Tag Archives: pain mitigation strategies

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.

Job Rotation Food Processing

5 Mistakes You’re Making in Job Rotation

Job Rotation Food ProcessingAn employee comes to you and says that’s he’s hurting. In this case, it’s his shoulders.  So, you look down the line for a workstation requiring a different activity, and you plan a regular job rotation with the person running that station on his same shift.  With gratitude, the employee goes back to work.

Four days later, the employee calls in sick.  His shoulders hurt too badly to work, he says.  He says his doctor wants him off the job for two weeks. Two weeks go by, and ultimately he doesn’t ever come back.  You’re surprised by this.  You did what you thought would solve the problem.  What happened?

This is a regular occurrence in manufacturing job rotation, and there are five common mistakes made in designing a job rotation program that, if avoided, will actually set you on the path to establishing an assertive injury prevention program.

Mistake #1: Not including movement training.  Nothing would get done without humans moving.  But are they moving the right way?  Work has two parts: the tasks to be done and a method for doing them.  Each task can be performed in such a way to minimize the risk of causing personal discomfort and injury.  Do you know the best way to physically approach each task that a worker will perform each day, over and over? It’s not relying solely on the use of correct angles, which is common in ergonomics.  That’s just a start. Using technology such as sEMG, it is possible to see how an individual’s approach to the work is causing him or her discomfort, and how to modify the approach to reduce or completely eliminate that discomfort.  More importantly, sEMG shows aberrant muscle firing patterns and different types of muscle fatigue.  Individuals most often can’t perceive this in themselves; therefore, identifying the patterns prior to an injury and prior to a complaint can dramatically decrease risk for musculoskeletal injuries.  Health professionals highly skilled in  movement retraining  can then train individuals on optimal movement patterns for them that will avoid musculoskeletal disorders (MSDs) and injury.

Mistake #2: Not designing a specific stretching/dynamic movement program for each workstation.  A generic stretching program is a good start, but if different movements are required at different workstations, specific stretches geared to those movements will provide the most benefit.  For example, a welder may just need to stand up straight and perform forearm stretches between units to relieve upper body stress or have a high stool to sit on for a minute to relieve low back pain, or both.  Workers need to be taught these specific stretches and countering movements along with the task at hand when they are rotated into a new position.  Employees leading the stretch programs should have additional education on the general whys, hows, a developing critical eye, and an attitude of engaging employees that half-heartedly participate or do not participate.  This type of engagement will assist the program to become better.

Mistake #3: Not breaking tasks down into their minimal components and addressing each.  The task may be a grip and cut in food processing, for example, but there’s also a repetitive reach to get the next piece of work.  Are all of these movements considered when planning job rotation?  Analyzing time exposure, static positions, the number of repetitions, and stress angles on joints required by the work at each station are just some of the factors that should be considered in a quality job rotation program.

Mistake #4: Not proactively responding to complaints.  If the lines of communication are open and broad between workers and management, the first hints of discomfort will be revealed.  This is an opportunity to proactively address them.  First aid massage, Kinesio Taping, and movement retraining, review and correction are just some of the tools that can be used to diminish the risk and return the worker to a better physical ability.

Mistake #5:  Rotating employees to workstations with similar versus completely diverse movements.  Do both stations require using the upper extremities in similar ways?  Constant gripping or twisting or reaching and lifting, for example?  How is the back being used at each workstation? Is repetitive twisting involved?  Reaching down and pulling?  If you can switch an employee to a station where none of the same movements are required you’ll get the best results.  Even the order in which the rotation happens can have an impact.

Job rotation in a production environment is an art, but it can produce amazing results if done in concert with a highly trained production movement specialist.  If you’d like a free and confidential consult on an area of concern in your own company, please give us a call at 803-716-9167.

 

Reducing Workers’ Comp Claims: A Radio Interview

Mike Switzer of the SC Business Review interviews Lori Peacock, CEO of Physical Performance Solutions, on the often overlooked and unique contributors to employee discomfort—including physical fitness—and how to optimize management of and provide relief for those factors.

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.
Professional Early Symptom Intervention

Early Symptom Intervention (ESI) & Its Benefits

What is Early Symptom Intervention, or ESI, and how can both employers and employees benefit by focusing on it?

Waiting too long to address an employee discomfort issue is no doubt a contributing reason to why organizations find themselves trying to cover missed shifts, dealing with FMLA forms, watching their employees suffer, and blowing budgets.

Whether it’s the employee’s delay or our own, the outcome is the same: pain that finally insists on being dealt with, often at great expense to all involved. Continue reading

Correct Movement Patterns Reduce Soft Tissue Injuries

Movement pattern changes occurs in all of us.  Whether you exercise or not, are an elite athlete or couch potato, it does not matter, all patterns of movements change.  The reasons vary greatly with every individual.

This applies at work, whether a desk job or a more physical job as in assembling, material handling or construction.  Those of us involved in medical safety often witness this:  a worker comes to the nurse's office and says, "all I did was the same lift I have done for as long as I have been on that job.  I don't know what happened.  I just know my back hurts now and I can't lean forward without back pain." A soft tissue injury has occurred, that can cost companies hundreds of thousands of dollars with even one incident.

The key to reducing this type of injury begins by watching movement patterns before a worker reports an injury.

By correcting a dysfunctional movement pattern, the worker can now perform his or her specific tasks with a decreased risk of injury.

Correcting movement patterns is a skill well known and practiced in the physical therapy realm and sports arenas. Physical therapists as well as other qualified health professionals analyze movements and movement strategies; something that they are skilled at doing.  Combining this salient skill with  treating soft tissue adhesions, whether post trauma, postsurgical or problems of insidious onset, yields extremely positive results in reducing soft tissue injury - preferably before the injury!

And reducing soft tissue injuries goes right to your company's bottom line.

 

 

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.