Tag Archives: musculoskeletal disorders

Low back pain is a symptom of other musculoskeletal disorders

How Does the Range of Motion of All of Our Joints Really Affect Us?

Morning movement and stretch programs can do more for you than you think.

Low back pain is common and often misdiagnosed.

Points to changing how you move.

It does not matter what we do for work, outside of work, or where we are, movement is key to doing anything.  Even static positions are movement.  Muscles must attain a certain level of synchronized firing or you would not have the ability to sit.  Anyone that has even minimal neurological deficits understands this. This truth is never more important than as we age!

Certain joints are designed to provide stability, while other joints promote mobility.  Ball and socket joints are more mobile, while hinge joints such as the elbow and knee are more for stability.   In the diagram below, you can see alterations between stable and mobile from one joint to the next.

Some joints promote stability, others mobilityThe lumbar spine (low back) should be more stable, but because of hip or thoracic joint movement limitations, the low back must become the more mobile part.  In these cases, chronic low back pain and injury result. Looking at the model, “S” meaning stable and “M” meaning mobile, notice that the S’s and M’s alternate.  Now further look and compare between the model’s right side: “How We Should Be,” and the model’s left side: “How Most of Us Are.” One joint limitation can impact all other joints—not only how they move but more importantly their job function!

Also notice that if the hip range of motion becomes limited—stable—then the knee, a hinge joint that is considered stable, becomes more mobile.

The approach to morning stretch/movement programs and work place wellness programs linked below begin to address this.

https://www.functionalmovement.com/Articles/848/why_your_back_is_often_the_victim_not_the_culprit

 

3D printer manufacturing

Innovation Is Not Just for the New and Most Up-to-Date Products for Consumers

Your employees deserve innovation, too.

3D printer manufacturingA recent article in the Harvard Business Review focused on the importance of U.S. firms bringing home their innovation centers—which they’ve shifted overseas right along with manufacturing (Sridhar Kota, et al., 2018). The article additionally points out that the U.S. “has also lost the ability to do the kinds of process improvements that are essential for innovation.” Our expertise and experience tell us that there’s a particular deficit when it comes to factoring in the humans, particularly those on the production line and the assembly floor.

Sports medicine technology and injury prevention innovations and their benefits are not being captured by industry.  Innovations made in data science, virtual technologies, and data collection and manipulation can now reveal, in real time, just how individuals move, thereby creating the platforms for movement retraining and other methods to restore optimal movements in any individual employee.  The impact of poor movement and the benefits of optimal movement aren’t a line item on any profit and loss statement, but they are certainly being felt there.  You’ll never see human movement in a strategy document, either, but you should, and here’s why.

As technology innovations advance, companies can begin to see exponential growth.  However, if these new types of technologies are imbalanced within a company, collisions will begin to occur—in output, life cycles, and elsewhere.  Although these innovations work on paper, they don’t always integrate and succeed on the assembly floor.

An example here would be that engineering innovators are using technologies such as virtual simulators, like 3D printing and other types of technologies.  While on the assembly floor, employees are still required to contort their bodies in order to assemble the product.  Some of the processes can now take longer due to the intricacies of advancements in product design and manufacturing.

In addition, these enhanced assembly processes now require increased skills from employees.  Current employees require more training, and new employees require new and different training.  This eats up valuable resources and does show up on the profit and loss statement as employees must be educated, trained, and mentored much longer.

Manufacturers have no choice but to invest in innovative approaches in the manufacturing assembling process.  Robotic assembly is not the only innovative restructuring process out there, and in fact is ancient in today’s marketplace. Powerfully integrating employees into today’s advanced manufacturing processes is the Holy Grail.

This type of methodology and use of technology can be referred to as “translational research”: not only investing in the R&D, but turning that R&D into physical reality, and that includes technology-enabled proactive and positive integration of the human part of the equation.  It’s this type of innovative use of human-focused technology in process design that can decrease employee injury, increase the consistency of quality of product, and increase the efficiency of production time.

Most large organizations have not yet come to the realization that seeking out cutting edge responses to human limitations on the assembly floor is a critical component of strategy and process design in today’s quickly changing production environment.  SMBs are looking for big business models to follow.  In both cases, the ROI of focusing on such solutions is rapid and a conservative >800% in the first few months.*

For some years to come, human beings will be on the assembly floor, much of the work there requiring more awkward positions and/or tedious fine motor skills of the upper extremities.  Biology of the human body is not getting a facelift in the near future.  Therefore, using the innovations happening in human movement analysis, correction and optimization will help to integrate and capitalize on the human aspect of assembling the new innovations created by engineering designers.

*Case studies available on request.

The benefits of treating musculoskeletal discomfort before it becomes injury.

The Benefits of Reducing Musculoskeletal Disorders (MSDs) Through Better Movements, Postures and Tools

The Benefits of Treating musculoskeletal discomfort before it becomes injury.
Let’s be realistic: many organizations’ production/manufacturing processes and equipment will not be changing to “fit” the worker any time soon. And even if they were, workers will still become injured. Why? Soft tissue adhesions will continue to happen due to work station alignments that can’t be customized to individual workers. MSDs will result in individuals due to historical injuries that are difficult to record, track or know about. “Proactive” ergonomic changes such as reducing steps or reducing how many times someone handles materials can inadvertently cause other worker injury risks. For example, changing the work requirement from walking to static standing can be absolutely debilitating.

What’s left out of so many employee health and safety or ergonomic programs is a a focus on the individual. A blanket ergonomic program can correct many problems, but ultimately one size fits one. A proactive program to analyze and correct poor movements for individuals as well as overall has many benefits.

Such as:

  • Focusing on and correcting poor movements ultimately reduces costs. By proactively preventing and reducing MSDs, companies save approximately $1 out of every $3 in workers’ compensation costs. By continuing to focus on and correcting poor movements everywhere in the company and reducing the MSDs, indirect costs also go down, which can be up to 20 times the cost of one reported injury. If an average cost of an MSD episode without surgery costs $12,000.00, indirect costs will be dramatically higher!
  • Correct human movements boost productivity. Posture and movement solutions improve productivity by reducing muscle fatigue, especially towards the latter half of the work day. Optimal movement patterns need less muscle exertion, resulting in better efficiency of movement and a better quality product produced.
  • To emphasize, correct human movements improve product quality. Non-efficient movements lead to fatigued workers. This creates two issues: 1), increased risk for an injury due to lack of concentration, and 2), decreased quality of product made. The latter now delves into indirect costs rising.
  • Proactive programs to resolve movement-related discomforts create better employee/employer relations. Employees do notice when their employer takes action to foster their health and safety. And they certainly know when they feel better! And feeling better directly as a result of an employer-sponsored, employee-centric program builds a sense of satisfaction, loyalty and commitment of the company as a whole to build better products and to stay happily engaged in the process. Less employee turnover means less dollars spent on the hiring process and re-training. Less job-related fatigue and discomfort means less time away from work, less shifts that have to be covered, less disruption overall.
  • Early symptom intervention programs cultivate better safety practices. Safety is obviously a core value these days. As proactive care programs permeate a company’s culture, they increase all employees’ education on health and safety, demonstrate the value the company places on its employees, and improve employee self-esteem. It’s not the product or your customers that is your most important asset. It’s your employees. And caring for them in this way has an exceptional ROI.
Serving the textile industry

Press Release: Physical Performance Solutions Now Servicing the Textile Industry

Serving the textile industryFOR IMMEDIATE RELEASE

May 8, 2018

Contact:  Lori Peacock, Physical Performance Solutions, LLC
lpeacock@physicalperformancesolutions.com
803-716-9167

Physical Performance Solutions Now Servicing the Textile Industry

Aiken, SC – Physical Performance Solutions, LLC announced today that it has added textiles to its growing list of industries served. The company offers Early Symptom Intervention programs to resolve employee discomfort before more serious injury, pain or cost accrues for employees and the companies for which they work.

“Although the textile industry is unique in what it does, employee discomfort can be found in just about any industry,” said Lori Peacock, president of Physical Performance Solutions. “Our proven, comprehensive process will bring relief to textile employees and employers alike.”

Physical Performance Solutions provides onsite services that analyze, diagnose and treat employee health issues before they escalate. Analysis may consist of interviews with employees, observation of workstation layouts and uses, job rotation review, and hands-on examination of muscle movement.

“Our mission is to pursue and utilize the best means available in technology, manual therapies, and movement re-training to empower our clients,” Ms. Peacock added. “We will always provide superior and customized attention to all of our clients so that they in turn may achieve their own missions.”

Industries currently served by the company include food processing, aerospace, automotive, and electrical component manufacturing.

ABOUT PHYSICAL PERFORMANCE SOLUTIONS
Physical Performance Solutions, LLC, based in Aiken, South Carolina, is a leader in evidence-based biomechanics, offering cutting edge, cost effective and proactive strategies for reducing worker discomfort and injury in manufacturing and corporate environments. Our “one solution fits one” approach ensures the highest quality care for individual employees while dramatically reducing risk and safety issues for their employers. Learn more at www.PhysicalPerformanceSolutions.com.

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Your Time in the Gym Can Be Bad for Your Health!

Your Time at the Gym, on the Bike or on Your Horse Can Be Bad for Your Health

Your Time in the Gym Can Be Bad for Your Health!Finally, data analysts and orthopedic surgeons have gotten together to conduct a study of cervical injury across the United States, with a particular focus on sports-related injuries.  The findings of the study were presented at the 2018 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

Guess what?  Football is bad for your neck! No surprise there.  In sporting related neck injuries, the study found that football leads as the most common cause of neck sprains in men.

But unexpectedly, the study revealed that the most common cause for cervical fractures in men is cycling injuries.  The study’s lead author J. Mason DePasse, MD, orthopedic trauma surgery fellow at Brown University, stated that “the biggest takeaway was that cycling is the number one cause of neck fractures, which suggests we may need to investigate this in terms of safety."

For women, weightlifting and aerobic exercise were the leading causes of cervical sprains, along with trampoline and cheerleading.  Cervical fractures for women occurred primarily during horseback riding, followed by cycling and time in the pool diving or swimming.

The study was conducted using data from the National Electronic Injury Surveillance System (NEISS) database. The database is managed by the Consumer Product Safety Commission (CPSC) and collects information on emergency room patients from 100 U.S. hospitals.  27,546 patients who sustained a neck injury during a sporting activity were identified in the database by using data analytics to sift through 50,000 specific cases.

"Cervical spine injury is a substantial cause of morbidity and mortality, and, as far as injuries go, one of the more devastating injuries that we as orthopaedic surgeons can treat," said lead study author J. Mason DePasse, MD, orthopaedic trauma surgery fellow at Brown University.

From 2000 to 2015, the study found that neck sprains increased 66% during weightlifting and aerobic exercise.  The very things we’re doing to keep us strong and healthy turn out to be a major cause of pain and debilitation.  Take those injuries into work with you, and your woes will likely be compounded.

So, what can you do to reduce your chances of sustaining exercise-related neck injuries and pain?

  • According to Harvard Health, maintaining core strength is key. "If your core muscles aren't strong, your neck and shoulder muscles will be overworked," according to Dana Kotler, instructor in physical medicine at Harvard Medical School. "Once you strengthen your core muscles, everything falls into line a little better. It has an effect similar to adding a pillow to support your back." Also, we are now learning that muscles will remember incorrect firing patterns, which create movement dysfunction patterns. This dramatically increases risk for injury - even during exercise.
  • Harvard Health also recommends creating awareness of and correcting your posture when performing any exercise to avoid neck pain and reduce your chance of injury. Checking your posture when performing particular tasks at both home and work can help, too. To be redundant, posture patterns are movement patterns too. It is actually more important to focus on increasing your posture awareness to correct movement patterns that improve your flexibility and create better muscle firing patterns than your exercising. If you are exercising incorrectly, you are inadvertently increasing your risk for soft tissue injuries, including joints. Health care professionals trained in this area are your target contacts to help you to correct posture and movement pattern dysfunctions.
  • A study conducted by Denmark's National Research Centre for the Working Environment found that using three particular strength-building exercises using weights—shoulder shrugs, upright rows and reverse flies—can reduce neck pain by 80% in less than three months, according to Prevention. The other side of the coin is that too many of these exercises that isolate muscles without looking at the whole leads to shoulder movement pattern dysfunction. Some of the problems with "exercises" is that we are looking at parts instead of the whole system: the body.
  • Lastly, each of us is aging. Whenever you engage in a sporting activity, keep in mind that your body is changing and a different approach to exercise may be required over time. But, please!  Don’t stop exercising!  Your cells are aging, too, and a recent study in Preventative Medicine concluded that high levels of physical activity help curb and even reverse cellular aging as well as sarcopenia, or muscle loss.

Risk Factors for Injuries in the Workplace

Tissue Adhesions and Dysfunctional Movement Patterns Can Be Risk Factors for Injuries in the Workplace

Many institutions publish excellent guidelines on identifying risk in and around the workplace. For example, the Health and Safety Executive, a UK government organization concerned with the health and safety of Great Britain’s people at work or in the community, is one of the thousands of websites that use a digital platform to inform.

Information given out on these professionally managed websites regarding risk factors for work injury or accidents acts as a “filter.” Filtration is a process that separates the impurities, or risks, from the good of the process. So the question is: what are you trying to catch in the filter of your risk management?

For example:

The above pictures are a minute representation of postures workers assume during their work hours. Often these awkward postures either must be sustained to maintain accuracy of the work involved, or moderate force is also required in these types of positions, or workers must routinely get in and out the awkward positions throughout a work shift.

The same is also true regarding awkward postures for professional sports:

Although many of the assumed postures do not result in an instantaneous injury, the body can develop tissue adhesions that will eventually affect how tissues move and muscles behave. The end result will be stiffness, soreness, edema, discomfort, limited joint motion and tissue flexibility, and of course, pain, unless corrective measures are introduced prior to an injury.

In addition, different workers performing the same job tasks, will need to perform them differently due to their varied body types, strengths, and existing movement pattern dysfunctions. One worker is slim without difficulties in joints. The second worker is older and has been a physical worker their entire adult life. This person is carrying extra weight in the abdomen, which now increases the difficulty of squatting. Instead they must stoop over, thus dramatically increasing a risk of low back or possibly hamstring injury.

When you speak with workers on this topic, you may very well hear something like: “I don’t have any trouble moving like this. I always do and I never feel any pain.” Comments like this reveal that the worker doesn’t understand that he or she is just one more stoop away from hurting his or her low back. And, of course, it may not be at work. This scenario can play itself out in a home setting as well. The end result is an injured worker, and the time and cost now associated with finding help until they recover.

Risk Management = Proactive Movement Correction

Thanks to sports, we now know, through current research and publications in peer reviewed literature, that tissue adhesions, contusions, and other seemingly small innocuous injuries lead to movement dysfunctions: changes in how tissue moves and how voluntary muscles act (Hui Liu a 2012).

In light of this, even though a workstation has been ergonomically re-designed, a worker with muscle movement pattern dysfunctions will not “self-correct.” The body, when placed in a better posture or position will still require retraining (Peter Kent1 2015). This is conducted after going through movement screens and tissue adhesions are beginning to resolve (Richard W. Willy 2012) (Cook 2010).

This is one of the reasons why Musculoskeletal Disorders, MSDs, continue to reign high in worker’s compensation claims. Risk design is important not just for ergonomic reasons, but for movement patterns as well. This is an area that very few organizations, from industrial manufacturing companies to dental offices, assess. Specific and highly trained skills are necessary to determine what is to be filtered in the process of a risk assessment.

When we get together for a risk assessment of a work area, think of what you would like to filter.

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Works Cited

  • Cook, Grey. 2010. Movement: Functional Movement Systems: Screening Assessment and Corrective Strategies. Aptos CA: On Target Publications.
  • Hui Liu a, William E. Garrett b, Claude T. Moorman b, Bing Yu c,*. 2012. "Injury rate, mechanism, and risk factors of hamstring strain injuries in sports: A review of the literature." Journal of Sport and Health Science 92-101.
  • Peter Kent1, 2*, Robert Laird3 and Terry Haines. 2015. "The effect of changing movement and posture using motion-sensor biofeedback, versus guidelines-based care, on the clinical outcomes of people with sub-acute or chronic low back pain-a multicentre, cluster-randomised, placebo-controlled, pilot trial." BMC Musculoskeletal Disorders 2-31.
  • Richard W. Willy, PT, PhD1,*, John P. Scholz, PT, PhD2, and Irene S. Davis, PT, PhD3. 2012. "Mirror gait retraining for the treatment of patellofemoral pain in." Clin Biomech 1045–1051.

Have You Really GEMBA Walked Workstation Movements?

Look on the Other Side of the Coin
Most manufacturing companies have heard, read and used a GEMBA walk within a LEAN approach to identify waste, develop more efficiency, produce what is necessary, and increase good communications through discussions with workers in a specific area and reviewing current processes.

GEMBA walks, LEAN manufacturing and Kaizen events are only a few methods and ideologies that help to spur and create the necessary positive changes in an organization. The experienced quality leader will also note the existing positive processes and conditions that produce a quality end product with efficiency, less waste, and engaged workers.

In any organization that creates products for customers, it is that end product and the high value it imparts that the customer appreciates. The common thread through manufacturing processes is to involve both the vertical management and the horizontal workforce together to identify the good and the “what is needed” for added value with less waste.

These activities often require an evolution of skill sets that happens over time through planning and conducting GEMBA walks in order to hone the process. The best and most obvious skill to develop is the eye. The eye can focus on one small object, or span out to view the larger surround. It is here, observing by eye, that the movements of workers at their stations can be viewed and more thoroughly analyzed.

Typically, when observing a worker at a station, we look globally: how far is that worker walking to obtain a part or tool? Are there too many or too few parts or tools? Maybe the worker is moving the parts too many times, or perhaps having to lift heavier parts too many times. In the process of removing waste through designing smaller work stations, reducing an overflow of parts, and creating additional work stations, workers may now only need to move their arms little, or take a few steps occasionally.

On the one hand, we are possibly helping to reduce human error, and therefore may be reducing the risk of mishandling something that results in an accident or injury. The workstation now may be such that more types of workers will be able to perform the job tasks at that station. Those are all benefits.

The “other side of the coin” is: are we creating a scenario for the worker to sustain relatively static postures, that, over time, increase fatigue in postural muscles, thereby increasing the possibility of mental fatigue, stiff muscles, sore feet and neck?

In the past few years, many of us have heard or read about the new “silent killer”: prolonged sitting. The deleterious effects of sitting are reducing quality of life by dramatically decreasing physical abilities and increasing onsets of various disease processes.

In manufacturing, however, the opposite maybe taking place: prolonged static standing. This is a common posture in assembling, the food industry, and other labor jobs. Many assembling plants are looking to minimize foot step movement and the number of times product is handled in order to decrease risk of physical injury and increase efficiency of the work tasks. The goals are excellent, but these “optimizations” may result in workers virtually frozen in prolonged standing postures.

Prolonged standing, as illustrated in the table above, has negative effects on the human body that are well documented: pooling of the blood in the lower extremities and increased muscle fatigue due to prolonged co-contraction of muscles for erect standing. Both create discomfort or pain in the feet, legs, lower back, neck, shoulders, and hips.

At Physical Performance Solutions, we have treated hundreds of individuals over the years whose static postures were a large contributing factor to soft tissue injury. In our work assisting organizations to reduce soft tissue injury in the workplace, we are seeing firsthand some of the results of these changes. Many studies published in peer review literature are coming up with similar conclusions. (FTüchsen, 2005), (Marwan El-Rich 2005).

Static loads and fixed postures are increasing stress and strain on the spine, ligaments, and surrounding soft tissues, in addition to sustained compressive forces on all load bearing joints. Occupational Health and Safety published about this subject in 2003, (Joy M. Ebben 2003), yet there more workstations than ever that are increasing standing postures. Our evidence is more than anecdotal; we are seeing more individuals with tissue adhesions not just in the lower neck/upper trapezius region, but also lumbar spine and calf muscles as well. Prior to recent redesign of particular workstations, those types of complaints and identification of adhesions was minimal.

Here are some suggestions to see if the changes your organization has made may be contributing to the “other side of the coin.” Some of these indicators should be fairly easy to track and document, while others will be more difficult due to the individual nature of each employee.

  1. Compare quality of product over time. There should significantly fewer mistakes. If there are mistakes, can you identify who is making the mistake? What time of day is the mistake being made? This is taking into account all parts and supplies are defect free.
  2. What are the age ranges of the workers at particular stations? How many women vs. men, and what are their ethnic and social backgrounds?
  3. Is there a consistent job rotation of the work area?
  4. Have there been any accidents, injuries, or other physical complaints prior to and after any changes?
  5. Are there new workers in the area now?
  6. Have soft tissue musculoskeletal disorders within that area decreased? By how much?

Manufacturing production and Lean are truly more than finding the waste and inefficiency that is external. It is also looking at any tradeoffs that might be created by reducing “wasted” movement and locking a worker into a static position for hours at a time.

Is the organization saving money in one area, but creating expenditure elsewhere, as expressed, perhaps, in days off from work due to soreness? Workers experiencing issues from changes in work movement patterns may not be confident enough to speak up for fear of losing their jobs. They might also have difficulty articulating what they are experiencing. Many workers do not truly realize that just standing can have so many ill effects on the body.

This is a microscopic view in relation to all of manufacturing and all companies that utilize Lean concepts and practices around the world. However, the “other side of the coin” bears watching, and companies that are proactive will begin to practice new approaches to further create a positive culture within the organization and an excellent product.