By Scott Ege, P.T., M.S.
Tennis elbow. Tendonitis. Carpal tunnel syndrome. Shoulder impingement. Back pain. Employers and occupational health and safety professionals are certainly familiar with these conditions. In general, work-related musculoskeletal disorders (MSDs) continue to create significant care management challenges for employers, healthcare professionals, insurers, and patients.
Studies show that MSD-related medical treatment and productivity loss cost employers billions of dollars a year.1 When combined with factors such as an aging workforce, obesity, and poor worker fitness levels, one can see why MSDs continue to significantly impact the bottom line and the overall health and safety of the workforce.
Meanwhile, the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH) have identified factors that contribute to these disorders, including awkward or static postures, excessive force, repetition, vibration, direct contact stress, and poor worker fitness. NIOSH further recommends employers implement certain controls to reduce or eliminate exposure to MSD hazards.
Stretching as a Preventive Measure
Employers often look to the expertise of occupational health and safety professionals to help address MSDs and workplace stretching is often proposed as a preventive measure. From a wellness perspective, stretching has long been recognized for its positive health benefits. It promotes good posture, improves flexibility, and energizes the body. It just feels good to stretch!
However, while stretching helps reduce injuries, many stretching programs fail to achieve desired outcomes over the long term. The root cause of disappointing results is typically not an incorrect technique or lack of frequency; it is the lack of a process for developing, implementing, and monitoring the program. Experience shows that successful prevention strategies feature processes that focus on continuous and sustainable improvement – and that many programs lack the necessary attributes.
Three cornerstone elements are crucial for an effective workplace stretching program. When these elements are combined, employers see a marked improvement in injury reduction and safety performance. For the occupational health provider, an appropriately structured workplace stretching program creates a natural platform to sustain an onsite presence that can lead to other injury management and prevention services.
Cornerstone Elements
Organizational Structure The stretching program must be fully supported by top management and organized by levels of responsibility. An effective program needs an internal champion who is responsible for organizing, managing, and monitoring the program.
Senior management, especially the champion, must sustain a highly visible role throughout the course of the program. Supervisors must be encouraged to embrace, actively support, and contribute to the stretching initiative.
Research demonstrates there is a direct correlation between the presence and active participation of the supervisor during the stretching sessions and the overall success of the program. Obtaining outside expertise should also be part of the organizational structure. While the vast majority of employees will have no pain or physical difficulty performing the stretches, situations requiring exercise modifications will arise. Medical history, current/active symptoms, work restrictions, and/or other physical disabilities should be addressed in a non-confrontational manner.
An ongoing relationship with a licensed local rehabilitation specialist, such as a physical or occupational therapist, to help manage these situations is highly advisable. Otherwise, the employer risks losing the participation of less-able employees who could benefit the most from the stretching program. The rehabilitation professional can also provide added value by training employees to lead their own stretch groups.
Employee Participation
Stretch groups, or teams, should be limited to 10 employees to allow for adequate supervision of all participants and optimal participation. Fellow employees who have completed training and demonstrated competency with all of the stretches should initially lead a newly formed team. (These individuals are identified as “stretch coaches” in the Stretch It Out!© program. See related article). Stretch coaches either volunteer or are nominated by their supervisor to lead their team. The coach’s primary responsibility is to provide guidance on proper stretching and serve as a communication liaison between the supervisor and the internal champion.
Once the group is familiar with the stretches, it is recommended that a rotation schedule be developed to allow each member to lead stretching sessions. Variety and an element of fun help ensure long-term success.
Monitoring
The employer’s ability to measure and monitor progress is critical to a successful injury prevention initiative. The process includes: identifying goals, developing a plan, implementing solutions, and establishing measures that will be used to assess progress toward the goal(s).
The employer’s OSHA-300 injury and illness recordkeeping log is commonly used for benchmarking and making past-to-present comparisons. The employer also may track leading indicators to identify conditions that require intervention to sustain the effectiveness of the stretching program. Random employee surveys and coach and stretch group observations also are effective information-gathering mechanisms. In addition, feedback from supervisors and top stakeholders is important when program modifications are proposed.
In Summary
Workplace stretching can be an effective prevention measure for workers who are exposed to factors that lead to MSDs. Employers often look to occupational health experts to help them develop a regimen of appropriate stretches for their workforce. By providing these services onsite, the occupational health provider is strategically positioned to forge a lasting relationship with their employer clients. Successful stretching programs must feature a structure that is supported by top management encourages employee leadership and participation, and provides clearly defined roles and responsibilities. Long-term success will only be realized when a monitoring component is in place.
About the author: Scott Ege is President of Ege WorkSmart Solutions PC, Rockton, Ill., and the developer of Stretch It Out!©, a comprehensive safety resource designed to assist employers and occupational health providers in developing, implementing and sustaining an effective workplace stretching program. He is a graduate of the University of Iowa and received his master’s degree in physical therapy from Des Moines University.
