miller Health Occupational Health and Fitness

ACMJ. SEPTEMBER 2008

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

45 people, 21 men and 24 women took part in two CrookBack Clinics and one Seven Habits of Fit and Healthy people programs.

■ Everyone completed the Health, Fitness and Wellbeing profile

■ 36 people completed the Musculo-skeletal Risk Factor profile

■ 14 people completed the Career Satisfaction profile

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 including migraines	0	1	2	3	4	5	6	7	8	9	10
2.	Lack of energy and vitality	0	1	2	3	4	5	6	7	8	9	10
3.	Candida - jock itch, thrush, tinea ...	0	1	2	3	4	5	6	7	8	9	10
4.	Poor sleep. If on tablets score 10	0	1	2	3	4	5	6	7	8	9	10
5.	Snoring &/or sleep apnoea. Score 10 if using a mask	0	1	2	3	4	5	6	7	8	9	10
6.	Crook back, stiff neck, sore shoulders, dicky knee RSI ...	0	1	2	3	4	5	6	7	8	9	10
7.	Frequent colds, flu, sinus	0	1	2	3	4	5	6	7	8	9	10
8.	Unsettled stomach, reflux (Score 10 if on medication)	0	1	2	3	4	5	6	7	8	9	10
9.	Overweight - 1 point for every 2Kg	0	1	2	3	4	5	6	7	8	9	10
10.	Irritable bowel, constipation	0	1	2	3	4	5	6	7	8	9	10
11.	Asthma	0	1	2	3	4	5	6	7	8	9	10
12.	Low level of aerobic fitness	0	1	2	3	4	5	6	7	8	9	10
13.	Chest pain, palpitations	0	1	2	3	4	5	6	7	8	9	10
14.	Rashes, itchiness, skin outbreaks, psoriasis ...	0	1	2	3	4	5	6	7	8	9	10
15.	Mouth ulcers, cold sores	0	1	2	3	4	5	6	7	8	9	10
16.	Elevated blood pressure. Score 0 on pills	0	1	2	3	4	5	6	7	8	9	10
17.	Elevated blood cholesterol. Score o if on pills	0	1	2	3	4	5	6	7	8	9	10
18.	Elevated blood glucose. Score 0 if on medication	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, insecure, apprehensive	0	1	2	3	4	5	6	7	8	9	10
25.	Sad or depressed (On medication, score 0)	0	1	2	3	4	5	6	7	8	9	10
26.	In wrong job for now	0	1	2	3	4	5	6	7	8	9	10
27.	Under-appreciated at work	0	1	2	3	4	5	6	7	8	9	10
28.	Have poor work/life balance	0	1	2	3	4	5	6	7	8	9	10
29.	Unhappy with family life	0	1	2	3	4	5	6	7	8	9	10
30.	Unhappy with financial status	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. The average score was 88. 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
	Crook back, sore shoulders	84
	Low level of fitness	56
	Lack of Energy	53
	Overweight	53
	Poor sleep	44
	Under appreciated at work	44
	Snoring, sleep apnoea	40
	Poor work-life balance	38
	Financial status	33
	Elevated blood pressure	31
	Elevated cholesterol	31
	Headaches	29
	Wrong job	29
	Alcohol	27
	Anxious	27
	Frequent colds, flu, sinus	24
	Grinding teeth	24
	Caffeine	24
	Depressed	24
	Irritable bowel, constipation etc	20
	Unhappy family life	20
	Itchy, rashes, psoriasis	16
	Candida	13
	Reflux, unsettled stomach	13
	Chest pain, palpitations	11
	Smoking	11
	Shortness of breath from asthma	9
	Shakes, nervous mannerisms	9
	Mouth ulcers	7
	Elevated glucose	4

We registered those scores of 5 and over as being a symptom, issue or concern, the most pressing of which have been highlighted.

Perception

Based on people's perception (where they gave a particular symptom a score of 5 or more, and backed up by objective scores) the key issues are

•	Musculo-skeletal dysfunction 84% of people said they had some sort of musculo-skeletal dysfunction. (Admittedly the people who came to the session were probably people with musculo-skeletal dysfunctions. The audience was well targeted.) Musculo-skeletal dysfunction goes with low levels of strength and flexibility. Those are greatest risk need encouragement to attend a strength and flexibility training program several times a week.

•	Obesity 53% of people said they were more than 10Kg over weight. It's 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. Obesity is a major cause of a lack of mobility, which in turn severely compromises musculo-skeletal function. The recommendation, 53% of people need to get out and exercise at lunch time and eat from the top of the Hourglass.

•	Snoring 40% of people said they snored loudly enough for it to be a problem. The recipe for a good snore is to be male, be unfit and at least 20Kg over weight, to have high blood pressure, have a few drinks every night, be stressed out of their brain and sleep on their back.

•	Lack of energy 53% of people said they lacked energy. Low levels of energy come from many sources, including: - - lack of a good aerobic fitness training program - a diet high in wheat flour and sugar - dullness - ...

•	Fitness 56% said they were unfit. 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.

•	Headaches 29% of people said they regularly get headaches. Headaches are 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 - ...

•	Under-appreciation at work 44% said they were under-appreciated at work. Compared with other groups this is a poor result. Whilst it is not a great cause for concern, 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.

•	Being in the wrong job 29% of people said they were in the wrong job. There is usually a high and positive correlation between people being in the wrong job and people saying they are under-appreciated at work, this was less apparent with this group. Nevertheless with close to a third of the workforce saying they're in the wrong job and 44% saying they are under=-appreciated at work there are some management challenges that need to be faced.

•	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. 11 people gave themselves a score of 5 or more on the depression question, indicating risk that needs to be dealt with. 5 people were on anti-depressant medication. Compared with other groups this is a very poor result. There is a significant core of depression that relates to poor health generally. All body systems are connected. The epidemic of depression will continue to escalate at the same rate as the epidemic of all other body system dysfunctions. People need to be given encouragement to exercise regularly and vigorous, eat less flour and sugar and imbibe less of the culturally chemicals - particularly nicotine, caffeine and alcohol. Because of the relationship of depression to fitness and diet there is a chance that some people have been misdiagnosed. Some aspects of depression relate to psychologically generated issues. It is important that these people be encouraged to have regular counselling - through the EAP or other counsellors - 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.

•	Blood pressure 8 people indicated they were on blood pressure medication. This is a high proportion of people. Blood pressure is a symptom of body system dysfunction relating directly to - lack of aerobic fitness - being over weight - being stressed.

•	Smoking There were 5 confirmed smokers. Now lets move heaven and earth to assist these people to give it away altogether.

•	Alcohol intake 27% of people indicated a higher than acceptable level of alcohol consumption. For too many people it is culturally acceptable to drink half a dozen cans of beer a night. Not only does willpower dissolve in alcohol but it increases the size of the waist.

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?)


A poor result. It's good that people came to the session. Those scoring less the 6 need to obligate themselves to attend a prehab/rehab program, twice a week.		Too many people were over weight. This places stress on joints and restricts mobility.

This is a fair set of scores. On the whole, leg strength was good.		This is a very poor result. 75% of people couldn't do one sit up. It's one of the explanations for the high degree of musculo-skeletal dysfunction in the group. People lack the abdominal strength needed to keep their vertebrae in alignment.

This is not a good result. 75% of people failed the arm, upper back and shoulder strength test. Poor arm, shoulder and upper back strength is a precursor of shoulder and arm pain.		This is a poor result. 41% of people couldn’t touch their toes. There is a high risk of lower back and neck dysfunction for people who have tight muscles along the back side of their body - calves, hamstrings, buttock and back. It's caused by two things - sitting down and not having a flexibility program.

A poor result. People scoring less than 7 have a mobility problem.		A mediocre result. 41% of people failed the shoulder function test. People need to loosen off those muscles that prevent them from standing up straight and increase shoulder strength and flexibility.

It's usually the case that few people have a regular strength and flexibility program. With this group, this was not the case. A number of people had a strength and flexibility training program. However, 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. This means access to the organisations gym for all staff.

Average score: 46. This is a very low average score. People are not in particularly good musculo-skeletal condition. In the main they have low levels of strength and flexibility. 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 the Organisation needs 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 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 and 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 and shoulder functionis 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.

CAREER SATISFACTION PROFILE

The parameters in the profile relate to a mix of factors influences by the participant, management and their colleagues.

• How close are you to doing the job you’d really like to be doing?

• Are you in the right job for now?

• Is work giving you life or sucking life out of you?

• Are you focused on your career options?

• Do you get good feedback from your manager?

• Do you receive an appropriate financial reward?

• Do you feel you and your work are valued and appreciated?

• Do you work for an organisation that cares about people?

• Do you enjoy the company of the people you work with?

• What’s the level of morale like in your work group?

Normally, when results on the overall career profile are less than 70/100, people agree that they’re not in the right job. Certainly those scoring less than 60 have sufficient issues relating to career management as to seriously consider going somewhere else.

SCORING GUIDELINES

Excellent, scoring 8 or more

Good, scoring 7 or more

Fair, scoring 5 or 6

Poor, scoring less than 5

‘Pass mark’ on all parameters 7/10.


	This is a poor score - My encouragement to people who scored less than 6 is to move heaven and earth to work out what it is they really want to do - and develop a plan to get there as soon as they can.	This is a mediocre result. Good managers can find out who the people scoring less than 7/10 are and assist them to move to the job they'd really like to have. It could be within the organisation or somewhere else. OR the current job could become transformed with a vitality transplant.

	This is a mediocre result, Work is probably about as stressful as you want it to be. Walk away. Make appointments for your Self that allow you to get on with your work unhindered by interruptions.	A poor result. Too many people are not focused. The result; they they have to put up with whatever comes their way.

	This is a poor result. Of all our profile questions, this one is usually the worst answered. In this organisation there's some extra work for managers. For staff our recommendation is always to manage up. A lot of managers fall into the trap of getting on with their own work rather than seeing the principal function of their work being to manage their staff.	These people do not believe they are well remunerated for what they do. If you're not happy, you're selling yourself short. Log onto Seek and get your suit dry cleaned!

	This is a poor result. Too many people do not believe their work is valued or appreciated.	This is a poor score, the aim is to have all staff recording a score of 7 or more.

	This is a fair score. Some people don’t particularly like the people they work with.	With a few exceptions, morale is poor. It's generally the case that our morale is good when my morale is good.

Average score: 58 Compared with other groups, this is a poor, result. For people who score less than 70, there is the whiff of a suggestion they're not in the right job. The situation is certainly redeemable. For people scoring less than 60 the smell is becoming distinctly stronger and below 50 it is very strong. Being in the wrong job sucks all vitality out of you. On our estimation 9 of the people in the group are in the wrong job. There are three options; change the manager, change the job or change themselves.

The Buddha and Confucius both said 'Find the job you'd love to do and you don't have to do another days work in your life.'

RECOMMENDATIONS

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