Back Training Study in New England Journal of Medicine Flawed
By Dennis Downing, President of Future Industrial Technologies.

   
Subject: Can training in lifting techniques be made effective?
Posted by: Dennis Downing
Posted on: Oct 12, 2005, 12:52 PM

Hello,

I have read this thread and I am glad to see "some" people are experiencing benefits of training. I have seen and read how "back schools" or back training is generally not effective. I must say Dave, that fellow you listened to in Australia regarding the explicit and implicit way to learn is way off base as far as my experience is concerned. I can understand how it has become an accepted inference that training does not work. Companies across the globe have tried to abate back injuries and other sprain/strains to no avail. I even spoke with a medical doctor that conducted a study on back training and published the poor results in the New England Journal of Medicine. This ill fated study further propagated the fiction that people can't be trained to be more in control of their musculoskeletal well-being.

I was curious to speak with him because our experience was the exact opposite. If one looked at the conclusion that people can't be trained to use their bodies differently, it would be hard to believe. Look at all the aspects of life that are "transferable" to other people through education and training. We teach 12 year old girls to do back-flips on balance beams-4 inches wide, we teach micro surgery, swimming, riding bikes and driving cars, and the vast myriad of kinetic fundamentals germane to each sport that exists. One must wonder then, why is learning how to lift properly the only thing on planet earth that is non-transferable to others?

The problem has been in the training methodologies not in peoples' unwillingness or incapacity to learn. Society has been training people how to lift, bend, pull, sit, etc., incorrectly for decades. For example, in the interview with the previously mentioned MD, I found that there was not a chance in hell that the training would ever net any positive results. It was doomed to fail from the outset.

Some of the design flaws were: there was no buy-in from management (free program with no vested interest for it working); no employee buy-in, the personal benefits to the employees were not explicit; the training was theory and demonstration only (try teaching a kid how to swim with a video or by demonstration in the family room); no stretching was recommended (yes the chin tucks for one are nothing short of miraculous for some job descriptions); and nothing set up to reinforce or maintain the program. It all added up to NO ENLIGHTENMENT, just bored workers and an incorrect conclusion that training does not work.

The end result of a proper training methodology is employees that make a self-determined decision to change behavior because it is to THEIR benefit. The lowest common denominator we look at here, is that people have an aversion to pain and want more energy.

Sign me up, that motivates me too. The results of one using their body properly at work and in life are less pain and more energy. That should be the goal of the training which boils down to helping people to learn something we all should have learned as youngsters but never did. The reduction of workers' comp costs is merely the positive by-product of these results. It works every time.

I do not mean to go off here, but we have witnessed thousands and thousands of employees that have received proper training that has resulted in reductions in workers' comp costs and better quality of life issues.

We need to realize that training kinetic activities such as how to lift, push, pull, dig, transfer patients, pull cable, cut meat, drive and unload vehicles, sit and use a computer and all the other motions involved in the workaday world, is a different bird than teaching theoretical topics.

You teach someone how to do something, a doing-ness if you will, much differently than teaching anatomy or history for instance. As for what lifting techniques are better than others, that is less important than the training methodology itself unless of course you are teaching harmful technique.

One of the entries below mentions neutral posture. This is right on. We need to teach people how to perform their specific job tasks in ways that produce less daily innocent stress on their bodies. There is no one way to do it. We know that too much back flexion is not good, we know torque is not good (twisting), and we know that keeping the load close to one's body is better than extending with the load. But what if we are lifting watermelons out of a crate and can't bend our knees? There are straight back techniques for this that does keep the spine in neutral. What if one has bad knees and cannot bend to the degree necessary? They need to be taught ways that are safer for that person even if it is not perfect.

My point here is, as a society we have done a lousy job of teaching people how to avert innocent physical stresses in life that over time lead to discomfort, pain and injury. Kids are lifting backpacks incorrectly all day which unnecessarily causes pain and injury; mothers lift kids incorrectly; and virtually no one has the faintest idea of how to correctly adjust their chairs and workstations-even after companies spend $400 to $800 on office chairs and $4,000 on workstations.

Ergonomics and training are a great combination. Training does work if done correctly. A monkey can be taught to jump rope and yes people can learn to lift, bend and pull. We just need to apply the right teaching methodologies. It's like a nice watch. It looks simple but there is a lot of detail and know-how that makes it tick. The results are quite magical actually.

Dennis Downing, President
Future Industrial Technologies