Managing Musculoskeletal issues in the workplace

Sophie DrakeGraduate Sports Therapist

Occupational Health Papworth Hospital NHS

Foundation Trust

Who am I?

Papworth Hospital NHS Foundation Trust

Papworth Hospital NHS Foundation Trust

Number of episodes & WTE days by Qtr

Qtr 32013/14

Qtr 2 2013/14

Qtr 1 2013/14

Reason

All Musculo-skeletal

124 episodes 1493.35 WTE days

110 episodes 1351.93 WTE days

97 episodes 1001.82 WTE days

Anxiety/stress/depression/other psychiatric illnesses

61 episodes986.6 WTEdays

63 episodes 1351.93 WTE days

38 episodes 520.19 WTE days

Cold, Cough, Flu 309 episodes 866.45 WTE days

105 episodes234.37 WTE days

146 episodes 392.21 WTE days

Occupational Health Musculoskeletal Clinic

• Onsite – OH department• Aim triage – appointment in 2 weeks or less• 1st appointment 45 mins, Review 30 mins• Referred via OH advisor or Self referral• 1 free assessment, 3 free treatments• Work closely with OH advisors, OH physician

Occupational Health Musculoskeletal Clinic

What is offered?– Assessment and diagnosis

– Sports Massage– Exercise Prescription

– Ultrasound– Taping and strapping– Postural education

– Loan of tens machines– Work station assessments and recommendations

– Task analysis in work place / support return to work

Occupational Health Musculoskeletal Clinic

Clinic Metrix

MonthNumber of appointments

New Assessments Follow ups WPA Massages

Apr-13 18 10 7 0 1May-13 35 10 19 3 1Jun-13 23 7 12 3 1Jul-13 38 15 23 3 0

Aug-13 33 13 18 2 2Sep-13 45 10 30 4 1Oct-13 65 29 29 3 4Nov-13 56 9 44 3 3Dec-13 46 17 24 4 1Jan-14 72 24 39 7 2

Clinic Metrix

Month Self referral? OH referral?Clinical staff

Non clinical staff

Apr-13 10 8 12 6May-13 16 19 24 11Jun-13 3 5 4 4Jul-13 7 8 10 5

Aug-13 6 7 7 6Sep-13 6 4 7 3Oct-13 17 12 9 20Nov-13 4 5 5 4Dec-13 12 5 13 4Jan-14 15 8 18 6

Clinic Metrix

Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-140

5

10

15

20

25

30

Common injuries

Feet/anklesKneeHipWristElbowNeck/ShoulderLower back

Nu,

ber o

f new

refe

rrak

s see

n

Clinic Metrix

New Assessments Work related injury?

May-13 10 9Jun-13 7 0Jul-13 15 8

Aug-13 13 7Sep-13 10 5Oct-13 29 13

Nov-13 9 5Dec-13 17 15Jan-14 24 10

Audit resultsTable 5 : Breakdown of the impact of injury on various strength of activities

As can be seen in the above illustration, there is a decline in those reporting that their activity is affected “a lot” post referral compared to those numbers pre-referral. Conversely there is also a rise in the combined number of those who report their activity is affected either “a little” or “not limited” post referral to the Injury Clinic

Audit results Table 8: Impact of injury on capacity to work

Again there is a clear trend of increased number of people reporting no difficulties and decreased number reporting difficulties in capacity at work post clinic.

Audit resultsTable10: Whether the reported injury has impacted on social life

As can be seen this graph shows improvement again pre to post clinic both in increased numbers of those reporting “not at all” to social impact questions and those reporting decreased numbers of “slightly” and “moderately”.

Prevention

• Induction Presentation• Introduce clinic

• Encourage early referral to OH• Manual Handling Advice

• Advertise staff gym

Prevention

Prevention

• Squats• Core activation• Static load – 3-4 seconds and how it is

detrimental– Think about your workers and how long they sit,

carry out an activity for.

Prevention Key Points• Keep up to date with manual handling• Good communication• Speak up if there is a problem• Risk assess all tasks – TILE• Avoid manual handling if able – use equipment• Maintain posture• Bend your knees, using your legs not your back• Look after yourself – eat well, exercise, manage stress

levels• Think about your footwear, clothing• Highlight problems as early as possible even if you feel they

are insignificant!

Future Plans

• Health and Wellbeing • Drop in clinics• Lifestyle Clinics• On site exercise classes• Improve on site gym• Encourage getting away from desk

Back to you• Could you start something similar?• Look at NHS OH local services • Could you pay a private physio/therapist/masseuse to come in, set up deal• Bring in an ergonomist from time to time• Look into purchasing desk based programmes e.g desk yoga• Look at local gyms, could you set up schemes to encourage H&W• Internet – free resources to hand out to colleagues – Back Care, Arthritis UK,

other charities• Could you put on/ arrange exercise classes (Pilates)• Start a company walking group, after work running club, Perkins half

marathon• Come up with an induction pack/ generic office stretches/ prevention advice • Ask other companies, what do they do?• Ask the staff …. What do they want? What would help them?

Thank you for listening!

Any Questions?