miller Health Occupational Health and Fitness

Index

104. NHAV MARCH 2008

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NEWSLETTER

FACT SHEETS

John Miller conducted a Health Management program for The Group in March 2008.

20 people completed the following profiles: -

■ Health, Fitness and Wellbeing

■ Musculo-skeletal risk factor

The results are presented in graphic format, with commentary.

Click here to read what the assessments are all about

HEALTH, FITNESS AND WELLBEING PROFILE

The Health, Fitness and Wellbeing profile provides people with a very good idea of how well the various systems of the body are functioning, particularly the

• the mind

• autonomic nervous system

• immune system

• digestive system

• circulatory system

• elimination system

• musculo-skeletal system.

	Symptom	None		Not much			A fair bit			A lot
1.	Headaches	0	1	2	3	4	5	6	7	8	9	10
2.	Migraines	0	1	2	3	4	5	6	7	8	9	10
3.	Lack of energy and vitality	0	1	2	3	4	5	6	7	8	9	10
4.	Candida - jock itch, thrush, tinea ...	0	1	2	3	4	5	6	7	8	9	10
5.	Poor sleep. If on tablets score 10	0	1	2	3	4	5	6	7	8	9	10
6.	Snoring &/or sleep apnoea.	0	1	2	3	4	5	6	7	8	9	10
7.	Crook back, sore shoulders RSI ...	0	1	2	3	4	5	6	7	8	9	10
8.	Frequent colds, flu, sinus	0	1	2	3	4	5	6	7	8	9	10
9.	Unsettled stomach, reflux	0	1	2	3	4	5	6	7	8	9	10
10.	Irritable bowel, constipation, trots ...	0	1	2	3	4	5	6	7	8	9	10
11.	Overweight - 1 point for every 2Kg	0	1	2	3	4	5	6	7	8	9	10
12.	Asthma	0	1	2	3	4	5	6	7	8	9	10
13.	Low level of aerobic fitness	0	1	2	3	4	5	6	7	8	9	10
14.	Chest pain, palpitations	0	1	2	3	4	5	6	7	8	9	10
15.	Rashes, itchiness, psoriasis, zits	0	1	2	3	4	5	6	7	8	9	10
16.	Mouth ulcers, cold sores	0	1	2	3	4	5	6	7	8	9	10
17.	Elevated blood pressure. Score 0 on pills	0	1	2	3	4	5	6	7	8	9	10
18.	Reduced libido	0	1	2	3	4	5	6	7	8	9	10
19.	Shakes, nervous ticks, mannerisms	0	1	2	3	4	5	6	7	8	9	10
20.	Grinding teeth	0	1	2	3	4	5	6	7	8	9	10
21.	Alcoholic drinks per day (2 pts/drink)	0	1	2	3	4	5	6	7	8	9	10
22.	Smoking. (1 pt/cigarette/day)	0	1	2	3	4	5	6	7	8	9	10
23.	Caffeine (1 pt/cup per day)	0	1	2	3	4	5	6	7	8	9	10
24.	Anxious about life in general	0	1	2	3	4	5	6	7	8	9	10
25.	Insecure/apprehensive about the future	0	1	2	3	4	5	6	7	8	9	10
26.	Sad or depressed (On medication, score 0)	0	1	2	3	4	5	6	7	8	9	10
27.	In wrong job for now	0	1	2	3	4	5	6	7	8	9	10
28.	Under-appreciated at work	0	1	2	3	4	5	6	7	8	9	10
29.	Under-appreciated at home	0	1	2	3	4	5	6	7	8	9	10
30.	Unhappy with family and romantic life	0	1	2	3	4	5	6	7	8	9	10

Score

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.

We know a fit and healthy group when we see the majority of scores below 40. This was not the case with this group. By and large higher scores are usually a reflection of

• low levels of fitness

• an inability to deal with what life and work are serving up to people.

Remember, it is not what happens, but how we deal with what happens that determines our level of stress.

Classification of average scores: Excellent - less than 40. Good - 41 - 50. Fair 51-60. Poor - over 60.

This profile is described as poor, though not nearly as poor as many we see. The average score was 62. Anyone scoring more than 80 is putting up with a lot of 'background noise'.

HEALTH CLIMATE SURVEY

Based on scores received in the Health, Fitness and Wellbeing profile we've compiled a Health Climate Survey. Scores on each item have ranked - the higher the score the worse the problem. We added the scores for each item. The results appear in the table below.

Symptoms/ issues / concerns	% of people scoring over 5
Musculo-skeletal dysfunction	75
Snoring, sleep apnoea	50
Lack of Energy	40
Overweight	35
Poor sleep	25
Frequent colds, flu, sinus	20
Low level of fitness	20
High caffeine intake	20
Under appreciated at work	20
Reflux, unsettled stomach	15
Itchy, rashes, psoriasis	15
Elevated cholesterol	15
Alcohol	15
Smoking	15	3
Anxious	15
Unhappy with financial status	15
Headaches	10
Furry tongue, thrush, tinea,	10
Irritable bowel, constipation etc	10
Unhappy family life	10
Shortness of breath from asthma	5
Mouth ulcers	5
Elevated blood pressure	5	0
Elevated glucose	5
Grinding teeth	5
Wrong job	5
Work-life balance	5
Chest pain, palpitations	0
Shakes, nervous mannerisms	0
Depressed	0	0

We registered those scores of 5 and over as being a symptom, issue or concern, the most pressing of which have been highlighted. Compared with other groups we've surveyed, there were not a large number of issues. I'd rate the top 4 as the key issues to be addressed. Basically they're fitness issues - aerobic fitness and flexibility.

Perception

Based on people's perception (where they gave a particular symptom a score of 5 or more) the key issues are highlighted in the table above. Below are some comments about the most frequent, high-rating scores in the people we survey.

•	Musculo-skeletal dysfunction A high proportion of staff scored more than 5 for musculo-skeletal dysfunction. Generally speaking, musculo-skeletal dysfunction goes with low levels of strength and flexibility. However, on this occasion, whilst participants had good levels of strength their bodies were out of alignment, enough to cause pain in various muscles, tendons and ligaments. For most of them, poor function can be restored to good by persistently doing the right flexibility exercises. Just about everyone who took part in the session said they were happy to take part in a 10 minute strength and flexibility session during the day and/or attend a 40 minute strength and flexibility training program, twice a week in company time until they were better. This was a very encouraging response to the session. The strength scores were also very encouraging. This group is not in bad shape and certainly redeemable.

•	Snoring The recipe for a good snore is to be male, over 40 years of age, 20 kilos of more over weight, stressed out of your brain, have a few drinks and sleep on your back. It's a good measure of metabolic dysfunction. It doesn't get better by wearing a gas mask or having your sleeping partner dig you in the ribs! It's telling you to get fit and lose weight. This is not rocket science.

•	Over-weight Whilst 35% of people scored themselves as being 10 or more Kg over weight, compared with other groups we survey this group did not have many people more than 15Kg over weight. In general, as a group they looked in reasonable shape. Having extra fat around your body is a symptom of metabolic dysfunction and relates to high energy diets and low energy lifestyles. It's suggestive of elevated levels of insulin floating around the body, which is a precursor of all manner of body system dysfunctions - elevated blood pressure, elevated cholesterol, elevated blood glucose. The recommendation, 35% of people need to get out and exercise at lunch time and eat from the top of the Hourglass. It's stimulated by eating too much high density food - too much of fat and too much of the garbohydrates - and too little vigorous physical activity. Plus, you can't satisfy the inner hunger by eating. Find out why you're eating too much. A good counselor could help.

•	Poor Sleep A lot of people in our community don't sleep well. Some are anxious - the first casualty of anxiety is poor sleep. Some aren't physically tired. People who are physically fit and physically tired sleep like logs. Some want to sleep too long. Some need to 'wake up to themselves', get up and get on with life... To read more about it click here.

•	Colds and flu Symptom of a depressed immune system, one which can be strengthened by eating from the top of the Hourglass and getting plenty of aerobic exercise.

•	Fitness As a group, people looked in pretty good shape. 20% of staff indicated they weren't particularly fit. We recommend staff be given the greatest encouragement to leave the office at lunch time and get in some physical activity. One organisation we work for gives staff an hour and a half off for lunch, providing people exercise during that time. Fitness has a significant bearing on the scores for low levels of energy, poor sleep, snoring, depression and headaches. Very few people got fitter in a surgery or pharmacy and I don't r4ecall anyone getting fitter by having someone do something to them!

•	High caffeine intake Drinking too much coffee is an easy trap to fall into. It's a drug. It can become a habit. Maybe a couple of cups a day, before lunch is about a reasonable dosage. As your mum used to say when you said you were thirsty, 'Go and have a drink of water.' Check the colour of your urine to see whether you are getting enough water. If it's clear you're in the clear. If it's dark yellow you're dehydrated. Drink more water. I recommend urine color charts be posted up in every urinal and water closet.

•	Under-appreciation at work 20% of people said they were under-appreciated at work. My research indicates that people who don't have a clear picture of the job they want to do and aren't in the right job for now score poorly on this question. This is a course for concern and managers need to take note and put in train a series of measures to improve this score in say, 3 months time. This factor certainly needs addressing in more detail and re-evaluation.

•	Headaches Caused by - a diet high in wheat flour and sugar - caffeine withdrawal - lack of oxygen getting to the head - a sluggish elimination system - a head out of alignment due to tight and weak muscles - beating your head against a brick wall - ...

•	Blood pressure No-one was on medication. This is a goods result, not one we see very often. Blood pressure is a symptom of body system dysfunction relating directly to - lack of aerobic fitness - being over-weight - being stressed.

•	Rashes and itchiness Can be caused by a range of things: - - a body that's stressed producing too much cortisol - a toxic diet - a sluggish elimination system - itching to get away from something - ...

•	Being in the wrong job There is a high and positive correlation between people being in the wrong job and people saying they are under-appreciated at work. There is evidence that a career development program may be needed in this workplace and/or people given strong encouragement to have a few sessions with the employee assistance program people - or me!

•	Diet A diet high in flour and sugar and low in fruit, vegetables and fibre leads to irritable and bowel, reflux.

•	Depression and anxiety There is an epidemic of depression in our community and we encourage all organisations to target depression. No-one scored higher than 5 on the depression question. No-one was on anti-depressant medication. This is good news. It's unusual in this day and age. There is an epidemic of depression in our community. This epidemic relates to poor health generally and will, of course increase at the same rate as the epidemic of all other body system dysfunctions. The mind is just another part of the human ecosystem - an ecosystem under threat from low levels of health, fitness and wellbeing. It is important that people who are depressed or a risk of becoming depressed be encouraged to have regular counseling - through the EAP or other counselors - and be given encouragement to do the things that unstressed people. In particular it means encouraging people to exercise at lunch time. It means taking their holidays, eating wisely, not working too many hours and ‘getting a life’. Stress, anxiety and depression can be a high price to pay for achievement. As the population becomes less physically active, eats diets high in flour and sugar and low in omega 3 fats, selenium and B group vitamins, lacks resilience, drinks too much alcohol and caffeine, has difficulty managing the internal and external conversations going on inside their head and/or live lives devoid of meaning and purpose, we can expect rates of anxiety and depression to increase. Whilst not wishing to make light of the true ‘black dog’ of clinical depression, for some people the symptoms of stress, unhappiness, sadness, grief, hopelessness, disappointment, despair, vacuity, anger and anxiety are being treated as if they were the symptoms of clinical depression. The best book about depression I've read, and what you can do about it, and one that I recommend highly is by psychiatrist, David Servan-Schreiber, Healing Without Freud or Prozac.

•	Smoking 3 people smoked. Now lets move heaven and earth to assist these people to give it away altogether.

MUSCULO-SKELETAL RISK FACTOR

Our musculo-skeletal risk factor profile looked at a range of parameters including mobility, strength and flexibility and whether people are training to keep themselves strong and flexible.

The musculo-skeletal risk factor profile is comprised of a mix of 7 objective and 3 subjective assessments.

• Current musculo-skeletal condition

• Abdominal strength test

• Upper body strength test

• Flexibility

• Functional mobility – the ability to sit down and stand up with ease.

• Shoulder function

• Dominant hand grip

• Non-dominant hand grip

• Flexibility training behaviour

• Strength training behaviour

A score of 70% is attainable by those who have a regular and systematic training program.

Those scoring less than 70 are not doing sufficient in the way of strength and flexibility exercises. They are therefore exposing themselves to a high risk of musculo-skeletal dysfunction. (It would be bizarre for a workplace to offer to pay the rehabilitation costs of people who were not keeping themselves strong enough or flexible enough to do their job without succumbing to musculo-skeletal dysfunction, wouldn't it?)

This risk to The Organisation is much higher than the risk we see in other organisations. This is a poor result.


Not a particularly good result. Those scoring less the 6 need to be required attend a prehab/rehab program, for their own benefit and that of the organisation.		This is an excellent result. I don't think we've surveyed a group where everyone passed the sit-up test.

With only 3 exceptions, this is an excellent result. Shoulder and arm strength is good.		This is a poor result. 6 people couldn't touch their toes; most had difficulty. This indicates that the muscles designed to keep the body in alignment are in fact pulling the body out of alignment. Poor flexibility, not a lack of strength is why people are out of alignment. Redeemable.

With 3 exceptions, this is a good result. These 3 people have lost of lot of mobility and function.		This is a poor result. There is a lot of shoulder dysfunction in this group due to tight calves, hamstring and buttock muscles and tight shoulder muscles. Redeemable.

Grip strength was assessed as being good.

In the groups we survey is usually the case that few people have a regular strength and flexibility program. With this group a much higher proportion of staff were doing some training that other groups. Nevertheless I believe the organisation needs to put in train a regular and systematic training program, on site, that includes 1. specialist prehab and rehab sessions for those at serious risk and those already dysfunctional and on compo 2. daily strength and flexibility sessions in the workplace.

Average score: 70. This is one of the best results we have seen. But whilst people are strong, they are not flexible and as a result a lot of bodies have been pulled out of alignment. There is a strong case of the organisation to implement an obligatory strength and flexibility program for those who scored less than 60 in this profile.

Lack of strength and flexibility is something that all organisations to take seriously and monitor carefully and put in place an organisation-wide strategy to improve musculo-skeletal function. By far and away a high proportion of people we survey do not have a strength and flexibility program. As a result they are getting weaker and tighter by the week, thereby exposing themselves and the organisation to risk.

When push comes to shove and people become dysfunctional, it will be The Organisation that ends up paying the high cost of an avoidable musculo-skeletal complaint. Click here to read the article from injury to dysfunction. Click here to read about swifties and fallacies.

In our opinion musculo-skeletal dysfunction caused by lack of a regular and systematic strength and flexibility program cannot be classified as an injury. Responsibility for musculo-skeletal dysfunction needs to be sheeted home to individual employees, though it’s unlikely to happen without the establishment of a culture within the organisation that supports, values and understands strength and flexibility.

We recommend a range of strength and flexibility classes that are readily available Australia-wide:

•	Posture and Flexibility
•	Yoga
•	Crookback Clinic
•	Tai Chi
•	Pontius Pilates

The Organisation would place itself in the forefront of OH&S practice if it took the musculo-skeletal risk seriously, moved heaven and earth to educate all staff about this risk and encourage them to take part in a regular strength and flexibility program. Maybe The Organisation and its worker's compensation insurer could invest in a pilot program to increase staff strength and flexibility!

The lack of strength and flexibility training coupled with poor abdominal strength, upper body strength, flexibility, shoulder function and grip strength is a cause for concern and needs the attention of individual staff and managers.

RECOMMENDATION

We strongly recommend that the people who are in current poor musculo-skeletal condition, and who lack abdominal strength, upper body strength, flexibility, shoulder function and functional mobility, in particular those who scored less than 60 on the profile, be obligated to attend regular, in-house strength and flexibility classes.

The pressure on the organisation's workers' compensation costs is such that to do otherwise would, in our opinion be to abrogate a responsibility for the prudent management of the organisation's finances.

See the generic list of recommendations that cover all our profiles.