. Check that you are not angled to the right in your positioning. Stretching is helpful and core exercises. I especially like exercises on a thoracic half roll.

For standing desks, besides having a cushioned floor pad, any other recommendations and movements you can make to minimize fatigue? Any ways to minimize varicose vein formation? Is there a limit to how long we should stand and work in a day, or is it that the longer that you can the better?

 Yes, I should have mentioned compression garments that can be bought online but also at Orthotics stores. I especially like Active Life orthotics, prosthetics and compression and Intimate Images, Woodland Hills. For most, a 15 to 18mmhg garment is a good start, others may need 20/30mmhg.

Is there a source to identify muscle pain? Having a tough time learning what I need to strengthen.

Working with an exercise specialist, I am partial to physical therapists but you get some really good exercise trainers also can be very helpful to get you started.