from the research how-to Feb 18, 2021
 

Is it essential to use stretching as part of your ergonomics solutions to clients? This is one of the most commonly asked questions within the ergonomics industry. Many companies actually see value in applying stretching programs as a way to fill the gap between the employees and what can be done ergonomically to safeguard them. However, research shows varied results regarding the implementation of stretching programs. So in this post, I’m going to be looking at literature and statistics to give us a clear answer if we, as professionals, should be recommending stretches as part of our ergonomics interventions.

Workplace Stretching Programs: Are They Ergo-wise?

The framework that I follow whenever I do consulting and teaching in my programs is to provide high-impact, low-cost solutions. Now here’s a curveball with stretching: everyone says that stretching is a low-cost solution, but is it high-impact? Many employers regard stretching like a silver bullet. They think that once they’ve implemented stretching programs, they've already covered ergonomics. From my experience, it's a bit of an exaggeration to say that stretching can prevent work-related injuries, especially if done on its own. I'm going to be sharing below some facts, strategies, and best practices about how we should approach stretching when conducting ergonomics assessments. 

Program Costs

Firstly, I want to talk about direct and indirect costs. Direct costs refer to expenses that directly go into producing goods or providing services. Meanwhile, indirect costs are general expenses that are required to keep you operating. Now stretching is low-cost, so it mostly doesn't require direct costs. If an organization doesn't pay for an expert to come in and teach stretching, they do pay, however, for the time the employees spend stretching rather than working. Additionally, they would pay directly if there's any sort of liability or ineffectiveness that may impact the rest of the program or their employees’ health and wellness. So if the program is not bringing in the desired results, or someone gets injured while doing the stretching program, that would be a workers’ compensation claim. In order to ensure that you’re recommending the most high-impact, low-cost solution, make sure that you measure the implementation of the intervention.

On a side note, I have a question for you. As a consultant, have you ever seen a long-term employer-supported stretching program? Well, I'd like to share my insights on this. I've been in the industry for more than 15 years, and I also have a pretty big network of ergonomics professionals. I can say, without a shadow of a doubt, that I’ve never seen a long-term stretching program in any organization that is done from the grassroots. Keep in mind that whatever stretching component your organization is going to use has to be measured and implemented, at least from management control. And if there's no management implementation, then the effectiveness tends to fizzle out. 

NIOSH - The Definition of Ergonomics

To give us a direction in this whole idea of stretching, let’s take a look at the definition of ergonomics according to NIOSH. The National Institute for Occupational Safety and Health (NIOSH) is legitimately the gold standard for so many things about ergonomics. You’ve probably used their lifting equation several times like me. So according to NIOSH, ergonomics is the science of fitting workplace conditions and job demands to the capabilities of the working population. While on the contrary, stretching is not a change to the workplace conditions or the job demands, but rather a change to the worker. And just from that, we can already see that stretching isn’t in alignment.

It is true that workplace stretching does provide some benefits. However, these benefits are quite difficult to measure. Some of its benefits can include: improve employee morale, give better flexibility, enhance the range of motion, perhaps it's less stress, maybe even less stiffness, and fewer muscle aches.

Don’t you think that using stretching as a substitute for a comprehensive ergonomics program doesn't deliver as large as an impact? Essentially, MSD prevention needs various approaches in order to identify and manage the risk factors.

What Does Literature Tell Us?

For contrast, let's look at what's recommended for professional athletes. Well, it's recommended for them to stretch, right? But you'll be as shocked as I was when I found out that the results of stretching on athletes' performance isn’t what we thought. There's a lot of literature that points to the fact that stretching actually leads to negative outcomes. At the bottom of this article, you’ll find a list of references that you can check yourself, so you can make your own decision about whether or not to include stretching as part of your ergonomics program. 

Let's talk about engineering controls. As we know, engineering controls are the changes to the physical aspect of the working environment. They're usually high-impact, low-cost, or moderate cost. Goggins’ research from 2008 shows that engineering controls were found to be much more cost-effective, between 40% and 100%, compared to controls that rely simply on the person’s change in behavior to reduce a variety of negative musculoskeletal outcomes including incident rates, lost workdays, and workers’ compensation costs. The overall research states that while stretching can benefit personal wellness and fitness, it isn’t as effective as a comprehensive ergonomics program at preventing musculoskeletal disorders.

The research for the effectiveness of workplace stretching programs to reduce musculoskeletal disorders are inconclusive at best. In fact, one research article identified that 90% of common office ergonomics stretching exercises could actually aggravate pre-existing conditions. Another study concluded that while research does support that stretching can improve flexibility and range of motion, implementing it alone might not prevent work-related musculoskeletal disorders and injuries.

So recommending workplace stretching programs alone to your client is a moot point. Research proves that stretching programs alone do not prevent injuries in any significant, statistical way.

What I do

Now, you might be wondering what I do when I conduct my own ergonomics assessments or when I teach my students in any of my programs. And the really cool thing about what I do is that I have all these students come in with all these different levels of expertise of healthcare professionalism including physical therapists, occupational therapists, massage therapists, kinesiologists. Now, my whole framework with this is firstly, we have to focus on high-impact, low-cost solutions. That means our primary solution would be to focus on engineering-out the ergonomic risk. Secondly, there is value in combining someone's expertise in stretching or other behavioral solutions with an engineering solution. That's the only way for someone to have lasting results.

That said, relying solely on your client to do stretching or other behavioral controls by themselves means that whatever we recommend has a risk of not being effective. People tend to not remember to do behaviorial based controls in the long haul because everyone's busy. We have busy jobs and we have busy lives. That's why implementing solutions that focus on how the work is arranged, or how it's set up will lead to better results. 

If you can follow this strategy, you’ll probably have fantastic results for the employers that you're working with. It’s best to implement a comprehensive ergonomics program to address engineering controls, and if you have the expertise (I don't) then add a stretching program as a supplement. Combining your expertise with the ergonomics framework to do an effective ergonomic strategy is what makes ergonomics quite niche and unique. However, my disclaimer is that you really have to follow the framework of what NIOSH recommends ergonomics is. That means looking at changing the workplace and not changing the employee, like what technically stretching does. 

And that’s it. I hope you guys gained valuable insights from this blog. If you’re interested to learn how other healthcare professionals are successfully adding ergonomics expertise to their services and practice, join my training. All you have to do is head on this link and get started today.

References:

  • Goggins, R.W., Spielholz, & P., Nothstein, G.L. (2008). Estimating the effectiveness of ergonomics interventions through case studies: Implications for predictive cost-benefit analysis. Journal of Safety Research, 39, 339-344.
  • Bruno, R.C & Vieira, E.R. (2008). Stretching to reduce work-related musculoskeletal disorders: A systematic review. Journal of Rehabilitation Medicine, 40, 321-328.
  • Hess, J. & Hecker, S. (2003). Stretching at work for injury prevention: issues, evidence, and recommendations. Applied Occupational and Environmental Hygiene, 18(5), 331-338.
  • Silverstein, B. & Clark, R. (2004). Interventions to reduce work-related musculoskeletal disorders. Journal of Electromyography and Kinesiology, 14(1) 135-152.
  • Lee K., et al. (1992). A Review of physical exercises recommended for VDT operators.Applied Ergonomics Vol 23(6).
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