Nick Hind is an exciting speedster from the Essendon Football Club. After injury impacted his ability to be selected in his draft year, Nick continued his plumbing apprenticeship whilst pursuing his...
David Hall is the National Chair of the Occupational Health Group of the Australian Physiotherapy Association (APA).
Daniel: All right. Welcome to another episode of Masters Plumbers Radio. My name is Daniel Carrol l and today my guest is David Hall, National Chair of the Occupational Health and safety Group at the Australian Physiotherapy Association. In today’s episode we’ll take a focus on you and your body because after all the best tools in the world are not useful at all if you’re not able to bend over and pick them up. Good day, David, in my research I’ve seen that you’ve been involved in physiotherapy for 25 years. It’s a pretty good stand and it gives you a great indication that you love what you do. Tell us a little bit about how you got involved and what you’ve experienced in your career thus far.
David: Yeah, thanks Daniel. Thanks for inviting me to join today. Initially, over those 25 years, I started working clinically, so helping people once they’re already hurt, and then around 15 years ago I thought, “Oh I’m at the wrong end of the stick here. It’d be good to try and help people to prevent them from injury.” So I moved into various workplaces. That included tradies but also office environments and various other environments. And since then I’ve been focused on helping people stay well at work rather than needing my colleagues who are still doing the clinical work.
Daniel: I can imagine in that 25 years it would give you a pretty good visual on trends that seem to develop over time in regard to the types of injuries people are suffering on the job and at home. Have you noticed anything in particular that you can share with us? We live in a much more informed time now. So more advanced tools and a stronger focus on WH&S. Surely there’s some noticeable decline in injuries. Would that be the case?
David: Yeah, definitely. It’s really changed a huge amount in that time. It’s a bit scary to think how long that’s been, but yeah, that’s been a full generation of workers and things have improved. There’s no doubt they’ve improved. So what we first saw when I was a new grad and when we started out, it was a lot of focus on the individual with their manual handling. So it almost became folklore, the whole, bend the knees, keep the back straight. So a lot of focus on the individual doing the right thing. And I mean that’s always remained something that’s important to do but then really over the last probably more 15 years or so, there was more onus put through legislation, changes on the workplace in providing good training, good tools, and much more of a focus on systems in the workplace and actually using equipment and processes and good work design to help. So that was a big shift.
David: So that’s improved things and there’s much more accountability. Where tradies have probably missed out on that a little bit is a lot of tradies are self employed. Where a lot of those improvements really happened in the larger employers, a lot of the self employed tradies remained outside of that. From a physiotherapy point of view, and as I say, I’m involved mostly in prevention, but still have close links with the clinical work that my colleagues in the profession do, tradies are famous for limping in the door, basically really in a bad way. Finally admitting that they just can’t work anymore and they need some help and of course physios can help them and we do. We do that every day, but it’s far from ideal. They’ve got to be much more on the front foot than that. So, that’s that change. Probably the other thing I’m just seeing lately is just in the last five years in particular is around mental health and workplace culture and how we communicate with each other and more of that sort of wellbeing side of things is kicking in a lot more. So that’s been interesting.
Daniel: Well you said you’ve dealt a little bit with people in trades. What are the types of injuries that people are presenting with? I know you mentioned before about limping in and saying, “All right, I finally, I can’t do it anymore. I’ve got to get something done.” Is there a particular category of injury, whether it’s a lot of back injuries or leg injuries, what do you seem to find there?
David: Yeah, there’s two types of issues and one tends to be more the young guys and girls, the other one tends to be more the older crowd. The young ones are more susceptible to that quite severe back injury where they’ve just really done the wrong thing and tried to be a hero and they’ve done a lift poorly or no one’s around to help and they’ve tried to do something where really they should have got some equipment or another person or two to help them. So the young people are more susceptible to something where they’ve tried to be a hero. The older people, they tend to have learned that the hard way. We’re pretty reactive as a species. They’ve unfortunately had a few, usually had a few back niggles along the way. And the APA research has looked into this and found that most tradies have had a significant episode or two or three of back pain or shoulder pain or neck pain. They’ll tend to more just be getting those sort of cumulative aches and pains after they have a bigger day. But they’ve learned-
Daniel: General wear and tear.
David: General wear and tear. But they’ve learned and they try to get the young people thinking about it, but it’s just an interesting human psychology about are we able to really take on board preventative advice or do we actually need to experience it to know what’s going on?
Daniel: I get that. I’ve always had office based work but in early days doing some casual work here and there, there’s a lot of focus around OH&S then, showing videos of correct manual handling techniques and whatever else. But a lot of the people I was with sort of almost just switched off and use that time as a bit of a rest. You know…That’s never going to happen to me. I think at this point that’s where a lot of people get themselves into trouble. Just like other serious illnesses like anything you think of. “Oh, it will never happen to me.”
David: Absolutely. It’s interesting isn’t it?
Daniel: You mentioned before you’ve had a little bit to do with people in trades and usually they present with a sore back or sore shoulder or whatever. How can a physio help a person in general and in particular a tradie?
David: Physios actually can be much more involved than people might realize. I think traditionally people know that if you’re injured you can go to a physio and they can help you with the injury management side of things, of things like sore back, sore neck, shoulders, knees, that type of thing. Now physios are also, myself included and many of our colleagues that are involved in prevention of injury in the first place. Helping with training and helping with risk assessments in work sites to help tradies to be aware of the risks so they can be a step ahead of those. And also with some exercise programs that organizations and individuals can use to help prevent injuries. the prevention side of things as a whole heap, a physio can help with. On the injury management side and the holistic side of things as well as helping tradies who’ve got musculoskeletal issues. Also, things like type two diabetes and more general sort of issues. So men’s health type issues as well. Pelvic floor, that type of thing. There’s a wide range of conditions that physios can help with in helping tradies stay healthy and well at work.
Daniel: In saying that, for people that are thinking, “Oh, I’ve got that thing, that sort of niggle in my knee. I dunno if I should see someone about it.” What’s your advice to them? Do you just go out and see somebody, book in for an appointment?
David: If they’re nervous about the cost of it, I just say just be up front with the therapist and say, “Look, I don’t want to keep coming back here for ongoing treatment. Can I just get some exercises or some advice?” So often it’s just a one off session. I can’t tell you the number of times over the years someone’s come to me for a quick one off session, learned some really simple strategies or exercises and then I’ll follow up with them six months or 12 months later. They say, “I wish I’d come to you 10 years ago.” Particularly with knees and backs and shoulders. The things that often get injured. Don’t be afraid and also just be up front if you don’t want to find yourself in that treatment model, if you like to say, “Look, I just want some advice, one off session. What have you got for me?”
Daniel: And in the age of Dr. Google, how important is it for people to actually go and see somebody that knows what they’re talking about as opposed to saying, “Yeah, I think that’s what I’ve got.”
David: Yeah, absolutely. The challenge of Dr Google is it really focuses on what goes wrong and on the horror stories. So it’s getting better. You got to know where to look. But yeah, just that trusted health professional face to face who can actually get their hands on and then have a look at you properly, still definitely the way to go.
Daniel: I’ve played sports all my life too and before I started playing or training or whatever, there’s always the coaches and other staff would always encourage you to stretch. Does the same thing apply when you go into work and picking up tools and what can people do to prevent these types of injuries from happening?
David: Yeah, absolutely. I mean a big part of the APA campaign’s been around the concept of being an industrial athlete, if you like, and taking a similar approach. If you’re going to do a heavy day of work, if you’re going to play a game of Footie, you’d always stretch and warm up. So we definitely recommend that. Quite often good teams of workers, they get together anyway and plan the day. You see them on work sites at the start of the day, they’ll get together, they’ll often just be sitting around, having a cupper or whatnot, or having a snack and talking about what they’re going to do that day. “We need to do this first and then we’ll do that and then we’ll do that.” So really we’d say that’s really a golden opportunity to just stand and do some warmup stretches as a group. It’s a great way of just getting on the right path.
Daniel: Any particular thing to focus on or just whatever gets you moving?
David: Yeah, look, any movement is going to be helpful. Obviously people can see physios or personal trainers and get specific exercises, but often it depends where they are. There’s a lot of work sites you need to be standing because there’s a lot of mud and debris around, so there’s a lot of good stretches done standing.
Daniel: It also depends on the type of work they’re doing, whether they’re bending over on their knees or lifting above the head and whatever else.
David: Exactly. Yeah. Yeah. It is helpful that again, depending on where they are, if there’s a floor surface already on the site, if they’re doing housing and that type of thing, then to sit down and do some stretches. Just gets them off their feet as well for a little while. Look, any stretch is good, but when in doubt go and see a physio and get a little program together.
Daniel: Okay, cool. And when you talk about a program, for the people that might not have been to a physio before, what would that entail?
David: So the three key things to not get injured is one, to be reasonably flexible, and the second one is to be reasonably strong. With the tradies, the strength is usually not the issue. Tradies are usually pretty strong. Flexibility can definitely be more of an issue. The third one is we just call that basically body awareness. How do we move? How do we do things? You might be really flexible and really strong, but if you do stupid things you’ll get injured. So that’s that whole, how conscious we are about the way we move. Everyone knows about back straight, bend the knees because that became folklore in the training. But it’s other things too around pacing your day, around asking for help when you need to, to keeping the loads close to the body. Just being sensible and being body aware is the third thing. When you’re thinking about those three things, it’s worth reflecting on, “Where’s my weak point?” From tradies often it’s A, flexibility is often a weak point and B, it’s that third one. And how body aware they are.
Daniel: I know a lot of people will learn from experience, it’s just a shame that a lot of people don’t get the opportunity to kick on if it’s a bad experience. Most of the time if you twist an ankle or whatever, you might be sitting at home with your leg up for a few days. But if it’s something a little bit more significant, like you see back injuries more than likely tend to hang around for the rest of your life.
David: Yeah, well that’s right and we’ve seen Safe Work Australia’s statistics show that two in three and five, so about 60% of serious workplace injuries are tradies. That’s a pretty large percentage. When you think that tradies make up about 30% of the workforce. So, that’s a pretty high representation there. Something is sort of going wrong at a lot of levels. Look, it’s not all bad news for tradies. The good thing is that we know that sedentary works really bad for you as well. So tradies are really active, so that’s great, but they’ve got to be active and smart about it. One thing that’s probably worth saying too is I think I’ve seen over the years that a lot of tradies have not a great relationship with the word no. Or later. “You can do that later, but not now.” That’s not just tradies but I think it’s particularly relevant to tradies. I think sometimes people have just got to own the word no if it’s there. But like most of us people, tradies, they want to please people, they want to get the job done, they’re working to tight deadlines.
Daniel: They don’t want to have to come back.
David: Don’t want to have to come back the next day. Particularly when they’ve got just those last couple of hours to get something done. The lights getting a bit dim. So the two real risk points, one is first thing in the morning if you don’t warm up. And the other even greater risk point is the last hour or so in the day when you start pushing to the line. That might be when you take some shortcuts that you might regret.
Daniel: I read as part of the tradie health month, last year, I think it’s August. That tradies or those that were part of the survey said that they took care of their tools better than they do their own bodies. And it’s pretty staggering to hear that because tradies rely on their bodies to do their work and so their bodies are their primary work tool. If that breaks down or they become incapacitated through for whatever reason, they’re not able to do their work to the full ability and that sort of compounds on what they do at home as well. You mentioned before, you touched on a few of the findings from the survey. Is there anything else that really stood out in regard to tradies?
David: I think that percentage was incredible, so we found that about 80% of them said they really work hard to take care of that tools and less than half says, 47%, said they really work hard to take care of their body.
Daniel: That’s crazy.
David: We really think they’ve got that the wrong way ran around. It comes down to that gung ho approach. Trying to be a bit of a hero and not really understanding that a tool, as much as it is important to take care of your tools, you can actually replace your tools. If you really stuff up, you just get more tools. You don’t always get that opportunity with your body. If you have a significant, particularly spinal injury or shoulder injury in a lot of cases too, that can be compromised for the rest of your life.
Daniel: In saying that there’s a lot of people out there that are working for themselves and if they don’t work, they don’t get paid. If they don’t get paid, they can’t pay the bills and that affects their family and what they do in their life in general. And it becomes a vicious cycle of pushing themselves to work in the morning because if they’re not able to earn, it effects their families. How are we going to break that cycle of a lot of self employed people out there have to go out and do that?
David: Yeah, they do. And as you say, it can be a vicious cycle and I totally get it. I totally get how that cycle continues. And look, I’ll be frank, I’ve got two small kids, they’re getting a little bit older now. Five and nine actually now. But I think in particular it’s when you’ve got young kids. Because they’re so hands on. That time that you might’ve set aside for some stretching and exercise and going swimming, things that just help you look after your body, those little gaps just get taken.
Daniel: Breakfast. Who needs that?
David: Yeah, exactly.
Daniel: I’ll just get a coffee on the way to work.
David: Yeah. We’re finding that that’s improving. The research talking about, I mean look, anecdotally you still see a lot of tradies don’t eat what they should, but that’s getting a little bit better. There’s at least a bit of an attempt and an awareness that they should try and eat healthily. How much that plays into practice is variable. But yeah, I think there’s just that blind spot isn’t there? Around how important it is to put time and energy and thinking into your body. I’d say first and foremost, you don’t need more time to do some simple things that are good for your body. You just need to be smarter about it. You need to actually work a bit smarter, ask for help when you need to, say no when you need to, be assertive about that stuff. That doesn’t take more time.
David: Then you also need to make sure your equipment’s up to date and you use it. If you’ve got wheelbarrows and trolleys and things there, use them. A lot of times people just don’t because they’re just quickly trying to get the job done. You know what I mean? It doesn’t necessarily mean you need more time because I agree, a lot of us are really time poor, but just being smarter with the time that you’ve got and in the short term it might feel like you’d be less productive. But if you’re going to roll up the next day feeling fit and well and set to go, then overall your productivity is going to be better rather than worse.
Daniel: Of course. I can see a lot of, of course if you’re a boss with maybe half a dozen people working for you and you’re responsible for them and their wellbeing. If you are putting the processes in place for them to do things and they’re not following what you’re trying to do, you’re sort of at the mercy of what happens to them for them to learn by experience or what we’re talking about before. Is there any sort of techniques or ways to sort of encourage people that are sort of resistant initially to what you’re trying to do?
David: It’s a really good point you bring up as we’re talking about trends at the start of the show and I mentioned about legislation and Australia is really led the world in these legislation changes which puts the accountability on the employer. We’re really ahead of the game compared to even other western countries on that. It’s sort of gone full circle in the time that I’ve been a physio from where the bosses could be a significant part of the problem, really trying to push and push and push. Now it’s often the other way around, well they’re actually legally accountable if there are some issues and there’s injuries. So they’re really encouraging people, work safe, let’s do this properly. But look at the same time, whether it’s consciously or unconsciously, there is often production pressures on them.
David: So firstly you’d say the bosses have got to recognize that, hey, if you want the people to work safe, you’ve got to put realistic productivity targets on what they’re doing because otherwise those two don’t match. But coming back to your point, so that’s probably the first part of that point. So don’t just give it lip service and meanwhile have a target that actually sets a different-
Daniel: Have to be reasonable about it.
David: Be reasonable about it. Look, in terms of, I think just the building that rapport. I think it’s not just about training someone to do it and then they’re going to go and go out there and do it every time. I think you’ve got to build in a working team. You’ve got to build a culture where it’s okay for people to tap each other on the shoulder and interrupt each other. You know that culture where you can say, “Hey mate, don’t rush. It’s all right. Just hang on to that. I’ll come and give you a hand in a sec.” Or, “Hey man, just stop there for sec. You’re just forgetting about your knees. Let’s get the machine.”
Daniel: Typical example of coming home from doing the shopping and you’ve got a boot full of grocery bags. I reckon I can get these in one go.
David: Yeah. Exactly.
Daniel: I can’t feel my fingers afterwards, but I got them all in one trip.
David: Yep. I’m guilty. I gave myself a nerve injury one time. Doing exactly that. That last one around the forearm and had to carry it up some stairs. Yeah. So we all do it. And sometimes it’s just that last bag or two, if you had four bags, you go, “I’ll come back and get that.” Looked, that culture is important. I think coming back to your question, I think with bosses, you’re trying to create a culture within a working team. But again, the challenge there when there’s contractors and various, tradies again are a little bit of a challenge there because you’ve got a working team that day or maybe for a few weeks.
Daniel: Every one is different.
David: Yeah. Might go quite well. But then in come the guys doing the painting and in come the guys doing the plumbing aspect of it and so then suddenly it’s a different working team.
Daniel: And a couple of days later, you’re onto another job.
David: And then a whole different dynamic again. The individuals within that team have to take a lot of accountability and you only get one body. There’s a few more stats. This is not through the APA stats, but stats I know from elsewhere is around choices too. When people injure themselves in the vast majority of cases, they had, in around 95% to 98% of cases where there was an injury, someone had a choice that led to that. Usually they should have said no. And you know that 80% of those, that person who got injured had one of the choices that led up to that. And again, usually it was, it should’ve just been a whoa. No, not now. We’re not ready for that. Let’s get the ladder. Let’s whatever it might have been.
Daniel: Okay. I touched on before the national tradies health month. It’s approaching again in August I believe, and the APA is about to run a survey to get a better idea of how they can help people in trades manage their bodies. Can you tell us a little bit more about that and what the findings will be used for?
David: Yes. Last year’s survey was really interesting. That’s where we found out about the priority to look after tools more than their own bodies, their own health, and some of the attitudes that we’ve spoken about today. This year there’s more of a focus on a couple of things. One is around stretching and warming up and who’s doing it, what’s the prevalence of that, and is it helping? Also, looking at people who are tradies and are also playing sport as well. How do those interact?
Daniel: I know a lot of people who have risked their career for a kick on the weekend and paid the price.
David: Yeah. Yup. And look, if you’re passionate about it, this is why we live. So certainly we’re not looking to suggest that you don’t do things that you’re passionate about. But again, are we going to play with those injuries or do we take ourselves a little bit more seriously. That’s some of the things we’ll be looking at this year.
Daniel: Of course. Okay, fantastic. And for people that want to get involved, how do they go about doing that?
David: Yeah, so August is the month where the campaign takes place, Daniel, but certainly an opportunity in the lead up to that to get involved online.
Daniel: Okay. And I think we’ve got a link to the survey contained within the description to this podcast and for the Master Plumbers Members will also be receiving something via email. Keep an eye on your inboxes for that one. Dave, thanks for coming on and join us on Master Plumbers Radio today and thank you very much.
David: Great, thanks Daniel. And thanks for your support.