Health Risk Report snoberri

Musculo-skeletal Health Seminar Results

16. Moo Cow

John Miller conducted the Global Back Care Musculo-skeletal Health Seminar for The Group in August 2013.

13 participants completed the Health, Fitness and Wellbeing profile and the Musculo-skeletal Risk profile.

The results are presented in graphic format, with commentary.

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.

On this profile a good score is a low score.

	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 low levels of fitness and 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. Reasonable 51-60. Poor - over 60.

This profile is described as not bad. The average score was 61. 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	77
	Lack of Energy	46
	Poor sleep	38
	Overweight	38
	Anxious	38
	Snoring, sleep apnoea	31
	Reflux, unsettled stomach	31
	Headaches	23
	Low level of fitness	23
	Depressed	23
	Under appreciated at work	23
	Work-life balance	23
	Irritable bowel, constipation etc	15
	Alcohol intake	15
	Caffeine	15
	Wrong job	15
	Financial status	15
	Frequent colds, flu, sinus	8
	Shortness of breath from asthma	8
	Chest pain, palpitations	8
	Elevated blood pressure	8
	Grinding teeth	8
	Unhappy family life	8
	Candida	0
	Itchy, rashes, psoriasis	0
	Mouth ulcers	0
	Elevated cholesterol	0
	Elevated glucose	0
	Shakes, nervous mannerisms	0
	Smoking	0

Musculo-skeletal Risk factor Profile

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 9 objective and 3 subjective assessments.

• Current musculo-skeletal condition

• Closeness to ideal weight

• leg strength

• Abdominal strength test

• Upper body strength test

• Flexibility

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

• Shoulder function

• Strength training behaviour

• Flexibility 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?)


	Not a particularly good result. Over 50% of people are experiencing pain and discomfort. In a corporate setting we'd recommend that those scoring less the 6 need to be required attend a prehab/rehab program, for their own benefit and that of the organisation.	20% of people were 15Kg or more overweight.

	Leg strength was very good	A patchy result.

	A good result with only 1 person seriously lacking in arm and shoulder strength. The best predictor of risk of lower back pain is the ability to do pressups.	Only 2 people couldn't touch their toes. Lower back pain goes with poor hamstring flexibility.

	4 people couldn't sit up straight with legs crossed and hands behind their back, without falling over. A major cause of lower back pain is tight buttock muscles.	Shoulder function was patchy.

Its always the case, few people have a regular strength and flexibility program. The group 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 for everyone.

Average score: 58. Not particularly good. This graph show why people are experiencing pain. Most people are not in doing the things they need to do to keep their musculo-skeletal system in good shape. There is a strong case of the group to implement an obligatory strength and flexibility program for those who scored less than 60 in this profile.

We recommend the Organisation take seriously and monitor carefully the incidence of musculo-skeletal dysfunction and put in place an organisation-wide strategy to improve strength, flexibility and mobility. 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. 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 function 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 50 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.

Universal Fitness Test and Fit-for-Work Award

For details on the Universal Fitness Test click on this link: http://www.johnmiller.com.au/universal_fitness_test/index.html

The award is based on the lowest points scored for a particular test item. Tests included in this report were pressups, situps and squats.

Level	Award	20m run - laps -		Press- ups	Situps	Squats	Arm hang - seconds -		% body fat		Award
		Men	Women				Men	Wom	Men	Wom
10	Platinum	55	52	70	70	70	100	80	<14	<24
9	Diamond	53	49	60	60	60	80	60	<16	<26
8	Ruby	50	46	50	50	50	60	50	<18	<28
7	Emerald	45	43	40	40	40	50	40	<20	<30
6	Gold	40	38	30	30	30	40	35	<22	<32
5	Silver	38	36	25	25	25	35	30	<24	<34
4	Bronze	36	34	20	20	20	30	25	<26	<36	7
3	Green	32	30	15	15	15	25	20	<28	<38	2
2	Amber	26	24	10	10	10	20	15	<30	<40	2
1	Red	22	20	<10	<10	<10	10	10	<35	>45	1
0	Black	<22	<20	<5	<5	<5	<10	<10	>35	>45	1

Strength tests taken until exhaustion - without stopping. 20m run - laps in 5 minutes

A fair standard for people to aim at would be the Bronze Award - 20 situps, 20 pressups and 20 squats. Of the 6 people who failed to reach the bronze level, the two people in the 'amber' zone are not in great shape. The two people in the red and black zones are likely candidates for a prehab program.

Recommendations

One of the aims of a work health and safety program is to prevent people with non-work related personally-generated musculo-skeletal dysfunctions from getting past the firewall and becoming workers compensation cases.

We recommend the Organisation take seriously and monitor carefully the incidence of personally-generated musculo-skeletal dysfunction and put in place an organisation-wide strategy to improve strength, flexibility and mobility. 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.

A high proportion of people said they would willingly agree to take part in a daily exercise program to improve their musculo-skeletal health.

A high proportion of people said they'd take part in a prehab program.

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

The Organisation would place itself in the forefront of WHS 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.

Workplace Accident Insurance Blueprint

The Workplace Accident Insurance Blue Print contains a detailed analysis of the whys and wherefores of putting in train measures to enhance the musculo-skeletal status of staff and protect its workers compensation arrangements.

Our recommendation is that organisations adopt the following mandatory approach to measuring and managing risk:

		Safety induction and policy discussion, including simple safety procedures like hanging on to rails when going up or down stairs and wearing appropriate footwear …

		First aid course – so people know what to do when they sprain and ankle, strain a muscle, herniate a disc

		Manual handling seminar

		Work station assessment and set-up

		Books, audio files and videos

		Musculo-skeletal health seminar

		Yearly specific joint assessment

		Yearly ten point musculo-skeletal risk screen

		Clinical Diagnostic Assessment for people at risk and people wanting to make a workers compensation claim

		Diagnostic imaging for people with existing conditions

		Pro-Active Rehab program for people at risk and people on workers compensation

		Daily strength and flexibility exercise program for all staff.

This is a mandatory strategy with a ‘no ticket, no start’ requirement. The stakes are too high to do otherwise.

Staff need to know they can’t make a workers compensation claim until they’ve been through the process outlined above.

Prehab and rehab classes

Miller Health

7 Salvado Place Stirling ACT 2611

(02) 6288 7703