Musculo-skeletal Health Risk Report

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Health Fitness and Wellbeing Seminar Results

19. Duck August 2013

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

74 participants (33 men and 41 women) completed the

- Health, Fitness and Wellbeing profile.

- 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 poor. The average score was 77. 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	No. of people scoring over 10
Musculo-skeletal dysfunction	76
Lack of Energy	50
Poor sleep	47
Anxious	39
Under appreciated at work	36
Headaches	35
Low level of fitness	35
Grinding teeth	31
Snoring, sleep apnoea	27
Overweight	26
Wrong job	26
Work-life balance	26
Frequent colds, flu, sinus	24
Reflux, unsettled stomach	24
Financial status	24
Irritable bowel, constipation etc	23
Itchy, rashes, psoriasis	20
Depressed	18	4
Elevated cholesterol	15	2
Candida	11
Elevated blood pressure	11	7
Caffeine	9
Unhappy family life	9
Shortness of breath from asthma	8
Elevated glucose	8	2
Alcohol intake	8
Mouth ulcers	7
Shakes, nervous mannerisms	5
Smoking	4
Chest pain, palpitations	3

It's normal that the scores for wrong job and under-appreciated at work are about the same. This was not the case in this survey. Many more people (36%) said they were under-appreciated.

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

• Ability to sit up straight with legs crossed

• 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.	Around 10% of people were 15Kg or more overweight. Compared with other groups this is not a bad score.

	Leg strength was, generally speaking good. Only 3 people couldn't squat down and up once in 30 seconds.	Overall, not a bad result. Only 8 people out of 74 couldn't do one situp.

	Patchy, 25% of people failing the arm and upper body strength test. The best predictor of risk of lower back pain is the ability to do pressups.	Close to 20% of people couldn't touch their toes. Lower back pain goes with poor hamstring flexibility.

	Around 20% of people couldn't sit up straight with legs crossed and hands clasped behind their back, without falling over. A major cause of lower back pain is tight buttock muscles.	Shoulder function was good.

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: 62. Not particularly good, but not particularly bad. This graph show why people are experiencing pain. Too many 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.

Fit for Work

Scores in the Musculo-skeletal Health Risk Assessment have been used for the Fit for Work Award.

Level	Award	Pressups	Situps	Squats	Awards for 9 people
50	Platinum	50	50	50	1
40	Gold	40	40	40	3
30	Silver	30	30	30	9
20	Bronze	20	20	20	16
15	Green	15	15	15	10
10	Amber	10	10	10	11
<10	Red	<10	<10	<10	24

Pressups in 60 seconds: Situps in 90 seconds: Squats in 90 seconds: 20m run - laps in 5 minutes

A fair standard for people to aim at would be the Silver Award - 30 situps, 30 pressups and 30 squats. The 5 people who failed to reach the bronze level are in poor musculo-skeletal health and candidates for a prehab program.

Recommendations

Measure risk and Manage Risk

There is an epidemic of personally-generated musculo-skeletal dysfunction in our workplaces.

Most organisations neither measure the risk nor manage it.

Their workers compensation insurer doesn't measure the risk either. They don't rate premiums against individual risk.

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.

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 the importance of staff keeping themselves strong and flexible.

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 obligated 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.

Prehab and rehab classes

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 - who failed to attain the bronze award - 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.

Miller Health

In association with Integrated Health Systems

7 Salvado Place Stirling ACT 2611

(02) 6288 7703