trainthetrainer

Ergonomics:“Train the Trainer”: 

Ergonomics: “Train the Trainer” Randy Wegge

Definition: 

Definition Webster: er·go·nom·ics (ûr'gə-nŏm'ĭks): an applied science concerned with designing and arranging things people use so that the people and things interact most efficiently and safely. Literal definition: Ergon = work Nomos = rules “The rules of work”

Ergonomics: 

Ergonomics Ergonomics : the engineering science concerned with the physical and psychological relationship between machines and the people who use them. The practice of adapting products and processes to human characteristics and capabilities in order to improve people’s well-being and optimize productivity. “Fitting the job to the worker” We must understand: What tasks are being performed Who is performing the tasks What is being used to perform the tasks

Components of a Work Station Fitting all the pieces together!: 

Components of a Work Station Fitting all the pieces together! Chair Work surface Keyboard/Mouse Monitor Telephone Environment Accessories

Chair : 

Chair Seat Height Able to reach the floor comfortable with both feet flat on the floor Seat Angle Slightly forward tilt Seat Depth Allow a width of three fingers between calf and seat pan Backrest Height Back support hits the lumbar region Backrest Angle Allows for 90° - 120° hip flexion Armrests Must be used correctly or should not be used at all

Adjusting Your Chair - Video: 

Adjusting Your Chair - Video Watch Video Let’s give it a try!

Work Surface: 

Work Surface What can be adjusted? Height Should be adjusted to the proper chair position. Allows for ergonomic positioning. Arrangement Primary, secondary, reference zone

Workstation Set-up: 

Workstation Set-up Primary Work Zone The distance from elbow to hand Able to reach these items without reaching for them. Secondary Work Zone Within arm’s reach Reference Zone Outside of arm’s reach

Keyboard/Mouse: 

Keyboard/Mouse For most employees these should be situated in the primary work space. Arrange directly in front of monitor. Demonstrate how to correctly use the mouse and keyboard.

Monitor: 

Monitor Distance Good rule of thumb is approx. an arms length away (18-30 in.). Height Eye level should be at the top 1/3 of monitor. Bifocals – need to have monitor as low as you can. Location Directly in front of the keyboard. Angle Approx. 10°-20° Font Size Clarity/Resolution Color Schemes Light colored font on dark background.

Telephone: 

Telephone Depending on employee, the phone will normally be placed either in the primary or secondary work space. Headsets: More than 2 hrs of use per day = Mandatory? Built-up hand set attachments do not do enough.

Environment – Every day nuisances : 

Environment – Every day nuisances Lighting Air Quality Temperature Space Noise Neighbors Fax, Copier, Telephone, etc.

Accessories : 

Accessories Document Holders Footrests Glare Screens

Assessment Process : 

Assessment Process Gather information. Evaluate how the existing set-up looks. Adjust what is already there. Make your adjustments/recommendations. Follow up/Re-evaluate (2 weeks). If still deficient…try new adjustments and consider introducing equipment. TRAIN how to use! Follow up as needed.

Gather Information: 

Gather Information Interview the employee: What are your job tasks? How often do you do these tasks each day? How long have you noticed this pain? When does it hurt most…end of day, busier days, towards the end of the week, etc.? Do you take regular breaks? What irritates it the most? What specifically hurts? What do you think the issue is? What do you think will help? Observe the employee: Watch them work for awhile. Encourage them to work as they “normally” would. How do they interact with their environment?

Assessment Process…: 

Assessment Process… Evaluate the existing set-up Use checklists if available (initial assessments) What is already present and what can we adjust? The workstation components The process The worker Look for postural issues and bad habits Adjust what is adjustable Who will be responsible for making adjustments? Make your recommendations Document Stick only to the facts. What was said, what was observed, measurements. Name, date, specific report of discomfort, observations, recommendations, plan of action, and follow up needs.

Sample documentation: 

Sample documentation ____ contacted me yesterday after seeing ____., a hand therapist at _________ . ____ has been having difficulty bilaterally with tendonitis in her wrists every since being pregnant. In looking at her workstation, I noted that her mouse is positioned in a way that causes her to reach forward with her shoulder and she is also anchoring her wrist down causing her to remain in a static wrist extension for prolonged periods of time. I moved her mouse so it is at the edged of her desk, reducing/eliminating shoulder flexion and I placed a piece of dycem underneath her mouse pad to eliminate any sliding. I also demonstrated the proper way to hold and use the mouse so that it involves the entire arm movement and keeps her wrist in a neutral position vs. anchoring at the wrist. I replaced her split keyboard with a regular one because her keyboard seemed too large for her. She still needs to reach laterally a good distance to get to her mouse so I ordered a keyboard with the number pad on the left side which will allow her to keep her mouse much closer to her side, reducing her lateral reach. I will follow up with ____ in one week and install the keyboard as soon as it arrives. rw

Assessment Process…: 

Assessment Process… Follow up When? Varies depending on the situation. Has there been any improvement? Have conditions worsened? Re-evaluate Do you still note some areas of concerns? If so…is there anything else already present that can be adjusted? May need to look at introducing some type of ergonomic equipment. Explain why…train how to use…use it yourself

“Ergonomic” EquipmentGadgets, Gizmos, and Other Stuff: 

“Ergonomic” Equipment Gadgets, Gizmos, and Other Stuff Wrist Rests Pros Maintain neutral wrist positioning Reduce weight throughout shoulders Softens the surface under the wrists Cons Promotes anchoring at the wrist Contact point on the wrist

Slide24: 

Keyboard Trays Pros May adjust the keyboard height and angle to custom fit the users needs Allows for more posture changes Cons May decrease knee clearance May force longer reaches for other things If adjusted incorrectly, may exaggerate problems

Slide25: 

Alternative “ergo” Mice/Keyboards Pros Allows you to use different muscle groups Reduce/Eliminate awkward postures of the arms or wrists Reduce/Eliminate movement at the wrist Cons Difficulty adapting, leading to reduced production May be using more/different/smaller muscle groups No evidence that trackballs help/hinder

Do we need an ergo intervention?: 

Do we need an ergo intervention?

Trouble ShootingWhy do we hurt???: 

Trouble Shooting Why do we hurt??? Poor posture Lack of movement Frequent “micro” breaks Prolonged poor posture can decrease productivity by as much as 50% Stand to sit ratio of 70:30 60 second break every hour

Troubleshooting : 

Troubleshooting Headaches Muscle tension Stress Irritated/Dry Eyes Monitor glare Distance of monitor Prolonged computer use/Lack of breaks Font selection Poor vision Neck Pain Poor head postures Monitor height Monitor location Document viewing Arms extended Cradling the phone Armrests Lack of breaks

Troubleshooting: 

Troubleshooting Shoulder Pain Poor conditioning Forward head posture Mouse/keyboard too high or off to the side Arms extended Overhead reaching/lifting Overuse/Lack of breaks Elbow Pain Keyboard too high Leaning on elbows Repetitive squeezing/pinching Striking keys too hard Reaching for mouse Overuse/Lack of breaks

Troubleshooting: 

Troubleshooting Wrist/Forearm Pain Keyboard/mouse positioning Contact forces Striking keys too hard Wrist alignment Wrist deviation Resting on elbows Gripping too tight Type of mouse Overuse/Lack of breaks

Troubleshooting : 

Troubleshooting Hand/Finger Pain Excessive force on mouse/keyboard Holding static positions Contact points at wrists Type of mouse Wrist alignment Gripping pen too tightly Keyboard/mouse positioning Overuse/Lack of breaks

Troubleshooting: 

Troubleshooting Upper Back Pain Poor conditioning Elevated shoulders (armrests) Extended arms Forward head Muscle tension Mouse/keyboard is too high/low Seating Lack of breaks

Troubleshooting : 

Troubleshooting Low Back Pain Poor posture One foot under buttocks Arms extended Twisting Seating Feet do not touch floor Lack of breaks Leg/Feet Pain Seating Feet dangling Seat pan depth Posture Lack of breaks

Common Themes??: 

Common Themes?? Poor Posture Failure to take breaks We need to continuously stress the importance of each employee taking a personal responsibility for themselves.

Upper Extremity Musculoskeletal Disorders: 

Upper Extremity Musculoskeletal Disorders What are they? Soft tissue ailments to the upper extremities, most commonly caused by overuse. Soft tissue: refers to any tissue that connects, supports, or surrounds other structures (bones, joints) and organs. Examples: muscles, tendons, cartilage, ligaments, nerves, fat cells, blood vessels Also referred to as: CTD (Cumulative Trauma Disorder) RSI (Repetitive Stress Injury) Overuse Syndrome Musculoskeletal Injuries

Common repetitive-type injuries found in the office setting: 

Common repetitive-type injuries found in the office setting Lateral Epicondylitis Medial Epicondylitis Tendonitis Carpal Tunnel Syndrome Ulnar Nerve Impingement DeQuervain’s Tendonitis Shoulder Tendonitis, Bursitis, Impingement Rotator Cuff Tear Thoracic Outlet Syndrome

Tendonitis : 

Tendonitis Literally means inflammation of the tendon. Tendons connect your muscles to your bone. Common cause is overuse, when muscles are being asked to do higher levels of activity they are not accustomed to doing. Treatments: Icing the affected area Rest Brace – protects the tendon Anti-inflammatory medication

Lateral Epicondylitis: 

Lateral Epicondylitis More commonly known as “Tennis Elbow” Pain in the lateral aspect of the elbow where the muscles connect to the bone. Treatment: Stop or limit activity Anti-inflammatory medication Brace may be worn Stretching and strengthening.

Medial Epicondylitis : 

Medial Epicondylitis Also known as “Golfer’s Elbow” Similar condition as Lat. Epi., only the pain in on the inside of the elbow around the boney prominence. Treatment is the same as with Lat. Epicondylitis.

Carpal Tunnel Syndrome : 

Carpal Tunnel Syndrome A disorder in which the median nerve is compressed at the wrist Causes numbness and tingling. Usually on the thumb side fingers. Treatment: Wear brace at night or during activities Limit activities that aggravate condition Surgical intervention

Ulnar Nerve Impingement: 

Ulnar Nerve Impingement Occurs when the Ulnar Nerve becomes compressed and cannot function properly Numbness and tingling in the ring finger and little finger. Causes: Overuse with the elbow in a bent position Direct blow to the elbow Sleep habits

DeQuervain’s Tendonitis: 

DeQuervain’s Tendonitis A condition caused by irritation or swelling of the tendons found along the thumb side of the wrist. Pain over the thumb side of the wrist is the main symptom. Usually described as sharp, stabbing pain.

Shoulder Tendonitis, Bursitis, Impingement: 

Shoulder Tendonitis, Bursitis, Impingement Tendons of the rotator cuff make contact with the acromion and they become swollen. The swollen tendon can get trapped and pinched under the acromion. This is known as an impingement. Bursitis: fluid-filled sacs called “bursa” become inflamed.

Rotator Cuff Tear: 

Rotator Cuff Tear A tear in the tendon Chronic: over time, RC tenditis eventually wears a hole through the tendon. Acute: a sudden motion or lift causing a “pop” in the shoulder. Usually experience an immediate onset of pain.

Thoracic Outlet Syndrome: 

Thoracic Outlet Syndrome Your thoracic outlet is the small space between your collarbone (clavicle) and your first rib. Caused by pressure on the nerves and/or blood vessels that pass through the thoracic outlet. Symptoms can include: pain, numbness, tingling, weakness, or coldness in the upper extremity.

Personal factors/habits: 

Personal factors/habits Posture Attitude Sleep Postures Hobbies/Sports Age Gender Driving Psychological Impact Obesity/Exercise & Fitness Smoking Personal Habits

Posture and neutral position gets the first look: 

Posture and neutral position gets the first look

Not so innocent victims: 

Not so innocent victims

And so on….: 

And so on….

And so on….: 

And so on….

Slide52: 

Modified from Chaffin & Anderson

What was always Mother’s Advice???: 

What was always Mother’s Advice??? Sit up straight!!! Guess what…she was absolutely right! Decreases the load on your spine Helps the organs of your body function more efficiently It promotes movement efficiency and endurance and contributes to an overall feeling of well-being Helps you look confident

Lifelong misuse of our bodies: 

Lifelong misuse of our bodies We trick our bodies into thinking we are comfortable. No longer using our core muscle groups. Results in muscles weakening (atrophy) May lead to: Fatigue Muscle strain Pain Dr. Wilfred Barlow, a well known physician, has found that misuse is usually a major factor in both causing and perpetuating rheumatism, backache, arthritis, breathing disorders, hypertension, fatigue, gastro-intestinal conditions, headaches and certain sexual problems.

What is Proper Posture?: 

What is Proper Posture? Head, trunk, arms and legs are aligned with one another Look around, how many people demonstrate good posture?

Slide56: 

At what age do you think kids start to develop poor posture?

Slide57: 

Try breathing with head down and hunched shoulders compared to head up in proper alignment. Which gives you better breathing capacity?

Attitude of employees: 

Attitude of employees Interactions with co-workers Job Satisfaction Unhappy attitude causes discomfort Work Culture Time Pressures (Stress) No time for stretching, breaks, lunch Performance Measures

What are other factors?: 

What are other factors? √ Posture √ Attitude Sleep Postures Hobbies/Sports Age Gender Driving Psychological Impact Obesity/Exercise & Fitness Smoking Personal Habits

Things to consider : 

Things to consider Longer work hours (is it really 40 hour work weeks?) Smaller workstations Productivity Technology - faxing from desks, emailing, etc. Aging Workforce (people working later in life) Disabilities Obesity (excuse of no time to exercise) Sedentary lifestyles (workstations too efficient?)

Other things you can do…: 

Other things you can do… Watch your weight Try to maintain an adequate body weight Excess weight exaggerates poor postures Stop Smoking Constricted Blood Vessels Reduced Oxygen Coughing (mechanical strain) Harder to recover from injury and illness

Key Components to a successful injury prevention program:: 

Key Components to a successful injury prevention program: Buy-in from the top down Define a purpose/Set goals Employee involvement Track statistics Training Have expectations/consequences/accountability Be clear and consistent

Buy-in from the top down: 

Buy-in from the top down If your CEO, Director, etc. does not believe in establishing a program…IT WILL FAIL! Need to allocate resources Delineate authority

Define a purpose and set goals : 

Define a purpose and set goals Ask yourself… Why are we establishing a program? What is it you are trying to achieve? Are the employees ready to change?

Employee involvement: 

Employee involvement Involve them in all aspects of the program Recognize employees for positive behavior Recognize and analyze problem area Survey the employees to find “hot spots” Follow through after analyzing the surveys

Track injury statistics : 

Track injury statistics This is a good starting point Look at your loss runs, claims filed, near miss reports Are there trends with injuries types, location where injuries occur, jobs with most instances?

Training : 

Training Train all employees on ergonomics, as well as your policies for managing injuries. Employees must be informed of the expectations you have for them. Employees must be informed of consequences.

Expectations/Requirements: 

Expectations/Requirements What do you expect/require from your employees? 1. Attend training, learn the basic principles of ergonomics and apply them to your daily tasks. 2. Learn what you can do to decrease your chances of being hurt at work. 3. Immediately report any signs of discomfort to your supervisor. 4. Follow through with ergonomic recommendations.

Employee Responsibilities : 

Employee Responsibilities Report any signs of discomfort immediately Take breaks Be willing to try recommendations Do your part to stay healthy Muscles that are well toned are less likely to be injured & recover faster from injury. Develop a personal lifelong fitness plan to include: stretching strengthening endurance

Expectations/Requirements: 

Expectations/Requirements What do you expect/require from your upper level management? (Supervisors, managers, directors, etc.) Conduct initial work station assessments within the first week of a new employee’s start date. Document all ergo visits. Include date, symptoms, observations and any recommendations given. Address your employees ergo needs in a timely manner. Discuss safety/ergonomics regularly at your dept. meetings

Supervisor Responsibilities: 

Supervisor Responsibilities COMMUNICATION!! Address employee concerns in a timely manner Encourage functional and effective work environments Learn and use adjustment features Organize workflow Rotate job tasks Promote positive employee, supervisor relations Demonstrate self responsibility and healthy lifestyles Perform a self evaluation and modify workstation, job or habits

Clear and consistent : 

Clear and consistent Does your work environment reflect what you are telling your employees? Do you follow the policies when corrective actions need to be taken? Does everyone fully understand their role and responsibilities?

Other things that can be done: 

Other things that can be done Know the basic principles and use them throughout the day. Apply intervention methods at work and at home Set the example: adjust chair, stretch, take breaks, etc. Talk ergonomics and safety with employees often

Before & After Look at Ergonomics: 

Before & After Look at Ergonomics

Hands-on: 

Hands-on We’ll head upstairs at this point to conduct assessments of actual workstations.

Conclusion : 

Conclusion Don’t be afraid to try something. Communication is key! It is no longer acceptable to be hurting while at work Talk about safety often…bring your ideas to the table Ergonomics is not rocket science, once you learn the basic principles most of this is common sense.