On the Job Stretching Programs – Are They Effective for Reducing MSDs?

by Richard Bunch, October 2, 2017

According to Bureau of Labor Statistics (2016) musculoskeletal disorder (MSD) cases account for one-third of all worker injury and illness cases. Work-related MSDs (WMSDs), injuries of the joints, and nerves caused or aggravated by work, are among the most frequently reported causes of lost or restricted work time. WMSDs can include carpal tunnel syndrome, tendinitis, rotator cuff injuries, epicondylitis, sprains/strains and back injuries (OSHA, 2016)1.

Recently, the effectiveness of on the job stretching programs was addressed in a study published in Professional Safety (May, 2017) and authored by Sang Choi, Sathy Rajendran and Kwangseog Ahn.2 In this article, the authors pointed out that stretching programs are intended to reduce the incidence and/or severity of injuries by increasing flexibility.

Flexibility is commonly defined as the range of movement possible around a specific joint of series of joints. It is commonly believed that workers who are less flexible are more likely to suffer a MSD. It is hypothesized that for individuals with short or tight muscles, stretching will increase flexibility by elongating tissues to a more physiologically normal range, promoting optimal function and reducing the risk of injury (Hess & Hecker, 2003).3

Choi and Rejendran identified the perceptions of construction workers on the effectiveness of stretching programs in preventing work-related musculoskeletal disorders.4 Among construction workers, sprain/strain was the most frequent musculoskeletal disorder (MSD) injury type followed by rotator cuff injury, back injury, tendinitis, epicondylitis and carpal tunnel syndrome due to overexertion, motion/position, tools/ machinery, lifting impurely and wear/tear. They found that workers commonly perceived that stretching programs helped prevent WMSDs. Workers also perceived other stretching program benefits such as increased alertness and focus, communication, team building, improved flexibility and safety planning.

Moore’s research on stretching programs at a pharmaceutical manufacturing facility found that participants experienced an increase in flexibility and physical self-perceptions (e.g., body attractiveness, physical conditioning, and overall self-worth).5 A study of computer workstations that examined the effects of stretching on the prevention of upper limb disorders reported an improvement on the function of the arm muscles (Jepsen & Thomsen, 2008)6. NIOSH researchers examined the effects of rest breaks and stretching exercises on symptoms and performance of data-entry workers. They recommended further research on stretching (Galinsky, Swanson, Sauter, et al., 2007).7

The findings from these limited studies suggest that stretching programs may have significant effects on safety performance. Particularly, participants noted that WMSD rates were lower when stretching programs were implemented. Moreover, participants reported positive comments and perceptions on the effects that stretching programs had on safety performance.

The authors of the referenced Professional Safety article, Choi, Rajendran, and Ahn, believe that the reason stretching programs have never truly taken hold industry-wide is a complex subject. While avoiding large scale speculation, the authors believe the primary reason may be lack of empirical research reporting the benefits of stretching programs in preventing WMSDs. Furthermore, it was opined that employers may be reluctant to invest in a program that requires significant resources without knowing the true return on investment. It is opined by WorkSaver that research directed at correlating reduction of MSDs with a stretching program is complicated by confounding variables related impacted by the effects of other proactive programs such as job matching and ergonomics.

WorkSaver Systems offers on the job stretching programs along with ergonomic interventions. Dr. Bunch (CEO) and Trevor Bardarson, (President) of WorkSaver Systems, created a stretching program based on sequential stretching for both warm up and posture relief.8 The concept of sequential stretching is based on the effectiveness of stretching muscles in a manner that avoids recruiting too many muscles in a stretch at one time.

For example, stretching the lower back by performing toe-touch stretches from standing, places significant mechanical stress on the back muscles and the hamstring muscles simultaneously. Stretching of numerous muscles at one time triggers many inhibitory reflexes via the nerve endings in the muscle tendons. This reflex reaction does not permit an optimum stretch. In addition, stretching too many muscles at one time can lead to an over-exertion injury, especially in a very deconditioned employee. Sequential stretching avoids this negative impact of over-recruiting muscles by using a modified toe touch approach which stretches the back muscles first and then slowly stretches the hamstrings second. Sequential stretching consequently avoids over-exertion and provides maximum benefit in terms of obtaining noticeable stretching effects.

WorkSaver has used the sequential stretching program very effectively with railroad, warehouse, oil, marine, and utility companies. For more information on sequential stretching, contact WorkSaver at (800) 414-2174.

References:

  1. OSHA (2016). Safety and health topics: Prevention of musculoskeletal disorders in the workplace. Retrieved from osha.gov/SLTC/ergonomics
  2. Choi, S., Rajendran, S., Kwangseog Ahn, K. (2017). Stretch & flex programs – Effects on the reduction of musculoskeletal disorders & injuries. Professional Safety, Journal of the ASSE, 38-43.
  3. Hess, J.A. & Hecker, S. (2003). Stretching at work for injury prevention: Issues, evidence and recommendations. Applied Occupational and Environmental Hygiene, 18(5), 333-338.
  4. Choi, S.D. & and Rejendran, S. (2014). Construction workers’perception of stretch and flex program effectiveness in preventing work-related musculoskeletal disorders. Proceedings of the XXVI Annual Occupational Ergon0omics and Safety Conference, El Paso, TX (pp.19-25).
  5. Moore, T.M. (1998). A workplace stretching program: Physiologic and perception measurements before and after participation. AAOHN Journal, 46(12), 563-568.
  6. J.R. & Thomsen, G. (2008). Prevention of upper limb symptoms and signs of nerve afflictions in computer operators: The effect of intervention by stretching. Journal of Occupational Medicine and Toxicology, 3(1).
  7. Galinsky, T., Swanson, N., Sauter, S., et al. (2007). Supplementary breaks and exercise stretching exercises for data entry operators: A follow-upfield study. American Journal of Industrial Medicine, 50(7), 519-527.
  8. Bunch, R.W. & Bardarson, T.D. (2003). The CBES Ergonomics and Wellness Manual.

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