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Principles of

musculo-skeletal

dysfunction

 

THE EPIDEMIC

There's an absolute epidemic of musculo-skeletal dysfunction in our workplaces.

 

For a lot of people it happens because their muscles aren't strong enough or flexible enough to keep their skeleton in correct alignment. If anything it's due to lifestyle neglect. It's got nothing to do with work.

 

However, work frequently gets the blame, mainly due to neglect in implementing sensible occupational health and fitness procedures but also because it's usually a big, soft, slow moving target. You can read more about the fallacy of post hoc ergo propter hoc (after this therefore because of this) and other swifties by clicking here.

 

So what can you do about it?

There are (at least) two issues key issues to you to deal with.

1.

 You want your staff member to get better in the shortest possible time. You have a concern for their well-being, your productivity and your insurance premiums.

 

  

2.

 You don't want work to pay for it if work didn't cause the problem in the first place.

 

 

What can I do for you?

What I can do is to provide you, the employer, your staff member and your insurer with an opinion as to who's responsible for the dysfunction. Then it's  up to the three of you to work out what you do with the information.

 

OCCUPATIONAL HEALTH AND FITNESS - a two-way street

I hold to the belief that people have a responsibility to come to work in such a physical condition as they can do their job without suffering from a musculo-skeletal  breakdown. The right to a fair and reasonable workers' compensation insurance scheme is attended by a responsibility to keep ourselves fit and healthy to the best of our ability.

 

From my assessments and audits it's clear than many people are not in sufficient condition to sit down and tap a key board, or do simple filing and maneuvering tasks without getting a crook back, stiff neck, the 'cold' shoulder or RSI.

 

By the same token, I also hold the belief that it is in the interest of employers to do whatever it takes to educate and inform their staff about the causes of musculo-skeletal dysfunction, to measure the risk and put in train strategies to minimize it.

 

There is a high level of ignorance in our community and in our workplaces about we all need to do to keep ourselves fit and healthy enough to do even what appears to be even the most undemanding of jobs.

 

Don't believe me. Read some of these reports.

 

REWARD GOOD BEHAVIOUR NOT BAD

I even go so far as the encourage employers to reward people who are in good physical condition. Why? Because it pays in the long run - lower rates of absenteeism, presenteeism and workers' compensation.

 

I'm a physical educator and over the years I've developed a certain degree of skill for sniffing out some of the more obvious causes of crook backs, stiff necks and 'cold' shoulders. Not all, just some.

 

The usual culprits - tight calves, hamstrings and buttocks and weak abdominal, back, neck and shoulder muscles.

 

By taking a dysfunctional employee through the Musculo-skeletal Risk Factor Profile and doing a few diagnostic tests, I can provide you with a second opinion as to the real cause of the dysfunction and what the employee can do to fix it up; after all, it's a big ask expecting to get better by having someone do something to you - sooner of later you have to do something to yourself.

 

Here's what I do

1.

 Take people through the Musculo-skeletal Risk Factor profile - see below.

 

  

2.

 Spend time putting them into exercise positions and seeing which muscles are tight and (in all probability) pulling bones out of alignment. In effect I do my best to work out the cause of the problem - and it usually is not located at the site of the pain.

 

  

3.

 Teach them some of the key exercises they need to do to several times a day get themselves back in alignment.

 

  

4.

 Provide them with a recommended list of modalities and things to do during the day to speed up the rehab process.

 

  

5.

Introduce them to the Formula 1 Rehabilitation concept. Just as there is a spin off from Formula 1 motor racing to the development of cars for regular folks, so there is a spin off from sports medicine technology to what regular folks can do to speed up the rehab process

I frequently see people who have done less in a year than an elite athlete will do in a week to fix themselves up. You wouldn't wish that on anyone.

 

  

6.

 Write a report for the employee, the employer and the insurer.

 

 

CONCLUSION

It would be good to find out early on that your organisation didn't have to compensate someone for a dysfunction that wasn't caused by work in the first place. It was caused by lifestyle neglect.  That might save your organisation  a lot of pain.

 

Your employees might also save themselves a lot of pain by spending a few hours a day doing some of the key exercises they need to do to get their skeleton back in alignment.

 

Read more by clicking through to From Injury to Dysfunction.

OCCUPATIONAL HEALTH AND FITNESS

You can read more about the place of occupational health and fitness within occupational health and safety by clicking here.

 

 

OCCUPATIONAL HEALTH AND FITNESS AUDIT

Click here to view some sample results of an occupational health and fitness audit.

 

THE FIRST TWO LAWS OF OCCUPATIONAL HEALTH AND FITNESS

Remember, the first law of occupational health and fitness is measure the risk. The second law? Do something about it.

 

You can save your organisation more than a fist full of dollars if you conduct an occupational health and fitness audit and then put in train health and fitness programs to lower the risk.

MUSCULO-SKELETAL RISK FACTOR PROFILE

Print off the Musculo-skeletal Risk Factor Profile below , fill it in and let me know what score you got. I'll tell you what sort of shape you're in and give you an OH&F risk rating.

 

MIND AND BODY PROFILE

While you're at it fill in the Mind and Body Profile below as well. It's  frequently the case that musculo-skeletal dysfunction is just one of many dysfunctions that a person is coping with. They're just not in good shape.

John Miller

 

THE MUSCULO-SKELETAL RISK FACTOR PROFILE

Give yourself a score out of ten, appropriate for your performance on each of  the ten questions below. A good score is a high score. A poor score is a low score.

 

        

1.

 Current musculo-skeletal condition

How would you rate the current condition of your musculo-skeletal system?

      

 

0

1

2

3

4

5

6

7

8

9

10

 

 

  

 

        

2.

 How old are you?

There can be a bit of wear and tear as we get older.

      

 

 >75 <75

<70

<65

<60

<55

<50

<45

<40

<35

<30

      

 

0

1

2

3

4

5

6

7

8

9

10

      

 

                            

3.

 Body composition

Are you carrying a lot of extra fat around your body? Whilst the best way of measuring how fat you are is using scales which also measure your percent body fat (we recommend Tanita scales which are available from sports stores and chemists), on this survey, make an estimate of how many kilograms you are over your ideal weight.

Kilograms over ideal weight ......

      

 

>20

<20

<18

<16

<14

<12

<10

<8

<6

<4

<2

 

xx

  

 

0

1

2

3

4

5

6

7

8

9

10

      

 

                            

4.

Abdominal strength

How many situps can you do in 30 seconds. Lie down on your back with feet flat, knees bent at 90 degrees and arms outstretched on your thighs. Sit up to touch the bottom of your knee caps. Don’t count those situps where your fingers can’t reach the bottom of your knee caps or your feet lift off the ground.    No. ……..

      

 

 <3 3

5

7

10

13

15

17

20

23

<25

      
 

0

1

2

3

4

5

6

7

8

9

10

      
  xxxxxxxxxxxxxxxxx

5.
Upper body strength

How many pressups can you do in 30 seconds; women on the knees and men on the toes. For women make sure your knees, bottom and shoulders are in a straight line; ie your backside shouldn’t be sticking up in the air. Don’t count those pressups where the body flops onto the floor. No. ……..

     

    

 

<3

3

5

7

10

13

15

17

20

23

>25

x

x

  
 

0

1

2

3

4

5

6

7

8

9

10

      
                             
6. Flexibility

In a sitting position, with legs outstretched in front of you, see how far down past your toes you can reach with your fingers. Keep your knees straight. Score 4 if you can get your fingers to your toes (T), 5 for the first knuckle, 6 for the second and 7 if you can get to the palms (P). Score 10 if you can get your wrists past your toes (W) and 8

 
  Can't touch toes F     P     W  

x

  
  0 4 5 6 7 8 9 10      
                       

7.

Functional mobility

How many times can you sit down and stand up in 30 seconds. Start standing up with legs straight. Sit down on the floor (legs straight out) and stand up. No. ……..

              
 

0

1

2

3

4

5

6

7

8

9

10+

 

 

  
 

0

1

2

3

4

5

6

7

8

9

10

      
   

8.

 Shoulder function - wall test - a subjective assessment
 

Stand with your back to the wall. Place your hands in the surrender position with elbows, forearms, wrists and fingers flat back on the wall. Score 10 if you can do this with ease. Score low if you have difficulty getting into this position or lower still if your elbows and wrists are a long way from the wall.

      
  Dreadful and painful             Wrists can't touch                 Easy
 

0

1

2

3

4

5

6

7

8

9

10+

 

 

  
 

0

1

2

3

4

5

6

7

8

9

10

      
                             

9.

Dominant hand grip strength

Low levels of finger, hand and lower arm strength are indicators of risk of musculo-skeletal dysfunction for people in the keyboarding professions. Using the grip dynamometer, record the best of two trials with your dominant hand. Start with your arm in a vertical position close to your thigh. Highest score .......
 

M

22

25

28

31

34

37

40

45

50

55

 

 

  
 

W

20

21

23

26

29

32

35

39

41

45

      
 

 

1

2

3

4

5

6

7

8

9

10

      
                             

10.

Non-dominant hand grip strength

Using the grip dynamometer, record the best of two trials with your non-dominant hand. Start with your arm in a vertical position close to your thigh. Highest score ......
 

M

22

25

28

31

34

37

40

45

50

55

 

 

  
  W

20

21

23

26

29

32

35

39

41

45

      
 

0

1

2

3

4

5

6

7

8

9

10

      
                             
                 

TOTAL

      

 

YOUR RISK OF MUSCULO-SKELETAL FUNCTION IS ASSESSED AS:

 

●   Low if you scored over 70

●   Medium if you scored between 50 and 70

●   High if you scored less than 50

 

If you scored less than 50 we suggest you attend the Crookback Clinic - or a Pontius Pilates, Body Balance, Pump or Complete Workout program three times a week. Do that and you'll get your musculo-skeletal system back into very good shape in a few months. You'll feel the difference after a couple of weeks.

 

If you want to take a look at some sample scores on this profile go to Musculo-skeletal Risk Factor Profile Results.

THE MIND AND BODY PROFILE

                                                                                 None       Not       A fair     A lot

                                                                                               much        bit

 

   1.   Headaches

   2.   Migraines

   3.   Lack of energy and vitality

   4.   Candida – jock itch, thrush, tine, furry tongue

   5.   Poor sleep

   6.   Snoring and/or sleep apnea

   7.   Crook back, sore shoulders, stiff neck, RSI …

   8.   Frequent colds, flu and sinus

   9.   Unsettled stomach, reflux

  10.   Irritable bowel, constipation or diarrhoea

  11.   Overweight

  12.   Shortness of breath from asthma

  13.   Low level of aerobic fitness

  14.   Chest pain, palpitations

  15.    Rashes, zits, skin outbreaks, psoriasis ...

  16.   Mouth ulcers, cold sores ...

  17.   Elevated blood pressure (score 10 on tablets)

  18    Reduced libido

  19.   Shakes, nervous tics and mannerisms

  20.   Grinding teeth

  21.   Drinking too much alcohol

  22.   Smoking too much (1 point per  cigarette/day)

  23.   Drinking too much caffeine

  24.   Anxious about life in general

  25.   Insecure &/or apprehensive

  26.   Depressed &/or sad (score 10 if on medication)

  27.   In the wrong job for now

  28.   Under appreciated work

  29.   Under appreciated at home

  30.   Unhappy with family (and romantic) life

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

   0   1   2   3   4   5   6   7   8   9  10

     

 

 TOTAL

 

 

The score of a normal, fit and healthy human being is less than 20

Higher scores are symptomatic of dysfunction of one or more body systems.

People with high levels of stress usually score well over 100.

For people with a score of more than 80, the ‘background noise’ of their life is becoming louder and louder. It is hard to concentrate on your work when body systems are dysfunctional.