These boots were made for walking

• lost weight – a stone so far with more to go, by eating less and moving more (see below)
• been attending a one hour Pilates class  weekly since September last year
• started running regularly
• resumed cycling, sometimes accompanying my husband whilst he’s running – he’s in training for The Seaton Grizzly  and then the West Highland Way
• got two more training weekends scheduled – long walks over tough hills with my co West Highland Way participants – and some local long coastal walks planned too

As we all know, preparation is everything, but it’s got to be fun and varied too otherwise there’s little incentive. Our training weekends involve us staying somewhere lovely, walking lots and enjoying the odd beer or two. Pilates classes are great fun and I’m really feeling the benefits too – hugely improved balance and mobility.

I think we’ll probably need a week off after the West Highland Way but I’m expecting it to be an incredible week!

My new pink trainers!!

I have entered the Reading Half Marathon which is on April 1st 2012. It will be my first official run of this distance and Fiona and myself are now well into our training. We meet once a week to go for a long run together and then run a few additional shorter faster runs or interval runs by ourselves.

So what’s your New Year’s Resolution? How is it going? Do you need any advice?

Good luck with it and keep in touch,

Katherine x

Christmas decorations - beautiful baubles or menacing maimers?

Much as we love to see our clients at any time of the year, we also like to make sure they’re healthy and that they have a fabulous Christmas.

Here are FIVE ways to avoid injury and enjoy your Christmas:

1. Decorate carefully: RoSPA says that around 1,000 a year are injured by their Christmas decorations. Nasty little things those baubles! Be sensible – use step ladders, rather than that spinning office chair, or get someone else to put the decs up and take the risk. Plug fairy lights in first to check they work, then you won’t be climbing up and down those ladders fifty times increasing the chance of falling off, trying to sort out the non-working lights. Don’t eat all those chocolate tree decorations yourself.
2. Protect your loved ones: 59% of a&e cases at Christmas are the result of family members falling out and fighting*. Consider hiring sumo wrestling suits or turning your living room into a padded living room to at least reduce the seriousness of the injuries. It could be more interesting than watching the Queen’s speech. Or you could turn the lights out and hide behind the sofa when family members arrive.
3. Avoid food poisoning and dishwasher’s elbow: There’s nothing worse than spending Boxing Day unable to leave the bathroom. Have your Christmas dinner at a local eatery, instead of at home. Still a tiny chance of food poisoning, but at least you won’t have to do the washing up. Food poisoning, however, could be the answer to the additional 2kg of weight that the average Brit puts on over Christmas, but it’s still not pleasant.
4. Pull those crackers carefully: Christmas crackers can contain not only ridiculous hats and stupid jokes, but also small explosive charges and missiles. Don’t pull crackers close to someone’s ear, however much you dislike them and certainly don’t pull a cracker with so much vigour that the plastic toy/magnifying glass/miniature pack of cards flies out as such a speed as could cause blindness should they strike someone in the eye.
5. Watch out for armchair neck and/or Wii related injuries: Nodding off in the arm chair in front of the TV after a huge Christmas dinner will only give you a nasty crick in your neck. Go out for a walk in the fresh air instead – it will aid your digestion and warm you up for the inevitable game of Twister or play with the new Wii later on. If you’re going to play on your brand new Wii, don’t forget to warm up properly beforehand, or you’ll risk straining muscles you never knew you had. Use the strap on the handset – your family, friends, TV and household fittings will thank you for this. Try not to be too competitive. Beating a seven year old at Just Dance 3 is nothing to shout about, or risk doing yourself a mystery for.

* Remember that 97% of statistics are made up by copy editors who have had a little too much Christmas cheer at lunch time.

Seriously though:

Freddie the Clinic skeleton in Christmas party mode

1. Reduce the likelihood of food poisoning – don’t wash your raw turkey under the tap and do make sure it’s properly cooked.
2. Switch off your fairy and Christmas lights and extinguish any lit candles before you go to bed or leave the house. Many, many house fires are caused by electrical faults in fairy lights or by unmonitored candles at Christmas.
3. Obvious really: don’t drink and drive.

It just remains for me to say that the Working-Health team, including the clinic skeleton Freddie in all his Christmas finery, wishes you a stress- and injury-free Christmas and a very merry New Year!

Photos by Nicola Bathe and Katherine Lewis.

Working-Health in print

A while ago I wrote a short article for Homes & Gardens Magazine* entitled “Choosing The Right Pillow” and it’s finally been published in the January 2012 edition, on page 105. So rush out to your local newsagents and buy yourself a copy (or three!).

Working-Health website updated

And whilst I’m at it, we’ve also had a tidy up of the Working-Health website, adding new pages including a testimonials page and a meet the team page. There will be more updates soon.

* Other interior/exterior publications are available.

Get a good night's sleep and you're ready to face the new day!

To wake up revitalised you simply need to get enough good quality sleep. We are all quite different in how much sleep we require but most adults need between seven and eight hours a night, although some people can routinely cope with much less.

Ten Steps To A Good Night’s Sleep

1. Get the temperature right. Most people sleep better in a room that is slightly on the cool side. This may be achieved by keeping a window open or turning off central heating during the winter.
2. Humidify the air: either by use of a humidifying machine or simply by placing a bowl of water near where you sleep. It really can make all the difference.
3. The use of aromatherapy essential oils or herb bags such as lavender can be helpful for a lot of people to sooth a good night’s sleep.
4. Black out blinds or curtains, particularly useful in the summer months, assist in the maintenance of good quality sleep throughout the night.
5. Avoid caffeine or alcohol as long as possible before going to bed and try to establish a sleep routine where you go to bed and wake up at the same time on most days.
6. If you wake up during the night, why is this? Common reasons could be due to temperature or lighting problems as mentioned above, but also could be from outside noise, a partner who snores or a sign of an underlying medical problem such as night cramps or even depression. Waking up in the early hours of the morning can be a symptom of depression so always discuss this with your GP if you have concerns.
7. If you cannot turn your mind off, have a note pad by your bed and write down what is on your mind. Your brain is then officially allowed to forget your stressful thoughts. If you really can’t sleep, it can be helpful to sit quietly in another room for 15-20 minutes but don’t be tempted to turn on your computer or TV, this will only make things worse.
8. Remove all laptops, palmtops, smart phones from your bedroom to make sure you are not tempted to use them just before bed. Switch any non-vital phones to silent.
9. Get the mattress right. In general the correct density of your mattress is decided by your body weight, with people below 10 stone often requiring a soft mattress, those between 10-15 stone requiring a medium mattress and anybody over 15 stone requiring a firm mattress. A good quality mattress is very important. Spend your money on the mattress as opposed to the bed frame if money is tight and try to spend as much time lying on the bed before you buy as possible! A pocket sprung mattress is often a safe bet.
10. Get the pillow right. A pillow should support your neck into an optimal neutral posture, whether you sleep on your back or your side, for the entire sleeping period. Correct alignment is essential at night time to maintain healthy joints and soft tissue structures. Incorrect posture is often caused by using a pillow that forces your neck away from this midline position, either forwards (usually from a pillow that is too high) or backwards (from inadequate support or lack of pillow). Lying on your tummy where your neck is twisted excessively to one side should also be avoided. Orthopaedic (or contoured pillows) are designed to help maintain neutral postures over night but try to make sure you get the right design for you. Try it out before you buy if possible or ask advice from your Physiotherapist, Osteopath or Chiropractor.

Five Ways To Stay Alert During The Day

Staying perky and alert all day!

To stay perky and alert during the day:

1. Make sure you eat healthy regular meals and keep hydrated (most people require about 2 litres of water a day).
2. Get away from your desk at lunch time and go for a walk.
3. Don’t eat your lunch at your desk and surf the internet, as your body needs movement to improve your circulation, concentration and overall comfort.
4. Try and meet and talk with friends or colleagues during breaks as a bit of socialising can really help with motivation and alertness.
5. Just by smiling we can uplift our mood, our productivity and overall vitality.

Images: graur codrin / FreeDigitalPhotos.net and Ambro / FreeDigitalPhotos.net.

In Part 1 and Part 2 of my recently published article, I introduced the need to think about the older workforce and outlined the physiological and psychological changes that impact on older workers. Here in Part 3, my article continues.

Complexity and Interaction of Factors Influencing Neuromusculoskeletal Health of an Ageing Worker

So it can be seen that physical and psychological factors play an important role in the ageing process at an individual level. Figure 1 below creates a schematic representation of additional factors that must be considered when assessing the suitability of current work demands for an ‘ageing’ employee. Such a model may also be used to help highlight where a ‘mismatch’ maybe present and to help prioritise resource.

Figure 1: A conceptual diagram representing the complex interactions of influencing factors on the neuromusculoskeletal health of an’ ageing’ worker.

The starting point for neuromusculoskeletal fitness for each individual will be different as will their course across the model. Good Occupational Health assessment and evaluation will help gain an insight into the individual’s current state of neuromusculoskeletal health. Likewise interview techniques with the worker either from Occupational Health or Line Management supervision can be utilised to identify the potential positive impacts. By plotting a path across the model, thought must be given to how these factors influence the neuromusculoskeletal health of the ‘ageing’ worker.

Other Assessment of Employee Fitness for Work in the Older Workforce

The Work Ability Index (WAI) was developed by Tuomi et al (1996) in Finland. It is an instrument used in clinical occupational health and research to assess work ability during health examinations and workplace surveys. It measures and records the work ability of employees and can be used at an individual, group or organizational level. The index is determined on the basis of the answers to a series of questions which take into consideration the demands of work, the worker’s health status and resources. It can be used to predict work ability in the near future. Recent results of a 28 year prospective study show that perceived poor WAI scores undertaken in midlife are associated with accelerated deterioration in health and functioning and can be used reliably as a predictor of health almost three decades later (von Bonsdorff et al 2011). Such inferences mean that midlife WAI scores can be used as an early predictor of functioning in old age.

Scores obtained from the WAI can be used to prioritize interventions aimed at improving the employee’s work ability. Table 1 below shows how the WAI is scored and corresponding action levels.

Table 1:  WAI Scoring System and Associated Action Levels

(Tuomi 2006)

Whilst the WAI assesses more health issues than neuromusculoskeletal health it is deemed a suitable tool for assessment of this, particularly in older workers, who are most likely to have co-existing pathologies, which are likely to be influencing neuromusculoskeletal health.

Best Practice Guidance for Age Management of WRMDs

A good understanding of the causation and complexity of WRMDs in the older worker is essential. Occupational Health and Safety Staff are encouraged to:

1. Assess the determinants of work ability of the older worker

2. Target available resources to identified problem areas. This maybe aimed at an individual, group or organizational level and may include:

• Examination of job demands versus individual capabilities
• Examination of work-rest scheduling
• Shift work guidance
• Examination of current reporting systems
• Provide health promotion, in particular the importance of maintenance of physical activity
• Training on age management to Human Resource Personnel, Occupational Health and Safety Staff and the ‘older’ worker
• Evaluation of job design
• Examination of organizational culture and worker ‘beliefs’

(Buckle et al 2008, Crawford 2011, van dem Berg et al 2008)

3. Consider Policy implications with regards to the neuromusculoskeletal health of the older worker.

• Age strategy
• Prevention of age discrimination

The positive effects of good age management can be seen in Figure 3 below:

Figure 3: The Effects of Age Management (Tuomi et al 2006)

Conclusions

Factors influencing WRMDs in the older workforce are numerous and complex. An increasing understanding of this is emerging. Due to a rapidly increasing ageing population, more research is required on WRMDs in this demographic group. Occupational Health, Safety, Human Factors, Human Resource and Management Professionals all have a role to play in the identification and management of neuromusculoskeletal health in the ageing worker. Current UK legislation and government initiatives are likely to have a positive effect on enabling older workers to remain at work longer, if this is their wish.

References

Black, C. (2008)
Working for a healthier tomorrow: Dame Carol Black’s review of the health of Britain’s working age population. TSO, Norwich

Buckle, P., Woods, V., Oztog, O. and Stubbs, D. (2008)
Workplace design for the older worker: Strategic Promotion of Ageing Research Capacity. University of Surrey

Crawford, J. (2011)
The Ergonomic Challenges of an Ageing Workforce: Manageing the Physical and Mental Workload, Institute of Occupational Medicine, Edinburgh, http://www.iom-world.org

Cierco, M.T. (44 BC)
Cited by
Balter, P.B. and Balter, M.M., (eds) (1993)
Successful ageing. Press Syndicate of the University of Cambridge, Canada pp1-2

Harper, S. and Marcus, S. (2006)
Age-related capacity decline: A review of some workplace implications. Ageing Horizons, 5 pp20-30

Havighurst, R.J. (1963)
Cited by
Balter, P.B. and Balter, M.M., (eds) (1993)
Successful ageing. Press Syndicate of the University of Cambridge, Canada pp1-2

Miranda, H., Kaila-Kangas, L., Heliovaara, M., Leino-Arjas, P., Haukka, E., Liira, J., and Viikari-Juntura E. (2009)
Musculoskeletal pain at multiple sites and its effects on work ability in a general working population. Occupational and Environmental Medicine, 67 (7) pp449-455
Office for National Statistics. http://www.statistics.gov.uk

Palmore, E. (1979)
Cited by
Balter, P.B. and Balter, M.M., (eds) (1993)
Successful ageing. Press Syndicate of the University of Cambridge, Canada pp1-2

Payton, O. D. and Poland, J.L. (1983)
Ageing process: Implications for clinical practice. Physical Therapy, 63 (1) pp 41-48

Raven, P. B. and Mitchell, J. (1980)
The effects of ageing on the cardiovascular response to dynamic and static exercise. In Weisfelt, M.L. (eds), The ageing heart, New York, Raven Press, pp 269-289

Ross, D. (2010)
Ageing and work: an overview. Occupational Medicine, 60 pp169-171

Tuomi, K., Ilmarinen, J., Jahkola, A., Katajarinne, L. and Tulkki, A. (1996)
cited by Tuomi (2003) see http://www.duurzaamdoorwerken.nl/files/usr_jpeeters/Publicaties/HELSINKI%20STUDIEREIS/Ilmarinen%20presentatie%20WAI.pdf

United Nations Publications, World Population Ageing (2007)
http://www.un.org/esa/population/publications/WPA2007/ES-English.pdf

van dem Berg, T.I., Elders, L. A., de Zwart, B. C. and Burdorf, A. (2008)
The effects of work-related and individual factors on the work ability index: a systematic review. Occup. Environ Med. 66 pp211-220

von Bonsdorff, M. B., Seitsamo, J., Ilmarinen, J., Nygard, C., von Bonsdorff,M. E. and Rantanen, T. (2011)
Work ability in midlife as a predictor of mortality and disability in later life: a 28-year prospective follow-up study. Canadian Medical Association Journal, Early release published at www.cmaj on 31st January 2011.

Williams, D. and Wirths, C. (1965)
Cited by
Balter, P.B. and Balter, M.M., (eds) (1993)
Successful ageing. Press Syndicate of the University of Cambridge, Canada pp1-2

Further Reading
HSE Management Standards for Stress
http://www.hse.gov.uk/stress/standards/
Working Late (Loughborough University)
http://www.workinglate.org/
Oxford Institute of Ageing
http://www.ageing.ox.ac.uk/

In Part 1 of my recently published article, I introduced the need to think about the older workforce. Here in Part 2, my article continues.

Main Physiological Impacts of Increasing Age on our Neuromusculoskeletal systems

Soft Tissue Structures:

Physiological impacts of age.

Bone and Joints:

As a person ages, the balance between bone absorption and bone formation changes, ultimately resulting in a loss of bone tissue. This is largely due to the mineral content of bones decreasing, making them less dense and more fragile. This may result in osteoporotic changes, making an individual more prone to poor posture, to crush fractures of the vertebrae and to fractures throughout the body.

The main effects on joints of ageing are a reduction in flexibility and reduced ‘cushioning’ from cartilage which may lead to inflammation and pain.

Ultimately these changes are likely to have a detrimental impact on an individual’s ability to undertake physical work tasks. For example, reduced strength and joint mobility will adversely affect the ability to perform strenuous manual handling tasks. Obesity and pain will further reduce function. Multi-site pain is an important risk factor for reduced work ability (Miranda et al 2009). All these factors may predispose an individual to adverse postural changes, which in turn creates more loading on the neuromusculoskeletal system.

Due to the complexity of issues such as occupational risk factors, lifestyle and genetics, it is difficult to determine at what age an individual’s physiological decline may be due to age. Despite this, Raven and Mitchell (1980) indicate that on average, strength begins to decline around the age of 40.

Physical Capacity

Current Supporting Evidence, from Crawford 2011: Systemic Review of Literature states that

• Reduction in aerobic capacity occurs at a rate of approximately 10% for each decade
• Increase in weight¹
• Reduction in stature¹
• Increase in BMI
• Reduction in muscle strength¹

These factors can be mediated by maintaining high levels of physical activity (Crawford 2011).

Balance Mechanisms

It is more difficult to maintain balance as a person ages due to changes in balance receptors (Harper and Marcuss 2006) and due to other common deficits that occur with age such as reduced visual abilities, pain syndromes and potential lack of joint proprioception associated with this. In turn an individual is more prone to slips, trips and falls, which may cause a traumatic musculoskeletal complaint or cause an existing complaint to be aggravated.

Psychological and Cognitive Functioning

Depression is most common in elderly population groups (Harper and Marcuss 2006). The main manifestations of depression such as a reduced interest in activities and hobbies and general low mood will have negative consequences on the neuromusculoskeletal health of an elderly person.

Age-Related Cognitive Decline (ARCD) includes:

• Working memory loss
• Processing problems
• Encoding problems (putting information into memory)
• Retrieval (finding information in memory)
• Reduced attention and concentration span (Harper and Marcuss 2006)

ARCD may adversely affect an employee’s ability to undertake effective ‘risk assessment’ or recall correct procedures in the work place, thus predisposing them to injury from undertaking poor manual handling techniques when undertaking work tasks. This must be balanced against the positive impacts of ageing such as increased experience and knowledge that may help to negate other unfavourable effects.

Psychological Changes (Current Supporting Evidence, from Crawford 2011: Systemic Review of Literature)

• Reduction in reaction time due to increased central processing time¹
• Increase in caution¹
• Increase in accumulated knowledge and experience¹
• Cognitive abilities affected by numerous external and internal factors¹

_________________________________________
¹ Moderate evidence provided by generally consistent findings in few, small or low quality scientific studies.

To be continued in Part 3…

Image: Ambro / FreeDigitalPhotos.net

An article of mine was recently published in Occupational Health magazine. It’s been split into three parts to make it more readable and the first part follows. Click back here soon for Part 2.

Introduction

Currently more than 20% of workers in developed nations are 60+ years old

When does old age occur? At what age does an individual become too old to carry on their current job tasks due to negative ageing effects on their neuromusculoskeletal system? In 44 BC Cicero, a Roman Philosopher and Statesman, declared that you must not confuse old age with illness and proclaimed the many virtues of increasing age. The concept of ‘successful ageing’ has been discussed for several decades (Havighurst 1963, Palmore 1979, Williams and Wirths 1965). So why is it in today’s society ‘ageing’ itself and the impact on organizations of employing an ageing workforce often gets a bad press?

In today’s society the topic of ‘ageing populations’ is increasingly researched and publicised. This is not surprising considering that at present a little >20% of workers in developed nations are >60 years old but it is predicted that this figure will rise to around 33% of >60 years of age by 2050 (United Nations Publications 2007). In the UK it is predicted that one-third of the population will be >60 by 2033 (Office for National Statistics). This change, due to lowered birth rates and people living longer, results in a reduction in the economically active population (J Crawford 2011). It will have a major impact on society and the economy in general and place challenges on Occupational Health Professionals and Employers alike, in sustaining a healthy and productive ‘ageing’ working population.

There is a growing tendency to challenge what it means to be an ‘older worker’. An emerging view of maintaining ability, developing potential and continued competence, rather than focusing on ‘age’ per se is taking place (Ross 2010). This complements the ‘Life Course Approach’ discussed by Crawford (2011) which considers that we are ageing from the time we are born until the time we die and the general message engendered by Black (2008) of ‘think capability not incapacity’.

Since the introduction of the Equalities Act in 2010, the removal of a forced retirement age will allow an individual to be assessed on whether they are able to cope with the demands of their work. This change in legislation complements our current understanding that a large variation exists regarding the effects of ageing on an individual (Crawford 2011) and allows a decision at an individual level to be made on whether an employee is fit to continue working after a certain age.

Other government initiatives such as the Health, Work and Well-being at Work scheme and EU programmes such as the plan to increase participation of older people in society in general, (making specific reference to work as a means to achieve this) (Ross 2010), will also be putting this subject firmly on the political agenda.

Work-Related Musculoskeletal Disorders (WRMDs) and the Ageing Process

WMSDs are multifactorial and influenced by such a large number of individual, psychosocial and physical factors. Is it therefore possible to predict or understand what impact the ageing process may have on WMSDs? This article will consider the positive and negative impacts of employing an older worker. It will aim to highlight how an organization can help support the ‘ageing population’ to help sustain a productive and healthy workforce with regards to neuromusculoskeletal health.

To be continued in Part 2…

Image: photostock / FreeDigitalPhotos.net.

Facebook

Perhaps one reason that I have failed to update my Blog is that I have been too busy on facebook! Now whilst my blog is professional my FB activities are most certainly personal. So why am I blogging about facebooking? I’m going to look at this from an ergonomic impact. Is it good for us or not and what may be the impact on our working lives?

Psychological Impacts:

FB most certainly is a sociable activity. It helps us to connect with other people at any time of day, fitting in with modern lifestyles and our ’24 hour’ society. Due to the advances in mobile technology, most of us are able to ‘ log in’ wherever we are and whatever we are doing. At work, this maybe during our lunch break. It may be at regular intervals throughout the working day or it may be a near constant use of facebook, when really we should be doing other things. So is this good or bad? Well I guess this may depend on what type of work you are undertaking. For some individuals involving themselves in facebook banter may enhance their work by increasing their motivation and overall happiness. For others, it is likely a distraction that takes their mind away from the task in hand.

Other problems maybe where professional and personal lives intertwine. What is safe for your close friends to witness on facebook may have more of a detrimental impact on current or past work colleagues, who know you in a more professional capacity. Having said that, I do feel that sometimes this can also be an advantage, as you may come across more positively. But the big danger of facebook must be what you post. How easy is it to have a rant on facebook, publically insult others, or even worse, come across badly yourself, possibly by too many negative status updates, washing your dirty laundry in public or basically appearing needy and sad? If you happen to be at work whilst writing or reading emotionally charged topics this may translate into more emotionally charged behaviour at work!

Physical impacts:

Sitting facebooking increases our exposure to sitting at a computer, whether this be a desk top, laptop or handheld device. For most people this will have a hugely detrimental impact and is likely lead to increased aches and pains. In clinic I treat too many bad backs or bad necks which are associated with sedentary lifestyles, especially when work is undertaken at a computer. Getting up and moving around or going for a walk at lunchtime, rather than sitting Facebooking is a much healthier habit.

My own personal experience:

From my own personal perspective I have only been active on facebook for about 7 months. I’m learning my way through. Whilst I think Facebook can be a great forum for topical and heavy issues I know that I personally have been a bit too deep and philosophical at times. I have tried really hard not to ‘slag’ anyone off but I know that I have not always got it right. BUT, I do have good friends on facebook and I know I will be let off easily for posting bits that really I shouldn’t have. I have tried to inject humour whenever possible but also to be supporting and understanding. I love the fact that I am now in contact with people that I certainly would not have been if it were not for Facebook. I love the whacky threads that sometimes come from nothing and from the interaction of your own friends with other people’s friends. I know I have certainly been a bit obsessive about it, and at times read and tried to evaluate other people in a way that should only be done face to face. It has got in the way of work a little but I have very flexible working hours, so work still does get done! At the end of the day the positives certainly outweigh the negatives for me. I will not be closing my Facebook account, but perhaps I will try to login a little less!!

It gives me great pleasure to introduce Dominic Quirk and Nicola Bathe, the two new team members at Working-Health Physiotherapy and Ergonomics.

Dominic is a Chartered Physiotherapist, who has a considerable wealth of experience in the treatment and management of musculoskeletal disorders. Dominic also offers acupuncture for pain relief, which is a great adjunct to other physiotherapeutic modalities. Dominic will be working evening clinics within Spirit Health Club, so please feel free to approach him to discuss any issues with aches and pains that you may be having. Email: dominic.quirk@working-health.com.

Nicola has come on board to help me with the back end of the business (and boy have I needed it??). Nicola is incredibly organized and effective and a real joy to work with. She takes on board everything I throw at her such as chasing up invoices, organising me and my spreadsheets, and optimizing my website. Nicola works remotely but is contactable on nicola.bathe@working-health.com.