1. Alternative Settings in Athletic Training: Industrial / Occupational Athletic Training Eric Gunderson MS, LAT

2. Tradition vs. Modern
Traditionally, ATC’s have been employed primarily in the athletic settings of colleges, universities, secondary schools, and professional sports
Recently, it has become common place to find ATC’s employed in:
Sports medicine clinics
U.S. military
Industrial / Occupational setting
40% of ATC’s work outside of school athletic setting

3. How do domains of Athletic Training relate to the occupational setting?
Domain I ‐ Prevention of Occupational Athletic Injuries and Illnesses
Domain II ‐ Recognition, Evaluation, and Assessment of Occupational Athletic Injuries and Illnesses
Domain III ‐ Immediate care of Occupational Athletic Injuries and Illnesses
Domain IV –Treatment, Rehabilitation and Reconditioning of Occupational Athletic Injuries and Illnesses
Domain V ‐Organization and Administration of Occupational Athletic Training Programs
Domain VI – Professional Development and Responsibility

4. “Industrial athlete”
Webster defines “athlete” as a person trained or skilled in acts or games requiring physical strength, agility and speed
He could have been referring to any number of industrial athletes who need skills, speed, strength, agility to do their jobs in an efficient and productive manner
Every year billions of dollars in productivity are lost as a result of employee injury and disability

5. Why Athletic Trainers?
Athletic trainers work with more than just athletes – they can be found just about anywhere that people are physically active
An ATC’s expertise allows for prevention, early intervention, and rehabilitation
Occupational ATC's are involved in the assessment and treatment of work-related injuries, injury management, on-site physical rehabilitation, case management, and return-to-work programs
ATC’s can be integrated into the healthcare team of occupational health nurses, PA’s, physicians, and physical therapists in these settings
Employers realize savings in the form of:
Improved productivity
Reduced lost workdays
Fewer emergency room visits

6. Why an Airline?
An ATC views an airline employee as an active individual who performs repetitive activities or who uses sustained or forceful motion to complete the required routine tasks
The employees are doing things on a daily basis that are repetitive, stressful to the body
They put themselves in positions that are taxing to the body by stressing the bones, muscles, tendons, ligaments, and nerves
The industrial athlete can be considered a million-dollar athlete, because job-related injuries escalate costs in lost work time and productivity

7. Athletic Training at Delta Airlines
Mission
Help Our Workforce Stay Fit and Healthy
Vision
To create the healthiest workforce in the airline industry
To improve the health and well-being of Delta employee’s lives through health education and fitness that will support positive lifestyle change; thereby resulting in improved employee safety, productivity, morale, and healthcare cost savings for Delta

8. Primary Objective of Program
Prevent Delta employees from developing cumulative trauma injuries through intervention at the early onset of discomfort and through body posture training, and implementing stretching into standardized work
Purpose:
To identify early symptoms of cumulative injuries
To prevent the onset of more severe symptoms (which may develop from minor discomfort)
Promote intervention proactively, not reactively
Improve processes, posture, and quality of life
Prevent long term injuries
Combine the knowledge of Employees, PLM/foreman, Safety, Athletic Trainer
Raise awareness of body mechanics and ergonomics
Provide sustainable, long-term injury prevention

9. ProgressiveHealth offers the following performance solutions:
Acute Injury Management (AIM)
Early Symptom Investigation / Intervention (ESI)
Job Site Analysis (JSA)
Job Description
Optimal Placement Program (OPP)
Health Profiles
New Hire Work Conditioning (NHWC)
Restrictions Management
Therapy and Rehabilitation
Return to Work (RTW)
Individual Fitness
Key Performance Indicators (KPI)
How's Your Process? (HYP)

11. Integrating Progressive Health into Delta Airlines

12. Acute Injury Management
ProgressiveHealth Industrial Specialists respond to incidents that result in acute injury:
providing first aid care
triaging
providing follow up treatments
Under the physician threshold, to mitigate the severity of the injury and ensure a safer and quicker return to work

13. ESI – Early Symptom Intervention / Investigation
Injury Prevention
Proactive element in avoiding injury or preventing minor injuries from becoming major ones
ATC will investigate reports of soreness, discomfort, or other issues to intercept these conditions and develop and implement corrective actions
ProgressiveHealth Athletic Trainer “walks the floor” to ensure Delta employees are performing their tasks in a safe, proper manner to minimize the risk of injury
Hot spots are noted
Root causes are identified
Corrective measures are considered and implemented

14. HYP - How’s Your Process
Regular process analysis and modification to prevent minor discomfort from becoming major injury
The intent of HYP is to:
Identify (in a compliant fashion) and promote intervention of early symptoms
Mechanism of injuries/illness
Prevent the onset of more severe symptoms which may develop from minor discomfort
As part of a regular “daily check,” Athletic Trainer may ask associates such questions as “Are you having any difficulties performing your job?”
Countermeasures are developed as appropriate, all with the intent of preventing situations of minor discomfort from turning into injuries
May include such items as posture improvement, process change, tool change, etc

15. Injury Management On-Site Physical Rehabilitation Case Management
Working under the direction and sometimes prescription of a physician, athletic trainers are effective health care practitioners who provide physical rehabilitation services
More cost effectively on-site as ProgressiveHealth clinicians know the jobs and they know the employee
Employee convenience and time on the job is enhanced as employees do not have to travel offsite for their rehabilitation care
Knowledge and Access helps to drive per case costs down
Case Management
Athletic trainers provide case management services by facilitating ongoing communication between the employer, physician, insurance company and the employee
Additionally, they frequently support the injured employee’s progress, monitor medical care, promote efficient reporting and investigation, and assist in finding modified-duty work for the employee

16. Importance of Early Reporting: Why Prevention is Important
Research shows that in the industrial setting reporting initial discomfort later than 3 days significantly decreases chances of a quick and timely recovery
Reasons Employees may not report discomfort:
It will jeopardize my job / promotion
Do not want to let team/department down
Did not think it was a big deal
Thought it would go away
Do not want to go to Occupational Health
I always hurt; it is part of job
Hard workers with high pain tolerance

17. Injury Prevention Programs
Ergonomics
Athletic trainers work to identify ergonomic risk factors, and then assist in recommending and implementing both engineering and administrative controls
Work Readiness/Conditioning
Athletic trainers use the principles of conditioning to develop work-specific physical readiness and conditioning programs for individuals or entire departments
Health & Wellness
Athletic trainers frequently manage fitness centers, physical activity, therapeutic exercise, stress management, nutrition, smoking cessation and other wellness programs
Education
Athletic trainers draw upon vast educational and clinical experiences to educate labor forces about all things related to health, wellness and safe workplace habits

18. Why Is Ergonomics Important?
Cumulative Trauma Disorder
Life Changing Injuries
Aging Workforce
Operational Issues

19. 3 Key Ergonomic Risk Factors
Posture/Motion
MSDs
Repetition & Duration
Force

20. Awkward Postures – Whole Body

21. Awkward Postures – Upper Extremities

22. Awkward Postures – Hands & Wrists

23. Force
Jobs that require forceful exertions, defined as the amount of physical
effort required to perform a task, may also be susceptible to MSDs.
• Repeated forceful exertions can cause inflammation of tendons,
nerves, and joints.
• Some of the contributing factors that determine whether the
forceful exertions are likely to cause an MSD include:
– Type of grip. For example, do you have a natural or awkward grip
when exerting force?
– Weight of object
– Body posture
– Type and duration of the task
• Examples of forceful exertions as a risk factor include repeatedly
turning a screwdriver while pushing at the same time; pushing or
pulling more than 20 pounds of initial force for more than 2 hours
a day.
Ask trainees to describe forceful exertions they have experienced and
discuss them.

24. Repetition
• Repetition on the job is a major contributor to MSDs. Doing the
same motion over and over puts stress on muscles and tendons.
• Some of the contributing factors that determine whether the
repetition is likely to cause an MSD include:
– How often and quickly the movement is repeated
– Number of muscles involved
– Required force
• An example of repetitive motion as a risk factor is raising and
lowering the same arm with the same force over and over again for
Hours.
Ask trainees to
describe examples of repetitive work tasks at their jobs.

25. Delta TechOps OJI’s History