miller Health Occupational Health and Fitness

Index

112 TCAS August 2008

USEFUL LINKS

NEWSLETTER

FACT SHEETS

John Miller conducted a Health Management program for The Group in August 2008.

8 people, 5 men and 3 women participants completed the following profiles: -

■ Health, Fitness and Wellbeing

■ Musculo-skeletal risk

The results are presented in graphic format, with commentary.

Click here to read what the assessments are all about

HEALTH, FITNESS AND WELLBEING PROFILE

The Health, Fitness and Wellbeing profile provides people with a very good idea of how well the various systems of the body are functioning, particularly the

• the mind

• autonomic nervous system

• immune system

• digestive system

• circulatory system

• elimination system

• musculo-skeletal system.

	Symptom	None		Not much			A fair bit			A lot
1.	Headaches including migraines	0	1	2	3	4	5	6	7	8	9	10
2.	Lack of energy and vitality	0	1	2	3	4	5	6	7	8	9	10
3.	Candida - jock itch, thrush, tinea ...	0	1	2	3	4	5	6	7	8	9	10
4.	Poor sleep. If on tablets score 10	0	1	2	3	4	5	6	7	8	9	10
5.	Snoring &/or sleep apnoea. Score 10 if using a mask	0	1	2	3	4	5	6	7	8	9	10
6.	Crook back, stiff neck, sore shoulders, dicky knee RSI ...	0	1	2	3	4	5	6	7	8	9	10
7.	Frequent colds, flu, sinus	0	1	2	3	4	5	6	7	8	9	10
8.	Unsettled stomach, reflux (Score 10 if on medication)	0	1	2	3	4	5	6	7	8	9	10
9.	Overweight - 1 point for every 2Kg	0	1	2	3	4	5	6	7	8	9	10
10.	Irritable bowel, constipation	0	1	2	3	4	5	6	7	8	9	10
11.	Asthma	0	1	2	3	4	5	6	7	8	9	10
12.	Low level of aerobic fitness	0	1	2	3	4	5	6	7	8	9	10
13.	Chest pain, palpitations	0	1	2	3	4	5	6	7	8	9	10
14.	Rashes, itchiness, skin outbreaks, psoriasis ...	0	1	2	3	4	5	6	7	8	9	10
15.	Mouth ulcers, cold sores	0	1	2	3	4	5	6	7	8	9	10
16.	Elevated blood pressure. Score 0 on pills	0	1	2	3	4	5	6	7	8	9	10
17.	Elevated blood cholesterol. Score o if on pills	0	1	2	3	4	5	6	7	8	9	10
18.	Elevated blood glucose. Score 0 if on medication	0	1	2	3	4	5	6	7	8	9	10
19.	Shakes, nervous ticks, mannerisms	0	1	2	3	4	5	6	7	8	9	10
20.	Grinding teeth	0	1	2	3	4	5	6	7	8	9	10
21.	Alcoholic drinks per day (2 pts/drink)	0	1	2	3	4	5	6	7	8	9	10
22.	Smoking. (1 pt/cigarette/day)	0	1	2	3	4	5	6	7	8	9	10
23.	Caffeine (1 pt/cup per day)	0	1	2	3	4	5	6	7	8	9	10
24.	Anxious about life, insecure, apprehensive	0	1	2	3	4	5	6	7	8	9	10
25.	Sad or depressed (On medication, score 0)	0	1	2	3	4	5	6	7	8	9	10
26.	In wrong job for now	0	1	2	3	4	5	6	7	8	9	10
27.	Under-appreciated at work	0	1	2	3	4	5	6	7	8	9	10
28.	Have poor work/life balance	0	1	2	3	4	5	6	7	8	9	10
29.	Unhappy with family life	0	1	2	3	4	5	6	7	8	9	10
30.	Unhappy with financial status	0	1	2	3	4	5	6	7	8	9	10

Score

The score of a normal, fit and healthy human being is less than 20

Higher scores are symptomatic of dysfunction of one or more body systems.

People with high levels of stress usually score well over 100.

For people with a score of more than 80, the ‘background noise’ of their life is becoming louder and louder. It is hard to concentrate on your work when body systems are dysfunctional.

We know a fit and healthy group when we see the majority of scores below 40. This was not the case with this group. By and large higher scores are usually a reflection of

• low levels of fitness

• an inability to deal with what life and work are serving up to people.

Remember, it is not what happens, but how we deal with what happens that determines our level of stress.

Classification of average scores: Excellent - less than 40. Good - 41 - 50. Fair 51-60. Poor - over 60.

This profile is described as poor. The average score was 72. Anyone scoring more than 80 is putting up with a lot of 'background noise'. Whilst I've rated the score as 'poor' we see many average scores that are more than 80.

HEALTH CLIMATE SURVEY

Based on scores received in the Health, Fitness and Wellbeing profile we've compiled a Health Climate Survey. Scores on each item have ranked - the higher the score the worse the problem. We added the scores for each item. The results appear in the table below.

Symptoms/ issues / concerns	% of people scoring over 5	% of people scoring 10
Poor sleep	63
Crook back, sore shoulders	63
Snoring, sleep apnoea	50
Reflux, unsettled stomach	50
Overweight	50	1
Low level of fitness	50
Lack of Energy	38
Alcohol	38
Under appreciated at work	38
Irritable bowel, constipation etc	25
Caffeine	25
Wrong job	25
Work-life balance	25
Headaches	13
Furry tongue, thrush, tinea,	13
Frequent colds, flu, sinus	13
Mouth ulcers	13
Elevated blood pressure	13	0
Grinding teeth	13
Smoking	13	2
Anxious	13
Depressed	13	0
Unhappy family life	13
Shortness of breath from asthma	0
Chest pain, palpitations	0
Itchy, rashes, psoriasis	0
Elevated cholesterol	0
Elevated glucose	0
Shakes, nervous mannerisms	0
Financial status	0

We registered those scores of 5 and over as being a symptom, issue or concern, the most pressing of which have been highlighted.

Perception

Based on people's perception (where they gave a particular symptom a score of 5 or more, and backed up by objective scores) the key issues are

•	Poor sleep 63% of people didn't sleep well. Poor sleep is usually caused by anxiety and/or lack of a good aerobic fitness training program.

•	Obesity 50% of people said they were more than 10Kg over weight. It's a symptom of metabolic dysfunction and relates to high energy diets and low energy lifestyles. It's suggestive of elevated levels of insulin floating around the body, which is a precursor of all manner of body system dysfunctions - elevated blood pressure, elevated cholesterol, elevated blood glucose. The recommendation, 50% of people need to get out and exercise at lunch time and eat from the top of the Hourglass.

•	Lack of energy 38% of people said they lacked energy. Low levels of energy come from many sources, including: - - lack of a good aerobic fitness training program - a diet high in wheat flour and sugar - dullness - ...

•	Fitness 50% of staff indicated they weren't particularly fit. We recommend staff be given the greatest encouragement to leave the office at lunch time and get in some physical activity. One organisation we work for gives staff an hour and a half off for lunch, providing people exercise during that time. Fitness has a significant bearing on the scores for low levels of energy, poor sleep, snoring, depression and headaches.

•	Musculo-skeletal dysfunction 63% of staff have some sort of musculo-skeletal dysfunction that they have to put up with constantly. Musculo-skeletal dysfunction goes with low levels of strength and flexibility. Those are greatest risk need encouragement to attend a strength and flexibility training program several times a week.

•	Rashes and itchiness Can be caused by a range of things: - - a body that's stressed producing too much cortisol - a toxic diet - a sluggish elimination system - itching to get away from something - ...

•	Headaches Caused by - a diet high in wheat flour and sugar - caffeine withdrawal - lack of oxygen getting to the head - a sluggish elimination system - a head out of alignment due to tight and weak muscles - beating your head against a brick wall - ...

•	Colds and flu Symptom of a depressed immune system, one which can be strengthened by eating from the top of the Hourglass and getting plenty of aerobic exercise.

•	Under-appreciation at work 38% of people said they were under-appreciated at work. Ppeople feeling under-appreciated at work is always a cause for concern and managers need to take note and put in train a series of measures to improve this score in say, 3 months time.

•	Being in the wrong job 25% of people said they were in the wrong job. This is a lower than normal score. Usually, there is a high and positive correlation between people being in the wrong job and people saying they are under-appreciated at work.

•	Diet A diet high in flour and sugar and low in fruit, vegetables and fibre leads to irritable and bowel, reflux.

	Depression and anxiety There is an epidemic of depression in our community and we encourage all organisations to target depression. Nobody was on anti-depressant medication. There is an epidemic of depression in our community. This epidemic relates to poor health in general and will, of course increase at the same rate as the epidemic of all other body system dysfunctions. The mind is just another part of the human ecosystem - an ecosystem under threat from low levels of health, fitness and wellbeing. It is important that people who are depressed or a risk of becoming depressed be encouraged to have regular counseling - through the EAP or other counselors - and be given encouragement to do the things that unstressed people. In particular it means encouraging people to exercise at lunch time. It means taking their holidays, eating wisely, not working too many hours and ‘getting a life’. Stress, anxiety and depression can be a high price to pay for achievement. As the population becomes less physically active, eats diets high in flour and sugar and low in omega 3 fats, selenium and B group vitamins, lacks resilience, drinks too much alcohol and caffeine, has difficulty managing the internal and external conversations going on inside their head and/or live lives devoid of meaning and purpose, we can expect rates of anxiety and depression to increase. Whilst not wishing to make light of the true ‘black dog’ of clinical depression, for some people the symptoms of stress, unhappiness, sadness, grief, hopelessness, disappointment, despair, vacuity, anger and anxiety are being treated as if they were the symptoms of clinical depression. The best book about depression I've read, and what you can do about it, and one that I recommend highly is by psychiatrist, David Servan-Schreiber, Healing Without Freud or Prozac.

	Blood pressure No people were on medication. Blood pressure is a symptom of body system dysfunction relating directly to - lack of aerobic fitness - being over weight - being stressed.

	Smoking 2 people smoked. Now lets move heaven and earth to assist these people to give it away altogether.

MUSCULO-SKELETAL RISK FACTOR

Our musculo-skeletal risk factor profile looked at a range of parameters including mobility, strength and flexibility and whether people are training to keep themselves strong and flexible.

The musculo-skeletal risk factor profile is comprised of a mix of 7 objective and 3 subjective assessments.

• Current musculo-skeletal condition

• Closeness to ideal weight

• Leg strength - full squat

• Abdominal strength test

• Upper body strength test

• Flexibility

• Functional mobility – the ability to sit down and stand up with ease.

• Shoulder function

• Flexibility training behaviour

• Strength training behaviour

A score of 70% is attainable by those who have a regular and systematic training program.

Those scoring less than 70 are not doing sufficient in the way of strength and flexibility exercises. They are therefore exposing themselves to a high risk of musculo-skeletal dysfunction. (It would be bizarre for a workplace to offer to pay the rehabilitation costs of people who were not keeping themselves strong enough or flexible enough to do their job without succumbing to musculo-skeletal dysfunction, wouldn't it?)

This risk to The Organisation is much higher than the risk we see in other organisations. This is a poor result.


A poor result. It's good that people came to the session. Those scoring less the 6 need to obligate themselves to attend a prehab/rehab program, twice a week.		Too many people were over weight. This places stress on joints and restricts mobility.

This is a good set of scores. On the whole, leg strength was good.		This is a poor result. 4 people couldn't do one sit up. It's one of the explanations for the high degree of musculo-skeletal dysfunction in the group. People lack the abdominal strength needed to keep their vertebrae in alignment.

Not a particularly good result for 3 people. Poor arm, shoulder and upper back strength is a precursor of shoulder and arm pain.		This is mixed result. There is a high risk of lower back and neck dysfunction for people who have tight muscles along the back side of their body - calves, hamstrings, buttock and back. It's caused by two things - sitting down and not having a flexibility program.

A reasonable result. People scoring less than 7 have a mobility problem.		A fair result. Only 2 people had a shoulder dysfunction. People need to loosen off those muscles that prevent them from standing up straight and increase shoulder strength and flexibility.

It's usually the case that few people have a regular strength and flexibility program. With this group, this was not the case. A number of people had a strength and flexibility training program. However, the organisation needs to put in train a regular and systematic training program, on site, that includes 1. specialist prehab and rehab sessions for those at serious risk and those already dysfunctional and on compo 2. daily strength and flexibility sessions in the workplace. This means access to the organisations gym for all staff.

Average score: 60. Not good. People are not in particularly good musculo-skeletal condition. In the main they have low levels of strength and flexibility. There is a strong case of the organisation to implement an obligatory strength and flexibility program for those who scored less than 60 in this profile.

Lack of strength and flexibility is something that the Organisation needs to take seriously and monitor carefully and put in place an organisation-wide strategy to improve musculo-skeletal function. By far and away a high proportion of people do not have a strength and flexibility program. As a result they are getting weaker and tighter by the week, thereby exposing themselves and the organisation to risk.

When push comes to shove and people become dysfunctional, it will be The Organisation that ends up paying the high cost of an avoidable musculo-skeletal complaint. Click here to read the article from injury to dysfunction. Click here to read about swifties and fallacies.

In our opinion musculo-skeletal dysfunction caused by lack of a regular and systematic strength and flexibility program cannot be classified as an injury. Responsibility for musculo-skeletal dysfunction needs to be sheeted home to individual employees, though it’s unlikely to happen without the establishment of a culture within the organisation that supports, values and understands strength and flexibility.

We recommend a range of strength and flexibility classes that are readily available Australia-wide:

•	Posture and Flexibility
•	Yoga
•	Crookback Clinic
•	Tai Chi
•	Pontius Pilates

The Organisation would place itself in the forefront of OH&S practice if it took the musculo-skeletal risk seriously, moved heaven and earth to educate all staff about this risk and encourage them to take part in a regular strength and flexibility program. Maybe The Organisation and its worker's compensation insurer could invest in a pilot program to increase staff strength and flexibility!

The lack of strength and flexibility training coupled with poor abdominal strength, upper body strength, flexibility, shoulder function and grip strength is a cause for concern and needs the attention of individual staff and managers.

RECOMMENDATION

We strongly recommend that the people who are in current poor musculo-skeletal condition, and who lack abdominal strength, upper body strength, flexibility, shoulder function and functional mobility, in particular those who scored less than 60 on the profile, be obligated to attend regular, in-house strength and flexibility classes.

The pressure on the organisation's workers' compensation costs is such that to do otherwise would, in our opinion be to abrogate a responsibility for the prudent management of the organisation's finances.