What's Inside - 13 Slides

ERGONOMICS & PHYSIOTHERAPY SESSION

Radiology Department | Patient Care Department

SECTION 1: WHY ERGONOMICS MATTERS IN YOUR DEPARTMENT

• 60-80% of healthcare workers experience back pain at some point in their career
• MSDs are among the top 3 causes of sick leave in hospital settings
• The average standing time per shift for radiology and ward staff is 6-8 hours
• Every additional hour of uninterrupted standing raises injury risk by approximately 40%
• Prolonged standing without movement causes blood to pool in the legs and feet, leading to chronic varicose veins, joint stiffness, and accelerated fatigue

SECTION 2: COMMON INJURIES FROM PROLONGED STANDING & WALKING

2.1 Neck & Shoulders

• Neck muscle fatigue and tension (from looking at screens or down at patients)
• Cervical strain from forward head posture ("tech neck")
• Shoulder impingement from repetitive reaching and bending
• Upper trapezius tightness - very common in radiology reporting staff

2.2 Lower Back

• Lumbar disc stress (increased load when standing with a forward lean)
• Facet joint irritation from prolonged standing in lordotic posture
• Erector spinae muscle strain
• Disc herniation risk with repeated bending + twisting (patient transfers)

2.3 Knees & Legs

• Early-onset knee osteoarthritis
• Varicose veins and chronic leg swelling
• Patellofemoral pain syndrome (kneecap pain - from locked knee standing)
• Shin splints and leg cramps

2.4 Feet & Ankles

• Plantar fasciitis (heel pain, worst in the morning) - most common in ward nurses and radiographers
• Ankle swelling and tendinopathy
• Metatarsalgia (forefoot pain from hard hospital floors)
• Flat foot worsening over time with insufficient footwear support

SECTION 3: ERGONOMIC PRINCIPLES & WORKPLACE ADJUSTMENTS

3.1 Work Surface Height

• Adjust all work surfaces to elbow height
• For radiology consoles and nursing stations, the surface should sit 2-5 cm below your elbow when standing
• Surfaces that are too low force you to hunch; too high causes shoulder elevation
• Action: Check your workstation height today and request an adjustment if needed

3.2 Anti-Fatigue Matting

• Gel or foam anti-fatigue mats should be placed at all fixed standing workstations
• This includes: radiology reporting rooms, medication preparation bays, nursing counters, and scanner control areas
• Anti-fatigue mats reduce lower limb fatigue by up to 35% by encouraging subtle micro-movements in the legs
• Minimum mat thickness: 1.5 cm
• Action: Identify stations in your department that lack mats and report to your manager

3.3 Sit-Stand Variation

• The body is not designed to stay in any one position for extended periods
• Alternate between sitting and standing every 20-30 minutes where possible
• Request sit-stand stools at imaging workstations and documentation areas
• Even shifting weight from one foot to the other significantly reduces spinal load

3.4 Reach Zone Management

• Keep all frequently used items (instruments, files, supplies) within your primary reach zone - no more than arm's length away
• Avoid twisting your back to reach for items to the side or behind you
• In radiology: position your mouse, keyboard, and phone within easy reach before each session

3.5 Lighting & Screen Positioning

• Position monitors at eye level - the top of the screen should be at or slightly below eye level
• Reduce glare on PACS screens to prevent you from unconsciously leaning forward
• Poor lighting causes you to adopt awkward postures without realising it
• For patient care: ensure adequate lighting when performing procedures to avoid hunching

3.6 Task Rotation

• Rotate between high-load (physical) and low-load (administrative) tasks every 45-60 minutes
• In radiology: alternate between scan positioning (physical) and reporting (seated)
• In patient care: alternate between patient transfer duties and documentation or medication preparation
• Task rotation is one of the single most effective interventions for preventing MSDs

SECTION 4: POSTURE CORRECTION & BODY MECHANICS

4.1 Ideal Standing Posture Checklist

• Head directly above shoulders - chin slightly tucked in, not jutting forward
• Ears aligned over the mid-shoulder (not in front of it)
• Shoulders relaxed - not elevated (shrugged) or rolled forward
• Core lightly engaged - gently draw navel toward spine without holding your breath
• Natural lumbar curve maintained - a slight inward curve in the lower back is normal and healthy
• Knees soft - not locked in full extension (locked knees compress knee joints and reduce circulation)
• Weight evenly distributed on both feet
• Feet hip-width apart, toes pointing forward

4.2 Common Postural Faults to Avoid

4.3 Body Mechanics for Patient Handling

1. Always bend at the hips and knees - never at the back. Think "sit down to the task."
2. Keep the load close to your body - the further away a patient is, the more force goes through your spine
3. Use mechanical aids (hoists, slide sheets, transfer boards) for any transfer exceeding 16 kg
4. Communicate with colleagues before any lift - count to three, move together
5. Never twist your back while holding a load - pivot using your feet, turning your whole body
6. Do not rush transfers - most injuries happen when staff are hurrying

SECTION 5: PRACTICAL STRETCHING & EXERCISE PROGRAMME

PART A - Stretches (Do Every 45-60 Minutes During Your Shift)

Stretch 1: Calf Raises

1. Stand with feet hip-width apart, hands resting on a surface for balance if needed
2. Rise slowly onto your tiptoes, lifting both heels off the floor
3. Hold at the top for 2 seconds
4. Lower slowly back down
5. Perform 10-15 repetitions, 2 sets

Stretch 2: Standing Hip Flexor Stretch

1. Step one foot forward into a lunge position
2. Keep your back knee straight (do not bend it)
3. Push your hips gently forward until you feel a stretch at the front of the back hip
4. Keep your torso upright - do not lean forward
5. Hold for 20-30 seconds, then switch sides

Stretch 3: Thoracic Extension

1. Clasp your hands behind your head with elbows out to the sides
2. Gently arch backwards, looking upward toward the ceiling
3. Feel the stretch across the upper chest and mid-back
4. Hold for 10-15 seconds, return slowly
5. Repeat 5 times

Stretch 4: Neck Side Tilt

1. Sit or stand with your spine upright
2. Gently tilt your head to the right, bringing your right ear toward your right shoulder
3. Use your right hand to apply very gentle additional pressure (do not pull forcefully)
4. Hold for 20-30 seconds, feel the stretch on the left side of your neck
5. Repeat on the other side

Stretch 5: Shoulder Rolls & Chest Opener

1. Roll both shoulders backwards in large, slow circles - 10 times
2. Then clasp hands behind your back
3. Gently squeeze shoulder blades together and lift hands slightly
4. Hold 10-15 seconds - feel the chest opening
5. Repeat 3 times

Stretch 6: Seated Lumbar Rotation

1. Sit upright in a chair with feet flat on the floor
2. Cross your right leg over your left
3. Place your left hand on the outside of your right knee
4. Gently rotate your upper body to the right, looking over your right shoulder
5. Hold 20-30 seconds, switch sides
6. Repeat twice each side

PART B - Strengthening Exercises (3 Times per Week)

Exercise 1: Wall Squat

1. Stand with your back flat against a wall
2. Walk your feet out and slide down until your thighs are parallel to the floor (like sitting in a chair)
3. Hold for 20-40 seconds
4. Slide back up slowly
5. Perform 3 sets of 10-12 repetitions

Exercise 2: Glute Bridges

1. Lie on your back with knees bent and feet flat on the floor, hip-width apart
2. Push through your heels and lift your hips up toward the ceiling
3. Squeeze your glutes firmly at the top
4. Hold for 3 seconds, then lower slowly
5. Perform 15 repetitions, 3 sets

Exercise 3: Bird-Dog

1. Start on all fours with hands directly under shoulders and knees under hips
2. Extend your right arm and left leg simultaneously, reaching long
3. Keep your spine completely neutral - do not let the lower back arch or rotate
4. Hold for 5 seconds
5. Return and switch to left arm + right leg
6. Perform 10 repetitions each side, 3 sets

Exercise 4: Ankle Circles & Foot Rolling

1. Sit or stand balancing on one leg
2. Rotate the raised ankle clockwise 10 times
3. Rotate anticlockwise 10 times
4. Switch feet and repeat
5. Then sit and roll the bottom of each foot on a tennis ball or foot roller for 60 seconds
6. Focus on any tender spots - this is targeted plantar fascia release

Exercise 5: Dead Bug

1. Lie on your back, arms pointing straight up toward the ceiling
2. Raise both knees to 90 degrees (tabletop position)
3. Slowly lower your right arm behind your head while simultaneously straightening your left leg toward the floor
4. Do not let your lower back lift off the floor
5. Return and switch sides
6. Perform 10 repetitions each side, 3 sets

SECTION 6: THE MICRO-BREAK PROTOCOL

SECTION 7: FOOTWEAR, FLOORING & EQUIPMENT GUIDANCE

7.1 Footwear Recommendations

• Snug at the heel (no slipping)
• At least 1 cm of space beyond your longest toe
• Wide enough not to compress the forefoot

7.2 Flooring & Workstation Equipment

• Place anti-fatigue mats at all fixed standing workstations (minimum 1.5 cm thick gel or foam)
• Install footrest rails at radiology reporting desks to allow weight shifting
• Request height-adjustable worktops where available
• Use sit-stand stools at imaging consoles where the workflow allows

7.3 Radiology-Specific Equipment Notes

• PACS monitors: Set at eye level to prevent forward head posture during reporting
• Mouse and keyboard: Position within comfortable reach - no stretching or leaning
• Lead aprons: Always hang on a proper stand when not in use - never drape over a chair. Wear only when required. Report any apron discomfort to your supervisor as prolonged lead apron use is a known cause of back pain
• Scanner room: Rotate between scan positioning (physical, active) and control room work (seated) to balance load
• C-arm and portable X-ray: Use correct pushing posture - maintain neutral spine, use whole body to push, avoid twisting

SECTION 8: RECOVERY & SELF-CARE STRATEGIES

8.1 Post-Shift Leg Recovery

• Elevate your legs for 15-20 minutes as soon as possible after a standing shift
• A cold water foot soak (10 minutes) reduces swelling effectively
• Self-massage your calves with upward strokes (toward the heart) to assist venous return
• Remove compression stockings at home (not during the shift)

8.2 Hydration

• Aim for 2-2.5 litres of water during your shift
• Dehydration accelerates muscle fatigue and increases cramping
• Avoid excess caffeine - it has a diuretic effect and contributes to dehydration
• Keep a water bottle visible at your workstation as a reminder

8.3 Sleep & Rest

• Aim for 7-9 hours of sleep - this is when tissue repair and muscle recovery happen
• If you experience lower back pain, try sleeping with a pillow placed between your knees (side lying) or under your knees (back lying)
• Avoid screens for 1 hour before bed to improve sleep quality and depth

8.4 Active Recovery on Days Off

• Light walking and swimming are ideal active recovery activities
• Yoga or Pilates 2 times per week significantly improves core strength and flexibility
• Avoid complete rest (lying on the sofa all day) - gentle movement heals faster than inactivity
• Cycling (stationary or outdoor) is excellent for legs without joint impact

8.5 Nutrition for Muscle & Joint Health

• Anti-inflammatory foods: oily fish (omega-3), leafy greens, berries, walnuts, olive oil
• Magnesium-rich foods (pumpkin seeds, spinach, almonds) support muscle recovery and reduce cramping
• Adequate protein (1.2-1.6 g per kg body weight) supports muscle repair
• Limit processed foods and high-sugar intake - both increase systemic inflammation

8.6 When to Seek Professional Help

• Pain persisting for more than 2 weeks despite self-management
• Pain that radiates down the leg (below the knee) or down the arm (below the elbow)
• Numbness, tingling, or pins and needles in the limbs
• Pain that is present at rest or wakes you at night
• Any sudden increase in pain after a patient handling task
• Swelling, redness, or heat around a joint

SECTION 9: DAILY ACTION PLAN SUMMARY

Before Your Shift

• Put on compression stockings before starting
• Do a 5-minute light warm-up (leg swings, shoulder circles, gentle walking)
• Check your footwear is appropriate and not worn out
• Set up your workstation to the correct height
• Place anti-fatigue mat if not already there

During Your Shift

• Micro-break every 45-60 minutes - stretch and reset posture
• Rotate between physical and sedentary tasks
• Drink at least one glass of water per hour
• Use mechanical aids for all patient transfers over 16 kg
• Never lock your knees - keep them soft
• Avoid twisting at the back when reaching or transferring

After Your Shift

• Elevate legs for 15-20 minutes
• Perform 10-minute cool-down stretching (use Part A stretches)
• Self-massage calves and feet
• Remove compression stockings at home
• Report any new onset pain to your supervisor or physiotherapy team
• Hydrate and eat a recovery-supportive meal

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