Everett Chiropractic Center Blog

March 30, 2017

A Memo On Preventing Back Pain Injury

I sent the following out just now… If you know an employer interested in preventing back injuries, please share it.

 

Greetings,

(You are getting this because either you have already shown an interest in preventing work place back injury, or there is some reason for me to belief that you might be interested.)

Last month the Annuals of Internal Medicine published the newest guidelines for the management of acute, sub-acute, and chronic low back pain (from the American College of Physicians).

You may be interested to know that Tai Chi made the list of recommendations.

Tai Chi has been referred to as “the perfect exercise”, and when researchers at the Mayo Clinic studied it in 2011, Tai Chi became their number one recommendation for Employee Wellness Programs. Researchers at the Harvard Medical School were so impressed that they wrote The Harvard Medical School Guide to Tai Chi in 2013.

I mention all of this because the epiphany that I had six years ago that I could help employers measure the risk of, and prevent, back injuries among their employees, was heavily informed by my, then, 15 years of Tai Chi practice. So far, while there has been expressed interest, my efforts to reach out have not resulted in meaningful conversations with those who have both the courage to advocate for a tested solution, and the authority to make a decision. (This is not about everyone doing Tai Chi: It is about measuring risk of back injury and then doing something about it that will measurably reduce that risk.)

My hope is that the growing impact of the problems of back pain injury (both direct costs and indirect costs) and the growing evidence of simple and efficient solutions will someday intersect with your priorities and the priorities of your employers. I would like to help, when/if that time comes.

Dennis Dilday, D.C.

Everett Chiropractic Center

Health – Naturally, through Chiropractic, Fitness & Whole-Food Nutrition

8625 Evergreen Way, #210

Everett, WA 98203

(425) 348-5207

http://www.doctordilday.com

July 27, 2016

101 Benefits of Exercise.78

WSDOTworker150x150 (This photo is from a State of Washington website dedicated to the subject of Safety: they just forgot to tell this guy how to bend over safely. Do you wonder why?)

Research overwhelmingly shows that regular exercise lowers the risk for many diseases, enhances the functioning of virtually every physiological system in the human body and improves psychological well-being.

78. Reduces your likelihood of developing low-back problems.

(This blog has over a thousand Posts, the vast majority of which address that very issue. Feel free to ‘search’ around, there is a Search Box over on the right: follow your interests – you will be amazed at what you will find. Or you could ask questions: all comments are forwarded to me and I will respond. For example, you could search “nurses”.)

I will be Posting a benefit every day – well, most days – from a list put together by Dr. Dave Phillips, M.D. He is an M.D. from Atlanta, GA who specializes in Sports Medicine. As a former All-American swimmer he knows a few things about exercise. He is also on the JuicePlus+ Health Advisory Board. He is also all over YouTube doing videos on JuicePlus+, exercise, and other health-related topics.

You can be healthier: this is list of ways exercise affects the body; think of them as motivational if you like.

July 24, 2015

The “Big Three” (Abdominal Crunches)

I mentioned the Big Three the other day.

Here I want to clarify the Abdominal Crunches part of it. I do this because most people still think crunches and sit-ups are pretty much the same thing. Rather than take up a bunch of space dealing with all of that confusion, here I will discuss the exercise that I use with patients who are coming out of an episode of back pain and want to prevent a relapse. (At the end, if this isn’t too long, I will review proper Crunch technique.)

The “Reverse Back Crunch” is an exercise taught by Peter Egoscue in his book, Pain Free. To do the exercise you lie on your back like you were going to do a crunch (knees up, feet flat). It doesn’t matter what you do with your head (leave it down) or your arms because they are not involved.

From here you simply push your lower back down into the floor/mat/bed (whatever you are on). That’s it! Push down – contracting in other words – for a couple of seven second breaths. Then release and relax. Then repeat, 6, 8, 10, 12 times whatever seems like a “challenging” number of repetitions. Rest a while and do it again. It is a (ab) strengthening exercise so, as mentioned earlier, you can use the 3-5 protocol. But it also sends reflex signals to the lower back muscles to relax, so that’s a bonus – and a needed one for many.

[I looked for a photo, but only found photos showing things I wouldn’t want you to see, so…]

Now the crunch. You can Google it and find YouTube videos, but what I recommend you won’t find there. Keep the chin on the chest the entire time! This protects your neck and keeps you from injuries you don’t need. Up ’til your palms are on your knees; down until your shoulder blades touch is a rep. This is a decent exercise and the one used to test you for normal abdominal strength. When you can do a “normal” number of these we can talk about an ab exercise that is really worth doing; one that has at least 6 different benefits – which justifies taking the time and trouble to do anything at all for your abs.

July 10, 2015

Kids and Chiropractic…

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Something to think about if you have kids…

I first used that photo (above) as an illustration of how NOT to bend over, but it works here too:-)

DrD

June 3, 2015

Risk Factors and the Back Injury Prevention Program

I have already written Posts that introduce the concept of risk factors, and how we can turn that thinking around when we try to cause health. Prevention is about managing risk factors. Period. Eliminating a risk factor doesn’t guarantee that you won’t get the condition, but it reduces the risk.

Of the list of risk factors for developing low back pain, some you can do something about, others you are stuck with. Look at this list and you will see example of both categories:

– a mentally stressful job,

– pregnancy,

– a sedentary lifestyle (if you sit all day at work, you have a sedentary lifestyle by definition),

– age (the older you are the more likely you will experience back pain – think aging work force),

– depression,

– gender (women are more likely than men to get back pain)

– obesity/overweight,

– smoking,

– strenuous physical exercise,

– strenuous physical work

(Medical News Today, December 3, 2009).

To that last one on the list ergonomists would add heavy, awkward, and/or frequent lifting.

And that list is not a complete list: the #1 predictor of developing low back pain is a history of already having lower back pain (not much you can do about that!). And close behind that is weak lower back muscles (measurable and correctable!). Poor lifting technique is another recognized risk factor (and it’s a main reason that numbers 9 and 10 above are on the list; it’s also why heavy, awkward and frequent are on the list). Poor bending and lifting technique is even easier to measure and much simpler to correct.

It’s also on the list of Certainties. We are all going to be bending and lifting off and on all day no matter what else we are doing. Doing it poorly puts us at risk; doing it well strengthens and lessons out risk of injury.

How an employee bends and lifts IS the low hanging fruit in the battle to reduce job-related injury health costs – prevent pays. Right now back injuries are the #1 job-related injury, the most expensive job-related injury, and the most disabling job-related injury. Ouch!

It is something the employer (and the employee) DO have control over and can change.

It is easy to evaluate and measure (therefore monitor).

And it is easy to change.

The Back Injury Prevention Course does all of that… in less that 2 hours.

May 29, 2015

I Was Right About The Back Injury Prevention Course

When I introduced the Back Injury Prevention Course three years ago, I promised that I could teach a course that would reduce the risk of on-the-job back injury by managing a risk factor, poor body mechanics.

Unique to any back injury prevention approach that I have been able to find, I also promised that an employer would be able to measure their risk of job-related back injuries among employees.

There is a thought process behind why I chose body mechanics, or how to bend and lift, that I will share in another Post soon, but the results so far go something like this:

Before the Course: less than 9% of the employees successfully demonstrate how to properly bend and lift by passing a screening maneuver.

After the Course: almost two-thirds (64%) successfully demonstrate how to properly bend and lift.

May 25, 2015

The Back Injury Prevention Course: Assumptions, Certainties, and Risk Factors

This Course follows an outline. There is a reasoning process, a certain logic, and considerable thought behind that outline. There is a reason for each of the Topics in the Outline so here, and with the next few Blog Posts, I intend to share the thinking and address the questions which are answered by the Outline Topics. This will give participants something to refer to, in review, after the Course, and give you some insight into why.

Why “risk factors”? Why that risk factor? Why even discuss “assumptions,” and “certainties”?

Remember, the main audience for Posts related the Course is employers. This entire effort is an attempt to help them (you) with a problem that they (you?) have: back pain injury at work. Some are stopped in their tracks by the Assumptions with no where to go, hence the sense of inevitability that we now have in many circles within industry and the healing professions. Most haven’t calculated in the Certainties because they haven’t made the connection or they think that these are uncontrollable.

I believe if we accept the Assumptions as a given, we can move on. Why? Because of the Certainties. These are going to happen no matter what.

April 29, 2015

Talking To M.D.s About Chiropractic

Dr. Malic Slosberg presents to 500 eager docs…

December 6, 2014

Absenteeism: What are the odds?

How to guarantee that you will get back pain

How to guarantee that you will get back pain

Well according to a recent article in the journal Spine (1), there is a 22% increased chance a person will miss work if they have chronic low back pain. A person with chronic neck pain is 20% more likely to miss work on any given day than someone who doesn’t. (Saying that reminds me of a survey of 5,000 nurses, 83% of whom said that they were working with back pain at the time of the survey. That suggests a lot of “chronic” back pain among nurses anyway.)

Absenteeism is one of those “indirect costs” of back pain that is rarely calculated. When all the direct and indirect costs of back pain are factored in, back pain is #1: the most common job-related injury; the most expensive; and the most disabling.

It’s interesting that things are so bad that, for example, hospitals are required by legislation to have “policies or programs to decrease work-related injuries”. Like all the other safety regulations and risk management structure, there is a requirement to have the policy, the program, or the procedure, but no requirement to show improvement in that thing supposedly the subject of the policy: back pain injury. The prevalence of that just keeps going up. The company stays in “compliance” but when you look at how their employees move or the back injury statistics, it just keeps getting worse.

Why? I don’t know. The Risk Managers get to check off a box indicating the employee watched a video or went to a safety meeting (they’ve done their job); the safety guy/gal held a safety meeting and showed a video (they’ve done their job); the employee attended (so they have done their job).

But when it comes to back pain injury, the videos are not any good at teaching what to do. The booklets from the Department of Labor & Industries are no better (which is where employers should be able to look for leadership). So the focus is on what not to do – the physics of holding stuff too far away, etc. And… poor lifting and bending continues. Where ever in the company the pain of the cost is felt, it isn’t accessible. Because the indirect costs don’t show up anywhere as a line item, they are essentially invisible.

There is a way to move that is safer and less likely to result in injury.

There are ways of quickly, easily, and affordably evaluated how people move (so you can tell who does and who does not need training) (This is a measurement of risk!)

How to properly bend & lift (and perform other movements) can be learned and taught in a very short period of time by anyone with average intelligence, (think Safety Person at work…).

Call us at (425) 348-5207 if you or your employer would like to know how.

(1) Spine, July 1, 2014:39(15):1243-53

November 30, 2014

How Not To Bend Over

72Cover-SMALL-1

As a chiropractic doctor focused on health and fitness – that includes back pain injuries, how to help with them and in particular how to prevent then – I notice how people move. (Notice this woman’s age, her activity of choice, and her bending over technique – it’s a habitualized technique that she repeats hundreds of times per day, all day, whether she is in the garden or not.)

For some people it’s a difficult stretch of reasoning, but moving well is preventive; moving poorly is a risk factor, a major risk factor. (When this woman reaches 40 – the average age of the typical injured worker – she will have a back pain injury story to tell – the most common on-the-job injury.)

Who teaches people how to bend and lift properly? So far, in my experience, almost no one: not your family, not your coach or personal trainer, not your boss, and not your doctor.

Why? Because almost no one is interested (for a variety of reasons, chief among them is that they think they already know and they think it doesn’t matter much), or they can’t talk about it. That’s a shame. The price is high indeed. (When the direct and the indirect costs of back pain are calculated, because of it’s prevalence, back pain is the most expensive job-related injury in this country.)

My all time favorite magazine, BTW:-)

DrD
(425) 348-5207

P.S. – It takes less than a minute to screen someone’s bending and lifting technique (a way for employers to measure risk); and about an hour to teach someone how to teach others how to bend and lift properly (a way to decrease that risk) – think Safety Meetings.

P.S.S. – In a progressive, seriously safety-minded company offering a so-called “stretch & flex” class at the beginning of the work day, it takes about a minute of correct movement training each day to habitualize proper bending and lifting technique. (Search “neuroplasticity”.) That practice and the change in corporate culture that comes from awareness and leadership could save more pain than you could imagine and more money than you can count. Could, theoretically, that is.

October 22, 2014

What Is the #1 Disability for Active Military Personnel?

You guessed it, back pain. What a shame. I have mentioned before the rise of back pain disability in this country and the world (It is the #1 cause of disability!!).

Here is an article focused mostly on the drugs, shots and surgery offered back pain sufferers in the military, and how that amounts to the “poster child of inefficient spine care.”

“The DoD readily admits that 20 percent of disabled vets and 30 percent of hospitalizations stem from low back pain, which has become the largest disabling condition among active forces. According to research done in 2000 by Johns Hopkins School of Public Health, “Unintentional and Musculoskeletal Injuries Greatest Threat to Military Personnel,” “in all three branches of the service, injuries and musculoskeletal conditions resulted in more soldiers missing time from work than any other health condition.”13

A Johns Hopkins study 10 years later found that the top reasons for medical evacuation from Iraq and Afghanistan are musculoskeletal disorders, not combat injuries. In the study, “Back Pain Permanently Sidelines Soldiers at War: Few Rejoin Units in Iraq or Afghanistan Regardless of Treatment,” researchers examined the records of more than 34,000 military personnel evacuated from Iraq and Afghanistan between January 2004 and December 2007. They found that 24 percent had musculoskeletal disorders, compared to only 14 percent who had suffered combat injuries.”

It’s gotten so bad that the terms “Disability Industrial Complex” are used to describe, essentially, the economics of profiting from this suffering.

From the standpoint of back pain injury in the Military, it’s no different that any other workplace injury. When it comes to that, the numbers are revealing as well.

And I have mentioned some options as an alternative.

When offered, people often say that prevention costs too much. It costs individuals, companies and our entire country NOT to invest in prevention, I would say. And prevention is possible, predictable and measurable.

September 25, 2014

Seth Godin on Symptoms

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Today’s Post makes a lot of sense on many levels. Contemplate the implications.

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