Work Place Injury, Prevention is the Key.

Most of a typical person’s day is spent at work. It should be no surprise that a good portion of the patients we see at One80 are coming to us due to job related injuries. Just like athletes who do active warm ups prior to exercise and use proper equipment in order to minimize the risk of injury, everyone should be preparing themselves for the activities of work.

Work related injury can range from a stiff neck due to poor ergonomics, a lumbar disc injury from lifting a heavy box, foot pain from improper shoe wear, or shoulder pain from repetitive reaching. Just by changing a few things, like your desk set up, doing a pre-work warm up, assessing footwear, and learning proper body mechanics, you can decrease the chances of a work-related injury.

Assess your workstation

Follow these tips to decrease the likelihood of cervical issues, thoracic outlet syndrome and carpal tunnel problems.

Keyboard: Place the keyboard directly in front of you, your arms should hang comfortably and your elbows should be at a 90 degree angle. Adjust the slope of the keyboard so that your forearms, wrists and hands feel comfortable, and avoid resting on hard edges.

Mouse: Make sure the mouse is located immediately to the right or left of your keyboard. Use a mouse that fits well in your hand.

Monitor: The middle of the screen should be at eye level and directly in front of you so there is no need to turn your head. The monitor should be approximately two feet away from you. If you find yourself leaning forward or backwards, you may need to check your eyesight.

Sitting vs standing: Standing desks and workstations have become very popular recently. We are big fans of using both a sitting and standing workstation in order to change position throughout the day. If you don’t have a standing option, try to get up every 15-20 and take a short walk around your work area. Spending some of your workday sitting on a physioball is another great way to put your body in a different position and engage different muscles.

Heavy duty

If your job involves lifting, pushing, pulling, reaching, squatting or maybe even throwing, there are a few things you should due to avoid injury:

Are strong enough for the job? Employers usually give a baseline assessment to new hires in order to make sure they can tolerate the job. This doesn’t mean you are in great shape, it just means you meet minimum requirements. Employers would be smart to include a gym membership or an onsite work out area with some type of exercise education in order prevent on the job injury.

Use a daily warm up routine. Once again, a savvy employer would integrate an active total body warm up into the work day. In as little as 10 minutes, many workman’s compensation claims could be eliminated. This plan would also educate employees on the dangers of stretching, foam rolling, massage, etc.
Report injuries immediately. The faster you assess and treat an injury, the faster you can recover. Having either an onsite medical professional (PT, ATC, MD) or one close by that your company contracts with, can make the difference in missing a week or a month of work.

Break it up. Try to avoid doing the same task repetitively or sitting in one position all day. Take a quick break to do a functional movement pattern or take a short walk. No time? No room? No clue what a functional movement pattern is? Ask One80, we can show you that you do have time, you do have room, and the exercises are easier than you think.

As you can see, some easy preventative ideas can keep employees and employers from falling into the workman’s compensation rut. If you’d like One80 to help your company design a specific prevention plan or provide rehabilitation services, give us a call and add us to your team. As always, “Think Different. Live Well.”

What is MoStreBility [mō-stru-bility]?

One of my favorite things to talk about is MoStreBility because it has so much to do with what we do as physical therapists, coaches, trainers, and professionals throughout the medical community.  Before we get too far, let’s first take apart the pieces of MoStreBility, which are motion, strength, and stability.

Motion – The ability of a joint to experience full motion, actively, both with and without load, in a functional plane (a-planar).  We want our athletes and patients, healthy or injured, to obtain full, active, functional range of motion. Be careful when talking about motion, it is NOT synonymous with “flexibility.” Stay tuned for the pitfalls of flexibility in a future blog.

Strength – Strength is what gets us in and out of the end range of motion.  It’s what produces the power for us to do work at our highest level of performance. It is what gives our joints stability allowing them to function efficiently and avoid breakdown. One huge component of strength that many people, including medical and performance experts, forget about is that: strength (more specifically neuromuscular facilitation) is what allows normal joint motion. When people say, “I need to get my motion back,” they forget that motion is directly dependent on strength.

Stability – This is the ability to move from one position to another, under a load, without a loss of strength or reduction in performance. A stable joint will neither move too much (hypermobile) or too little (hypomobile).  We want joints to go through full range of motion, with normal tension (supplied by muscle) so unnecessary tension, compression and shear are not being transferred to tissue such as a ligament, cartilage, or bone.

So, motion + strength + stability is MoStreBility.  And if you have MoStreBility, your chances of being injured are little, your chances of recovering from an injury are much greater, and your performance level increases.  Without MoStreBility, you may have motion, but you don’t have the strength or the stability to make that motion safe. Let’s look at an example of a runner who’s healthy, but has some hip pain.

After performing a functional screen, we conclude that a patient doesn’t have enough internal hip rotation.  If we’re just looking for motion, we can simply stretch the hip rotators by using external pressure to force joint motion. We could also find the “tight” muscles that are limiting motion and massage or foam roll them. Both of these scenarios will get us motion. But what did we sacrifice to get that motion?  We sacrificed strength, and we sacrificed stability.  The patient then runs a 5-10K with great range of motion, poor strength, and poor stability. What’s going to happen? Decreased performance, increased risk of injury, and joint breakdown.

After the run, they will most likely say something like, “I felt good for a while, but now my hip is really tight and hurts even more.” If we don’t know any better, we give them another massage, send them home with a handout of 5 pre-run stretches, and sell them a foam roller. Eventually they stop running, continue to run with pain, or find someone who understands MoStreBility.

The Recipe for Injury

Early in my career, before the One80 System had been developed, I began looking at my patient’s pain and injuries through a different lens. I compared and contrasted patient symptoms and wondered if there were similarities amongst the injuries I was treating.

I knew that the recipe for injury was a combination of certain ingredients at a specific moment in time. So, I asked myself: If I can prevent these components from integrating, can I prevent the injury from occurring?

On the flip side, I wondered: If I eliminated these certain “ingredients” after an injury had already occurred, could I eliminate an existing injury altogether?

Just like baking an apple pie, there must be specific ingredients mixed together to produce the end product. Without flour, apples, or eggs, your apple pie can’t exist, therefore your injury can’t exist. Similarly, in order to have an injury (either chronic or acute), the following four ingredients must have collaborated at the time of injury.

1. Gravity – Gravity is what keeps us attached to the earth but also causes joint compression. Since we can’t eliminate gravity in our every day lives, we had better figure out how to live with it.

2. End Range of Motion – We experience range of motion every day. This occurs even more frequently and at extreme levels if we’re dealing with an athletic individual. Athletes are successful because they are able to get their joints in and out of end range of motion quickly, efficiently, and safely. If we restrict our bodies from performing in extremes of motion, we would eventually loose motion and become limited in our functional abilities.

3. Transverse Plane Motion – All functional movement has some type of transverse plane or twisting component to it. Whether someone suffers a hamstring pull, ACL tear, shoulder impingement, ankle sprain, or herniated disc, it’s due in part to the lack of transverse plane control. If we eliminated our ability to twist in the transverse plane, we would become robotic and very limited in our daily lives.  So, we once again, need to live productively with this ingredient.

Experiencing the above ingredients is inevitable, but the next ingredient is a wild card that can be removed (effectively preventing future injury AND reversing current injury) provided the proper measures are taken.

4. Neuromuscular Inhibition – In order for a muscle to fire correctly, it has to be stimulated by a nerve.  If a nerve impulse doesn’t stimulate the targeted muscle at the appropriate time, with the appropriate amount of facilitation, the muscle either will not contract on time, or it won’t contract with enough force. This misfiring will negatively affect joint motion and stability.  Therefore, when a joint reaches the end range of motion, and there is a transverse plane component, and gravity is applying pressure, and the muscle is unable to stabilize it, either acute injury will occur or chronic joint breakdown will continue. But, if the there is normal neuromuscular facilitation (nerve/muscle communication) providing joint stability, the fourth ingredient in the Recipe for Injury is eliminated and the joint is safe.

So how can we live with the first three ingredients in the recipe and get rid of the fourth one?

Surprisingly, lot of things that physical therapists, physicians, strength and conditioning experts, and coaches do, actually cause neuromuscular inhibition.

By simply asking patients to eliminate common strategies like stretching, foam rolling, massage, joint manipulation, and shoe inserts (just to name a few), and replacing them with active warm up, muscle specific isometrics, barefoot walking, and functional (sport specific) movements, our patients eliminate neuromuscular inhibition and recover from a variety of injuries in as little as 2-3 visits.

 

All this apple pie talk has got our mouths watering! Here is one of our staff member’s favorite apple pie recipes. Enjoy!

1 pie crust
½ cup unsalted butter
3 tablespoons all-purpose flour
1/4 cup water
2/3 cup brown sugar
1/4 cup white sugar
8 Granny Smith apples (peeled, cored and diced)
*optional: your favorite caramel cubed candy

Directions:

  1. Preheat oven to 425 degrees F. Melt butter in saucepan and stir in flour to form a paste. Add water, brown sugar and white sugar. Bring to a boil. Reduce temperature and let simmer.
  2. Place the pie crust in the bottom of your pan. Fill with apples and sprinkle on caramel candies. Cover with a lattice work of crust. Gently pour the sugar and butter liquid over the crust. Pour slowly so that it does not run off.
  3. Bake 15 minutes in the preheated oven. Reduce the temperature to 350 degrees F (175 degrees C). Continue baking for 35-45 minutes, until apples are soft.

 

If you have questions on this entry, feel free to give us a call at (970)593-9300.