Ergonomics… From Another Perspective Background and case histories Petti Redding, OTR P.R.I.D.E. Wellness Systems, Inc.
Dec 16, 2015
Ergonomics…From Another Perspective Background and case histories
Petti Redding, OTRP.R.I.D.E. Wellness
Systems, Inc.
RSI statisticsRSI statistics
OSHA studies show that…
• RSI’s account for 34% of all lost workdays due to injury
• RSI’s claim $1 out of every $3 spent for Workers’ Comp
• Total annual RSI costs exceed $60 billion
• RSI’s are the fastest growing workplace injuries in the U.S.
• RSI's result in the highest median days away from work
• RSI's have the highest average Workers’ Comp cost-per-case from $14,000 to $29,000
Lost Work Days Per RSI(Median # of Days)Lost Work Days Per RSI(Median # of Days)
• Carpal Tunnel Syndrome – 27 days• Repetitive Motion Injury – 19 days• Shoulder – 16 days• Upper Arm – 15 days • MSD – 14
days• Wrist – 14
days• Tendonitis – 14 days • Tenosynovitis – 14 days • Hand & Fingers – 10 days• Hand & Wrist – 11 days• Bursitis – 7 days
Bureau of Labor Statistics - 2006
Primary problems of RSI’sPrimary problems of RSI’s
• Pain (burning, sharp, dull, achy, etc.)• Parasthesia (numbness and tingling)• Weakness• Fatigue of body part
Can we find a common link?
The concept of structural integrity of the musculoskeletal system
The concept of structural integrity of the musculoskeletal system
Unbalanced
Typical, dysfunctional postures leading to musculo-skeletal pain, vertebral dysfunction, arthritic conditions, etc.
Root cause of dysfunction…MusclesRoot cause of dysfunction…Muscles
Bones are pulled out of alignment by muscles that are generally :
1. Weak and overstretched on 1 side
2. Tight & stronger on the opposite side
Primary cause of RSI Pain- the trigger pointPrimary cause of RSI Pain- the trigger point
• Mechanisms of injury include muscle that work overstretched, overshortened or overloaded
• Based on energy crisis and dysfunctional motor endplates
• Most often overlooked in the diagnostic process by the medical community- Why?
At the cellular level…the sliding mechanism theoryAt the cellular level…the sliding mechanism theory
Dysfunctional muscles…the trigger pointDysfunctional muscles…the trigger point• Muscles contracting in over-stretched, over-
shortened or over-worked positions• Muscles holding a static, isometric contraction
for extended periods of time
… lead to a in blood flow and resulting energy crisis
Trigger Point FormationTrigger Point Formation
1st Actin and myosin proteins fail to disconnect in multiple sarcomeres
2nd Leading to increased tension throughout the entire muscle
Relationship of trigger points and nerve entrapmentRelationship of trigger points and nerve entrapmentTight muscles
Lack of nerve glide
Nerve compression
Nerve damage
Gluteus minimus trigger point and referred pain patternGluteus minimus trigger point and referred pain pattern
Infraspinatus trigger point and referred pain patternInfraspinatus trigger point and referred pain pattern
Trigger point deactivationTrigger point deactivation
• Locate trigger point• Apply firm, moderate pressure• Hold about a minute• Stretch muscle afterward• Repeat 6-8 times a day• Usually takes 1 day to 1-2 weeks (depending how long it’s been there)
Primary Cause of Structural DysfunctionPrimary Cause of Structural Dysfunction
Behaviors lead to…
non-balanced, structurally misaligned postures lead to…
muscles statically overstretched and overworked which leads to…
1. Pain
2. Nerve entrapments
3. Misaligned joints that contribute
heavily to degenerative joint disease (Osteoarthritis)
Postural dysfunctionPostural dysfunction
• Muscles adapt to the position that it is put in over time
• Muscles dictate the position of the skeleton
BUT
Muscles can be re-trained, shortened, lengthened, strengthened
To regain structural integrity
Case Histories: Early InterventionCase Histories: Early Intervention• All employees achieved these results
ON THEIR OWN• No employee was “treated”. There were
no modalities, or physical therapy interventions
• No employee visited a physician• No employee became an OSHA
recordable injury or W/C injury.
Sample techniquesSample techniques
• Bumper stretch• Noodle stretch• Cross over girlie knee stretch• Legs up wall stretch• Sit on hand stretch• Supermans
(Petti- play the video!)
Symptoms/frequency
Lower and upper back pain, right sideMost of the timeMedium severity
Trigger point releases
Top and back of shoulder (traps, levator scapula)Booty (gluteus medius/minimus)Chest (pectoralis minor)
Exercises and stretches
Noodle stretch, cross-over girlie knee stretch, legs up wall, sit-on-hand neck stretch
Ergo modifications
Double wedgie, lowered table, raised monitor, wrist rest
Sebastian B. (30’s)EngineerSebastian B. (30’s)Engineer
Symptoms/frequency
Pain in forearms, shoulders, upper back, lower back; most of the time; medium to high severity
Trigger point releases
Neck (scalenes) shoulders (traps, levator scapula) upper back (rhomboids) forearms (extensors)
Exercises and stretches
Noodle stretch w/head press; supermans; cobra; sit-on-hand neck stretch
Ergo modifications
Wedgies, lowered table, wrist rest, HEADSET;
Comments “oh my god! I never knew I could feel this good, even at work!”
Kari H (30’s)HR repKari H (30’s)HR rep
Symptoms/frequency
Pain in low back, shoulders, and neckPain is frequent, and medium in severity
Trigger point releases
Inside of shoulderblade (Subscapularis)Booty (gluteus minimus)Shoulders (upper and middle traps)
Exercises and stretches
Supermans, noodle stretch, cross-over girlie knee stretch
Ergo modifications
Double wedgie, lowered table, raised monitors, added wrist rest65 cm ball
Comments “ I have had shoulder pain for 10 years, and its finally gone”
Aida B. (50’s)IT Specialist (45+ hrs/week) Aida B. (50’s)IT Specialist (45+ hrs/week)
Symptoms/frequency
Neck, shoulders, feetConstant pain, medium in severity(had been seeing podiatrist for 1 year)
Trigger point releases
Neck (scalenes) shoulders (traps, levator scapula, subscapularis) Upper back (rhomboids) calves (soleus)
Exercises and stretches
Noodle stretch, chin tucks, supermans, heel drops
Ergo modifications
Wedgies, lowered monitor A LOT (bifocals)55cm ball, lowered table
Comments “shoulder is wonderful! I’m doing noodle stretch 2x a day! And I love that little ball!”
Deb P. (50’s)IT Specialist 40-45 hrs/weekDeb P. (50’s)IT Specialist 40-45 hrs/week
Additional commentsAdditional comments“I have been seeing a podiatrist for heel pain for several months. I have been to see the doctor 3 times with only sight relief. He said if the last stronger prescriptionMedication didn't work he would inject the heel. Petti was checking up on me and the neck issue last week. I said my neck was fine, but I was going to the doctor to have my foot injected. She got a racket ball and showed me how to find another trigger point in the back of my calf that is causing the heel problem. I felt relied immediately. After less that a week I have less pain than after 6 weeks of medication! I think I can completely resolve the heel issue if I just keep using the ball.”
My Point…My Point…
• Ergonomics is not just about the stuff• Anthropometric data is not the total
picture• The biggest risk factors for injury lie in the
PERSON, not the task (in terms of RSI’s)• Put some effort into helping your
workforce fix their bodies… you’ll be amazed at the results