Musculo-skeletal Health Risk Report

Health, Fitness and Wellbeing Results

3. SNAFU - to end of May 2013

John Miller has conducted a series of Global Back Care Clinics for The Organisation in during 2012 and 2013. This report displays the cumulative results of all seminars conducted until the end of May 2013.

164 participants, 88 women and 76 men completed two health profiles

■ Health, Fitness and Wellbeing

■ Musculo-skeletal risk

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 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.

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. Fair 51-60. Poor - over 60.

This profile is described as poor. The average score is 74. With a few exceptions, this group of people was not in good shape. Anyone scoring more than 80 is putting up with a lot of 'background noise'. Although it's hard to read the number on the 'x' axis, the graph peaks between 70 and 80. Two people scored under 20 and one person scored over 150. Keep in mind the score of a fit and healthy human being is less than 20. A reasonable score is less than 50.

The attention of the mathematically inclined is drawn to the symmetry of the graph!

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. We registered those scores of 5 and over as being a symptom, issue or concern, the most pressing of which have been highlighted.

Being conducted as part of a musculo-skeletal health seminar it is to be expected that the percentage for musculo-skeletal dysfunction is high. In most organisations the average score for musculo-skeletal health is closer to 50%.

Symptoms/ issues / concerns	% of people scoring over 5	No. scoring 10 N=164
Musculo-skeletal dysfunction*	77	18
Low level of fitness	52
Lack of Energy	45
Poor sleep	45	5
Anxious	38	4
Snoring, sleep apnoea	32
Overweight	31	13
Under appreciated at work	30
Work-life balance	29
Headaches	28
Financial status	26
Frequent colds, flu, sinus	24
Irritable bowel, constipation etc	24
Wrong job	23
Depressed	23	9
Reflux, unsettled stomach	21
Elevated cholesterol	18	9
Grinding teeth	17
Alcohol intake	16
Itchy, rashes, psoriasis	16
Elevated blood pressure	15	11
Mouth ulcers	12
Caffeine	10
Unhappy family life	10
Candida	9
Shortness of breath from asthma	9
Chest pain, palpitations	7
Elevated glucose	6	2
Shakes, nervous mannerisms	5
Smoking	3

* Of course the musculo-skeletal dysfunction score was high because people were attending this particular seminar because they had some sort of musculo-skeletal complaint.

This is a poor result. As a group these people are not particularly fit and healthy. In particular, this is reflected in their musculo-skeletal health.

23% believe they could be in the wrong job. 30% say they are under-appreciated at work. There is no excuse for people being under-appreciated at work. It's a fundamental role of managers to appreciate they staff.

This is a profile of people lacking in aerobic fitness, strength and flexibility and who are are willing accomplices to a stressful, garbohydrate way of life.

Highlight of the profile is the very low level of smoking, 3% as opposed to just under 20% for the community generally.

Click here to read more about the garbohydrate way of life.

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 7 objective and 3 subjective assessments.

• Current musculo-skeletal condition

• Body composition

• Leg strength test

• Abdominal strength test

• Upper body strength test

• Flexibility

• Functional mobility – the sit down, stand test.

• Shoulder function

• Strength training behaviour

• Flexibility training behaviour

Click here to view the Musculo-skeletal Health Risk Profile.

On this profile a good score is a high score. 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?)


A poor result. Most people scored less than 7/10. They are experiencing pain and discomfort. Those scoring less the 6 need to be required attend a prehab/rehab program, for their own benefit and that of the organisation.		Those scoring down the left hand end of the graph were 20 or more Kg over weight. Being overweight greatly compromises mobility and increased the risk of joint and muscle pain. Overall not a bad result.

A good result, except that 18 people couldn't squat down once in 30 seconds.		This is a very poor result with most people failing the test. Around a third of participants couldn't do one situp. This means that the strength of the muscles on the front of their body is not sufficient to keep their pelvis and spinal column in good alignment.

This is a poor result. Most people failed the test. Quite a few people couldn't do 1 pressup. One of the best predictors of risk of lower back pain is an ability to do pressups.		This is a mediocre result. Too many people have tight muscles along the back side of their body - calves, hamstrings, buttock and back. It's caused by two things - sitting down and not having a flexibility program. There is a high risk of lower back, neck and shoulder dysfunction.

Surprisingly this was a better result.		Patchy. 26% had dysfunctional shoulders. The good news is that's it's redeemable.

Too few people have a good strength and flexibility training program. It behooves all organisations 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. 2. daily 10 minute strength and flexibility sessions for all staff.

Average score: 56. As a group this is a poor result. For those scoring less than 60, the risk of musculo-skeletal dysfunction is high, due to low levels of strength and flexibility. There is a strong case for the organisation to implement an obligatory strength and flexibility program for those who scored less than 60 in this profile.

Lack of strength and flexibility is something that the Organisation needs to take seriously and monitor carefully and put in place an organisation-wide strategy to improve musculo-skeletal function.

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 the 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

• Global Back Care 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.

Recommendations

We strongly recommend that:

1. the organisation implement an obligatory, 10 minute daily strength and flexibility training program for all its staff.

2. the people who are in current poor musculo-skeletal health, and who lack abdominal strength, upper body strength, flexibility, shoulder function and functional mobility, in particular those who scored less than 60 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.

Miller Health

In association with Integrated Health Systems

7 Salvado Place Stirling ACT 2611

(02) 6288 7703