The 4 Es of Injury Prevention

When addressing injury prevention for computer users, four components need to be attended to in order to ensure success.  Here are the four Es that will provide a well-rounded ergonomic program along with links to additional information.

• Ergonomics – Ergonomics provides the optimal environment in which the body works.  Ergonomics places the body in the most efficient and least stressful working positions.  Without an appropriate ergonomic environment, the body will be at constant risk for injury.


• Ergonomic ABCs        


• Monitor Position & Ergonomic Tips     


• Top Ten Ergonomic Picks        


• Exercise – Warming-up muscles prepares them for work.  Warming-up increases blood and oxygen flow to the muscles and increases the muscle flexibility.  Stretching ensures that the muscle is able to contract and work to its fullest efficiency without placing stress at the point that the muscle or tendon unit attaches to the bone.


• Exercises for Preventing Hand Pain      


• Stretching for the Computer Athlete     


• Education – The work environment can be perfect but the equipment loses its effectiveness if it is not used appropriately.  Training programs must be developed to support ergonomic programs.


• Typing Style - Repetitive Injuries are NOT just about the Keyboard           


• Pain-Free Mousing      


• Monitor Position & Ergonomic Tips     


• Energy – Our body’s potential to produce work is a component of our fitness, health and well-being.  Practicing general healthy habits will help our bodies heal from the everyday wear-and-tear and help prevent the micro-trauma that leads to repetitive injuries.


• How to Develop Healthier Ergonomic Habits   


• The Effect of Smoking on Repetitive Strain Injuries       

Marji Hajic is an Occupational Therapist and a Certified Hand Therapist practicing at the Hand Therapy & Occupational Fitness Center in Santa Barbara, California. For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources. 

 

ASHT News Bulletin Kids and Electronics

A majority of children are now using desk computers, hand-held electronics such as smart phones and PDAs, and gaming controls on a daily basis.  Parents should take an active part in teaching their children techniques that will help them prevent future injuries such as carpal tunnel syndrome and tendinitis. 

The American Society of Hand Therapists (ASHT) stresses the importance of developing good habits early on in children to prevent hand and wrist injuries in adulthood.  Healthy techniques learned at a young age can carry over into other aspects of life where there is a similar injury risk such as sitting in front of a computer or playing musical instruments. The ASHT Media News Bureau provided the following overall tips and health guidelines for kids and video gamers of all ages: 

Prevent Future Injuries such as Carpal Tunnel Syndrome and Tendonitis

• Tell your child to use a neutral grip when holding the controller. A neutral grip is when the wrist is straight, not bent in either direction (not strong or weak). It will allow for wrist motion in a plane where more motion is available in the wrist. 


• Ask your child to take a break every hour or switch to another activity. Overuse of repetitive motions, such as pressing buttons, can cause tendonitis of the elbow or lead to Carpal Tunnel Syndrome. 


• Don’t let your child sit back on his/her knees. Bending the knees this far is not only a hard position for the knee joint, but it requires your child to push most of his/her body weight up with his/her hands and wrists, placing increased pressure on these joints as well.


• Make sure the monitor is at the correct height.  While looking at the horizon, your child’s eyes should be looking at the top of the monitor.(this may vary if child wears glasses)


• If your child is typing, the keyboard should be at a height so that with his/her wrist/hands are straight, his/her forearms are parallel to the keyboard surface. 


• When using a GameBoy (or other hand held gaming devices), encourage your child to put pillows in their laps and rest arms on pillows. This will allow them to keep their head in a more upright position and therefore decrease neck strain.  The pillows will help support the arms so they do not have to be held up in the air.


• Whenever, possible your child should be sitting in an appropriate chair.  This would be a chair that allows your child to comfortably put their feet on the floor and also provides good back support. 


• When s/he is using a single control device (like a mouse), encourage your child to switch hands frequently.  This will allow the one hand to rest and reduce fatigue. 


• Have your child frequently focus on a distant object (away from the monitor) to help reduce eye fatigue.

The ASHT Media News Bureau is a central source for information on the specialized profession of hand therapy. ASHT members serve millions of patients nationwide, providing treatment for injuries and preventative care.  For more information about prevention technique and professional hand therapy, visit www.asht.org.
Marji Hajic is an Occupational Therapist and a Certified Hand Therapist practicing at the Hand Therapy & Occupational Fitness Center in Santa Barbara, California. For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.

ASHT Guidlines for Hand Held Devices

According to The American Society of Hand Therapists (ASHT), heavy use of hand held electronic devices can lead to hand ailments.  In this national consumer education alert - initially issued in January of 2005 and recently reissued - professional hand therapists offer tips for preventing injuries caused by the extreme use of small personal music devices, smart phones and PDAs.

The excessive use of scroll wheels and frequent text-messaging associated with portable electronic devices are causing thumb, finger and wrist pain. “We are giving our thumbs, wrists, and elbows a real workout with heavy use of hand held electronics like blackberries and iPods,” said former ASHT president Donna Breger Stanton.  Injuries such as carpal tunnel syndrome, “BlackBerry Thumb” and tendinitis are being seen with increasing frequency as the use of these popular devices is increasing.

ASHT GUIDELINES FOR HEALTHIER USE OF HANDHELD ELECTRONIC DEVICES – A SUMMARY

Respect Pain.   If you have pain while using a hand held device, stop and take a break.  Pain is the body’s warning sign that something is wrong.  Pain may be indicating that you are straining muscle groups.

Be aware of wrist positioning.  Hold the device with the wrist in a neutral position (not bent forward or back or angled to either side).  Even a small amount of wrist angulation can increase tension on the tendons and nerves.

Take a break.   Every 20 minutes or so, take a micro-break (stop the activity for one or two minutes, stretch, or switch to another activity).  Repetitive motions such as pressing small device buttons can cause inflammation of the tendons or cause nerve irritation.

Relax your arms.  If possible, place pillows in your lap and rest your arms on the pillows.  Or use the device with the forearms supported on a desk or tabletop (however, do not lean the elbows onto a hard surface or press the elbow or forearms onto the sharp edge of the desk).   This will allow you to keep your head in a more upright position than if the device is held in your lap and therefore decrease neck strain.  The pillows or desk will help support the arms so they do not have to be held up in the air.

Sit in an appropriate chair.  This is a chair that allows you to put your feet comfortably on the floor and also provides good back support.

Switch hands frequently and vary the finger being used for texting or activating the electronic device.   This will allow the one hand or other fingers not being used to rest for awhile and reduce muscle fatigue.

Don’t forget the eyes.  Frequently look away from the screen and focus on a distant object to help reduce eye fatigue.

Download the ASHT Alert

The American Society of Hand Therapists is a not-for-profit organization seeking to advance the specialty of hand therapy through communication, education, research and the establishment of clinical standards. ASHT’s 3,000 members in the United States, Canada and around the world strive to be recognized leaders in the hand therapy profession. For more information about hand therapy or to find a hand therapist in your area, visit www.asht.org.

Marji Hajic is a member of ASHT and an Occupational Therapist and a Certified Hand Therapist practicing in Santa Barbara, California.  For more information on hand and upper extremity injuries, prevention and recovery, visit
Hand Health Resources

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Laptop Ergonomics

PC & Video Gaming – Ergonomic Tips

Wi-itis and Other New Repetitive Injuries

Rotator Cuff

Chances are, if you are experiencing shoulder pain, the rotator cuff is involved. The rotator cuff is composed of four muscles - the suprasinatus, the infraspinatus, the teres minor and the subscapularis - that provide a stable base for shoulder movement.

The stability of the shoulder is provided through these four muscles rather than by bony structure. These muscles are responsible for positioning and holding the head of the humerus (the long bone of the upper arm) into the shoulder joint. If the head of the humerus is not positioned correctly, it hits the overlying bone, the acromion, pinching the tendons and the bursa (a sack-like, fluid-filled cushion in the joint) causing pain and inflammation. When the head of the humerus is correctly positioned, the larger muscles that move and position the arm can work efficiently and properly.

Because the stability of the shoulder is provided by soft tissues such as the ligaments and muscles, the shoulder has great ability to position the arm and hand in a wide arc of motion for activity. However, the shoulder is also at greater risk for muscular sprains and strains than a joint that derives its stability from bone (such as the elbow).

Even though the muscles of a healthy shoulder work in well-balanced synergy, the muscles that rotate the shoulder inward (internal rotators) are naturally stronger than those that rotate the shoulder outward (external rotators). However, it is the external rotators that are essential for proper positioning of the humeral head into the shoulder joint.
When the muscles of the rotator cuff are in balance, shoulder movement is pain-free. When the muscles are out of balance, the risk for injury, pain and inflammation increases. The rounded shoulder posture that often develops from computer and desk work can lead to muscular imbalance. A large percentage of those who experience hand and elbow pain also have shoulder pain.

To prevent rotator cuff injuries, it is important to do the following:

• Stretch the Internal Rotators
  
  • Lie on your right side with your right arm at shoulder height, elbow bent 90 degrees. Using your other arm, gently rotate your shoulder inward bringing your hand towards the mat by your hip. Hold for 20 seconds. Repeat 2-3 times. Switch sides and stretch the left side.
  • Picture of a Posterior Capsule Stretch from The Journal of the American Academy of Orthopaedic Surgeons
    
  • Picture A – Use a pillow to support the neck in a neutral position and stretch the shoulder gently, not aggressively.
  
  
• Stretch the Chest
  • Standing by a door, rest your right forearm along the door frame with the elbow at shoulder height or slightly below. Keeping the forearm on the door frame, slowly turn your body away from your arm until you feel a gentle stretch across the chest and into the front of the shoulder. If you feel a pinch in the back, take a small step forward until you feel the stretch in the chest instead. Hold for 20 seconds. Repeat 2-3 times. Switch sides and stretch the left side.
  • Picture of Doorway Stretch for the Chest (Pectoralis) from PhysioTherapyExercises.com
  
  Strengthen the External Rotators
  • Lie on your right side with your left elbow tucked into your side and bent at a 90 degree angle, hand towards the mat. Rotate your shoulder outward bringing the hand up towards the ceiling. Keep the elbow bent at the 90 degree angle and the elbow tucked in at the side. Hold at the end range for 3-5 seconds then relax the shoulder rotation and bring the hand back towards the mat. Repeat 8-12 times. Switch sides and strengthen the right side.
  • Picture of External Rotator Strengthening Exercise from PhysioTherapyExercises.com
  
  Focus on Posture
  • Avoiding the rounded shoulder posture will help keep the head of the humerus in proper position.
  • See these related articles for more information.
    • Perfect Posture - The Basics
    • Rounded Shoulders
    • Rounded Shoulders and Forward Head Posture
    
    
  Follow Ergonomic Guidelines for Improving Positioning
  • Being aware of correct ergonomic positioning while working at your desk or on your computer will help avoid the rounded shoulder posture.
  • See these related articles for more information.
    • How to Develop Healthier Ergonomic Habits
    • Ergonomics & Common Sense - Improving Posture
    • Ergonomic ABCs
    
    
  
  

If you are experiencing shoulder pain that is interrupting sleep or work and leisure activity, it is important to seek medical consultation.

Information for this article was taken from The Seven Minute Rotator Cuff Solution: A Complete Program to Prevent and Rehabilitate Rotator Cuff Injuries by Joseph Horrigan, D.C. & Jerry Robinson.

Also available from Amazon.com

The Frozen Shoulder Workbook by Claire Davies & Treat Your Own Rotator Cuff by Jim Johnson, P.T.

Additional Products Helpful for Relieving Shoulder Pain



Marji Hajic is an Occupational Therapist and a Certified Hand Therapist practicing in Santa Barbara, California. For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.

Epicondylitis

Epicondylitis is pain at either side of the elbow where the finger and wrist muscles originate at the bony bumps of the humerus (upper arm bone). 

Although frequently mistakenly thought of as a tendinitis, epicondylitis is caused by the accumulation of microscopic tearing and damage.   The gradual accumulation of tearing and scarring that can be caused by repetitive trauma initially causes inflammation;  However, eventually, as the body is unable to heal the build-up of daily injury, the condition changes from one of inflammation to one of degeneration.  A physical change in the cellular structure of the tendons occurs including disorganization of the collagen fibers, calcifications, and loss of blood flow to the area. 

The proper classification of this injury is a tendinosis, a failed healing of microscopic tissue tears.  This can become an important distinction in prevention and healing of these injuries.  In the early stages, treatments for inflammation such as the use of cold packs and the use of anti-inflammatory medications may be helpful.  In the later stages, however, the goal may be to improve circulation to promote healing in addition to specific conditioning exercises to help organize the tissues around the elbow.

Tennis Elbow

• Lateral epicondylitis, commonly described as tennis elbow, is caused by injury to the outside edge of the elbow. 
  
• The damage is specific to the tendons of the muscles that straighten the fingers, pull the wrist back, and turn the palm up. 
  
• Only 20% of lateral epicondylitis is caused by actually playing tennis.

Golfer's Elbow

• Medial epicondylitis, or golfer's elbow, is caused by injury to the inside edge of the elbow.
  
• The damage is specific to the tendons of the muscles that close the fingers, bend the wrist forward, and turn the palm down.
  
• Golfer's elbow occurs only 10-20% as frequently as tennis elbow.

SYMPTOMS

Classic Symptoms

• Tenderness at the sides of the elbow over the bony protuberances. 
  
• Localized swelling at the point of tenderness.
  
• Pain may radiate from the elbow down the forearm and into the upper arm in more severe cases. 
  
• Activity increases pain. 
  
  • Tennis elbow is aggravated by gripping objects with the wrist bent backwards. 
    
  • Golfer's elbow is aggravated by gripping objects with the wrist bent forward.

Other Possible Symptoms

• A loss of full elbow and wrist motion because of pain.
  
• A feeling of weakness in the arm muscles because of pain.
  
• Generalized swelling of the elbow.

COMPUTER-RELATED CAUSES OF EPICONDYLITIS

One of the most common causes of tennis or golfer’s elbow for computer users can be positioning of the mouse.  

• Reaching forward for the mouse onto a desk that is higher than the keyboard.
  
• Reaching for the mouse placed to the far side of the keyboard.
  
• Gripping the mouse tightly while using wrist motion to activate.
  
• Planting the wrist down and swiveling the mouse using wrist motion.

OTHER OFFICE-RELATED CAUSES OF EPICONDYLITIS

• Reaching frequently for the phone or to take heavy manuals or binders down from high shelves.  
  
• Pulling thick files out of densely packed cabinets or drawers.

CAUSES OF EPICONDYLITIS RELATED TO TRAVEL

Those using laptops or traveling frequently on business are also at high risk.

• Carrying heavy objects such as a suitcase, briefcase or back pack.
  
• Lifting these objects onto surfaces with the palm down and the elbow straight (such as swinging them onto the security table at an airport).

PREVENTION FOR COMPUTER, OFFICE & TRAVEL RELATED CAUSES OF EPICONDYLITIS

Mouse use

• Activate the mouse by using the shoulder muscles. 
  
• The mouse should be at about the same level of the keyboard and positioned as closely to the keyboard as possible. 
  
• Don’t reach forward or out to the side. 
  
• The shoulder should be directly positioned over the elbow.  Keep the shoulders relaxed.
  
• Hold the mouse lightly.
  
• See Ergonomic ABCs for additional information.

Mouse Positioning 

• Use an attachable mouse holder. 
  
• Or use a keyboard bridge over the numerical keys if you do not use the 10-key portion of the keyboard.  
  
• Or use a keyboard station such as the Contour Roller Pro which has a rollerbar mouse that is positioned immediately below the space bar.

Mouse Style

• Use an ergonomic mouse.
  
• Vertical mice are good choices as the “hand shake” position with the forearm neutral rather than palm down can relieve stress on the tissues . 

Office & Travel Tips

• Avoid repetitive and strong gripping, especially with the elbow straight.  (for example, move the heavy manuals and binders down off the high shelves of the computer desk).
  
• Place frequently used objects within easy reach (between eye and hip level and within an easy arm’s reach to prevent excessive stretch).
  
• Use a wheeled suitcase, laptop or backpack.
  
• When using a backpack, place both arms through the straps to distribute the weight evenly across the back.  This takes the stress off the arm.
  
• Pack lightly.  Take only the needed laptop accessories to lighten the load.

General Tips

• Use both hands when lifting to share the load between the arms. 
  
• Keep objects in close to the body. 
  
• Use the strong leg muscles to help with the lift, not the back.
  
• Try to lift heavier objects with the palms up (as if you are scooping up the object).
  
• Take micro-breaks and rest the arms during repetitive or stressful activity.  
  
• Stretch often.
  
• Use heat for comfort, to improve flexibility and to increase blood flow.
  
• Use cold for inflammation or acute injury.

Marji Hajic is an Occupational Therapist and a Certified Hand Therapist practicing in Santa Barbara, California. For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.

Samples of Products Mentioned in this Article

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Choosing & Adjusting an Ergonomic Chair

The human body was not designed to keep still for long periods of time. And yet, the majority of American workers spend hours sitting in a chair while performing job activity. While sitting, the large muscles of the back, shoulders and neck contract to support the active movement of the arms and hands. This constant contraction can lead to fatigue and trigger points in the muscles. A good seating system can help alleviate this risk.

A good seating system allows for adjustability between body types. However, one size does not always fit all. A worker who is petite or larger may need to seek out special chair sizes that accommodate their body frames.

Here are some common adjustments that your office chair should be able to make.


1. Height - The chair should be able to be raised and lowered easily. Height is the first adjustment that should be made. When looking at the proper height of the chair, the elbows should be slightly higher than the work surface (desk or keyboard) so that the elbow is opened slightly greater than 90 degrees. The feet should be placed flat on the floor and the work surface adjusted (such as with an adjustable keyboard tray) if possible. However, if the work surface is not adjustable then the height of the work surface dictates the height of the chair. In this case, a footrest may be necessary to support the feet.

2. Depth of Seat Pan - The seat pan should slide forward and back to accommodate for differences in thigh length. If the seat pan is too shallow then body weight will not be distributed evenly through the thighs. If the seat pan is too deep or too narrow, you will be more likely to sit forward on the edge of the chair rather than taking advantage of the support of the chair back. The seat pan should also be rounded so that sharp edges do not press into the thighs and impede circulation. You should have a space of 2-3 fingers width between the edge of the chair and the back of the knee so that pressure is not placed on the nerves of the leg.

3. Back Support - The back of the chair should be able to be adjusted higher or lower to accommodate for a variety of heights. Proper lumbar support will help maintain the natural curves of the back and reduce the risk of back pain.

4. Seat Pan Tilt - Tilting the pan of the seat will allow you to accommodate for a variety of job tasks while still maintaining lumbar support. It will also allow you to vary working postures throughout the work day. Recent studies are now showing that a mild recline in a supported position is healthy for the back and reduces back pain. Slouching, however, reduces spinal disk height causing wear and tear on the lowest two spinal levels.

5. Arm Rests - The arm rests should raise and lower so that they support the forearms without causing the shoulders to be lifted towards the ears. A good chair will also have arm rests that can swivel or be pushed out of the way if needed. Arm rests should be broad and padded so that the forearm does not press into sharp edges.

6. Chair Base - Any rolling office chair should have a 5-point base of support for safety and stability.


A few more tips to help you remain pain-free while sitting at your desk or workstation -


* Visit an office supply store and take the time to sit in a variety of chairs to get the feel for one that is comfortable for you.

* Look for suppliers who have sample chairs that you can test for several weeks in the office environment.

* Learn to use the adjustments.

* Get up often and stretch frequently to increase circulation and reduce muscle fatigue.

Laptop Ergonomics

Laptop computers and portable technology have changed the way we do business.  With portable equipment, we are now able to work away from our primary office in a temporary or more comfortable location.  We now have the luxury of working in a secondary or off-site office, while traveling, from the comfort of our home, and while lounging on the couch.  However, in spite of their many benefits, portable computers, by their nature, increase the risk of developing repetitive strain injuries. 

• The keyboard and screen are attached in one unit.  Because they are unable to be adjusted independently, an ergonomic compromise is created on positioning and comfort of either the neck or the arm.
  
• Laptops are often used in cramped spaces compromising posture.
  
• Laptop keys are smaller than traditional, desk-top keyboards causing the potential for increased hand and finger strain.
  
• Laptop screens are typically smaller than standard causing potential eye strain.
  
• It is harder to adjust the laptop screen to reduce glare.
  
• Portable equipment is heavy to carry.

These shortfalls create the risk for pain, aching and muscular fatigue in the neck, shoulders, back, elbows, wrists and hands.  They also create the potential for eye strain, headaches, numbness and tingling in the arms.

Putting these simple ergonomic adjustments into practice can help you reduce the risk of developing injuries while working on your laptop.

Stretch often.

Be aware of posture.

Take frequent breaks, every 20-30 minutes if possible.

Change your position often.

Switch the laptop position from the lap to the table every 30 minutes. 

• Putting the laptop in your lap will relax your shoulders. 
• Putting it on the table will relax the neck and reduce eyestrain.

Limit the peripherals you carry to the bare essentials to reduce the weight you carry.

Use a carrier with padded straps and frequently change the shoulder that the bag is carried on; or use a backpack with both straps over the shoulders to distribute the weight; better still, use a carrier with wheels.

Follow standard ergonomic positioning for a keyboard as closely as possible.

• Keep the wrists neutral.
  
• Keep the elbows open to 90 degrees or slightly greater.
  
• The ears, shoulders and elbows should be in vertical alignment.
  
• The shoulders should be relaxed.  Do not round shoulders forward or hunch them up towards the ears.
  
• The head and neck should be relaxed.  Do not let head drop forward out of alignment with shoulders.

Use proper finger positioning, typing & mousing techniques.

• Use two hands for 2-key functions.
  
• Use the stronger fingers (modified hunt and peck) rather than stretching the fingers to reach for keys.
  
• Keep the fingers relaxed.
  
• Use a light touch while typing.
  
• Movements should come from the larger shoulder muscles.  Do not isolate the smaller wrist and hand muscles while typing by planting the wrists down.

Prevent eye-strain and headaches.

• Frequently look away from the screen and look at an object far in the distance.  Follow the 30-30-30 rule.
  
  
  • rest the eyes for 30 seconds
    
  • by looking 30 feet away
    
  • for every 30 minutes of typing


• Rub your hands briskly together until warmth is created and then place your warm palms over closed eyes.  Hold the position for 20 seconds.
  
• Frequently clean the screen using the appropriate antistatic cleaners.
  
• Adjust font for color, contrast and size so that reading the screen is comfortable.

If you use the laptop as your primary computer, it is especially important to be aware of your positioning.  

• When you are in your office or primary work environment, elevate the laptop using monitor risers so that the screen in an optimal position and you do not need to bend your neck when looking at the screen; then, connect a separate keyboard and mouse at elbow level to position the arms appropriately.
  
• When sitting in a chair without elbow supports or a couch, use pillows to support the arms whenever possible.  Keep the same general ergonomic positioning guidelines in mind even if you are in a relaxed work environment.

The following exercises will help you stay flexible and keep you pain-free.

• Stretch the thumb by gently pulling it back.  Hold for 20 seconds.
  
• Stretch the palm up.  Hold for 20 seconds.
  
• Perform basic forearm stretches. 
  
  
  • Place your hand out in front of you as if you are saying “stop” and pull the fingers gently back with the other hand.  Hold for 20 seconds. 
    
  • Now let gravity drop the wrist down and gently increase the stretch by pulling with the other hand.  Hold for 20 seconds.
  
  
• Stretch the triceps and biceps stretches.
  
• Perform shoulder and neck stretches.
  
• Stretch the back.
  • Gently interlace the fingers behind the neck and arch your upper back as if you are trying to look up at the ceiling (be careful not to pull the head forward).  Hold for 20 seconds. 
  • Place your hands on your hips and arch the lower back as if you are trying to look up at the ceiling.  Hold for 20 seconds.
  
  
• Perform 15-20 minutes of daily cardio activity to improve circulation and oxygen flow to the arms for improved conditioning and better healing.
  
• Perform core strengthening exercises to improve general postural stability.

Check out these samples of a laptop stand, ergonomic carrier and wheeled carrying case available from Amazon.com.

And a very cute laptop charm -

Marji Hajic is an occupational therapist and a certified hand therapist practicing in Santa Barbara, California. For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.

Governor Schwarzenegger's Prevention & Wellness Proposal - Ergonomic Impact

On February 6, 2007, California Governor Arnold Schwarzenegger, supported by a diverse group of leaders representing labor, business, consumer, insurer, senior, ethnic and medical professions, outlined the prevention and wellness aspects of his comprehensive health care reform proposal. The Governor stated that prevention is the least expensive and most effective way to cut down health care costs.
The Governor proposed five areas of focus for promoting health and wellness. Two of the five will cover programs and public awareness campaigns that fight obesity and tobacco use. A third encourages a Diabetes Prevention and Management Initiative. The fourth plan focuses on increasing patient safety and reducing medical errors in health care facilities and through more clearly written prescriptions. Lastly, Governor Schwarzenegger hopes to reward Californians who take personal responsibility for preventing disease and illness through the practice of healthy lifestyle choices. Benefits and incentives such as insurance premium reduction will be offered to those who reach certain healthy living goals.. The Governor does clarify that those who are overweight, smoke or have diabetes will not be penalized by increased premiums.
Governor Schwarzenegger’s prevention and wellness proposals were supported by several high-ranking executives during his presentation. Harold Goldstein, the executive director for the California Center for Public Health Advocates, emphasized that the solution to every major health challenge in modern history has been prevention. Steve Sanger, CEO of General Mills, summarized programs that have been effectively implemented by General Mills. Employees are provided with a Health Number Program that provides tools to help manage a healthier lifestyle through education and motivation. Their Lodi plant offers an on-site fitness center that supports the Physical Fitness and Anti-obesity Initiative that was proposed previously by Governor Schwarzenegger. Steve Burd, CEO of Safeway, discussed the redesign over the last two years of Safeway’s health care plan for non-union workers. The new plan, which focuses on prevention, wellness and positive behavior changes, is based on the belief is that 50-70% of health care costs are driven by behavior.
The key to this reform, and to the programs implemented by some of the largest employers in California, is that prevention is the cornerstone to saving lives, improving quality of life, and reducing health care costs.
Although the proposed prevention, health and wellness initiatives do not specifically address ergonomic issues, the plan does suggest that help will be given for employers to integrate wellness programs into employee benefits plans and worksites. It makes good sense that improving the general fitness and health of employees will help to improve work safety and reduce work injuries.
Medically, we know that obesity, smoking, and illness place additional stress on the body. Excess weight increases friction and tension on the body’s tissues, increases muscular exertion, and causes more rapid fatigue. Nicotine depletes the body of needed oxygen for muscular endurance and for healing of the daily microscopic damage caused by activity. Those who are suffering from or pre-disposed to heart-conditions, diabetes, and other illness and disease may be more prone to injury and heal more slowly.
A fit body is better able to withstand work demands. With the Healthy Action Program providing vouchers for health-related services such as gym memberships and weight management programs, employers could gently encourage, or even provide, healthy lifestyle management services in the work environment. With easy access to the programs, employees may be more likely to participate in such programs. The benefit to the company is a healthier, more productive employee who is less prone to injury and repetitive strain injuries.

Hand Health Resources