Workers still sulking at kitchen counters or sinking into recliners might want to upgrade if they are continuing their work-from-home routines in the post-COVID business world.

Studies have found more musculoskeletal injuries since the pandemic are partly due to lousy posture while working at home. Twin Cities Orthopedics (TCO) has tended to more worn-out wrists, shoulders and necks, often because people switched to makeshift workspaces.

"When someone goes from working at a desk to working on a couch with a laptop, you can guarantee there is going to be issues," said Anthony Nagy, who set up a home office ergonomics consultation program at TCO.

Minnesota appears at risk. More than 1 in 5 employed Minnesotans reported primarily working from home in 2021, the ninth-highest rate among states, according to an analysis from the state's Department of Employment and Economic Development (DEED).

"Even after the pandemic has waned, many employers are choosing to permanently allow employees to work remotely, signaling a long-term shift in where work is done," wrote Cameron Macht, a DEED analyst.

Working from home doesn't have to be so un-officelike. Brazilian research showed telecommuters before the pandemic set up ergonomic home offices. But after COVID-19 emerged, people crammed into whatever spaces they could find, often because they had to work around spouses or children taking online classes.

The state's private employers reported 73,100 nonfatal workplace injuries and illnesses in 2022, an injury rate that exceeded the national number. Minnesota responded with new ergonomic standards designed to protect employees from injuries in some of the highest-risk workplaces such as warehouses, meatpacking plants and hospitals. The rate of work-related musculoskeletal injuries is lower by comparison among office workers, but orthopedic centers have reported a steady or rising number of such patients in the work-from-home era.

Here are some ways to make sure your work setup isn't cramping your style:

Healthy office posture

Ergonomic experts follow the "rule of 90,″ encouraging people when sitting to keep their elbows, hips and knees at right angles to minimize stress on their joints. Feet should also be grounded and not dangling.

While it sounds simple, it takes intention, said Max Lipset, director of TCO's Health Quotient program, which provides ergonomic consultations for businesses.

"Most office furniture is built for somebody that is 5-foot-8," he said. "If you're on either side of that situation, you're going to want to customize your setup."

People should also set their monitors so they are looking squarely at them and not craning their necks up or scrunching down. That can result in what Lipset called "tech neck" injuries. Laptops make proper positioning difficult, so pairing them with wireless keyboards can help.

Adjusting desks and chairs to meet the rule of 90 helps, but ergonomics experts also recommend standing once in a while. The guidance for office workers is to spend 20 of every 30 minutes seated, but then eight minutes standing and two minutes walking.

Home improvements

Adjustable-height desks can help meet the standing goal, but Lipset also recommended a stool or step on the floor so people can vary their stances and ease pressure on their feet.

"Some bartender a long time ago ... realized having that little railing beneath the bar allowed people to stand longer," Lipset said. "That was pretty good for business. Applying that thinking in your home office allows you to stand for a longer episode."

Headsets for phone calls reduce neck strains. Workers also can reduce repetitive stress on their dominant arms by switching the mouse to the other side of the keyboard and operating it with the opposite hand, Lipset said.

"In just a couple weeks, you can become quite confident with using your left hand if you're right-handed for your day-to-day mousing," he said. "And that reduces your stress on those tissues 50 percent if you can just alternate."

Available resources

Only a minority of employers offer one-time or annual stipends workers can use to buy home office furnishings or equipment, surveys show. Minnesota is 1 of 11 states where employers are required to reimburse workers for certain home office supplies, but only under the law after they terminate the workers.

Employers sometimes agree to pay in the absence of formal benefits for furnishings that reduce injury risks, said Kristin Hallenberg, an occupational therapist with Allina Health's Courage Kenny Rehabilitation Institute that conducts home office ergonomic assessments. Workers should at least check with their bosses or HR departments, especially if they are noticing pains during their workdays.

Workers paying out of pocket can check with testing organizations such as Consumer Reports, which found a suitable ergonomic mouse for $17 and tested the comfort of office chairs ranging from $170 to $2,000.

People can sometimes use their health insurance benefits like pretax FSA or HSA dollars to help pay for home office equipment or services that prevent injuries, Lipset said. That includes TCO's $150 ergonomic consultations. Employers sometimes agree to pay for the consultations, which involve virtual inspections of home offices and recommendations on how to modify them to lower injury risks.

People with federally qualified disabilities or workers' compensation claims because of injuries have additional options. Minnesota also is offering grants right now for small employers to accommodate needs of workers with disabilities.

Exercise your right

Nagy encourages "work-break stretches" of the forearms, hamstrings and low back. Wrist exercises also counteract repetitive motions for office workers, who spend their days with their arms forward and palms down while they write, type and eat.

The American Academy of Orthopaedic Surgeons recommends thumb, finger and wrist stretches to avoid carpal tunnel syndrome, a painful form of nerve damage in the wrist. They include pushing the wrist gently downward and holding the position for 15 seconds. Another stretch involves straightening the hand, then balling the fingers, then rotating them down into a closed fist.

People at rest can stretch and straighten their posture simply by supinating their arms, which means sitting with their palms up and their thumbs pointed away, Hallenberg said.

"People think they look weird, but that really relaxes those forearm muscles," she said. "You just have to tell them to try it."

The Cleveland Clinic offers exercises specifically to avoid "dead-butt syndrome," which can occur when sitting too long. One exercise involves standing, then sitting down but suspending your position above the chair before straightening back up.

Moving around is important, and in some ways, easier for telecommuters, Hallenberg said.

"You can change your position more," she said. "You can go throw in your laundry or you can walk your dog at lunch."

Medical attention needed?

Problems such as carpal tunnel are treatable, so workers should seek medical attention if they aren't going away, Hallenberg said. Neglected problems can spread, she added. Back pain from poor posture can eventually radiate to the limbs.

Activities outside of work make a difference. Strength and core exercises can reduce injury risks. Extracurricular activities that mimic computer work can increase them.

"I had a remote worker who did computer work all day and then was sewing her daughter's dance costume," she said. "She was kind of in that position outside of work, too."