“Ergonomic” cases and “Red Flag Warnings”

Transcription

The Sports Medicine Model
for handling those tough
“Ergonomic” cases and “Red
Flag Warnings”
Michael Gee, ATC, CEES
PRO FIT Solutions
Advancing Companies through Healthy Employees
Copyright 2014 PRO FIT Solutions
Disclaimer
• All information is intended for general knowledge only
and is not a substitute for medical advice or treatment
for specific medical conditions. Consults with a
physician or other health care practitioner for any health
care concerns.
• This talk is to help you identify a few of the most
common conditions that we’ve encountered over the past
20 years working in the sports medicine and ergonomic
fields
• Not intended to be a medical diagnosis
• Not intended to replace sound Ergonomic guidelines and
principles
• Simply another set of tools and perspective to utilize for
the health and safety of your employees
How it all began
Why I do it!
• First Dr. appointment 10 years old for knee pain
• First knee surgery: 16 years old
▫ Was told to stop playing all the sports I loved
• Second knee surgery: 18 years old
▫ Your not going to walk when you are 25
▫ Became curious about “sports medicine”
• 27 years old I was living on IBU
▫ Extreme knee pain
▫ What I had learned up to that point wasn’t helping
▫ Doctors told me surgery was not an option….
 Something I would have to live with
3 Things happened to me
1.
I became discouraged with my
diagnosis and depressed because
there was nothing THEY could do, I
had lost hope
2.
I was “Sick and tired of being sick and
tired”
• I decided that it would be up to me to find the
answers, I would continue to learn, explore and
question the status quo
3.
I made a promise to myself
• If I found answers, I would share them with
everyone I could
I had found some answers
The Good Days
Age 32
NORBA Nationals
Big Bear, Ca, 2002
Age 40
Vet X Fall Motocross Series
Peris, Ca, 2009
The Bad Days
Don’t worry, No body was hurt in the
filming of this story!
Research and Development Department
•
•
•
•
•
•
•
•
•
4 right knee surgeries (meniscus, cartilage)
Left knee surgery (meniscus, cartilage, ACL)
Right dislocated shoulder, rotator cuff repair
Left torn bicep tendon
Broken right 2nd metatarsal (foot)
Broken left wrist
Dislocated right index finger
2 Broken right fibula (leg)
Multiple right ankle sprains at young age
▫ Resulted in complete ligament tears and bone spur
• Multiple ligament sprains, muscle strains and
contusion
• Multiple concussions
• Severe whip lash (neck injury)
Yours truly hard at work
• I took responsibility and understood the roll
I played in my own recovery
• I was congruent with my actions and was
100% committed to the model
• Its given me the tools, perspective and
confidence to help others
This is my
GIFT to you
Lets Get Started
Isn’t it frustrating when:
You can spend a lot of money on
“ergonomic” products to still have employees
in pain?
You make appropriate “ergonomic”
corrections and come back to find the
person is working in the same position you
found them in?
Some injuries are degenerative in nature
and suddenly happen “at work”?
Degenerative Disc Disease
Arthritis
The injury that occurred doesn’t match
the mechanism (how it happened)?
“I was just picking up my keys”
There are some jobs and tasks that just have
to be done and are almost impossible to
address with ergonomics?
Your best efforts towards Safety and
Ergonomics don’t seem to match your
worker compensation claims and health
care costs?
Well……..
There are some Solutions
• For the next hour we will discuss how occupational
injuries differ from athletic injuries?
• You will learn how can you incorporate the “Sports
Medicine model” into your current ergonomic
program to stop the worker comp bleeding.
• We will focus on a few “Red Flag warnings” and how
to identify what could contribute to potential
injuries from a Sports Medicine perspective.
• You will leave with a better understanding of how to
save money selecting the most appropriate
“ergonomic” product for your employees
• I will give you specific controls that you can begin
implementing today.
Differences in “Occupational”
injuries and Athletic Injuries
• There are virtually no differences in the
mechanical and physiological properties of an
“Athletic” injury and an “Occupational” injury
• There are virtually no differences psychologically
between an “Athletic” injury and an
“Occupational” injury
• However there seems to be a difference in the
rate of recovery between an “Athletic” injury and
an “Occupational” injury
So how do athletes return
to the field so quickly?
More importantly why
aren’t our employees
returning to work
quicker?
Bureau of Labor Statistics
NONFATAL OCCUPATIONAL INJURIES
AND ILLNESSES REQUIRING DAYS AWAY
FROM WORK, 2012
• “The median days away from work--a key
measure of severity of injuries and illnesses--was
9 days. This is one day more than in 2011”.
Bureau of Labor Statistics,
www.BLS.gov
You can not speed up recovery
3 phases to the healing process MUST take place and be managed correctly
• Protection Phases (Inflammatory Phase)
 Acute Phase
 2 - 4 days (Bleeding, Redness, Swelling, Pain,)
• Repair Phase
 Sub-acute Phase
 Up to 6 weeks
 Scar tissue being laid down, (pain, swelling usually
subside)
• Remodeling Phase
 Chronic Phase
 3 months to as much as 2 years for complete healing
You can’t speed up recovery
BUT You can slow it down!
• Continued exposure to risk
• Mismanagement of injury (not allowing all 3 phases of
healing to occur)
▫ Stress/Strain/Recover principles
• Poor healing capabilities
▫ Risky Behavioral Factors
 Diabetes – Smoking – High Blood Pressure – High Blood Sugar –
Alcohol Abuse – Obesity – Poor Nutrition
• Lack of taking action
▫ Don’t know what to do
▫ Don’t know who to tell
▫ It will be fine (Ignoring problem)
Chronic/Over use Injury
Repetitive motion injuries (RMI), Repetitive Stress injuries (RSI)
Musculoskeletal disorders (MSD)
• Chronic conditions lead to tissue
breakdown
• Mismanagement of condition
• Breakdown exceeds repair rate
▫ Can lead to Permeate/Irreversible damage
 Carpal Tunnel Syndrome, Lateral
Epicondylitis (Tennis Elbow),
Chondromalacia (softening of cartilage,
Arthritis) Degenerative disc disease
The Athletes
Average American
Health
Workers Health
Health Spectrum
Chronic Disease
Injury
Pain
Limitation
Seemingly Healthy
Optimum Health
• The five most costly and preventable
chronic conditions cost the U.S. nearly $347
billion—30% of total health spending—in
2010.
• 75 percent of employers' health care costs
and productivity losses are contributed to
employee lifestyle choices
• Every $1 spent on workplace wellness,
decreases medical costs by about $3.27 and
increases productivity, with absenteeism
costs decreasing by about $2.37
Copyright 2014 PRO FIT
Solutions
American Public Health Association www.apha.com
Center of Disease Control and Prevention www.CDC.gov
We are making employees happy…
but not making them WELL!
What is the
Athletes Advantage?
Sports Medicine
• A collaboration of many health care disciplines
to care for and enhance physical abilities in
athletes.
• This program is well defined and managed with
specific systems and procedures to achieve
positive return on investments
Injury
Management
Practice of
Medicine
Sports Physical
Therapy
Athletic Trainer
Human
Performance
Exercise Physiology
Biomechanics
Sports Nutritionist
Sports Psychologist
Strength and
Conditioning Coach
Personal Fitness
Training
The Athletic Trainer
Athletic Trainers
Scope of Practice
• Focus on injury and illness
prevention
• Clinical evaluation and
diagnosis, injury assessment
• Emphasis on immediate and
emergency care
• Treatment, rehabilitation,
reconditioning
• Return to play (ASAP)
National Athletic Trainers Association, www.nata.org
Sports Medicine “Magic”?
• The skills used in the prevention and recognition
of injuries for an athlete are the same skills
used in the prevention and recognition of
injuries for the employee.
• The skills used in the return to play for an
injured athlete are the same skills used for the
return to work for the injured employee.
• The differences lie in the awareness and
attention of the athletic injury vs. occupational
injury
Why Sports Medicine in Ergonomics
• Highly trained and specialized in the Injury management
processes
• Brings a different perspective
• Assess severity and implement immediate and necessary
course of action, “THE RED FLAGS”
• Management of controls that focus on the return to play
(work) as quickly as possible
• “The Human Connection” a necessary component
▫ Pain and Injury have a psychological impact
▫ Educating the patient is critical for self management
• All Inclusive “on-site” injury prevention, management
and wellness provider
• Proven results for Positive ROI and cost control
Sports Medicine at work
The knee Saver
Ergonomics and
Sports Medicine
come together
Dr. Douglas Farrago
MD. Invented original
Knee Saver in 1991
First Prototype in
Baseball Hall of Fame
Results that Save Human and Financial Resources
The National Athletic Trainers’ Association (www.NATA.org) recently conducted a national
survey of industrial companies that utilize the services of a certified athletic trainer.
• Results of the survey showed:
• 100% of the companies reported the athletic trainer provides a favorable return-oninvestment (ROI).
•
•
•
•
•
Of companies that knew the specific ROI amount:
30% indicated the ROI was at least $7/employee per $1 invested.
83% indicated the ROI was more than $3/employee per $1 invested.
94% of companies indicated the severity of injuries has decreased by at least 25%.
68% of the companies indicated that the athletic trainer helped to decrease restricted
workdays and worker’s compensation claims for musculoskeletal disorders (MSDs) by
more than 25%.
• 50% of companies report that the number of injuries decreased by at least 50%.
• 46% of the companies that provided on-site physical rehabilitation indicated that health
care costs had decreased by more than 50%.
National Athletic Trainers Association www.NATA.org
How do you implement the
Sports Medicine Model into
your current Ergonomic
processes?
The true secret to the Sports
Medicine model… “The Must Haves”
• The company must have a specific health and
safety initiative with defined goals and
procedures
• There must be congruency in managements
actions that support the company’s health and
safety initiative
• Employees must know their role in the
company initiative and must be offered the
necessary resources to take responsibility for
their own health and safety.
The Different Perspective from
Sports Medicine
“Red Flag” Warnings
• Two specific conditions we
have encountered that we
considered “RED FLAGS”
• How each condition is
implicated in our ergonomic
efforts
• Discuss the sports medicine
perspective related to each of
these conditions
• Provide proven solutions that
can be implemented today
“Red Flags” defined
• What do we mean by “Red Flag” warnings?
▫ Significant evidence that the current conditions
will lead to increased exposure to risk
• Where did the rational come from for
determining the “Red Flag” warnings we have
identified?
▫ Empirical based research
▫ Data collection and observations
▫ Peer reviewed ergonomic, physical therapy and
medical literature
WHY?
The “Ergonomic” approach
The workstation contributes to the cause
The “Ergonomic” Approach
OSHA Recommended Sitting/Standing Positions
The chair has the greatest influence
on our bodies posture…
Sounds like a great place to start!
United States Department of Labor Occupational Health and Safety Administration (OSHA)
But there is one more thing to consider
The Sports Medicine Approach
“Human” performance plays an important roll
Human Anatomy
There is a DESIGN to how
the body LOOKS
Skeletal Design
Muscular Design
Functional Anatomy
Biomechanics
If there is a DESIGN to
how the body LOOKS
There is a DESIGN to how
the body FUNCTIONS
Functional Anatomy
Touching Toes Assessment
• Tells us a lot about the FUNCTION of the spine
▫ Muscular Strengths/Weaknesses
▫ Ligament Strengths/Weaknesses
▫ Disparities from “normal”
• Great educational tool
• Helps identify continued exposure to risk
• Can tell us why some of our “ergonomic”
attempts aren’t working
• Helps us determine the most effective
intervention
Lumbar Flexion
Excessive Kyphosis
Most Critical
Flexion vs. Kyphosis
Which one is Correct?
Correct?
What does this have to do
with Ergonomics?
EVERYTHING!
It’s affects how we work
It’s affects how we sit
It can explain why
the “Ergonomic”
products and
processes we are
choosing don’t seem
to help
Flexion vs. Kyphosis
How do these conditions affect our sitting posture?
How it’s supposed to work
How it actually works
Tip a glass of water and it will stay
level… The same with your head.
Keeping a “Level” Head
The Flexion Sitting Posture
The kyphosis Sitting Posture
The Kyphosis Sitting Posture
POP QUIZ
What does the
“ergonomist” see?
Keyboard tray
Arm position
Monitor height
Monitor distance??
Lumbar support
What will the “Athletic
Trainer” also notice?
Excessive thoracic kyphosis
Excessive forward head
position
Neck extension
A Solution!
TODAY ONLY!
For a small down payment on
your credit card…
• 3 postural conditioning exercises (not stretches)
▫ Specific and most effective for these conditions
▫ Simple to perform every 30 minutes
▫ Can minimize continued tissue breakdown and
restore the tissue healing processes
▫ Empowers the employee, make them an active
participant for their own health and safety.
▫ Will transform a life from chronic pain to one of
hope and fulfillment
▫ Saves a lot of frustration trying to find the right
chair for each employee.. SAVES $$$$
Sitting Cats & Dogs
Sitting Chair Twist
Sitting Overhead Extension
Group Micro Breaks
Group Micro Breaks
What to look for in an “Ergonomic”
chair
Seating Recommendations
Quality material, affordable, warranty
Can accommodate the 5% female and 95% male
Adjustable seat pan length (seat slider)
Adjustable chair height
Adjustable arm rests (height and width)
Adjustable back rest (independent of seat pan) not
just lumbar support
Can accommodate an upright sitting posture
Adjustable seat pan tilt (independent of Back rest)
Positive and negative tilt (infinite)
“Red Flag” Warnings
The mouse and
keyboard
The Mouse
Microsoft PS2(Dell)
“Standard Dell” Mouse
Contour Roller Mouse
“This optimal work zone corrects posture and prevents
injury. “
The “Ergonomic” Keyboard
Google: The History of the Keyboard as a User Interface
http://w.tf/~fool/cs/sts331/keyboard.html
Standard and Natural Keyboard
Split keyboard Attempt
Hand Tools
Most working tasks
• 3 postural conditioning exercises
▫ Specific and most effective for this wrist condition
▫ Simple to perform every 30 minutes
▫ Can minimize continued tissue breakdown and
restore the tissue healing processes
▫ Empowers the employee, provides ownership to
their own health and safety.
▫ Will transform a life from chronic pain to one of
hope and fulfillment
▫ Saves a lot of frustration trying to find the right
product for each employee.. SAVES $$$$
Wrist Flexion Tendon Glides
Wrist Extension Tendon Glides
Radial Deviation Exercise
What have we learned
• Implement specific health and safety procedures
and ensure that each part of the system is
congruent with the company’s goals.
• Provide the necessary resources to achieve your
health and safety goals, not just products.
• Begin to understand the “human” factor in
workstation assessments and look past the
marketing materials for what will be most
effective.
• DO CATS & DOGS EVERY 30 Minutes!
Questions?
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“Ergonomic” cases and “Red Flag Warnings”

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