Leading Indicators: Workplace Injury Prevention

What could prevention look like at your company?

Our good friends at Injury Free have written at length and well about Lagging and Leading Indicators in an effort to help companies think about safety and prevention measurability.

In this post I will tie that concept to what’s been going on in the office lately. A few weeks ago it seemed like everyone had a TMJ (jaw joint) issue, and I did a post on that so that you would be aware that the joints of the jaw can be and are regularly checked and adjusted by (some) Chiropractors; and that they can be and are related to a number of typical complaints patients need help with. (That post is here!.)

Most recently it’s been the knees that have been showing up in the examination as needing to be addressed – often without any associated pain so the patient doesn’t know about it. That happened last week with a Boeing patient who crawls around inside planes on her hands knees regularly and has to get up and down off the ground, climbing stuff like someone on an obstacle course. She didn’t know her knee was not functioning properly; and she didn’t have any knee pain. But the knee needed to be adjusted. It had not been a problem in the past and the way it presented suggested to me that it might be a result of how she moves at work. (Refer back to this after reading the rest of this Post: This fits the description of a “screening.”)

I asked her about having to get up and down off of the ground. She said “yep” and often. I asked whether or not anyone at work taught her how to do that properly. She said “no one”.

So I finished adjusting the patient and then asked her to show me how she gets up and down off the ground. (In the workplace setting, this would be called a screening. The employee simply demonstrates the move; they either do it well or they don’t. If they don’t do it well then it indicates their risk of injury is higher than if they do do it well.) It took about 15 seconds. She got up fine. She consistently got down using the same right knee to support her on the way down. She broke the Knee Rule every time she went down. It was her right knee that showed up as needing work in the exam.

I pointed out what she was unaware of and explained why it put extra stress on her knee, and showed her how to do it correctly. (That took about a minute.)

In their article on Leading and Lagging Indicators, the Injury Free people use the example of wearing safety glasses as a Leadiing Indicator. It’s easy enough to measure how many people who should be wearing safety glasses are (a lot of people wearing them would be good, indicating a reduced risk of eye injury potential; a very low number of people wearing them would be bad). It’s easy enough to understand that even if there have not been a lot of eye injuries at work lately (that measurement would be a Lagging Indicator – the significant event has already happened), if very few people are wearing eye protection, the risk is unnecessarily high.

What if your employer screened all the employees who have to get up and down off the ground and measured the result: a high percentage do it well = risk is somewhat lower for related injury and health care costs, time loss costs, and loss of productivity costs; a high percentage do it poory, well… I think you understand. This is measuring risk.

Now, what if the employer made sure that everyone was taught how to properly gut up and down off the ground? Would people do it correctly? Of course they would, why wouldn’t they? People don’t really want to develop asymptomatic dysfunction that will (eventually) lead to degenerative changes, become arthritic and need treatment. They don’t have any idea that they are not getting up and down correctly: screening reveals that. It is a measurable indicator of risk. It is simple, quick and easy to correct. Once it is corrected it is easy to remember how to do well; the habit will form readily, and the risk will go away. Every time the employee gets up and down off the ground after that, he or she will be strengthening the leg, hip and back muscles rather than injuring the knee joints. This is what prevention looks like.

And it’s not just adults. We had a 10-year old new patient in a while back with a complaint of knee pain. Turns out he had been attending one of those Japanese martial arts classes where they have to get up and down off the mat a million times each session – and quickly. Turns out they do not teach how to properly get up and down off the ground. The kid didn’t even need to be adjusted, but he did need to learn the Knee Rule. His knee pain went away and I haven’t seen him since: his mother says that he has been fine since.

So what are the take home points?

1. Learn, either at work or on your own, how to move properly – it’s your knees and back!

2. It’s in an employer’s best interest to screen employees (measure) and make sure that everyone is taught how to get up and down off the ground – especially if that is part of their job description – it will show up on the bottom line!

3. Real “health” care is an investment, not a cost. It’s available – it could be more available, it’s affordable (can you continue not to afford it?), it’s measurable, it’s safe, and effective, and you can chose it: whether it’s your own health or the fiscal health of your company.

Contact me at (425) 348-5207 or dennis@doctordilday.com for more information about Workplace Wellness or to make an appointment.