Are Exercise /Stretching Programs the Best Way to Reduce Work-Related Injuries?

Recently there was an article in the Star Tribune about a auto dismantling company who started weekly Pilates classes for their workers who are required to participate.  The owners of the company, Ace Auto Parts, stated they hope the exercises will “help strengthen backs and shoulders and improve balance in ways that will ultimately reduce their workers’ compensation bills.”  (http://www.startribune.com/local/stpaul/103902038.html?elr=KArksUUUoDEy3LGDiO7aiU).  The story goes on to say that their workers experience injuries because they are always working with their arms overhead pulling apart the insides of cars which are suspended above them.  They have had “a few back injuries and work restrictions and time off work.”  The cost of their annual workers’ compensation insurance premium is $100,000/year.  The cost of hiring a Pilates instructor is $95/session.

This story made me think of two questions, 1) Is an exercise class the best way to lower workers’ compensation costs, and 2) What is the cost/benefit of having such a program?  To answer the first question one has to determine what is root cause for the injuries.   The owners’ problem of having injured workers and high workers’ compensation insurance premiums is quite common to many businesses, both small and large.  However, their solution—requiring their employees to perform Pilates exercises in hopes of improving their strength, flexibility and balance is not common, nor is it supported by research or case studies.  I am not challenging the benefits of exercise as that is proven to be beneficial for many health reasons.  I am questioning their chosen solution for reducing their work-related injuries.

When companies hire Kelby Ergo Design to help them decrease their workers’ compensation costs and prevent injuries the first we do is to identify the root cause(s) for the injuries.  In this case the causes appear to be due to the repetition, force and posture of the workers while they perform their task of dismantling the cars.  The position and posture of working over their heads nearly all day puts significant strain on the muscles and joints of neck, back and shoulders.  Add to that the amount of force the workers’ muscles have to produce to pull out the parts and what you have is a perfect scenario for injury.  Even if a person was very strong and flexible the wear and tear on the body’s muscles and joints caused from the workers’ overhead tasks will add up over time will add up and lead to injury.    

So the question is what is the best solution or the best order of solutions to this problem?  How do we minimize the awkward postures and repetition and reduce the force?  The best solution is always the one that eliminates the problem altogether and does not rely on employee behavior, compliance or fitness.  This is typically done through engineering and ergonomic solutions for how the job is done.  In this case the job that needs to be done is to remove the parts from the car.   The goal of ergonomics is to fit the task to the person so the question that should be asked is there a way to change the position of the worker in relation to the car?  Is there a way to minimize or eliminate working overhead?  This question and all of the possible solutions is, in my opinion, the first thing that should have been given serious attention and investigation.  All possible engineering solutions that are technologically and financially feasible that will target and eliminate/minimize the source of the problem should be considered first and foremost.  These are long term solutions that do not rely upon the worker.  The next options to consider are administrative solutions.  Examples of administrative solutions include job rotation and/or job enlargement that limit exposure to high risk activities.  The last option to consider is the human solution, relying on the worker to change and fit into the task.  The capacity and capability of human body and mind is limited to a certain amount.  When that is exceeded injuries and/or errors will occur. 

Engineering, administrative and “human” solutions can be implemented simultaneously or by themselves.  For companies that want to promote positive attitude, loyalty and wellness, incorporation of warm up activities and exercises at the start of a work shift as part of a safety or wellness program may be a great option.  These programs prepare the employee mentally and physically for the work day.  The key is in choosing the appropriate exercises that “stretch” over-worked muscles while dynamically strengthening the “opposite” muscles that are likely to be elongated and weak.  If the exercise program focuses primarily on increasing flexibility the result most likely will be a greater risk of injury because now the worker will have a greater range of motion without the strength to support and protect the joints in that new range of motion.

Research on the effectiveness of work shift exercise programs on reducing work-related injuries is not clear.  This author does not know of any definitive and reproducible studies that prove exercise programs do reduce injuries.  Most studies have focused on the effects of stretching programs.  In the article, the workers were doing Pilates which combines stretching, strengthening through holding positions and balance.  The effect of Pilates on injuries is unknown.

The answer to the first question which was, “Is an exercise class the best way to lower workers’ compensation costs?” is no, it is not the best way to lower work-related injuries and workers’ compensation costs.  The preferred order of solutions is engineering followed by administrative and lastly, “human”.

In my next blog we will explore the actual cost and benefits of exercise programs.