Reduce Repetitive Stress Injuries

Basic ergonomic education, like proper lifting and stretching, is a commonly used tool for reducing repetitive stress injuries (RSIs). But there are other tools employers could be utilizing to increase the efficacy of their risk-reduction efforts. In this article, we will talk about these other tools that belong in your program.

Injury-prevention programs generally include identification of risk, implementing safety measures and training employees. Incidents and accidents are reported and investigated to determine if further interventions could be helpful. This works very well for acute injuries, like sprains, fractures and lacerations. A specific injury occurs, and often a specific cause can be identified, investigated and remedied. This is not the case with RSIs; that makes injury-prevention efforts more complex.

Tools to ID Repetitive Stress Injuries

Repetitive stress injuries are cumulative. They build up over time from repeated microtrauma to soft tissues. Work tasks can contribute to the trauma; so can hobbies, sports and habits.

Symptoms can develop suddenly; come and go; or move from one place to another, making it confusing for employees. They often relate symptoms to aging, arthritis or an old sports injury, and they do not report them until significant damage has occurred. No two people have the same tolerance for microtrauma, so you might have someone with a significant injury, and someone else doing the same job has no complaints at all.

Risk comes from both work and personal factors, so using a combination of tools gives us the best opportunity to prevent or minimize injuries. Risk factors can be broken into job-related risk and personal risk.

Job-related risk comes from the physical demands of performing the job. Some common examples include sustained, awkward postures when working at an assembly line; frequent lifting in a warehouse; or exposure to vibration while using a jackhammer.

Person-related risk come from the way a person performs the job, i.e., how they lift; and/or whether or not they rush, take stretch breaks or even use PPE correctly.

Assessing the Risks

Below are some tools to address each risk in each category.

Job-focused controls include:

  • Job task analysis
  • Job modifications
  • Job-specific training

In a job task analysis, the physical demands of the job are identified and measured by their relative ergonomic risk. Ergonomic risks include awkward postures, repetitive tasks, force, temperature, speed, etc. Job tasks with higher risk scores are prioritized.

Job modification includes any activity taken to reduce the inherent risk of the job. Tool improvement, equipment adjustments, adding mechanical assists, task redistribution and job rotation are some examples.

Job-specific training includes body mechanics specifically for a particular task (as opposed to generalized recommendations); job specific recovery exercises; and proper tool use.

Generalized ergonomic principles are great, but limited. How many times have you heard “Lift with your legs and keep your back straight?” That is not always possible. To create meaningful training, look at the higher risk tasks of a job and determine the best possible way to realistically perform the job task and teach that.

Not all risk can be eliminated, but developing job-specific guidelines and recovery exercises can help employees’ bodies better tolerate the work. For example, a job that requires a lot of overhead work is a high risk to the neck and shoulders. Job-specific training can teach them to break these tasks up; alternate arms; get in a recovery position after sustained work; or perform particular stretches and exercises for the neck and shoulders.

Person-focused controls include:

  • General training
  • Job coaching
  • Early intervention
  • Injury management

General training includes common safety and ergonomic recommendations. Examples include proper lifting, generalized stretching routines and encouraging use of breaks.

Job coaching is done while observing the person as they perform the regular functions of their job. The “coach” then makes suggestions to reduce risk factors. This can include a better way to perform a lift; a better work position; avoiding rushing; and proper performance of stretches. Job coaching is usually done when an individual has reported discomfort or even an injury.

Early intervention is really an entire safety initiative, but we will focus on just a few components for the scope of this article. As counter-intuitive as it might sound, encouraging employees to report discomfort as soon as possible will reduce risk. Early reporting allows an opportunity to keep an injury from developing or to minimize injuries that do occur.

Once we are aware of someone needing help, we might provide a job coaching session or schedule a meeting to review stretches, exercises, use of heat/cold, rest and other self-care techniques.

This type of intervention does require strict adherence to guidelines that ensure compliance with workers’ compensation laws. You need to know exactly when to report an incident and/or injury and when to refer the employee to your work-related injury reporting process.

For example, if an employee reports back pain, you could schedule a job coaching session to give them a few tips about their lifting technique. Then, you might have a one-on-one meeting to review recovery exercises and make sure they are done properly. You could review basic ergonomic principles for driving and sleeping, and encourage them to use heat or stretch at home.

In some cases, this will be enough to resolve the discomfort, which means an injury was probably avoided. But, if symptoms do not resolve in a specified timeframe (i.e., one-three visits or within a few days), it’s best to refer them for a medical assessment.

The timeframe and types of interventions you provide to the employee are the criteria that need to be reviewed to ensure compliance with your workers’ compensation laws (in addition to OSHA and ADA). If you are using physical/occupational therapists or athletic trainers to provide these services, there are also state practice acts with which to comply.

Managing Injuries

Injury management begins as soon as an injury occurs. The goal is to remove any barriers to healing or returning to full duty to minimize the impact of the injury. Make sure all the tools have been implemented. Has the job been assessed for risk? Have modifications been suggested? Has the person been through a job coaching session?

In some cases, medical providers will make recommendations (job restrictions) that should help the employee heal. If that hasn’t happened, you might provide additional time to perform exercises or self-care, reduce productivity demands, etc. Using these tools for injury-prevention efforts can help you gain structure and control over the often challenging RSI.

Healthworks Ergonomics provides comprehensive ergonomics programs for all industries. If you would like help with your injury-prevention program, contact:

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