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A 2001 study by the Mayo
Clinic found heavy computer users (up to
seven hours a day) had the same rate of
carpal tunnel as the general population.
Harvard University headlined a 2005 press
release “Computer use deleted as carpal
tunnel syndrome cause.”
“Clearly, if keyboarding activities were a
significant risk for carpal tunnel, we
should have seen, over the last ten to 15
years, an explosion of cases,” said Dr. Kurt
Hegmann, director, the Rocky Mountain Center
for Occupational & Environmental Health. “If
keyboarding were a risk, it cannot be a
strong factor.”
Blue-collar workers, especially those doing
assembly-line work such as sewing, cleaning
and meat or poultry packing, have a far
greater incidence of carpal tunnel than
white-collar workers, according to Bureau of
Labor Statistics data.
That
doesn’t mean white-collar workers don’t get
carpal tunnel and related disorders. But it
may mean such disorders were over-diagnosed
when they were most in the news, resulting
in an artificially high number of cases by
the late 1990s. Most doctors have dropped
the term RSI, calling them “musculoskeletal
disorders” while government agencies like
“cumulative trauma disorders.”
Now,
some experts think some of those patients
had “referred pain” from trouble elsewhere,
such as the neck.
Excerpt from Associated
Press article on MSNBC March 4th 2008
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Anyone, regardless of whether they wield a
crow bar or have a cushy sit down job who
• can't do a situp or a
pressup
• can't touch their toes
• can't sit down on the floor
and stand up again
• can't get their hands flat
back against the wall while in the 'surrender' position
• can't sit up straight
• doesn't have a strength and flexibility
training program
• is 15Kg or more overweight
and blames their boss
for their crook back, stiff neck, ‘cold’ shoulder and 'limp' wrist is likely to be pulling a swiftie.
If you're an employer and you run a half decent musculo-skeletal risk management
program, that's the first swiftie you don't have to fall for.
What a good workplace musculo-skeletal
health program does is put in a
firewall between the personally
generated dysfunctions and the genuine work-related injuries.
The other swiftie people pull on their employers is based on the fallacy
of post hoc ergo propter hoc (after this therefore because of
this). In the world of rehab
and workers compensation it goes something like this.
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Someone gets a crook back (stiff neck, sore shoulders ...). |
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They go to the doctor. |
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Doctor sends them for an X-ray. |
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Doctor reads X-ray and says, 'Mate you've
popped a disc out.' Doctor doesn’t determine the cause of the dysfunction. (Doesn’t
and can’t because he or she hasn't got a clue what caused it. It just
happened out of the blue! Hello! |
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Doctor then asks 'Do you go to work?' |
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The bloke with the crook back says
'Yes.' |
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Doctor then says, 'Well, if you go to work
and you've got a crook back, then work must have caused it.'
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Doctor sends bloke down to Macquarie St for an
X-ray. Radiologist write back in Latin saying the bloke has
popped a disk. Radiologist doesn't give any hints as to what
caused the problem. Doesn't have a clue. Forgets to take a
photograph of the bloke in his bathers to see what's out of
alignment. Says it's not his job. |
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Bloke goes back to the doctor again.
Doctor pretends to understand Latin then
scribbles a note suggesting work buy
the person a $600 chair, give them a couple of months off, pay for a
gross of anti-inflammatory pills, a few rub downs, crunches
and electric shocks, none of which do anything to improve strength
and flexibility, lack of which was the original cause of the
dysfunction. |
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Work contacts rehab company and forks out $1,500
for an initial needs assessment, which, surprise, surprise,
parrots what the doctor's report has said. The bloke's
definitely got a crook back. |
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Work,
failing to realize that they haven't managed the risk of musculo-skeletal dysfunction within the organisation
at all well, cops it on the chin, agrees with what
the doctor and case manager say, signs the claim form and sends it off to the
insurer. |
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Person ends up getting the run-around
between doctor, case manager, OH&S supervisor, boss, physiotherapist,
massage therapist, chiropractor, chemist and counselor (because the
powers that be think he's going nuts). |
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No one tells the poor bloke with the crook back
that it will never get better until he starts to do something to
himself, like flexibility and strength exercises non-stop all
day. No-one points out that if he did what athletes do to get
better he'd be back on the job in a fortnight. But he's not
mad keen to get back to work is he? Despite a bit of
discomfort, this is the good life. He's getting paid to stay at
home lying on a couch. Hello! |
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Bloke with the crook back gets fatter and fatter
lolling around watching Days of Our Lives eating Delta Cremes
and waiting for the healing process to kick in. |
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It doesn't kick in so he starts feeling schidouse.
Doctor diagnoses condition as depression and gets him started on
a course of Prozac. |
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Everyone in the medical loop is
happy because they're all making money. Boss is very happy
because that's one less bludger he's got to put up with. Out of
sight, out of mind. |
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The insurer happily pays all the accounts, because it knows
they'll get their money back next year when they add another
50
Grand onto the employer's premium. |
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Back never gets better. |
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Bloke gets a payout and goes up to
Queensland and buys a lawn mowing franchise. Wife signs him up
for a gym membership. |
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Back gets better. Fresh air and
exercise appears to have stimulated a miraculous cure. Loses 15
Kg in the first 2 months. |
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Everyone's happy.
Employee happy. Back's better. Gold Coast
lifestyle just wonderful. XXXX tastes better by the week.
Employer happy; puffs chest out
because a problem has gone away (to Queensland) and their costs
are less than those of comparable organisations.
Doctor happy; patient gone away; hands
rubbed with glee due to extra fee that
was charged courtesy the compo system.
Physio, chiro, masseur and chemist all
happy. Money for jam banked and BAS statement all fixed up for another
quarter. |
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Insurer very happy - in expectation of
next year's premium increase; has
difficulty wiping jam off face.
Case
manager happy because a good result was achieved all round
and everyone else is happy. Problem
swept under the carpet. Reports
have been written up and filed away. Due process has been observed.
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Congratulations all round to the
non-participants. |
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Next customer is in the waiting room. |
In this day and age, if your not focused
on the health, fitness and wellbeing side of the OH&S equation, you're being taken for
a ride.
FROM REHAB TO PREHAB
Change your outlook on musculo-skeletal
dysfunctions within the workplace from rehab to prehab.
Just as staff expect to have access to
rehabilitation programs, it behooves organisations to implement
compulsory prehab programs for people at grave risk of musculo-skeletal
dysfunction.
As for the compulsion - it is doubtful
that anyone at great risk - and probably already experiencing pain and
discomfort would pass up the opportunity to get their musculo-skeletal
system back in good nick. They'll feel better.
I know that after attending the
CrookBack Clinic 99% of
people will willingly sign up for 10 minutes of exercises each day and
those in exceptionally poor nick a few longer sessions a week as well.
PRE-EMPLOYMENT FITNESS ASSESSMENT
A lot of organisations have a
pre-employment medical assessment. If they fog up the mirror when they
breathe on it the doctor gives them the nod!
One organisation I know who didn't screen
their employees, employed a 140Kg man who after 8 weeks slapped at DVT
claim on them. They lost and it cost them a fortune. You can screen out
people who are not physically suited to the job. All other things being
equal, it is reasonable to select the fitter and healthier person for
the job. If potential employees know that and they're keen to work for
your organisation, they'll train up. You want employees who will do
that; show's they're keen.
One bloke lied to us about his physical
condition before his aerobic fitness test. 2 laps into the test he
pulled up with a dickie knee and tried to blame us. Well you
wouldn't want this bloke pushing a clutch in 1000 times a week with a
pre-existing injury. A health examination would not have found that out.
There's more than one person we've
surveyed who lacked all shoulder and upper arm function. Tough to pull
on a steering wheel for long without putting in a claim.
But, it's not just the dysfunctions that
show up in the manual handling professions that you want to protect
yourself from, it's also the dysfunctions that show up in the sit down
professions.
If you want to see musculo-skeletal
dysfunction put your staff through a musculo-skeletal risk factor
assessment. Your eyes will roll through to the back of your neck when
you see the results. The people who lack the strength and flexibility to
sit up straight, regardless of the cost of the chair are legion.
And if you don't do these assessments on a
regular and systematic basis your workers compensation premiums are
going to go through the roof.
Click on the link to read more about the
musculo-skeletal risk factor profile.
Measure the risk before you employ people.
It will save you a fortune.
SO WHAT CAN YOU DO?
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First, set up a firewall between
the personally-generated body system dysfunctions and the
work-related injuries.
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Run
awareness seminars for all staff – attendance is not optional,
it’s obligatory. The seminar: -
The Crookback Clinic |
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Audit the risk of common body system dysfunctions, particularly
in those linked with physical fitness (including
musculo-skeletal) and stress.
Read our audit reports. |
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Train managers on their responsibility to manage the health
costs of their staff. |
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Get us to help train your OH&S staff to run in-house strength and flexibility
training programs for people at risk |
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Help you develop an occupational health and fitness manifesto |
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Institute a 10 minute a day strength and
flexibility training program |
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Work with you to develop a set of guidelines for OH&S staff,
medical practitioners, your insurer, case managers and rehab
providers to follow in the treatment of musculo-skeletal
dysfunction. Lack of suitable guidelines is costing
organisations a poultice. |
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Establish an effective
prehab
program that takes the focus of attention away from rehab. |
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Provide employees, employers and insurers with a
second opinion as to the cause of a particular musculo-skeletal
dysfunction. You can't rely on doctors. They don't have the
training to diagnose the cause of musculo-skeletal dysfunction. |
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Organise
pre-employment health
and fitness assessments. The medical exam isn't
sufficient to protect your organisation from people who are
going to slap a claim form on your desk within 6 months.
You need as fitness and
musculo-skeletal risk factor assessment. |
WRITE DOWN AND PUBLISH YOUR OHF&W
GOALS
The aim is to cut your workers'
compensation bill by 20% and to cut your absenteeism by 2 days per
person per year. On the presenteeism front, you're going to have a
measurably happier staff based on results of the Health, Fitness and
Wellbeing profile
and the Stress and Career Satisfaction profiles.
THE INVESTMENT
If you're going to make a dent in your
absenteeism, presenteeism and workers' compensation costs
you're going to have to spend some money.
How much? For starters - 10% of the money
you're currently spending on workers' compensation insurance and the
cost of 2 day's absenteeism across the organisation.
WHAT CAN MILLER HEALTH
DO FOR YOUR ORGANISATION?
1. We can assist you to
develop a musculo-skeletal health management system.
2. We can run the CrookBack
Clinic for all your staff.
3. We can provide you with an
audit report of your risk.
4. We can set up a regular
strength and flexibility training program for your staff.
THE CROOK BACK
EBOOK
Another thing we can do is to supply each
of your staff with a copy of the ebook, How to Fix Up a Crook Back.
Supplying it electronically makes it dirt
cheap. It includes the exercises people need to do to keep themselves in
good shape.
You can take a look at the book by
clicking
here.
Before you open it, read the instructions
and let your IT
staff know it is coming down the tube. Because it is
enveloped in an exe file, your gateway may presume it to have a virus
attached to it and block it out. To the best of my knowledge it doesn't
contain a virus and is safe to open.
John Miller
(02) 6288 7703
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