Health at work

--How do I know if I have work-related injury?

The results of a slip or fall at work are usually obvious—there can be bruising, skin abrasions, sore muscles and sometimes, broken bones or dislocated joints. However, overuse injuries occur gradually over time and the symptoms build up slowly. If you use the same muscles for long periods (holding objects or not moving regularly) or repeatedly for the same task (hammering, keyboarding or mousing) they will get tired over time. Muscle fatigue and soreness should ease within hours of stopping the task. If they do not and persist and build up over time, or if you feel them only at work, then this may indicate that you are developing an overuse injury.

--What is an overuse injury?

Physically demanding work can take many forms. It includes work that requires:

• repetitive or sustained force such as cleaning, gardening, nursing or working in mechanical or other trades
• high or sudden force such as heavy lifting, using heavy tools with impact forces or slipping or tripping
• repetitive movement such as working on a computer or on a production line
• sustained and/or awkward posture such as vehicle maintenance, building trades and working in restricted space
• exposure to vibration such as rough rides in off-road vehicles.

It is also important to understand that physically demanding work can be even more risky when it is combined with workplace stress. Factors such as how much you enjoy your work or how well you get along with other workers and your supervisor can also contribute.

After a day’s work, it's natural to feel tired, particularly when your work is physically hard or when you're not used to it. This discomfort can also result from just sitting at a computer or driving a vehicle all day. Lack of movement and using the same muscles (eg: in the shoulders and arms) repeatedly can put you at risk of injury, just as much as heavy work.

It can be hard to define the start of an overuse injury but typically there is gradual onset of discomfort that increases over time. These can be hard to describe. It could be tightness, an ache, a feeling like pulling or burning, or pins and needles.

Sometimes these symptoms may come on when you're feeling stressed or more tired than usual. You may ignore them because of this. Sometimes they may go away and never give you any further concern. However, if they persist and/or come and go, or maybe get gradually worse, it's time to seek advice.

Some employers will provide the opportunity for a physiotherapist to come to the workplace to review your tasks with you. Your occupational health physiotherapist can assess your tasks in relation to your symptoms to pinpoint possible causes. They can then help you and your employer to find other ways for you to do those tasks with less risk of injury.

--Should I be worried about aches, pains and other symptoms arising from my work?

Most people are reluctant to report what they think are minor symptoms. However, if you delay getting help, it may make things worse. For many people, it is often difficult to know where the reasonable cut-off point is between completing demanding tasks and maintaining health and safety. This is where your physiotherapist can help.

If you experience discomfort, soreness or tiredness in certain parts of your body, every day during and/or after work, or if these are gradually building up over time and spread from the one part of the body to another, then it's time to take these warning signs seriously.

Physiotherapists believe that early intervention is the best approach. This may mean discussing your problems with people at work, particularly your supervisor. It's likely to involve looking at ways to change your work to reduce or eliminate the risks of your developing symptoms, and perhaps seek treatment. These actions are far more successful if you do them early rather than later.

All workplaces should have an incident or near-miss report form. Most employers would prefer to know if an employee is experiencing symptoms as early as possible.

--How can physiotherapy help with treating, managing and preventing symptoms from work-related injuries and illnesses?

Occupational health physiotherpists can:

• manage acute injury sustained at work, or sustained at home (eg, sport or leisure activities) and provide advice about safely continuing or returning to work
• assist workers with chronic diseases to manage their condition and, if needed, modify their work—hence, enhancing ability to work safely and stay at work
• help workers who experience stress at work, leading to physical distress—this may be by identifying that stress is a problem (eg, leading to headache)
• assist employers and workers with modifying work to suit ageing process

A safe workplace culture can influence employee health and wellbeing. ‘Decent work,’ as defined by the International Labour Organization, is good for health.

Occupational health physiotherapists recommend early intervention both for prevention and treatment where it is required. If you report your symptoms early, this not only prevents them from getting worse, it also allows your employer to review the cause of your discomfort so that changes can be made. This can prevent you being re-injured and others from getting hurt.

Your physiotherapist knows how your body works and what might cause problems for you in all sorts of activities at work, home or when playing sport. They understand how the demands of your work may outdo your capacity to do the job from time to time.

Some workplaces will allow an occupational health physiotherapist to visit to review your tasks with you. They can assess your tasks and identify those that may be associated with risks for injury, then help make workplace changes. They can help you and your employer find other ways for you to do those tasks more efficiently and with fewer risks to your health and safety.

Looking after your health can reduce your risk of getting injured at work. For example, your risk of having an injury at work is less if you participate in regular physical activity, look after your mental health, maintain a healthy weight and do not smoke. Physiotherapists can show you ways to strengthen your muscles and joints in order to safely and efficiently perform your work. They can also look at the demands of your work and environment in order to make sure it is not placing unrealistic or excessive demands on your body.

In the clinic, physiotherapists can help by assessing your posture, observing your movements, identifying issues such as muscle tightness or muscle imbalance, and offer treatment to rectify any problems you might have. They will also direct your treatment program so that you can manage your own symptoms while you are recovering.

--What can I do to help reduce my symptoms?

Everybody is different with respect to gender, body size, strength and power. There is no one-size-fits-all solution. What works for your colleague or family member may not be suitable for you.

Seek help early—this is always the best approach. Make sure that you have a tailored self-management program that addresses your unique needs. Your occupational health physiotherapist can help you to understand the causes of your symptoms. They can also provide you with strategies to manage them.

--Things you could do to prevent workplace injury and illness

Identifying and addressing warning signs can help you prevent workplace injury and illness.

Ask yourself:

• do I ever feel tired or fatigued when performing jobs or tasks (parts of jobs) at work? If yes, what tasks in particular?
• when performing tasks at work, do I ever feel pain or discomfort? If yes, what tasks in particular?
• do I have to adopt any work postures/positions that are awkward and/or make tasks more difficult? If yes, what task(s)?
• do I feel stressed or tense at work because I think that my job demands are unrealistic or my supervisor does not support me?

If you answer ‘yes’ to any of these questions, try to probe a bit more and identify what parts of the jobs are causing you difficulties. You might try listing the tasks that you would change if you could. It is useful to talk to your supervisor about what you and your workmates can do to improve things.

There are times when you are more at risk of injury and illness, such as when:

• you are returning to work after holidays or serious illness—your muscles and joints are not as conditioned
• you are constantly trying to meet deadlines
• there are changes in your work or the way that you do it
• the work is just simply too hard for you at a particular time due to illness, injury, tiredness or stress

--What you can do for yourself at work 

Questions to ask yourself at work

• Are there particular aspects of my work that are causing me problems?
• Do the problems last all day or are they associated with particular tasks or combinations of tasks, such as speaking on the phone and doing other tasks; concentrating hard for long periods without a break; when you sit for too long (more than an hour) without getting out of the seat?
• Have I told my supervisor that I am experiencing fatigue or discomfort? If not, why not?
• Is there a set of rules in your workplace about reporting unusual symptoms, such as excessive tiredness, or sensations such as pain or discomfort?

Seated work

• If you are working on a computer, operating machinery or sitting at a production line, try to get up out of your seat and move every 45 minutes for a couple of minutes.
• Try gentle ‘micropause’ exercises every 15 minutes for 30–60 seconds. Examples of these include:
  
  • shrugging your shoulders
  • rolling your shoulders and squeezing your shoulder blades together
  • letting your arms drop by your sides, making circles with your hands and opening and closing your fingers
  • tucking your chin into your chest and holding for a few seconds
• Use the ‘buddy system’ and swap jobs with someone who works with you every hour or two. This requires good organisation and for each person to be trained and competent in each job. The jobs also need to be different enough to allow you use different postures and movements.

Heavier, more-active work

• If you are on your feet all day doing heavy work, sit down for a few minutes every 45 minutes. Ensure that you have regular breaks and drink sufficient water.
• Before lifting or moving objects, check the equipment used is safe and appropriate. Check the load and plan your tasks before starting.
• Are there safe operating procedures? Are these up-to-date and appropriate for your job? If not, you could suggest that they be revised to help make the job safer and more efficient. Revision should include the experience and knowledge of the people who do the work.
• Ensure that you are adequately trained in handling loads. This is a requirement of the work health and safety laws in Australia. If you believe that you are not properly trained talk to your supervisor.
• Look at thoughtful ways to lift loads by using handling aids and equipment. Loads can be made bigger, so that a lifting aid has to be used, or smaller, so that weights (including cumulative weights) can be lifted with a reasonable effort.
• Report faulty or badly designed equipment. By law, all equipment should be safe and fit-for-purpose.
• Report any near-misses that you experience or observe. Learning from these incidents is one very effective way of reducing workplace risks to health and safety.
• If you believe that a task is too heavy, repetitive or awkward and could have a high risk of injury, speak up and get assistance.

--General advice

• If you feel a task is too hard or not safe, talk to your supervisor. If your organisation is big enough, talk to your workplace health and safety representative.
• Make sure that when new jobs are planned, or old jobs are being redesigned, the workers who do those jobs are included in the design discussions. If it is safe to do so, get the engineers, architects or other designers to experience doing the tasks to give them first-hand experience of the requirements.
• Assess manual tasks before you start.
  • Have you given yourself enough time?
  • Are there any obstacles or hazards that you need to address first?
  • Do you know what weights you will be lifting or how often you will be doing the task at any one time?
• Promptly report any discomfort that arises at work and does not ease with rest.