Publish at May 04 2015 Updated March 02 2023

Prevention of musculoskeletal disorders in training

Interview with Christiane Daban, occupational health practitioner

Christiane Daban is an occupational health practitioner. Her basic training is in physical therapy. Located in the southwest of France, she intervenes in particular in companies to carry out prevention actions. She agreed to answer a few questions.

F.D. You intervene in the field of prevention at work. Many actors meet around this theme. Can you present us the framework of your action, and the link with other professionals?

C.D. Yes, I decided about twenty years ago to practice my activity as a physical therapist in 2 very complementary modes: rehabilitation in the office and at home, and prevention through missions in companies. These missions are of three kinds: information meetings, awareness conferences and prevention actions.

During these in-company interventions we have a major asset: we establish an individual assessment for each agent before any training. This individual interview, lasting 20 to 30 minutes, allows us to better understand the physical abilities before considering a visit to the workstation.

As far as prevention actions are concerned, it is not possible to work "alone in one's corner". Multidisciplinary actions are much more effective. The preparatory phase of implementation is essential (managers, occupational physicians, etc.), to coordinate the actions to be carried out with the different prevention actors (physiotherapists, ergonomists, nurses, occupational therapists, occupational psychologists, etc.). ) the orchestration of prevention is a guarantee of success.

F.D. Do these approaches have a place in the world of training and education?

C.D. Yes, of course. A few years ago, musculoskeletal disorders were associated with jobs that required a lot of handling. Now we know that even someone who works on their computer or grades papers can get sciatica or carpal tunnel if they're not careful.

Stress, clothing and context are also key determinants.

F.D. We're looking for recipes, rules to follow. Are there any good postures that can be advised to trainers?

C.D. It's the famous trainer myth: In all trainings, the company manager asks the trainer to teach the right technique, the right way, the right gesture to perform. We are "individuals", so each of us has our own abilities. Our role is to offer agents "a gesture toolbox" and help them choose from those that are best for them.

F.D. Does this mean that the question of which is better between a backpack, rolling suitcase or sling bag has no absolute answer?

C.D. It depends on the load to be carried, the physical capabilities of the wearer, and the amount of time he or she will be moving the load: we could add in repetitiveness factors (is it every day, several times a day), environmental factors, etc.

A priori, it is better to vary the ways of carrying and the types of bags. In handling activities (heavy equipment, copies,...), care should also be taken to carry the load close to the body.

F.D. Without talking about "good postures," are there any principles to know?

C.D. Already , a good formula to remember is, "How does it feel when I do ___?"

The strategy the body puts in place to stay upright is to maintain the center of gravity over a surface bounded by the feet, which is called "the polygon of sustentation."

the levitation polygon

This is a bit technical, but the implications are concrete. The more you close your feet, the closer you bring them, the less balanced you become. Martial arts specialists know this. But hairdressers, cooks, trainers... politely keep their feet together without giving their bodies any freedom. They must then use compensatory strategies.

F.D. What do you mean by compensation?

Our self-regulatory system allows the body to adapt in the face of physical stress. When this system is deficient, the body will compensate, tensions will settle elsewhere. For example, shoulder pain may cause us to carry differently, bending the body, or putting more strain on the other arm.

The tensions felt by these compensations are often greater than those at the start. We will therefore refer to these as adaptations/compensations.

Illustrations: Frédéric Duriez

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