sonographer pain and injury. ergonomics sins and skills to win
TRANSCRIPT
Sonographer Pain and Injury
Ergonomic Sins and Skills to WinProper Ergonomic Positions and Movement Skills to Win at Your Job and Life!
Mark Roozen,
M.Ed, CSCS,*D, FNSCACo-Owner-
Live Pain Free –The Right Moves
Doug Wuebben BA, AS RDCS, FASE
Co-Owner-Live Pain Free –The Right
Moves
THANK YOU
Want to thank each of you for being here
We all have choices – you made the choice to be here today – Some for personal reasons Some to learn Some to see what this is about HOPE THE CHOICES YOU MAKE AFTER
YOU LISTEN TODAY WILL BE THOSE THAT MAKE AN IMPACT ON YOUR LIFE!!!!
Introduction DOUG WUEBBEN
Want to introduce you to best friend, business partner, top in his field
Let him relate the story of how this whole process came together!
If you don’t get anything else from this message today – listen to what Doug says and did to impact his career, his life and those around him.
MY HISTORY
My History 17 years in this industry Love my job – work to be the best I can be
at my job Love to do the best that I can do.
I feel I can really make a difference I feel I directly help folks.
Approx 3 years in this industry developed terrible pain in both shoulders Was mortified about not being able to continue
doing my job KEY POINT: This is very important
I was active and working out all during this time. Been active and worked out my whole life.
Football Player in College - Europe
The Rozy EffectRIGHT EXERCISE THE RIGHT WAY FOR RIGHT RESULTS
My buddy Mark “Coach Rozy” Roozen -Hit up my good buddy Roz, the top of the top in fitness training and education• Rozy looked at the mechanics of what I was doing. • Rozy looked at what my job was, how I did it, and how it affected
my body• Rozy educated me on exercising the proper way.
1) Proper exercise - Very Important
• I was already exercisingng, • Was strong - had a near 400# bench press• Just exercise wasn't helping me.
2) Rozy instructed me on doing the "RIGHT EXERCISE THE RIGHT WAY" The most important point of this presentation. RIGHT EXERCISE RIGHT
DID WHAT IS NEEDED TO DO TO CONTINUE
I did what Rozy taught me-Correct exercise and stretching exercise choice. Train MOVEMENT and not MUSCLEWithin a few months, I was pain free
• I remain pain free today!• I do not have one worry about being able to continue in this industry for years to come
Reality SUCKS
If you make this your career – or it is your career 9 out of 10 of you will end up scanning in
pain
Out of those 9 - 1 or 2 of you will have to find a different job
Your pain and injury will debilitate you.
READY FOR SOME GOOD NEWS!!This is the GOOD STUFF!!
Good News! • You can get huge benefits from these exercises, and you don't have to exercise 3 hours a day
• If you want to exercise three hours a day, you still can, but if you don't want to you don't have to
• Look at me for heaven's sake, I would have a better chance auditioning for the dough boy ad than the strong man photo shoot .
EXCUSE NOOSE I DON’T HAVE TIME 24 hours in a day. 1440 minutes in a day. 168
hours in a week. I challenge you to keep track of your complete
schedule for one week, see how you spend your time. Add up sleeping, eating, showering, working,
driving to work, Fun time, cleaning house time, everything you think of that you do.
Do it for one week. I guarantee you that you will have time to spare that you cannot account for
"I don't have time to exercise is not an excuse" You do have time to exercise, anything less is just plain lazy and an excuse.
Introduction to my FriendMark “Rozy” Roozen
•Strength and Conditioning Coach for over 30 years; high school, college, professional
•Director of Hospital owned Wellness Center for 8 years
•Own Training Facility for 6 years
•Speaker and author; has traveled around the world; China, Europe, etc. to speak on training topics, fitness, performance,
•Working with National Education Department and Play60 in the NFL to develop a MOVEMENT SKILLS FOR LIFE program for youth to seniors
Ostrich Syndrome
PRO COACH - NO ONE CARES!! Excited to be here Hope to share information Few KEY POINTS for you to walk
away here with: We train MOVEMENT – Not MUSCLE We can’t be on our backs, butts or
braced to get the full benefits of training We move in multiple directions, need to
train that way!!
What are we talking aboutThis is YOUR TALK – if we get on a topic and you want more info – let us know
This talk will cover:
•The top Ergonomic mistakes that Sonographers make on the job - The best way to correct these mistakes
•Also, the talk will cover how to incorporate proper movement skills to assist when perfect ergonomic guidelines aren’t possible
•You’ll learn basic, simple and quick exercises and movements that can help improve how you feel, how you move and how you do your job.
•Movement skills will be demonstrated and you’ll be given a program that you can follow each week that only takes a few minutes to improve your job performance and make you feel better in daily life
Patterns
What is the goal of the session? “Clean up the Patterns” - Gray Cook Strengthen the Patterns Software vs. Hardware Prepare the body to perform
Patterns of Movement
Bend Rotate Extend Collapse Expand
Why Clean up the Patterns Fewer Injuries Improved Performance Rehab Injuries “Use it or Lose it”
Ignore Poor Patterns
Train shoddy movements Reinforce less than optimal
movements Increase chance of Injury Restrict performance levels “Lose it”
Specificity
What is the focus of today’s session? Speed, strength, power, fitness, skill
development, work capacity? Build the warm – up to reflect
preparation for the training session’s focus.
Progressions
How the Body Functions!
WE’RE LIKE BUILDING BLOCKS – If we move one block, another block has to be moved, adjusted and shifted to keep the body upright and able to function – QUESTION – IS JUST MOVING FUNCTION????
Foot – StableAnkle – Mobile
Knee – Stable
Hip – Mobile Lumbar Spine – Stable
Thoracic Spine – Mobile Scapula – Stable
Gleno-Humeral Joint – Stable
How this Process Came to PassWork with some GREAT PEOPLE!!
In the April 6, 2010 post by author Carolyn T. Coffin, MPH, RDMS, RVT, RDCS did a great job with addressing “The 10 Commandments of Ultrasound Ergonomics – the 10 biggest sins that can lead to chronic injury among sonographers and the top 10 ways to avoid them”.
What was shocking to me was that over a 15 year period, there have been vast improvements in ergonomic equipment design, sonographer education and awareness, and a greater industry standard and practice geared toward reducing sonographer injury. Yet statistics show that a huge percent of sonographers experience work-related musculoskeletal strain disorders (WRMSDs). More than 80% of sonographers are scanning in pain and 20% of theses professionals eventually experience a career ending injury. On average, within 5 years of entering the profession, sonographers experience pain while scanning.1
Sin #1 SIN #1 – ARM ABDUCTION – Ergonomic
aid; Adjust the height of your exam table and chair.
Performance Aid: As we look to add training into our program, we have to look at how the body moves, how it stabilizes, what muscles are being worked and different ways to improve or enhance movement to improve performance.
SOLUTION #1What to do to assist
1. Band High Row1.Holding on to a resistance tube with palms facing down, (as shown) begin pulling band towards the head and abduct the elbows as you row. You should finish each repetition as shown in figure 2. Return back to start and repeat for 10 repetitions. To increase difficulty, step back slightly as this will increase tension of the band or you can increase the number of repetitions or sets performed
2. Corner Stretch1.Find an open corner in a room. Stand with feet staggered as shown with elbows at shoulder height. Place elbows and palms of the hands on the wall and lean forward creating a stretch in the front of the chest and shoulder area. Hold for 15-20 seconds and then release. This can be repeated 2-3 times per session.
Sin #2 SIN #2 – GOING BEYOND YOUR REACH – Ergonomic aid; Get
closer to your patient
Performance Aid: Performance Aid: “Extensive reaching beyond 30 centimeters for extended periods” is what we are talking about!
Less than 12 inches can cause problems! How often in your job do you have to reach more than 12 inches –
and for long periods of time? All day!! Again, put yourself in the best possible position to decrease work
intensity, reduce factors that can cause fatigue which in turn can cause injury is important.
To assist in day to day performance, we need to develop strength in the shoulder and back area, increase stability and support that the muscles of the shoulders and back can offer and maintain mobility and flexibility in the muscles.
SOLUTION #2What to do to assist
1. Band Shoulder Retraction a. Holding on to a resistance band with palms facing down, (as shown) and arms extend. From this position, maintaining straight arms, retract the shoulder blades back and try to pinch them together . Hold this position for a two count and then repeat for 10 repetitions.
2. Standing Wall Stretcha. With palms facing down and about arms length away from wall,
look down toward the ground and extend the hips back away from wall. Place a comfortable amount of pressure on the hands (Figure 7 & 8). You should feel a good stretch on the back of the arms, upper back and shoulders. Hold for 15-20 seconds and then release. This can be repeated 2-3 times per session.
Sin #3 SIN #3 – EXCESSIVE NECK FLEXION AND
EXTENSION – Ergonomic aid; Position monitor with the top of the screen at eye level.
Performance Aid: To improve strength in the neck, a simple way to increase stability and strength is to so these basic isometric exercises. Isometric exercises are exercises that involve muscular contraction against resistance in which the length of the muscle remains the same. In other words, you make the muscles work, but nothing moves!
SOLUTION #3What to do to assist
1. Neck extension and flexion · For flexion - place your hands on the back of your neck. Keep your neck straight and attempt to push your head backwards while resisting the movement with your hands. Hold for a 8-10 seconds, then relax. Repeat for a second time.· For extension – place your hands on the top of your forehead. Keep your neck straight and attempt to push your head forwards while resisting the movement with your hands. Hold for 8-10 second, than relax. Repeat for a second time.
2. StretchesChin Tuck – Pull chin downward toward the sternum and lightly apply hand to the back of the head and pull forward. Lateral Stretches – With chin forward, bend neck to the side as if trying to put your ear on your shoulder. Apply a gentle stretch with the hand pulling head toward the shoulder. Hold for 10-20 seconds and repeat 1-2 times. Perform to both sides
Sin #4 SIN #4 – TWISTING YOUR NECK Ergonomic
aid; Position the monitor directly in front of you.
Performance Aid: Twisting the neck can cause tightness in the shoulders and up into the traps, the muscles from the shoulders up the neck to the skull. Lateral Flexion is sideways movement of the spine, as occurs when the neck moves towards the shoulder.
SOLUTION #4What to do to assist
1. Strength Movements:· Lateral Flexion – place hand on the side of the head and maintain keeping your head in a vertical neutral position. Press your head into the hand and hold for 8-10 seconds. Repeat this two times with each side. Stretching Movements:· Stretching can be very useful for people who suffer from tight, aching muscles in the upper back and neck – such as when you are spending long bouts in front of the computer. Doing a Lateral Flexion Neck Stretch can help with this problem. To do this, look straight forward and do not let your chin drop down. Move your ear towards your shoulder, not letting the shoulder rise to the ear, but the head and ear moving toward the shoulder. Hold for 10 to 30 seconds and repeat to the other side. To increase the intensity, further the stretch by using the hand opposite of the head movement to apply light pressure to the side of the head.
Strength Movements:· Lateral Flexion – place hand on the side of the head and maintain keeping your head in a vertical neutral position. Press your head into the hand and hold for 8-10 seconds. Repeat this two times with each side.Stretching Movements:· Stretching can be very useful for people who suffer from tight, aching muscles in the upper back and neck – such as when you are spending long bouts in front of the computer. Doing a Lateral Flexion Neck Stretch can help with this problem. To do this, look straight forward and do not let your chin drop down. Move your ear towards your shoulder, not letting the shoulder rise to the ear, but the head and ear moving toward the shoulder. Hold for 10 to 30 seconds and repeat to the other side. To increase the intensity, further the stretch by using the hand opposite of the head movement to apply light pressure to the side of the head.
Sin #5 SIN #5 – TWISTING YOUR TRUNK
Ergonomic aid; Position all equipment and the patient to minimize your need to twist
Performance Aid: Our “trunk”, or in fitness circles now called “The CORE”, is where all movement in your body begins. Our bodies are made to move in all directions through the trunk or core – even rotation!! Trunk/core exercises should be a major part of an exercise program. Many times, except for doing “traditional” abdominal exercises like a sit-up or crunch, the rest of the core is neglected and not part of a program.
SOLUTION #5What to do to assist
Strengthening Exercise:The Band Rotation Exercise can place your body in a position similar to the one you're in during work at the computer while standing. By doing this simple exercise you develop strength, endurance, and power in the core. For equipment, you’ll need some tubing (like with the shoulder exercise you did from before!).
Stretching Exercise:The Back Rotation Stretch and be done in a chair, so it can be done almost any where! To do this stretch, sit back in a chair and face forward. Cross your right leg over your left and put your left hand on your right knee. Now slowly and gently pull toward your left side with the left hand while slowly turning your head and shoulders to the right. The goal is to keep rotating as far as possible – with the goal of being able to turn until you can see over your right shoulder.
Strength Movements:· Lateral Flexion – place hand on the side of the head and maintain keeping your head in a vertical neutral position. Press your head into the hand and hold for 8-10 seconds. Repeat this two times with each side.Stretching Movements:· Stretching can be very useful for people who suffer from tight, aching muscles in the upper back and neck – such as when you are spending long bouts in front of the computer. Doing a Lateral Flexion Neck Stretch can help with this problem. To do this, look straight forward and do not let your chin drop down. Move your ear towards your shoulder, not letting the shoulder rise to the ear, but the head and ear moving toward the shoulder. Hold for 10 to 30 seconds and repeat to the other side. To increase the intensity, further the stretch by using the hand opposite of the head movement to apply light pressure to the side of the head.
Sin #6 SIN #6 – BENDING YOUR TRUNK
Ergonomic aid; Adjust the height of the exam table or stand to avoid bending over
Performance Aid: Just like flexion and extension of the neck, moving the upper body forward or backward creates flexion or extension in the upper body. In most cases, we are talking about bending forward, reaching over something or someone to get something or get into a better position to do a task.
Toned and flexible muscles are the spine's best defense against injury. Strengthening the muscles that support the spine with exercises, can prevent, reduce and even eliminate back pain.
SOLUTION #6What to do to assist
Strength Exercises:The Reverse Crunch is a lower abdominal exercise that is done on the floor. Lie flat on you back with your feet in the air. Bend your knees to 90 degrees. Place both your hands under your buttocks for support and make sure your lower back remains flat on the floor. Tightening your lower abdomen, work to lift your buttocks a few inches off your hands. Alternating Superman exercise is a great exercise for the lower back and can also work other areas of the body from the legs to the shoulders and arms. To start, lie face down on a mat on the floor with your arms stretched above your head (like superman flying!). As you raise your right arm and also lift your left leg about 5-6 inches off the ground (or as far as you comfortably can).
SOLUTION #6What to do to assist
Stretching Exercises:
Pelvic Tilt stretch is a lower back stretching exercise (it also strengthens the abs). For this stretch, lie on your back with your knees bent, keeping your feet flat on floor. Squeeze your buttocks and tighten your ab’s. While flexing those muscles, work to flattening the small of your back against the floor. Make sure movement, the contraction and relaxation is controlled and never rushed.
Knee to Chest is a gluteal stretching exercise and is also done on your back, knees bent, feet flat on floor. To do this stretch, grab the left leg behind the knee/back of thigh and pull knee towards left shoulder.
Piriformis Stretch will stretch the muscles we have that are gluteal (butt) muscles. For this exercise (which can be done anywhere!), sit on chair and place your left ankle over your right leg, just above the knee – just like your crossing your leg. From that position, work to lean forward.
Do we need to see different things?
Or See things differently?
Corrective Exercises are KEY Mobilization Movements Stretches Strength Continuum Exercises Proprioception/Stabilization Drills Progressions Work Capacity
THANK YOU!! QUESTIONS.
MARK ROOZEN Med. CSCS*D, FNSCA817-219-2811
DOUG WUEBBEN BA, AS, RDCS, FASE605-661-5754
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