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Reduce Workplace Pain And Become More Productive | Dr Euan Lawson

Dr Euan Lawson is a General Practitioner and author of The Healthy Writer. Lots of us sit at desks for a significant proportion of our lives, but a typical work station is severely unhealthy for body and mind. Expect to learn how to optimise your work station to reduce physical strain, fight RSI, improve sleep, turbo charge productivity and benefit your mood. This one is an absolute belter packed with amazing advice from Dr Lawson, get your pen & paper out! Follow Dr Lawson online: http://www.blokeology.io/ Buy The Healthy Writer: https://amzn.to/2LHkf1U - Listen to all episodes online. Search "Modern Wisdom" on any Podcast App or click here: iTunes: https://itunes.apple.com/gb/podcast/modern-wisdom/id1347973549 Spotify: https://open.spotify.com/show/0XrOqvxlqQI6bmdYHuIVnr?si=iUpczE97SJqe1kNdYBipnw Stitcher: https://www.stitcher.com/podcast/modern-wisdom - I want to hear from you!! Get in touch in the comments below or head to... Twitter: https://www.twitter.com/chriswillx Instagram: https://www.instagram.com/chriswillx Email: modernwisdompodcast@gmail.com

Chris WilliamsonhostDr Euan Lawsonguest
Jun 12, 20181h 12mWatch on YouTube ↗

EVERY SPOKEN WORD

  1. 0:00 – 3:01

    Episode setup: fixing desk pain, RSI, eye strain, and productivity

    1. CW

      (wind blowing) Hello, hello, hello. This week is an absolute belter. This genuinely could be the best podcast that I've done so far. Really, really happy with it. Dr. Ewen Lawson is my guest. He is the author of The Healthy Writer, also a general practitioner of medicine in the UK, and the host of the Blokeology podcast. Check that out on iTunes, Stitcher, all those good places. And today, we are talking about what it's like working at a desk. So very, very high proportion of people will spend at least a significant period of their week sat down working at a desk, looking at a screen. What we try to go through today is, with the help of Dr. Lawson's expertise, is to break down exactly what is good and bad practice when it comes to designing your workstation. So we're talking from seating posture, height of screen, cranial angle looking down, angle for your wrists, what you can do about reducing RSI, what you can do about reducing, um, stress on your eyes, improving your sleep, your work rhythms, how you can use some productivity tools and some productivity hacks to batch together your work into windows so that you're always accountable to yourself and so that you can improve your productivity. We go into journaling, we go into the health effects of sitting, of being sedentary. This really is absolutely jam packed, and I'm incredibly happy with it. Also, I have to say, the long awaited Love Island Podcast is now available and it will be a YouTube exclusive for the foreseeable future. So if you wanted to hear what it's really like living on Love Island with me, Johnny and Yusef, you have to go online. Head to YouTube and search Modern Wisdom Podcast. It'll come up. The response has been fantastic. We've broken through, I think, 3K views maybe already. Really, really happy with it. I've had loads of messages about it. So make sure that you head online. If you love the podcast on audio, every episode will be made available on YouTube as well now, and I'm going to be uploading video files for all of the old ones, including all subsequent episodes as well. Make sure that you head there, press subscribe, and please support the channel. But now it's time for Dr. Ewen Lawson. Enjoy, make some notes, and hopefully you will wake up tomorrow with a fresh set of eyes before you go to work. (upbeat music) Dr. Ewen

  2. 3:01 – 5:34

    Why so many desk workers hurt (and why ergonomics lags behind)

    1. CW

      Lawson, welcome to Modern Wisdom.

    2. EL

      Hello, Chris.

    3. CW

      How are you?

    4. EL

      Very well, thank you, and yourself?

    5. CW

      Yeah, very good, thank you. So I put a post out on my Instagram earlier today, and I said, "Do you work at a desk? Do you suffer with any, uh, physical ailments or repetitive strain injury, neck pain, back pain, tight hips?" And my inbox absolutely exploded. I think I could have announced that I was getting married or having a child and would have probably got less of a response.

    6. EL

      (laughs)

    7. CW

      Um, and yeah, the, the problem of working at a desk and sitting looking at a computer seems to be so widespread, and it was, it was a real, a real shock to me just how many people are, are, are, for want of a better term, kind of suffering in silence, dealing with it as a byproduct of, well, this is work and the same way as going down the coal mine, you know-

    8. EL

      Yeah.

    9. CW

      ... however many years ago would have been, "Oh, well, you know, this is just, it's just a, um, an issue that comes along with the particular chosen industry that I'm in." Um, why do you think that the use of desk work is so widespread, but the optimization of it and the making of it to be a healthy environment doesn't seem to be?

    10. EL

      Um, I, I guess the whole kind of... I, I think you're right, it's a bit of a modern plague, isn't it? There are people that are absolutely just getting increasingly aware of their, the pain it's putting them through. Um, it... I guess the problems with ergonomics and things have been known for a long time, but I wonder if it's just a case of, us, you know, it's a bit, there's a bit of catching up to do. You're in that sort of phase where it's become the social norm to look at a computer all the time. And, and if you think about it, it's only, you know, it's only 10, 20 years ago we didn't have little screens to look at, the iPhone was only invent... iPad only appeared, you know, a decade ago, whatever it was, it's a really short period of time, isn't it?

    11. CW

      Yeah.

    12. EL

      And so that, that... the health-related consequences of doing... looking at screens all the time, looking at computers, that screen time has just gone through the roof in the last few years, and I don't think the healthy kind of approaches to it have quite caught up yet, perhaps.

    13. CW

      Yeah. No, I think that's, uh, I think that's definitely, definitely an issue, that you've got the industry being ahead of the-

    14. EL

      Yeah.

    15. CW

      ... the research to a degree, or at least the, um, distribution of it and people's understanding. So hopefully today we can start to, uh, mitigate some of those problems, and people-

    16. EL

      Yeah, sure.

    17. CW

      ... may, people may, uh, be waking up tomorrow with a fresh set of eyes as they go into work. So can you-

    18. EL

      (laughs)

  3. 5:34 – 7:55

    Dr. Euan Lawson’s background: GP, health evidence, and ‘The Healthy Writer’

    1. CW

      ... um, can you give us a little bit of background to yourself please for the listeners who don't know who you are?

    2. EL

      Yeah. So, um, uh, I'm a, I'm a doctor. I'm, I'm a GP, so a general practitioner. And for those of them, those of you people not based in the kind of UK or Australia, New Zealand, other places, the GP is just a kind of like a, a specialist in family medicine, so it's cradle to the grave stuff. We see people before they get to hospital, from children to adults to kind of, uh, palliative care, end-of-life stuff as well. So-

    3. CW

      Yeah.

    4. EL

      ... very much kind of the full spectrum of health problems.... and we also spend a lot of time looking after people and just prevent, there's a certain element of preventative health and managing people, helping people with, um, lifestyle things like obesity or other, smoking, other related factors like that. Um, I have, um, I was in the army a few years ago. I've always had an interest in being physically healthy, of course. But, uh, like everybody, I've had my own set of, you know, tr- wrestling with these kind of problems. That's spending too much time sitting at a desk or trying to lose a little bit of weight, trying to be active in a world that is determined to get us to eat more all the time.

    5. CW

      Yeah.

    6. EL

      And that's one of my big moans about the modern world is how it's constantly, certainly in the Western world where you know, the society is pretty much trying to ram food down our throats-

    7. CW

      Yes.

    8. EL

      ... 99% of the time. Wrestling with all that, trying to keep fit, trying to kind of maintain family life, not trying to get burned out, um, trying to stay fit and well. So that, that's my own personal interest, um, and my, it obviously aligns with my personal and my professional life as well as a, um, as a doctor.

    9. CW

      Yeah.

    10. EL

      And I, I was involved in writing a book last year with, um, uh, Joanna Penn, a kind of well-known, uh, creative entrepreneur, non-fiction fiction writer, um, a book called The Healthy Writer, where we, and it was very much written for writers and for that group of people, but I think probably a lot of the stuff in there is applicable to anyone who finds themselves parked in front of a computer for their working life or-

    11. CW

      Absolutely.

    12. EL

      ... they're not getting active enough and they just wanna do something about it.

    13. CW

      Yeah. I agree. I think that's, I wouldn't like to guess the, um, the percentage of people, but a, a large majority of almost everyone will spend over 15, 20 hours a week, that's sort of towards the bottom end. And then you're talking, if you work in a call center or if you're a knowledge worker of pretty much any kind, it's that 37 and a half hours a week is probably 37 hours sat-

    14. EL

      Yeah. It's-

    15. CW

      ... sat, sat at a screen.

  4. 7:55 – 12:10

    ‘Sitting is the new smoking’: what the evidence does (and doesn’t) prove

    1. EL

      Yeah. It's insane. And I mean, the, I mean, there's the actual physical effects of just being sat there, but it's just the fact you're not moving as well that kind of... And it falls into, it's a, it's now become slightly a cliché that sitting is the new smoking, um, and the, and, uh, and it, it's kind of a lot of people have heard that in the last few years, but I think that kind of lack of movement, that's, and it's, you know, sedentary life, that's a, that's massively toxic, I think, and-

    2. CW

      So just-

    3. EL

      ... try to combat that.

    4. CW

      ... just how destructive is it?

    5. EL

      Um, I think it's certainly been, uh, the, some of the evidence around this is hard to pick out actually. That, I guess that's my other interest, that I'm really inter- I'm really keen on actually delving into the evidence and not just kind of putting out, uh, you, that, you know, uh, kind of vague opinion. And actually-

    6. CW

      Anecdotal.

    7. EL

      Yeah.

    8. CW

      Yeah.

    9. EL

      I, I, I, an- I recognize the importance of anecdotes as well that, you know, in certain extent, everybody that comes in to see you as a patient as an, and you know, they're then individual.

    10. CW

      (laughs) That's a good point.

    11. EL

      And evidence, there's problems with applying evidence to individuals. That's a-

    12. CW

      Yeah.

    13. EL

      That's the challenge of being a doctor. Um, it, it's hard to put a number on it because sometimes the relationship between sitting and poor health isn't completely demonstrable. It's not completely easy to show. Um, and it's a little bit contradictory in places. So I would s- you would struggle to quantify it.

    14. CW

      Mm-hmm.

    15. EL

      I think what it's easier to show is that people who are physically active enjoy, uh, longer life, better quality of life, um, and a whole lot of other kind of measurements that go with that in terms of their risk of this cardiovascular disease, diabetes, they're all massively improved by being active. And it's harder to prove that just sitting as an activity is actually bad for you.

    16. CW

      Yeah. I think-

    17. EL

      But I think it's the general e- ac- it's the general sort of the whole picture of y- how sedentary you are that's really important.

    18. CW

      Yeah, for sure. I think certainly for myself, I, um, I could probably hold my hands up and say that I know I train very hard when I do and go, go and do physical activity, but I also know that I'm very sedentary at other points as well.

    19. EL

      Yeah.

    20. CW

      And I think I've probably kidded myself into believing for quite a while that while it's fine, I'm, I'm looking after my activity levels across the day, therefore, if I spend three hours at a period in-between toilet breaks sitting at my desk and not moving and staring at screen, that's fine because the physical effects will be mitigated by me binning myself in a, a two-hour CrossFit session or whatever it might be.

    21. EL

      Yeah.

    22. CW

      Is-

    23. EL

      Well, the, yeah.

    24. CW

      ... is that the wrong way to look at it?

    25. EL

      No. No. Uh, actually, there is a, I looked into this a little bit for the book as well, and there's something that, you know, that you fall into that sort of slight category of weekend warrior, though I recognize it's not always just at the weekends.

    26. CW

      Yeah.

    27. EL

      And there is, there is some evidence that if you do your exercise batched up, say at the weekend in that classic weekend warrior kind of approach, that does seem to, that does seem to be helpful. So you, you can mitigate some of the harms of your r- rest of your week being relatively inactive.

    28. CW

      Okay.

    29. EL

      Um, I, I think there's... Some of the difficulty with this, you mentioned coal miners at the start.

    30. CW

      (laughs)

  5. 12:10 – 13:01

    Biggest workstation mistake: not designing one at all

    1. CW

      ... I wanted to-... uh, speak to yourself first off and try and get any common mistakes which people make when designing a workstation. And on the backside of that, what are the op- most optimal fixes for them?

    2. EL

      Okay, so I've- I've not s- ever seen any rev- evidence of what th- the mistakes people make, but what I would say is that the big- the initial mistake is most people don't make any effort to design their workstation at all.

    3. CW

      (laughs)

    4. EL

      The- the- is- so-

    5. CW

      Is there a seat? Is there a table? Is there a laptop?

    6. EL

      (laughs)

    7. CW

      Yeah, fine.

    8. EL

      Yeah. Is there anybody else sat there? No, this will do.

    9. CW

      Okay.

    10. EL

      That is probably their approach. And s- hot desking, that's certainly gonna be the approach that a lot of people have.

    11. CW

      Yeah. Well, that's all you can do, yeah.

    12. EL

      Um... Yeah, exactly. You just gotta turn up and plonk your butt down and, you know, and if you g- get a spare seat in the library, if you're a student, then you're happy-

    13. CW

      (laughs)

  6. 13:01 – 20:06

    Laptop ergonomics: wrist angle, external keyboard, and raising the screen

    1. EL

      ... um, and is often the way it goes. So, uh, I'm not sure about the sp- specific mistakes people make. Um, the kind of things that... The first thing I would- we could perhaps talk about is laptops and notebooks.

    2. CW

      Yeah.

    3. EL

      And I- I would say they're- they are kind of like the- they're- they are- they are to- they are toxic equivalent ergonomically. They are pretty horrific.

    4. CW

      (laughs)

    5. EL

      And, um, they- they- they- they put you in all the wrong position completely, and using a laptop and just typing on it without any kind of effort to change it, the position that you're in, could- will, for a lot of people, be a source of a great deal of problems.

    6. CW

      Okay.

    7. EL

      So, the first thing they do is they- they put your wrists at all the wrong angles and, um, the ideal position for your wrists is they're not resting on anything, and probably at about sort of parallel to the floor and 90 degrees to your body. So, the only way you can fix that normally is by adjusting the height of your keyboard. Now, if you're designing a workstation, then you can arrange for your desk to be at exactly the right height-

    8. CW

      Yeah.

    9. EL

      ... um, so that you can make that work for your relative reasonably easy. The best way to fix it with a laptop is not to use the keyboard on the laptop, is to get an external keyboard.

    10. CW

      Okay.

    11. EL

      Uh, and then because they're just not, you know, you've got the mouse sat in front of you, it's awkward, it tends to- your wrists end up contorted in the wrong position. So, an external keyboard's usually a really good investment. Um, the next thing after that is that you're probably always looking down at it if it's a laptop, unless you're- unless you're very small in stature-

    12. CW

      (laughs)

    13. EL

      ... you're gonna- you're always gonna be craning down at your laptop. And so, raising your laptop up, so your eye- so your neck's in a neutral position is the best way. And that does mean it needs to come up quite a bit.

    14. CW

      Yeah.

    15. EL

      Um...

    16. CW

      Yeah. The- the screen of a laptop is naturally very low.

    17. EL

      Yeah.

    18. CW

      A- am I right in thinking that having that cranial angle being more towards the floor will apply more stress to-

    19. EL

      I- I mean, I think that's the general thought and I kind of- I'm not an expert in ergonomics in that regard, but I certainly know that good ergonomic practice is to have your neck in a reasonably neutral position 'cause that- which is generally just sort of looking straight ahead, eyes slightly down possibly, um-

    20. CW

      So, eyes- eyes level with the top of the screen, right?

    21. EL

      Yeah, that works well. If your eyes are level with the top edge, then actually you're- you're just looking very slightly down at the screen itself. Um, that's a- that's usually a good way to do it. Um, and that just stops your neck muscles having to work e- as hard when they're- when you're in a n- normal position, so that's highly likely to relieve a lot of, um, problems and discomfort. And you got to remember, even things like, you know, tension headaches, if your neck's in the wrong position and you're under a bit of stress, then a lot of headaches that we- certainly we see as a- as a GP, a lot of headaches are tension headaches, and that's all related to muscular tension in the back of the neck and all the muscles-

    22. CW

      Where do, um- where do- where do tension headaches manifest?

    23. EL

      Uh, well, they're usually- the classic description is that they're a band, uh, sometimes around the front of the head, sometimes around the back of the head.

    24. CW

      Okay.

    25. EL

      And they- they tend to be very- they tend to be much more constant, not easily relieved by medication, uh, as a general rule.

    26. CW

      I'm looking at two points that I've got in my notes from messages I received earlier on. Headaches across brow and lower/back of skull.

    27. EL

      Okay, so that- you know-

    28. CW

      (laughs)

    29. EL

      ... that is almost, yeah. So, that- there- there you go. And n- we didn't rehearse that at all.

    30. CW

      No, we didn't (laughs) .

  7. 20:06 – 27:01

    Repetitive Strain Injury (RSI): two types and why some cases are hard

    1. EL

      And a lot of people do get a bit, kind of... y- you talk about discomfort, and I'm sure a couple of people have probably mentioned repetitive strain injury. I think you mentioned it at the start there.

    2. CW

      They have, yeah.

    3. EL

      Use- using the mouse is often a source of enormous discomfort for some people who get RSI.

    4. CW

      Why is that?

    5. EL

      And, um, I, I, I guess it mushes... um, I don't know why exactly. I guess it's any repetitive movement, particularly when you hold some- y- you hold your arm... I mean you can get RSI anywhere in the body, technically.

    6. CW

      Yeah.

    7. EL

      But I guess most people get it in their, um, they get it in their hands, wrists, forearms.

    8. CW

      So fine, fine motor movement with little bits of control and sort of small stabilizations and stuff like that, I guess, if you're doing that seven or eight hours a day?

    9. EL

      Yeah. I think that's exactly it, and that's the kind of... So a lot of people then suddenly, you know, g- g- it becomes really uncomfortable and distressing to keep on doing that, and that's exactly the kind of thing that can trigger off a bit of RSI in some people.

    10. CW

      Uh, you, you seem to have a, a pretty good understanding of RSI and am, am I right in thinking RSI actually has two, two distinct types to it?

    11. EL

      Yeah. Um-

    12. CW

      Can you, can you e- e- elaborate on that for me?

    13. EL

      Yeah, sure. I could... I run... The... Basically, I'm not sure I have a good understanding of it, in that I'm not sure anybody has a good understanding of it-

    14. CW

      (laughs)

    15. EL

      ... is the only thing I would say first of all.

    16. CW

      But if anyone, if anyone does-

    17. EL

      (laughs)

    18. CW

      ... we're relying on you here.

    19. EL

      Yeah, so, um, uh, the first thing I'll say is there's two types. RSI type one is easy, in that they, they are the ones where people do have a good understanding of it, and it's usually got a very distinct diagnosis. And the classic example is carpal tunnel syndrome, um, and lots of people have heard of that. It's where the, kind of, the, the, the, the nerve that goes through your wrist, the median nerve, there's a little sort of tunnel or space in the wrist there. And for various reasons, it can happen. Things like pregnancy, it can happen for all sorts of reasons. Uh, that gets a little bit, um, pressurized, that nerve, and you get symptoms that then go into your hand. And so there's a very... with things like carpal tunnel syndrome or certain tenosynovitises, where it's where you get an inflammation in the tendons going to your thumb or other things, there's a very u- there's usually a very clear treatment. Um, and, uh, uh, you know, there may be injections. There may be... carpal tunnel syndrome, you can even go on to have operations and releases. Um, they're the kind of the ones that are relatively easy to manage and as a GP, we don't feel too stressed by them because... and the patient doesn't feel too s- feels better because we can give them a diagnosis-

    20. CW

      Yes.

    21. EL

      ... and o- and offer a management plan. That's in comparison to RSI type two, which is a whole world of pain-

    22. CW

      Oh, no.

    23. EL

      ... you know, in, in several respects, because it's really nebulous and it's difficult to... there's not a single cause. It just usually is when people get numbness and discomfort and aches, maybe pins and needles, and it isn't really obviously reproducible. It kind of maybe varies a little, um, but it doesn't fit into any of the nice distinct patterns of these other kinda disorders like carpal tunnel syndrome.

    24. CW

      But can it be, um, due to a, a, an repetitive action which could be causing RSI one? Does that make sense? So it's-

    25. EL

      Yeah, yeah, yeah.

    26. CW

      ... is it ... you, you could be-

    27. EL

      Yep.

    28. CW

      ... you could be suffering with both essentially?

    29. EL

      Yeah, I, I think, uh, in many cases, it probably is due to some kind of repetitive, you know, or various ongoing stress or tension-

    30. CW

      Yeah.

  8. 27:01 – 29:06

    Seating posture fundamentals: feet planted, neutral spine, posture ‘self-checks’

    1. CW

      ... um, tight hips, back pain, both upper and lower, neck pain, the headache across, uh, their brow and the lower back of the skull, uh, difficulty in opening up the chest from being in that anterior folded forward shoulder tilt.

    2. EL

      Yeah.

    3. CW

      And a pain or weakness in between the shoulder blades which presumably is from the same, from not sitting with that open chest position.

    4. EL

      Yeah.

    5. CW

      Um, if you were to try and design someone's working day, so we've got their keyboards down, off the computer, potentially an external mouse as well, we've managed to lift the cranial angle up b- by, uh, raising the height of the display.

    6. EL

      Mm.

    7. CW

      What are we going to do next with regards to a seating posture? What about working rhythms, work rest and stuff like that during work? What can be done to assist in mitigating these problems?

    8. EL

      I mean, I think there's some basic stuff around seating posture you can do which is just, I mean, a- we're obviously talking seating at the moment rather than standing or anything else-

    9. CW

      Yeah.

    10. EL

      ... more exotic, because that's simply not an option for most people.

    11. CW

      Yeah.

    12. EL

      And it's, it's just simple stuff that actually, I- I mean, I guess, uh, your getting your feet on the ground is a massive thing. When you're sitting down and you're getting your, getting yourself in a nice neutral position, rather than your legs being stretched out and then that kind of changes the position of your lower back and, um, flattens out that kind of normal curve that you have in your spine, is actually sitting on your sit- s- actual sit bones, getting your feet flat on the ground.

    13. CW

      Okay.

    14. EL

      And then trying to ... and obviously some of that then is about being aware of your posture, um, as you mentioned there about the kind of, the not opening up the chest, just dropping your shoulders, making sure they're nice and relaxed. I think just spending a few minutes every ... look, and we could talk about the rhythm of this but-

    15. CW

      Yes.

    16. EL

      ... actually trying to build awareness, whether it's every 20, 25 minutes running through a little self-check-

    17. CW

      Mm-hmm.

    18. EL

      ... about what is my posture like at the moment and trying to, um, uh, and trying to adjust it as you go is the kind of thing that if you do regularly can start to become automatic and you actually, um, improve, uh, i- improve your general posture.

    19. CW

      Yes.

  9. 29:06 – 35:54

    Breaks that actually work: Pomodoro, movement, and avoiding ‘fake breaks’

    1. EL

      Um, and I think in terms of rhythm, that, that sort of, breaks is critical. I- I- more than anything. H- taking a break is absolutely essential. And m- my m- my personal approach to this is when I'm in a big block of writing or sitting at the computer is I- I tend to use the sort of Pomodoro method anyway 'cause I find that quite effective, but it works really well with taking breaks. So 25 minutes, um, of work, set a timer on my watch, it buzzes, uh, and then I get up and I take five minutes off. And during that five minutes I'll almost, I will make sure I get up and I walk around, uh, have a bit of a, you know, and just, uh, get myself away from the screen as well-

    2. CW

      Yeah.

    3. EL

      ... t- to help with my eyes, which we can also mention-

    4. CW

      Yes.

    5. EL

      ... um, uh, to, to help with that. And I find that that really makes a huge difference. I, the key for me th- about taking breaks is, and the thing I would mention to people and this fits, uh, is that you've got to get away from the screen if you can. (laughs)

    6. CW

      Yeah.

    7. EL

      Uh, th- you know, taking a break does not mean pushing the chair back-

    8. CW

      (laughs)

    9. EL

      ... you know, slop-

    10. CW

      Moving further away from the screen or closer to the screen.

    11. EL

      Yeah. (laughs)

    12. CW

      Or looking at your, looking at your phone, looking at a different screen instead. (laughs)

    13. EL

      Yeah, looking at your phone and checking, you know, checking Instagram-

    14. CW

      Yeah.

    15. EL

      ... and Facebook-

    16. CW

      That's not a break.

    17. EL

      ... while staring at another screen while you're kind of slumping j- and in your, slump in your chair. That's really-

    18. CW

      I'll, I'll take a break.

    19. EL

      That's not an effective break.

    20. CW

      I'll take the br- I'll take a break from my newly refined posture to slouch in my seat, put my, my head at a 90-degree angle to the floor, and sneak a quick look at my phone instead.

    21. EL

      Yeah, exactly. So-

    22. CW

      That's not, that's not what we're prescribing here.

    23. EL

      Yeah, and I think, you know, eh, most people listening will think, "Well, of course, I wouldn't do that," but, I mean, I've done it myself.

    24. CW

      No, I think you might do. Yeah.

    25. EL

      (laughs)

    26. CW

      I think you probably will.

    27. EL

      So actually taking- taking- taking a break is something most people know, but actually, it's putting it into action as well, isn't it, like all these things, and actually doing it properly so you give yourself a gen- a- um, um, an actual genuine chance of improving. I- I find if I do it, I can sustain much longer working periods, that 25 minutes, five minutes. I can do three or four hours of solid work in the morning and actually don't feel completely ruined by it.

    28. CW

      I agree. I think there's, um... It's a- a short-term sacrifice of work obviously by taking a five-minute break, but f- the total volume that you get, the total ti- effective time under the curve of work done by the end of the day will always be higher. Um...

    29. EL

      Yeah.

    30. CW

      It's interesting that you mentioned the Pomodoro Technique, which I am currently reading the illustrated guide to the Pomodoro Technique in a desperate attempt to try and make my work-

  10. 35:54 – 43:27

    Eye strain and screen fatigue: blinking, distance, zoom, and 20-20-20

    1. CW

      So, um, you- you touched on it there and one of the, um, next main issues which people came up with was an inability to switch off at night. Eyes flickering-

    2. EL

      Mm-hmm.

    3. CW

      ... as if you're still staring at the screen. Also, eye strain. I know that my business partner, Darren, who will be listening, has just had to start wearing glasses. Although he actually manages to pull them off, as much as I wish that he didn't, um...

    4. EL

      (laughs)

    5. CW

      ... he's had to start wearing glasses, and I think to myself, would he have needed to had we spent the volume of time that we do in front of a screen? So what's, what is looking at a screen doing to our eyesight?

    6. EL

      I think the main thing is... I don't, I don't know if there's any evidence that it increases your risk of, um, refractory problems where you need glasses, but... So it may just be he has a little bit of a, something like an astigmatism which is just give him extra problems-

    7. CW

      Darren, you're just, you're just blind, mate. Darren, you were never, you were never ever destined to be able to see properly I'm afraid.

    8. EL

      (laughs) No, just born, born...... damage.

    9. CW

      Cursed with that, yeah. (laughs)

    10. EL

      (laughs) Um, I think the main thing about staring at a screen is it dries your eyeballs out. They end up like shriveled up. The, uh, we normally blink about once every five seconds or something, uh, 12 to 15 times a minute, uh, something like that, off the top of my head, I think is the right amount. But when you start staring (laughs) at a screen, you stop blinking, and, um, to the extent that you only blink about sort of five or six times a minute, so once every 10 seconds.

    11. CW

      Wow, so you're, you're talking about like a, a f- 60% reduction.

    12. EL

      Yeah, yeah, I mean, it's huge. And I, I, I kind of, the whole thing about tears is obviously they're required to keep your eyes moist (laughs) and stop them drying out, and they help clear, um, bugs and ... they said not, so it's an important protective mechanism for your eyes as well.

    13. CW

      So is m- is it moisturizing the cornea on the front of the eye then, to a degree?

    14. EL

      Yeah, certainly. There's always that film of tears across the front of your eye, or across in front of your cornea, and if you, you, you, as anybody, your cornea, if for some reason you can't blink, you say you get like a, a facial nerve palsy, a Bell's palsy, where you can't, you can no longer close your eyelids properly.

    15. CW

      Okay.

    16. EL

      One, one of the priorities for us when we see something like that is to, people have to tape their eyes shut at night and they have to use artificial tears. Otherwise, the front of their eye dries out and the cornea can become quite damaged, ulcerated.

    17. CW

      Oh, wow.

    18. EL

      Now, I'm not saying staring at a screen will do that to you, but you're at that kind of point where blinking s-

    19. CW

      Well, the bottom end, the bottom end will be getting towards it, right?

    20. EL

      Yeah, yeah. Blinking's important, you know. That's, you know, and if you stop blinking as much-

    21. CW

      (laughs)

    22. EL

      ... then you're not going to ... y- your eyes are gonna feel uncomfortable and they're gonna get gritty and irritable and maybe slightly itchy and just feel just, you know, like you've got sand, we've all had that feeling, you know, your eyes have been sprinkled with sand.

    23. CW

      Yeah.

    24. EL

      And they just feel dreadful. Um, and so there's a couple of things you can do that perhaps can reduce eye strain. One of them is to sit a little bit further back from your screen. So usual advice is more than... I certainly read a, there was a good study which showed more than fif- people who, who were sat more than half a meter away, 50 centimeters from their screen, had less eye strain. And that's probably about an arm length or so. So, and the ridiculous thing about that is, and laptops are bad for this, that we, as well, it's another way that laptops damage us-

    25. CW

      (laughs)

    26. EL

      ... is that we crane over them and our nose are pract- is practically touching the screen.

    27. CW

      Yeah. Well, the whole point is because the, the screen is, I'm just looking at mine now, it's two inches-

    28. EL

      Yeah.

    29. CW

      ... away from the top of the ... uh-

    30. EL

      Yeah.

  11. 43:27 – 49:06

    Night-time screen use and sleep: digital sunset and low-evidence quick fixes

    1. CW

      Okay. So is there a reason why you would get this, uh, the manifestation of eyes flickering at night-

    2. EL

      Yeah.

    3. CW

      ... as if you're still staring at a screen? Do you understand what that's due to?

    4. EL

      No (laughs) .

    5. CW

      (laughs)

    6. EL

      I'm not sure, but I suspect it's somebody, you know ... It's somebody who's just got too much screen time and is not making a- and is not reducing ... I mean, uh, my th- my sy- my sense is ... I, I don't think, I'm not aware of any sort of specific neurological problem that that is due to.

    7. CW

      Yep.

    8. EL

      But it sounds like somebody who desperately needs to unwind a little and have an hour-

    9. CW

      (laughs)

    10. EL

      Somebo- somebo- someone who needs to have an hour before they go to bed of not looking at a screen.

    11. CW

      Yeah.

    12. EL

      I mean, and s- and we're, and we haven't talked about sleeping, but we've, we've got a chapter in sleeping, The Healthy Writer. And, uh, I mean, for me, it's a superpower and I prioritize it now more, in my life, more than I have ever done in my whole life, because if I don't sleep right, my life is rotten, and if I get my sleep right, I feel great. And part of that good sleep hygiene is turning, not looking at my screen. I go to bed at 10:00. My screens go off at 9:00.

    13. CW

      Digital suns- sunset, right?

    14. EL

      Absolutely. And you can do that whole using flocks or those, the things that change the kind of the, um-

    15. CW

      The hue.

    16. EL

      ... the background. Yeah, the hue of your screen, and I do a little bit of that as well, but actually you can beat just th- the off switch-

    17. CW

      Mm-hmm.

    18. EL

      ... (laughs) is the way to do it.

    19. CW

      Yeah.

    20. EL

      And I think if you really value your sleep, then you've just gotta get off your devices and, you know, read a book.

    21. CW

      Yeah. No, I, there was a, some really interesting studies. Have you read Why We Sleep by Mathew- Matthew Walker?

    22. EL

      I have, yes.

    23. CW

      Oh, I mean-

    24. EL

      Very good.

    25. CW

      ... anyone, anyone who's listening who's having trouble sleeping, before you try and get ahold of melatonin or think that burning incense or getting a diffuser in your room is where you need to go, buy Matthew Walker's book, Why We Sleep. Or if you can't deal with the reading of that, if you want to listen to Joe Rogan podcast 1109 ... I know it off by heart because of how many times I've listened to him on it.

    26. EL

      (laughs)

    27. CW

      It's one of my favorites, and he is, he's absolutely fantastic. And the, the, um, (sighs) the summaries that he makes and the, um, conclusions that he draws about just how important sleep is to short-term and long-term health, longevity and all the rest of it, is, uh, they're terrifying. They're nothing short of terrifying.

    28. EL

      I, I'm, I, I think, I, I've, you know, if ... Moving is really incredibly important, getting more exercise, but, you know, there three pillars of going, being healthy are moving more, eating a bit better, however that is, but sleep is number, it's absolutely up there as that kind of holy triumvirate-

    29. CW

      Yeah.

    30. EL

      ... of being healthy. And if you're not getting your sleep right, everything else falls apart. And I've got three kids. They were like, they're now a little bit, they're now like 11, 12, and 13, but when they were one, two and three, I wasn't getting a whole lot of sleep.

  12. 49:06 – 53:06

    Hot-desking and libraries: quick adjustments and a portable ‘ergonomics kit’

    1. CW

      So moving on, hot desking-

    2. EL

      Mm.

    3. CW

      ... and university libraries. So you actually, you actually touched on this earlier on.If someone doesn't have the capacity to, um, let's say, perfectly customize or build, build their ideal work station, I know that ... Am I right in saying that almost all doctors will be using shared desks at work?

    4. EL

      Um, well, yeah-

    5. CW

      Un-

    6. EL

      ... um, yeah, certainly there, a lot will be.

    7. CW

      Yeah.

    8. EL

      And certainly GPs. When, there's, a lot of GPs work part-time and you're, yeah, you're gonna be sh- a lot of premises struggle, so you will, you are, to a certain extent, you're, you won't have your own room, you'll be going in and out, yeah.

    9. CW

      Mm-hmm. So what are the, um, carry-in-your-bag, or the, I guess, the SOS, um-

    10. EL

      (laughs)

    11. CW

      ... pack of trying to fix ergonomics for work there?

    12. EL

      Um, yeah. So I think, I mean, an external keyboard and a mouse, relatively light, should be able to, I think, if you've got a notebook. Uh, I, I guess it depends on whether you're using your own laptop-

    13. CW

      Mm-hmm.

    14. EL

      ... and notebook, or whether you're using a, you know, like say a university student uni, using one of the PCs in the library-

    15. CW

      Yeah.

    16. EL

      ... or whatever's available. I guess the first thing I'd say is you don't have to carry anything with you, just to take a moment to, you can adjust the height screen of all of those, you can move things into the correct position, you can adjust the height of the chair.

    17. CW

      Mm-hmm.

    18. EL

      There's actually, rather than just plonking yourself down in, you know, whichever, you know, weirdly proportioned person was there before you-

    19. CW

      (laughs) She's almost definitely not gonna be exactly the same as yourself, yeah.

    20. EL

      Yeah, quite. The, and, and actually, take the time to make the adjustments. And as I said, get the, get the height of that screen so it's just, you know, the top of the screen's level with your eyes. Get the, um, uh, get the seat at the right height so that you're kind of, your, your thighs are likely to be parallel to the ground and your feet are flat on the floor. Do those things first so that you're absolutely sorted out. I think then if you're doing your own, then in terms of working continuously, I would make sure I had some way of, not my phone, of, um, preferably, uh, of, uh, a little alarm for 20, 25 minutes-

    21. CW

      Mm-hmm.

    22. EL

      ... so that you kind of stick to it. I've got a little watch, my watch buzzes, so that's handy in the library. When I'm at the, when I'm at the university library. Um-

    23. CW

      It would be cool if there was a, a web-based Pomodoro timer, wouldn't there? Like a cloud-based one.

    24. EL

      Yeah.

    25. CW

      I wonder if, I wonder if someone's come up with that. That would be a really good ... If someone needs a business idea, come up with-

    26. EL

      Yeah.

    27. CW

      ... Be Focused Pro for web browser that would allow notifications to pop up. That would be lovely.

    28. EL

      Yeah.

    29. CW

      (laughs)

    30. EL

      Yeah, that's the kind of thing, yeah, absolutely. So you need to, you need to have that handy. I would, um, you know, if you can, a, a notebook riser's a little bit of a big ask, I think, 'cause they're probably quite bulky to fit in a bag.

  13. 53:06 – 1:00:57

    Standing desks, Swiss balls, and treadmill desks: what’s promising vs hype

    1. CW

      Got you. Okay. So I wanted to talk about some more, some of the slightly more funky solutions that I've seen-

    2. EL

      (laughs)

    3. CW

      ... which exist for, uh, people who want to really optimize their work station. I know that Johnny, another one of the co-hosts of the show, um, he has a really fancy desk that g- does both seated and standing.

    4. EL

      Mm-hmm, nice.

    5. CW

      And I know that the, um, receptionist at, uh, BFIT, which is the, uh, physiotherapy place that I go to round the corner, uh, sits on a BOSU ball. When I go in, she's on a, sat on a big, big Swiss Ball, um-

    6. EL

      Yeah.

    7. CW

      ... ba- bouncing around. And I just, I wanted to know what the, um, efficacy of those particular approaches are, and if there's any others, any other sort of, uh, weird and wonderful approaches you've seen for ... I know, I know Ben Greenfield has a treadmill office.

    8. EL

      Yeah.

    9. CW

      A tread- a treadmill station where he can, uh, walk on a TrueForm Runner at the same time as dictating-

    10. EL

      Yeah.

    11. CW

      ... and writing and stuff like that.

    12. EL

      Yeah, Ben's a bit, he's quite out there though, he's pretty full on with his-

    13. CW

      Oh, yeah.

    14. EL

      ... self, um, efficacy stuff.

    15. CW

      Oh, yeah.

    16. EL

      Uh, (laughs) um, I would, the problem with all this is, uh, this is probably worth, uh, a, a, um, fairly minor digression, is that the evidence is rubbish, um, for a lot of this stuff.

    17. CW

      (laughs)

    18. EL

      It's really har- and it's not rubbish as in, it's just hard to do good research, medical research into this kind of thing. Because, you know, you can't do it, there's no sort of placebo effect, or you can never quite know what you're, whether you're measuring it in motivated people who then feel a bit better, or, uh, so the evidence is really hard to pick out. Um-

    19. CW

      Tenuous, right?

    20. EL

      Yeah, it's just not good quality. And so it re- makes it really hard to offer definit- you, you lurch into anecdote, uh, quite quickly.

    21. CW

      Mm-hmm.

    22. EL

      Uh, and personal opinion. Um, I would say there's not an awful lot of evidence for Swiss Balls. So that kind of, what's, they, they can fall under the category of dynamic sitting.

    23. CW

      Yeah.

    24. EL

      That kind of, where you've, you've got to continually adjust and micro-adjustments, but, you know, kind of using core strength and, to keep yourself in an upright position. Um-I have a Swiss ball in my room and (laughs) I don't use it very often.

    25. CW

      Yeah.

    26. EL

      Sometimes, if I'm a bit bored, I'll sit on it.

    27. CW

      Yeah.

    28. EL

      Um, there, there isn't great evidence they make a huge amount of difference, but it's one of those which I think if you get relief, it does force you to sit in a probably much better... It improves your posture. You, you got to, you can't slouch on a Swiss ball, or you end up on the floor. You know, you're o- you're obliged to put your feet flat down, you got to, you know, you've got to engage your core and you got to sit up straight.

    29. CW

      So potentially, rather than the, the Swiss ball actually being something magical in and of itself, it's just forcing you into a position that you could replicate on a normal seat?

    30. EL

      Y- I, I would s- I would think that's almost entirely it. Though I think there is a, there is a kind of evidence, there is research that's gone on around dynamic sitting-

  14. 1:00:57 – 1:08:57

    Gratitude journaling: evidence, wellbeing, and downstream sleep benefits

    1. CW

      Interesting. Yeah, that is cool. So I wanted to touch on more of the outside of the day, outside of work and outside of writing, uh-

    2. EL

      Yeah.

    3. CW

      ... health. The more sort of general health, as we could call it. And I know that you are a fan of gratitude journaling, based on some of the bits that I've read about you.... I wanted to allow you to elaborate. We haven't touched on gratitude journaling almost at all yet so far, although I do do it. I wanted to hear your thoughts on it and, um, your experiences with it.

    4. EL

      Yeah. So my ... And one of the things we wanted to do with the book was just to point out that writing in particular wasn't all just catastrophically bad for your health. There was a slight danger that the book was just gonna be-

    5. CW

      Give up being a writer, it's going to destroy you.

    6. EL

      Right. Yeah, exactly. Stop immediately, it's horrific.

    7. CW

      Yeah.

    8. EL

      Um, and one of the clearest bits of evidence about writing was writing is... I mean, there's certainly some medical stuff about writing as therapy, um, and people with mental health problems and other things. But actually for, just thinking for people in general and, um, for the wider population, there's something everybody can do, gratitude journaling has a really pretty decent... has, has some decent evidence that underpins it. And it goes back to, um, some Californian psychologists, um, who looked into this, uh, Emmon and McCullough. Um, and they ... There was an experiment. It goes, I think it was back to 2003 or the early 2000s, sometimes like, sometime like that, and they, they ran one of these studies that psychologists love to do. Um, and they got the participants to write down just a few things they were grateful for every day, whether that was the, you know, the kindness of a friend or a, a beautiful sunset. And incredibly, they only had to write a sentence and they only had to do it once a week, so it was really not a big ask.

    9. CW

      That's low investment, right?

    10. EL

      Yeah, that is really... You know, the biggest problem with that would be remembering to do it because it's so low.

    11. CW

      Yeah.

    12. EL

      Uh, it's absolutely tiny. And, um, they found that it really seemed to... They, they stopped... They found some clear improvements in wellbeing for those people and that they felt better. But really inter- one of the things that really piqued my interest about that study is because I can be a little bit cynical about some of these psychologists, psychology studies. They're often got very low numbers and, you know, you've got to be careful about how far you draw your inferences with them.

    13. CW

      Yes.

    14. EL

      But they also, they also found evidence that the, um, the families of the participants had noted that their loved ones were ... Seemed to be better in themselves-

    15. CW

      Brilliant.

    16. EL

      ... and they had improved wellbeing. And I thought that was r- that was a really, um, interesting kind of nugget as part of that, that really kind of, for me, gave this a lot more credibility.

    17. CW

      Mm-hmm.

    18. EL

      And, uh, the, the California psychologists have gone on to do more studies and there's some Manchester, um, psychologists who've also looked into this and a host of others. But what they also found ... So they also found that there was good evidence that doing a gratitude journal, um, could improve your sleep.

    19. CW

      Okay. Okay. (laughs)

    20. EL

      Um, and they... It reduced your anxiety, improved your sleep. So it feeds exactly back into what we were saying before, that if you have better sleep and you sleep longer, well, crikey, I mean, that is ... You can, you know ... The, the effects that Matt Walker have talked about-

    21. CW

      Yeah.

    22. EL

      ... has talked about in his book, that means that you're less likely to get cancer, you're less likely to have a heart attack-

    23. CW

      Alzheimer's.

    24. EL

      ... you're less li- you're less likely to have a stroke or Alzheimer's.

    25. CW

      Yeah.

    26. EL

      So actually, there is incredible power if a very simple intervention like a gratitude journal can reduce your anxiety, can help you to sleep a little bit better, there is... I mean, you've got to be a bit careful about pulling this chain out too far.

    27. CW

      Yeah, downst- downstream, where do you, where do you stop?

    28. EL

      Yeah. But there is ... If it makes you feel better at the time, then that's a pretty good place to start.

    29. CW

      Yeah.

    30. EL

      Because people are not very good at doing stuff that will keep them or get, make them live six months longer when they get to 70.

Episode duration: 1:12:47

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