Bionomics: An Approach to Reduce Cumulative Trauma
January 21, 2015
Dr. Sony Canteenwala
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Your Health and Injury Prevention
Examples of At Risk Postures
1. Physical
2. Chemical
3. Emotional
3 Types of Stress that Contribute To Poor Posture – leads to Injury
The Body’s Stress Response Includes A Change in Posture
Sympathetic Nervous System =
“Fight or Flight Response”
The Body’s Stress Response
Chronic Stress
Stress Posture
Defense Posture
Effects of Poor Posture
Injury
• Cumulative Stress Trauma
Energy Expenditure
• 90% of energy goes into keeping us up right against gravity.
Effects of Poor Posture
• Lung Capacity * • Range of Motion* • Muscle Tension • Muscle Imbalance • Neck and Back Pain • Increased risk of injury • Disc herniations • Scoliosis • Internal organ dysfunction
TO NAME A FEW…
Fast Facts: The Consequences of Forward Head Posture 1. Long-term forward neck posture leads to "long-term muscle strain, disc herniations and pinched nerves." (Mayo Clinic Health Letter, March 2000) 2. In regard to respiratory dysfunction in chronic neck pain patients, a recent study "demonstrated a strong association between an increased forward head posture and decreased respiratory muscle strength in neck patients." (Cephalgia, February 2009) 3. "For every inch of forward head posture, it can increase the weight of the head on the spine by an additional 10 pounds." (Kapandji, Physiology of the Joints, Volume 3) 4. "Loss of the cervical curve stretches the spinal cord 5-7 cm and causes disease." (Dr. Alf Breig, neurosurgeon and Nobel Prize recipient) 5. "90% of the stimulation and nutrition to the brain is generated by the movement of the spine," says Dr. Roger Sperry, Nobel Prize recipient for brain research. Dr. Sperry demonstrated that 90 percent of the energy output of the brain is used in relating the physical body to gravity. Only 10 percent has to do with thinking, metabolism, and healing, so when you have forward head posture, your brain will rob energy from your thinking, metabolism, and immune function to deal with abnormal gravity/posture relationships and processing. 6. According to Rene Cailliet MD, director of the Department of Physical Medicine and Rehabilitation at the University of Southern California, forward head posture can add up to 30 pounds of abnormal leverage on the cervical spine. This can pull the entire spine out of alignment. FHP results in loss of vital capacity of the lungs by as much as 30 percent. This shortness of breath can lead to heart and blood vascular disease. The entire gastrointestinal system is affected; particularly the large intestine. Loss of good bowel peristaltic function and evacuation is a common effect of FHP. It causes an increase in discomfort and pain because proprioceptive signals from the first four cervical vertebrae are a major source of the stimuli which create the body's pain controlling chemicals (endorphins). With inadequate endorphin production, many otherwise non-painful sensations are experienced as pain. FHP dramatically reduces endorphin production. 7. FHP has been shown to flatten the normal neck curve, resulting in disc compression, damage and early arthritis. (Spine, 1986)
Postural Analysis
•Standing Test – Head tilt •High Shoulder •High Hip •One Knee Rotating In •Foot Flare
Bionomics
• Effective workplace Injury Prevention Programs by definition must be cost effective.
ERGO = WORK NOMICS = MANAGING
Ergonomics - Adapting physical environment to the
person to prevent injuries
• Office furniture
• Newly designed tools
• Retooled factories
Is this the complete solution?
Workplace Injuries are Only an 8-5 Problem.
• True
• False
How Do We Re-Engineer The World Outside Work?
• At Work…
• Does an $800.00 office chair prevent
Carpal Tunnel Syndrome?
• Does a piece of patient handling
equipment prevent back injuries?
• If a problem persists you have not discovered or corrected
the true cause.
Why do:
• 80% of the people in Canada suffer from a
back incident
• Back and Carpal Tunnel surgeries end up
being some of the most common in the
Canada?
• The Underlying Cause of MSD’s is…..
And the Answer is… • Mothers lifting babies • Kids lifting backpacks • Lifting laundry • Getting out of the car • Sitting improperly • Incorrect posture at our computers • Innocent stresses over time lead to: • Fatigue • Discomfort • Pain • Injury
• Very Simple Common Denominator
• Very Simple Common Cause of MSD’s
• Very simple solution to controlling injuries
Ergonomics +
BIONOMICS™
BIONOMICSTM “BIO” = body + “NOMICS” = manage
• How to prevent the incurrence of physical
stress
• How to relieve any accumulation of
physical stress through proper body
management
Challenges to Effecting Change • Old Habits • Apathy • Management – Labor Disharmony • Educational Barriers • Language Barriers • Spread Out Work Force • Takes Too Much Time • Curriculum That Works To Help Employees To Be
Able To Be More Responsible For Their Own Well-being
• Employee Buy In
Traditional Training Media
• Video
• Lecture
• Slide Presentation
• Computer
Maxim For Effective Training
• The value of any training is
only as good as it can be
applied.
OBJECTIVE
• Create a training protocol that
teaches people, for the first time in
their lives, how to prevent physical
stress and how to relieve accumulated
stress that they can apply during daily
activities
The Backsafe® Strategy
Ensuring Long-Term Results
• Implement
• Maintain
• Reinforce
Components of the Backsafe/Sitting Safe Workshop 1. Job site analysis/pre-assessment 2. Design and customization of workshop 3. Introduction – we get employees to understand the program and
become motivated to be responsible for their own wellness. 4. Via our Sittingsafe video, employees learn proper office ergonomics and
other pertinent information to prevent harmful accumulation of physical stress that leads to pain, fatigue and injury.
5. Sittingsafe 3-minute stretching routine. 6. Practical learning module – each participant gets to apply what they
learned to ensure they can set up any work station properly for their bodies.
7. Questions and answers 8. Each employee fills out a Sittingsafe Course Critique Form to provide
instant feedback on the success of the program 9. Each employee receives a Sittingsafe “Certificate of Commitment”
BACKSAFE® 3-MINUTE WORKOUT & MICROSTRETCHES
• Quad Stretch
• Runners Stretch
• Neck Stretches
• Shoulder Rolls
• Back Extensions
• Hand and Wrist Stretches
• Chin Tuck
The Results Speak Of Significant Savings
United Airlines ……………. 63% Reduction Con Edison………………… 46% Reduction
Toys R Us………………….75% Reduction
Boeing Fabrication…………...41% Reduction Hillcrest Hospital…………..Reduced WCB Costs By
Over $1 Million In First Year Of Implementation >San Jose Mercury News……Reduced Lost Work Days
by 1,000 days and reduced costs by $750,000 (2001).
Hillcrest Medical Center Claims Summary By Year
$3,467,509 $3,264,452
$2,160,166
$1,100,000
1999 2000 2001 2002
1999 2000 2001 2002
F.I.T. Training/Patient
Handling Equipment
Implemented July 2000 (Start Of Fiscal Year 2001)
Totals include Indemnity and Medical costs.
1999 2000 2001 2002
1999 2000 2001 2002
Greyhound Managing Employee Injuries
Flat Results
We implemented the FIT/Backsafe Program because we wanted to find greater results. As an organization, we wanted to reduce the number of claims and the cost of those claims.
We introduced the rollout of the Backsafe Program in 2010.
Goal
Our goal is to reduce painful and costly work and non-work related sprain/strain injuries to our drivers and all employees. This will be accomplished by working together to embed the Backsafe principles into the daily lives of your drivers.
Keep our employee free of injury not just to be more productive at work. It’s also important that they feel good at home.
Managing Employee Injuries
327
1
40
25
61
32
5713
2
72
0 10 20 30 40 50 60 70 80
Dallas
Chicago
Total
Backsafe Pilot Survey Results
Excellent Very Good Good
Fair Poor Total
97% of employees rated the pilot workshop excellent or very good.
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
2009/10 2010/11 2011/12 2012/13 2013/14
17521
12922
10968 10811
8890
Lost Work Days 5 Year Trend
0
100
200
300
400
500
600
700
800
2009/10 2010/11 2011/12 2012/13 2013/14
745 748
647
474
403
All Injuries 5 Year Trend
0
50
100
150
200
250
300
2009/10 2010/11 2011/12 2012/13 2013/14
260
207 187
140
89
Lost Time Injuries 5 Year Trend
Computers Distributers Warehouse
Part 8 of the Workplace Safety and Health Regulation MR217/2006 - Musculoskeletal Injury (MSI) Prevention paraphrased as follows:
8.1(1) When an employer is aware, or ought reasonably to have been aware, or has been advised, that a work activity creates a risk of musculoskeletal injury, the employer must
(a)ensure that the risk is assessed; and (b)on the basis of the assessment, implement control measures to
eliminate or reduce, so far as is reasonably practicable, the risk of musculoskeletal injury to the worker.
8.1(2) The control measures may include one or more of the following:
(a)providing, positioning and maintaining equipment that is designed and constructed to reduce or eliminate the risk of musculoskeletal injury; (b)developing and implementing safe work procedures to eliminate or reduce the risk of musculoskeletal injuries;
(c)implementing work schedules that incorporate rest and recovery periods, changes to workload or other arrangements for alternating work; (d) providing personal protective equipment in accordance with Part 6 (Personal Protective Equipment).
8.1(3) An employer must (a)monitor the effectiveness of any control measure implemented
to eliminate or reduce the risk of musculoskeletal injury; and (b)where the monitoring identifies that a risk of musculoskeletal injury is not being or has not been eliminated or reduced, implement further control measures, where it is reasonably practicable to do so.
8.2 An employer must ensure that every worker who may be exposed
to a risk of musculoskeletal injury (a)is informed of the risk and of the signs and common symptoms of
any musculoskeletal injury associated with the worker's work; and (b)receives instruction and training respecting any control measure
implemented by the employer.
BACKSAFE® SITTINGSAFE®
Injury Prevention Programs
Dr. Sony Canteenwala
(204) 474-2002
www.backsafe.com