Keeping you work-safe, and out of the physio clinic.

 

As a physiotherapist, I assess and treat injuries that occur in the workplace. These can be sudden (acute), or gradually over time (overuse). Overuse injuries come from repeated stresses that cause micro-damage of muscles, ligaments, or joints. Over time the micro-damage turns larger, and pain and weaknesses become apparent. Overuse injuries are quite common, difficult to diagnose, but relatively easy to prevent.

Any job comes with some degree of risk of injury. Knowing what your risks are, and working together with your employer or organization to minimize these risks is important for keeping your body happy and work-ready.

When possible, look at your work environment to see if anything is within your control to be changed. I will use physiotherapy as an example: There are times when I can modify my environment in order to make a task easier on my body. I can raise and lower the treatment table, or my stool on which I’m sitting, or in some cases I can use equipment that is ergonomically friendly.

Other times, the environment is not ideal, but also not in our power to modify. This is when you need to think of your body mechanics – the way you use your body to perform a task. Here are some general tips, from head to toe, of ways you can keep good body mechanics. This list is not exhaustive so it is important to consider each task you have to do individually, and what risks may be involved.

Head and neck: a common posture that is a big no-no is the forward head posture where the chin juts forward and hinging occurs about one vertebra in the lower neck. Any time you are in an upright position, keep a nice gentle chin tuck, with the back of your neck long.

Upper body: the other common poor posture is the rounded shoulder posture. When in this position too long, the muscles in the front of the chest get tight, and muscles in the back get long and weak.  Also avoid hunching your upper back, which can also contribute to a forward head posture. Keep your shoulders pulled back, with your chest open and proud.

Arms: working repetitively above shoulder height can put you at risk of an injury called ‘impingement’ in the shoulder. When it is possible, avoid having your hands overhead, or above shoulder height, especially if lifting. This can mean using a step if you’re trying to reach high, or finding ways to better position yourself around your task. Avoid repetitive reaching away from the body; if it is possible, put your body closer to where you’re working.

Hands and fingers: if your job involves a lot of bending of your wrist or fingers, gripping or grasping, it is important to stretch those tired muscles, and to strengthen the opposing muscle groups to balance it out. If you work at a computer, look to see what your wrist position is at the keyboard or the mouse. Ideally, they shouldn’t be bent up toward you too far, and the bottom of your wrist shouldn’t sit on a hard surface for a prolonged time.

Low back: Lifting techniques and proper sitting posture can make a big difference in low back pain! If you sit a lot, try to support the normal curve of your spine either through a ‘lumbar support’ or a rolled towel. For those who lift during the work day, remember the following important points. Keep the load you’re lifting close to your body. If what you are lifting is below waist height get into a lunge, or a squat position and stick your bottom out like you’re going to sit in a chair. This helps to preserve a ‘neutral spine’ – which is slightly arched.  Lastly with regards to lifts, or picking anything up / putting anything down of any weight, avoid twisting and bending simultaneously.

Legs and feet: avoid twisting your body when you have a foot, or both, planted. Wear footwear that is supportive, and appropriate for your job. If you have been prescribed orthotics, ensure you wear them while working, to help support your feet and legs. If sitting, change up your position: try not to sit all your time with legs crossed, and if you do cross your legs, try to balance how long each is the leg on top.

If you do notice new pain or weakness, attend to it as soon as possible. While many injuries require 4-8 weeks to heal at the level of the tissue (although you may return to some functions during that period), this time frame can be made longer if the injury doesn’t have a chance to heal, or if it gets re-aggravated. Be conscious of what you feel, what your job demands are, what may have caused it, and how that risk can be minimized. Seek help when help is needed, be it through your work’s first aid service, or a health professional.

Helping Kids ‘Keep the ball rolling’

 

The sun is shining. Birds are singing. Blossoms are blooming… and the soccer balls are flying! Soccer is the most commonly played sport in the world enjoyed by all ages. In 2005, about 20% of children younger than 14 years of age participated in soccer, a number which is likely higher now.

Training in organized sports during the younger years has been shown to, improve general health, have psychological benefits, and enhance performance in physical activities. However, children and adolescents are at risk of injury with sports, and special considerations need to be kept with regards to their growing bodies. Studies have shown higher risk in younger age groups, particularly those under 15.

The leg joints and muscles are commonly hurt, with strains, sprains, and bone or cartilage damage. Injuries can occur due to a traumatic event, or overuse, in either a game or in practice. While some aches and pains are relatively minor, the sprain receiving the most attention in soccer is the ACL tear. The risk of this season-ender is high due to the nature of the sport with quick changes of directions, cutting manoeuvres, sudden stops with a foot planted on the ground, and collisions with other players.

The good news? Injuries can be prevented! Training programs exist specifically for soccer players and have been shown to reduce the risk of injuries, including the ACL tear. These programs are based on well designed studies, and can be carried out by an individual experienced with this kind of training: this could be, for example, a coach or a physiotherapist.
The programs decrease injury risk by:
Decreasing muscle fatigue
Improving stability of the trunk, pelvis and joints of the leg
Optimizing balance between muscle groups
Increasing balance
Improving body technique and body mechanics.
Special training programs for young soccer players often involve a cardiovascular warm-up, strength building, stretching, agility drills, and exercises with fast, powerful movements (plyometrics).
Note to any young athletes reading: remember all those dreaded drills of burpees, hopping over cones, and jumping on/off high steps? Try to smile through them, and think of how much you’re lowering your risk of being kept out of the game.

Having a history of previous injury increases the chances of getting hurt again. The high rate of re-injury suggests players often return to sport with incomplete healing or rehab. Factors to preventing recurrence of an injury include: completing a rehab program specific to the individual, gradual return to training and competing, use of bracing and taping if appropriate, and consulting a professional to ensure the young athlete is ready before returning to sport.

Another injury risk factor that can get overlooked in the young is the occurrence of a ‘burn out’, which can happen with over training. Some signs to watch for include:
Sleep changes
Persistent aches and pains
Decreased physical performance
Changes to mood and attention
Decreased academic performance
If you note these signs, consider if over-training is a factor. Consulting your coach or health professional is important for recognizing burn-out and preventing injury. An appropriate training program will be intense enough to obtain desirable goals, without resulting symptoms of overtraining.

Participating in organized sports has many benefits for children and adolescents. To prevent injuries to stay in the game: consider incorporating a special supervised training program, give time for injuries to heal, and be aware of signs of overtraining. As the temperatures soar into the double-digits, the clouds give us reprieve, and the spring sports recommence, I hope you and your young athletes stay injury-free… and have a ball!