Communicating Ergonomic Advice as a Physiotherapy Skill: Language, Expectations, and Follow-Up

Ergonomic Communication: From “Perfect Posture” to Practical Options

Ergonomic advice only helps if the client can understand it, try it in their real environment, and adjust it without feeling like they “failed.” As a physiotherapy skill, communication turns assessment findings into a plan that is actionable, realistic, and measurable.

1) Framing: “Find Comfortable Options” and “Build Tolerance” (Not “Fix Posture”)

Many clients arrive expecting a single correct posture. If you reinforce that belief, they may become rigid, anxious, or overly self-monitoring. A more useful frame is: there are multiple acceptable options, and the goal is to expand the range of positions and tasks they can tolerate.

• Replace posture perfection with options: “We’re going to find 2–3 comfortable ways you can sit and work, then rotate between them.”
• Replace “damage” language with capacity language: “Your body is sensitive right now; we’ll build tolerance gradually.”
• Replace permanent rules with experiments: “Let’s trial this for a week and see what changes.”

Useful phrases (client-facing):

• “There isn’t one perfect posture. There are better and worse fits for your body today.”
• “Comfort is data. We’ll use it to guide adjustments.”
• “We’re aiming for manageable symptoms during work and a quicker recovery after work.”
• “Think ‘change position before you need to,’ not ‘hold yourself still.’”

Phrases to avoid (often backfire):

• “Never slouch.”
• “Always sit up straight.”
• “Your posture is the cause.”
• “This will fix it.”

Make the goal explicit: comfort + function + predictability

When you give advice, state the target outcome in plain terms. Examples:

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• Comfort target: “Keep discomfort ≤3/10 while working.”
• Function target: “Type for 45 minutes with only mild symptoms.”
• Recovery target: “Symptoms settle within 30–60 minutes after finishing work.”

2) Shared Decision-Making: Prioritize Changes by Cost, Effort, and Impact

Clients rarely implement a long list. Shared decision-making means you propose options, then you and the client choose the smallest set with the best chance of success.

A simple prioritization method: the “CEI” grid

Use a quick ranking to choose 1–3 changes:

How to use it in-session (step-by-step):

• Step 1 — Offer a menu: Present 4–6 possible changes (mix of no-cost, low-cost, and higher-cost).
• Step 2 — Ask preference and constraints: “What feels realistic this week?” “What would your workplace allow?”
• Step 3 — Choose 1–3 actions: Prioritize low cost/effort with clear expected benefit.
• Step 4 — Define what success looks like: Use a measurable target (time, symptoms, recovery).

Set expectations about trade-offs

Some changes improve one area but create another issue. Make trade-offs explicit so the client doesn’t abandon the plan at the first inconvenience.

• “If we raise the chair, you may feel more pressure under the thighs at first; we’ll adjust seat depth or add a foot support if needed.”
• “If you use a headset, it may feel awkward for a few days; we’ll aim for ‘less neck holding’ rather than perfect comfort immediately.”

3) Behavior Change Tools: Implementation Intentions and Barrier Planning

Knowing what to do is not the same as doing it at 3 p.m. on a busy day. Two tools make ergonomic advice stick: (a) implementation intentions (if–then plans) and (b) barrier planning (what will get in the way and what to do about it).

Implementation intentions (“If–then” plans)

Turn general advice into a trigger-based script.

Template:

If [situation/trigger], then I will [specific action] for [duration/amount].

Examples:

• “If I open my email in the morning, then I will set a 30-minute timer for position changes.”
• “If I finish a call, then I will stand and take 10 slow breaths before the next task.”
• “If discomfort reaches 3/10, then I will switch to my second sitting option for 10 minutes.”

Barrier planning (anticipate failure points)

Ask: “What will stop you?” Then create a fallback that is smaller, faster, and still useful.

Make the plan “minimum viable”

When adherence is low, reduce the plan until it is almost impossible to fail, then build up.

• Too big: “Take a 5-minute break every 30 minutes.”
• Minimum viable: “Every 30 minutes, change position for 15–30 seconds.”
• Build tolerance: After 1 week, add a short walk once daily if the minimum plan is consistent.

Use neutral tracking language

Tracking is not a test. It is feedback for adjustment.

• Say: “Let’s collect data for 7 days.”
• Avoid: “Be strict,” “Be disciplined,” “Don’t cheat.”

4) Follow-Up Plan: What to Measure, How Long to Trial, What to Adjust Next

Ergonomic changes should be treated like a clinical trial: define measures, set a time window, and decide in advance what you’ll change if it doesn’t help.

What to measure (choose 2–4 metrics)

Pick measures that match the client’s goals and are easy to record.

• Symptom intensity: 0–10 rating at key times (start work, mid-day, end of day).
• Time-to-symptom: “How long until symptoms reach 3/10?”
• Recovery time: “How long to settle after work?”
• Task tolerance: minutes of typing/mousing/meetings before needing a change.
• Consistency: number of days the plan was attempted (not perfection).

Example tracking table (client-friendly):

How long to trial changes

• Immediate comfort checks: within the session or first day (e.g., “Does this feel easier right now?”).
• Short trial window: 5–10 workdays is often enough to see a pattern.
• Longer adaptation: 2–4 weeks for tolerance-building plans (especially if fear/avoidance or deconditioning is present).

Set the expectation that early discomfort does not automatically mean harm; it may mean “new load.” The decision point is whether symptoms and recovery trend in the right direction.

Decision rules: what to adjust next

Agree on simple rules so the client knows what to do between visits.

• If symptoms improve ≥30% and recovery is faster: keep the plan and consider adding one small progression (e.g., slightly longer work blocks).
• If symptoms are unchanged but plan adherence is low: simplify the plan (reduce steps, add reminders, change triggers).
• If symptoms worsen and recovery is slower for >3–5 days: reduce exposure (shorter blocks), increase variability, reassess the highest-load task, and consider whether non-ergonomic factors need attention.

Follow-up questions that produce useful data

• “Which part was easiest to do consistently?”
• “When did it fall apart—time of day, task, or stress level?”
• “What changed on the best day?”
• “What did you notice about recovery after work?”

Example Client-Facing Summaries (Copy/Paste Templates)

Template A: Minimal, actionable (for most clients)

Goal (this week): Keep symptoms ≤3/10 during work and settle within 60 minutes after work.

Your two comfortable options:

• Option 1: [describe briefly: e.g., sit back, feet supported, screen closer]
• Option 2: [describe briefly: e.g., perch/forward sit, different arm support]

Plan:

• Every 30 minutes: change position for 20–30 seconds (no need to stand up every time).
• If symptoms reach 3/10: switch to Option 2 for 10 minutes.

Track (5 days): max symptoms (0–10), time to 3/10, recovery time after work.

Next review: We’ll keep what works and adjust the one biggest barrier.

Template B: Shared decision-making summary (when many options exist)

We considered: [list 4–6 options briefly].

We chose these 3 because they are low effort and likely high impact:

1. [Change #1] (start today)
2. [Change #2] (start today)
3. [Change #3] (trial for 1 week)

What success looks like: [specific metric].

What might get in the way: [barrier].

If that happens, do this instead: [fallback].

Template C: For clients who fear movement or “getting it wrong”

Key message: There is no single correct posture. We’re building tolerance by changing positions earlier and more often.

Safety rule: Mild, temporary symptom increase is acceptable if it settles within [time window] and does not trend worse across the week.

Plan:

• Start with the easiest change: [one action].
• Use an if–then plan: “If [trigger], then I will [action].”
• Track recovery time after work (this is our main signal).

Checklist: Writing Clear Ergonomic Recommendations

• Outcome first: Did I state the goal in measurable terms (symptoms, time, recovery, function)?
• Options not perfection: Did I avoid “always/never” and “fix posture” language?
• Small set: Did we choose 1–3 actions (not a long list)?
• Specific behaviors: Are actions observable (what, when, how long), not vague (“sit better”)?
• Triggers included: Did I write at least one if–then plan?
• Barriers anticipated: Did we name the top barrier and a fallback plan?
• Cost/effort considered: Did we prioritize low-cost/low-effort changes before expensive purchases?
• Trial window: Did we agree on how long to test (e.g., 5–10 workdays) before changing the plan?
• Tracking kept simple: Did we choose 2–4 metrics and provide an easy way to record them?
• Decision rules: Did I specify what to do if better, same, or worse?
• Client language: Is the summary written at the client’s reading level, with minimal jargon?
• Confidence check: Did I ask, “On a scale of 0–10, how confident are you you can do this?” and simplify if <7?