Micro-Stretching

Micro-stretching WORKS… and works very well…IF IT IS DONE RIGHT !!

But most workplaces don’t do this correctly.
You cannot simply Google up a download and tell workers to do them.
THAT DOES NOT WORK!  

Stretches (or, better yet, microstretches) must be selected to match the MSD risks for the jobs. That can only be done by a professional who is expert on the pathomechanics of MSD (such as the Physical Therapist… the MOST highly trained profesional on this).  

Then, employees must be professionally trained: not just on what stretches to do and how to do them, but on WHY… othwise, they won’t do them.  Once they understand exactly how each MSD develops and how to reverse that process… then they will commit to doing them.

At least that is our experience at the last 500+ workplaces where we have done this.

Why workplaces micro-stretching ? … the critical value of micro-stretching?   Many jobs have MSD risks that just cannot be engineered away… no ergonomics corrections available.  How do we protect these workers?  Job task rotation to minimize uninterrupted exposure time… and micro-stretching.

MSD is a nutrient pathway-perfusion problem: When muscles contract, pulling on their tendons, moving or posturing body parts.. they create pressures and tension that exceed the blood pressure feeding those working tissues. That reduces blood flow to working tissues. That allows the waste products of work (acid wastes that become urine) to back up in those tissues, leading to irritation-inflammation and chemical damage… tendinitis, tendinosis, and degeneration of joints and discs.

Ongoing tension or repetitive contractions mechanically inhibit blood flow.  Very brief stretches to muscle-tendon groups can create nerve responses (the inhibitory response of the Golgi tendon organs) that relax these tissues, allowing improved blood supply, thus removing irritating and damaging chemical wastes.  We are not seeking lengthening of muscles with this particular tactic;  just relaxation of the muscle-tendon unit. The objective is to pause loading and relax the built-up background tension, to allow cleansing blood flow to remove metabolic wastes that accumulate and irritate. It also restores coordination and postural awareness.

One major advantage of brief targeted micro-stretches is it offers a prevention tactic that protects workers on jobs that cannot be made harmless through ergonomic modifications (as is so often the case on many jobs).

These may be done as a structured ‘everyone-do-it-together’ routine (less that 2 min total)… or… even better… everyone gets MSD School training teaching what stretches fit what risks and discomforts, so each individual worker will then be self-motivated and skilled at self-selecting stretches to be done whenever they encounter work discomfort (only 10 sec each).  This works great.

NEW CONCERN… Many companies now employ workplace stretches. But a new problem has appeared: INCORRECT STRETCHES.  Here are some at we recommend, because they are specifically targeted to the highest risk body parts.

CHIN TUCK stretches the upper spine into a posture that corrects slouching (a severe risk of neck, upper back, and shoulder degeneration).

STANDING BACK-BEND stretches lower back into extension, needed for proper disc health and to reduce gradual disc bulging from too much bending or sitting.  We recommend the worker flex at neck, not extend head on neck, to moderate spinal forces.

HAMSTRING STRETCH because tight hamstrings reduces hip bending, thus increasing bending loads on the vulnerable lower back, risking disc herniation and degeneration.

LATERAL NECK SCALENI STRETCHES because sitting and slouch allows later neck muscles to tighten, compressing blood vessels and nerves that pass through them on their way to the arm and carpal tunnel.  Common error is allowing rotation to occur during sidebending stretch.

SHOULDER CODMAN-PENDULUM for jobs with reaching, loading rotator cuff tendons.   This greatly relaxes cuff and restores blood supply to shoulder muscles.

TENNIS ELBOW STRETCH is often done incorrectly in many workplaces. This must stretch both wrist and finger extensors that usually lose elasticity from over-use. This micro-stretch restore blood supply and elasticity here.  Common error is stretching into wristflexion with fingers open-neutral… NOT correct…should be done with fist closed to include digit extensors in the stretch, since they share that proximal tendon and are part of radial tunnel.

GOLFER’S ELBOW & CARPAL TUNNEL STRETCH is also often done incorrectly by many workplaces. This is to stretch wrist-finger flexors (grip and pinch work) PLUS the pronator muscle at the front-to-inside of forearm-elbow, responsible for stressing inner elbow and squeezing nerves to carpal tunnel.  Common error is doing this stretch with forearm pronated… NOT correct… forearm should be supinated to include pronator teres in the stretch, since that is a source of median nv entrapment adding to CTS risk.

DEQUERVAIN’S–THUMB STRETCH addresses work tasks that use thumb loads.

CALF STRETCH reduces plantar fasciitis heel spur and achilles tendon risks.

There may be others, customized to specific jobs (middle back torsion for forklift drivers, others for maintenance tasks, e.g.).

Stretch programs should be designed by a professional Physical Therapist with knowledge of the jobs… to design a small, practical, targeted program.. that is taught to employees by that PT to motivate employee acceptance and skills in these.  The key is face to face training in an MSD School format that teaches not only what to do, but WHY to do it… or else they won’t do it at all.

THAT IS WHY WE DO NOT POST A DOWNLOAD OF OUR MICRO-STRETCHES

Here is one version customized for office setting (with a blocking overlay to inhibit download use).  Other versions customized for other settings, e.g., warehouse materials handling work, repetitive task mfg, etc.

Office format of micro-stretching

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Wider workplace demands micro-stretch program

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OUR OUTCOMES… Table of data from a study we did of our outcomes, published in Ortho APTA’s monograph self-study course “The Injured Worker” encompassing several thousand workers in multiple states trained by several PT’s using the same MSD School program and micro-stretch protocol. Claims reduced 37%; lost time claims reduced 59%; MSD lost days reduced 78%.

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