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Featuring articles from our principal Occupational Therapist, Dr Nicole Grant, members of the therapy team, and guest posts from members of our community.  

Posts tagged injury managment
I'll always remember my first

Director Nicole Grant reflects on her first client back in 2002.......

I remember his name, where he worked, and where he lived. I will never forget, because he was my first.

My first client.

He was referred to me for help returning to work after severing several tendons in his dominant hand. He was a carpenter, and this was a devastating injury. My job was to coordinate his return to work by liaising with his doctor, employer and insurer. I was to monitor his progress while he was treated and undergoing physical therapy, then at a time deemed appropriate by all involved, put together a graded return to work plan. I needed to identify suitable duties - duties that could be undertaken at his level of capacity (not much), and if no duties were available (there wasn't), find him a host employer who could give him some work to do while he was recovering.

I loved working with this carpenter. He had a fascinating injury and I loved following his treatment and progress with therapy. He was hopeless at turning up to therapy and gym appointments, and had absolutely no interest in returning to work as a carpenter. He wanted to use this 'opportunity' to move into a supervisory role. During the time I worked with him, I discovered more about his life beyond his injury e.g. he had received his injury falling through a glass door while drunk, and he was going through a messy relationship breakup.

Here's why I loved working with this guy. It's because I learned so much about all the additional complexities of being an OT with this one case - more than I could ever have in 6 years of attending university. I learned that being an OT is about the bigger picture, and about knowing all of the pieces of the puzzle in order to get an outcome. It's about using your knowledge of injuries, treatment protocols, and case management, to work towards an outcome that will hopefully benefit the client. But that this knowledge alone is not enough, and sometimes, success is out of your reach because of all of the other things going on in that person's life.

I didn't help him get back to work, because he was a long term case and I left town. I often think of the carpenter, and hope he got better. I often wonder if I would have more success with him now that I have so much more experience? If only I knew then, that his case would be one of the easier ones!

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Healthy Home Office Habits

If you work from home, chances are you have or will experience musculoskeletal pain.

 

Remember back in the 80's there was an epidemic of RSI (Repetitive Strain Injury)? You may at least, have heard of the term. The sudden increase in RSI cases coincided with the increased number of computers being used by office workers.

Following this, workplaces began to focus more on strategies to prevent the onset of injury related to constant computer use. Most workplaces now have training or other methods of ensuring their workers are aware of safe work practices and ergonomic principles. Unfortunately, most of us employ these principles at work, and then forget all about them at home!

There is a fantastic cartoon called the Evolution of Man that depicts a hunched over Neanderthal man evolving into modern upright man, and then over time becomes a man hunched over a computer – mimicking the posture of the earlier man. It's a cartoon that is often shown to us Occupational Therapists as students. It is humorous, but illustrates one of the reasons why so many people now report back, neck, and wrist pain.

An insightful client once pointed out to me that humans weren't designed to sit for long periods of time working on a computer. This is true. The largest muscle groups are in the lower limbs, to help us move around. Prolonged sitting, particularly with using a computer, can lead to fatigue of the smaller muscle groups, and eventually pain and injury.

Most offices now, are equipped with fully adjustable, ergonomic chairs and sometimes height adjustable desks. Monitors can be moved to an appropriate height, angle and viewing distance and screen settings can be adjusted to suit varying visual deficits. People who spend a lot of time on the phone often use headsets or the loudspeaker function, freeing their hands for note taking.

Then there's the whole range of ergonomic mouses, track balls, keyboards with wrist rests... the list goes on. Interestingly, workers still report symptoms of pain that are later diagnosed as Occupational Overuse Syndrome (OOS), or RSI.

One reason is that ergonomic and adaptive equipment may be in place, but used incorrectly. Another reason is that stress is contributing to muscle tension and/ or the worker is not taking enough rest or posture breakers. And the reason that applies to most of us – we don't apply preventative strategies at home.

Many of you are now working from home and trying to squeeze in computer time around meeting the needs of your families. Laptop computers, blackberries, iPhones and other electronics have made it easy to work while sitting on the couch, on the floor or even in bed. Unfortunately, safe work practices go completely out the window.

 The ideal working position is this:

·      knees, hips and elbows at a 90 degree angle when seated

·      feet flat and touching the floor

·      spine supported to maintain the natural curves

·      the monitor or screen height should be at eye level or just below

·      the keyboard should not be higher than your wrists, when your elbows are kept    at a 90 degree angle

·      Your wrists should be neutral (flat)

·      Your mouse, phone or other frequently used items should be within arms reach.

 In addition to the above, you should not be seated for longer than 20 to 30 minutes at a time. Go and grab a coffee or throw yourself on the floor with the kids, but don't stay seated for too long. Even if you are sitting in the position described above, your muscles will still fatigue and injury can result.

So what now? Find somewhere in your home to set up a workstation that allows you to adopt healthier work habits. If you must sit on the couch or in bed, make sure your back is well supported and you adhere to as many of the above points as you can. If you are still experiencing pain, numbness and/or tingling anywhere (except the good places!) see your doctor. It is also possible to consult with an Occupational Therapist (OT) who works in the area of vocational rehabilitation or ergonomics.

An OT can visit your home or office, assess your individual work needs, and provide you with advice, strategies and equipment recommendations if relevant. If you have employees, this is a good idea as a preventative measure to avoid expensive workers compensation claims.

 

Nicole is a qualified Rehabilitation Consultant and Occupational Therapist with over 15 years experience working with injured workers, helping them to return to work post-injury. Contact Nicole on 07 3398 9367 to arrange an assessment.

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