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

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

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

“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

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

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

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

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

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)

Integrating Progressive Health into Delta Airlines

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

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

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

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

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

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

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

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

Awkward Postures – Whole Body

Awkward Postures – Upper Extremities

Awkward Postures – Hands & Wrists

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.

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.

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