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Snafu Index

7. Snafu March 2015

John Miller conducted the Musculo-skeletal Health Seminar for The Group in February 2015.

17 participants (7women and 9 men) completed the

- Health, Fitness and Wellbeing profile.

- Specific Joint Assessment

- 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 65. 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 5/10 or more
	Musculo-skeletal dysfunction	81
	Lack of Energy	63
	Poor sleep	63
	Overweight	44
	Snoring, sleep apnoea	38
	Anxious	38
	Reflux, unsettled stomach	31
	Low level of fitness	31
	Depressed	31
	Candida	25
	Caffeine	25
	Work-life balance	25
	Elevated cholesterol	19
	Grinding teeth	19
	Unhappy family life	19
	Stressed financial status	19
	Headaches	13
	Frequent colds, flu, sinus	13
	Shortness of breath from asthma	13
	Chest pain, palpitations	13
	Itchy, rashes, psoriasis	13
	Elevated blood pressure	13
	High alcohol intake	13
	Under appreciated at work	13
	Irritable bowel, constipation etc	6
	Mouth ulcers	6
	Elevated glucose	6
	Shakes, nervous mannerisms	0
	Smoking	0
	Wrong job	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

• 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. Around 50% of people are experiencing constant pain and discomfort. In a corporate setting we'd recommend that those scoring less the 6 attend a prehab/rehab program, for their own benefit and that of the organisation.	For a group this is a fair score. With 2 exceptions, people eere fairly close to their ideal weight.

	With 1 exception, leg strength was good.	36% of people failed the front of body strength test. They couldn't do 1 situp. This puts them in the grave risk of lower back pain category.

	50% of people failed the pressups test. One of the best predictors of risk of lower back pain is the ability to do pressups.	40% of people couldn't touch their toes. Lower back pain goes with poor hamstring flexibility.

	Only 2 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.	With 3 exceptions, shoulder function was good.

Three people had a good strength training program. No-one had a good flexibility training program. It's usually the case that 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: 61. Not particularly good. 2 people scored less than 50/100. These people pose a grave risk to the organisations workers compensation arrangements.

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 16 people
6	Gold	30	30	30	2
5	Silver	25	25	25	2
4	Bronze	20	20	20	4
3	Green	15	15	15	1
2	Amber	10	10	10	2
1	Red	<10	<10	<10	5

Pressups, situps and squats in 60 seconds

A fair standard for people to aim at would be the Bronze Award - 20 situps, 20 pressups and 20 squats. You wouldn't judge anyone who failed to reach the bronze level as being fit for work.

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