It’s commonly believed that Albert Einstein stated ‘the definition of insanity is doing the same thing over and over, expecting a different result’. So, how does this relate to manual handling training? Well, if we take onboard Einstein’s message, it would be completely appropriate to label manual handling training as ‘insane’. Let me explain why.
Over the past 40 years physiotherapists have been delivering manual handling training in workplaces all over the world. The insane part is that injury rates related to manual handling haven’t decreased as a result. Often we see manual handling training programs that are simply designed as a ‘tick the box’ part of a worker’s induction. This can be online computer based modules or a one off, reactive, once per year program that’s put in place usually after a worker was injured. This can only be described as a waste of resources, money and time for all involved. Don’t just take my word for it, this has been concluded in an array of studies (Bos, Krol, Van Der Star, & Groothoff, 2006; Hignett, 2003; Lin et al., 2013; Martimo et al., 2008; van Poppel, Hooftman, & Koes, 2004; Verbeek et al., 2011).
A Cochrane review (Verbeek et al.) published in 2011 looked at manual handling training delivered to approximately 1400 people across 10 sites and concluded that:
“Material Manual Handling advice and training with or without assistive devices does not prevent back pain or back pain-related disability…”
Prior research published by Martimo et al. in the British Medical Journal in 2008 had concluded that:
“There is no evidence to support use of advice or training in working techniques with or without lifting equipment for preventing back pain or consequent disability. The findings challenge current widespread practice of advising workers on correct lifting technique.”
Unfortunately this evidence is now up to 10 years old and the message still hasn’t been adopted universally. So what’s the next step? Does this mean that we should abandon teaching lifting techniques all together?
The answer needs to be broader than teaching lifting techniques alone. Effective programs should include:
- Comprehensive risk assessment and management. This is of both manual tasks and workers.
- Building sufficient strength and conditioning to lift.
- Training efficient and variable lifting strategies. These may differ between workers.
- Reassuring workers regarding the robustness of their spine and teach that discomfort does not equal damage.
- Increase awareness of the positive impacts of leading a healthy lifestyle.
Employ Health provide MoveWell training to workers, as part of a comprehensive risk management solution for each of our partners. MoveWell training is an evidence based approach to providing training to workers that incorporates:
- Active risk assessment
- Planning how to undertake manual tasks
- Preparing their bodies for physical work
- Leading a healthy lifestyle
- Work within the Knuckles to Elbow Zone
- Adoption of key mindsets to put the training into action
Whilst training is an adequate platform to begin with, risk management for workplaces needs to be ongoing and address these three key factors in the long term:
- The health and physical capacity of the workers
- The manual tasks and manual risk associated with these tasks
- The culture of the workplace
There are varied interventions for each of these factors that I will detail further in other blog posts. To finish I’m going to put forward a scenario that I’d like you to answer about your workplace:
You have a worker in their early 50s, with diminishing physical capacity, who is stressed due to the culture of the workplace and don’t feel they could put their hand up with an early notification of pain and have something done about it…
How are you risk managing this worker?
How would this worker respond and cope with being placed in a situation where there is manual risk present?
If you can’t answer these questions then your workplace is in need of a solution – Fast.
Let’s just hope that the solution the worker is provided with isn’t more manual handling training….
Take a look at the comprehensive partnership that Employ Health offers:
https://employhealth.com.au/about-us/
References:
Bos, E. H., Krol, B., Van Der Star, A., & Groothoff, J. W. (2006). The effects of occupational interventions on reduction of musculoskeletal symptoms in the nursing profession. Ergonomics, 49(7), 706-723. doi:10.1080/00140130600578005
Hignett, S. (2003). Systematic review of patient handling activities starting in lying, sitting and standing positions. J Adv Nurs, 41(6), 545-552.
Martimo, K. P., Verbeek, J., Karppinen, J., Furlan, A. D., Takala, E. P., Kuijer, P. P., . . . Viikari-Juntura, E. (2008). Effect of training and lifting equipment for preventing back pain in lifting and handling: systematic review. Bmj, 336(7641), 429-431. doi:10.1136/bmj.39463.418380.BE
Lin, I. B., O'Sullivan, P. B., Coffin, J. A., Mak, D. B., Toussaint, S., & Straker, L. M. (2013). Disabling chronic low back pain as an iatrogenic disorder: a qualitative study in Aboriginal Australians. BMJ Open, 3(4). doi:10.1136/bmjopen-2013-002654
van Poppel, M. N., Hooftman, W. E., & Koes, B. W. (2004). An update of a systematic review of controlled clinical trials on the primary prevention of back pain at the workplace. Occup Med (Lond), 54(5), 345-352. doi:10.1093/occmed/kqh065
Verbeek, J. H., Martimo, K. P., Karppinen, J., Kuijer, P. P., Viikari-Juntura, E., & Takala, E. P. (2011). Manual material handling advice and assistive devices for preventing and treating back pain in workers. Cochrane Database Syst Rev(6), Cd005958. doi:10.1002/14651858.CD005958.pub3
