1. Work Related Musculoskeletal Injury In Radiographers Ross McGhee SOR H&S Rep BWoSCC

2. MSD The term MSD covers any injury, damage or disorder of the joints or other tissues in the upper/lower limbs or the back. (HSE) http://www.hse.gov.uk/msd/ Painful limb movements, muscle tenderness, spontaneous pain

3. WRMSD Most common work related illness in Britain 9 – 26% of population Average of 15 days lost per case

4. Physiology Patient strains muscle Muscle inflames as natural response Inflamed muscle traps associated nerve Nerve cells fire pain signals at small movements and light pressure

5. New Problem? NO!! Bernadino Ramazzini (1633 – 1714) “Incessant driving of the pen over the paper causes intense fatigue of the hand and the whole arm because of the continuous strain on the muscles and tendons” Samuel Solly 1864 said it was rare “notwithstanding the fact that the greastest part of the middle classes of London get their bread by the use of the pen” Increase in manual tasks at work have increased WRMSD

6. Contributory Factors Poor posture Exertive force Repetition Poorly developed environment Psychosocial factors Something's gotta give

7. SOR Radiographer Survey (2011) 56.6% of respondents suffer aches and pains 94.8% of respondents carry out work with a headache 99.1% of respondents feel excessive fatigue at the end of a working day 60.9% have never received training on reducing MSD 92.3% find it difficult to keep up with the work they are expected to do 95.6% feel under pressure 99.2% twist or bend in their body to do work 97% adopt awkward positions

8. SOR Rad Survey (2011) (Recovery) 15.8% take an hour to recover from discomfort 31.4% take 1-6 hours to recover 13.9% take 8-24 hours to recover 12.5% take 24 hours or more 9.7% do not recover!!!

9. Why Radiographers? Awkward positions Heavy patients High working height Time constraints / pressure Lack of recovery time “Ignoring pain to get the job done”

10. Multi-Task

11. What Can Help? DATIX!! - Responsibility to report incidents Risk register – list of risks out with managerial influence that have been identified to minimise problems and make staff aware of potential hazard

12. What Can Help Ergonomics – designing equipment around the user ONE SIZE DOES NOT FIT ALL

13. What Can Help? Keep active outside work Talk to your managers and reps If symptoms develop don’t suffer in silence SEEK HELP!!

14. What Can Help? Pilates – Improves flexibility and strength Relaxes and lengthens muscles Increases strength in abdominals and back muscles Reduces Stress Improves sex life

15. Alexander Technique Method of self improvement and re- education Makes us more aware of the way we move “When you stop doing the wrong thing the, right thing does itself” F M Alexander

16. Alexander Technique Helps with – back, neck & joint pain, muscle tension & stiffness, poor posture, stress & anxiety, breathing problems

17. Bad Habits “Curious things habits. People themselves never know they have them” Agatha Christie Inconvenience Quick & easy use Ineffective practice Habit

18. Rules Avoid – risky procedures Assess – if necessary assess the situation Reduce – the risk Monitor – the situation for future risk

19. Things to Remember Humeral–Scapular Rhythm – do not lead arm movement with the hand. Unlock the shoulder then move H&S is everyone's job – duty of care to yourself. If you don’t look after yourself you might inadvertently compromise your patient Know yourself – listen to your body

20. THE FUN BIT!!! EXERCISES FOR PREVENTION AND RECOVERY

28. References Health & Safety at Work Act 1974 Health & Safety (Display Screen Equipment) Regulations 1992 Provision & Use of Work Equipment Regulations 1998 Workplace (Health, Safety & Welfare) Regulations 1992 Industry Standards for the Prevention of Work Related Musculoskeletal Disorders in Sonography (SOR (2006)) The Causes of Musculoskeletal Injury Amongst Sonographers In The UK (SOR (2002)) Prevention of Work Related Musculoskeletal Disorders in Sonography (SOR(2007)) A Study of the Experiences of Participants Following Attendance at a Workshop on Methods to prevent or reduce Musculoskeletal Disorders Amongst Sonographers; V. Gibbs, P. Young; Radiography; 17 (2011) 223-229 The Alexander Technique; A. Cavallone (2011) Pro-active or Re-active Health & Safety: Issues Faced by Managers; A Francis (2011) MSD Risk Management: its what you do dn how you do it; L Nicholls (2011) Understanding Symptom Production In RSI; A, Dilley (2011) Musculoskeletal Disorders in Therapeutic Radiographers (SOR) (2011) Stop Yourself Becoming a Patient: Exercises for Prevention & Recovery; J, Burnage (2011)