Presented by:
Timothy A. Duke, D.C.
Amy Heckman, M.P.T.
Ellen Stoute, M.P.H., R.D., L.D.N.
Presentation Outline
 Timothy A. Duke, D.C.
 Biomechanics Associated with Common Workplace
Injuries, and Anticipated Conservative (Chiropractic)
Treatment After They Occur.
 Amy Heckman, M.P.T.
 Appropriate Stretching and Strengthening to Prevent
Injuries in the Workplace.
 Ellen Stoute, M.P.H., R.D., L.D.N.
 Obesity Trends and Worksite Wellness to Maintain
Optimal Health and Minimize Workplace Stress and
Injury.
Presented By: Timothy A. Duke, D.C.
Learning Objectives
 Discuss common workplace injuries
 Strain/sprain
 Discuss the biomechanics of common workplace
conditions
 Lifting
 Sitting
 Expected conservative treatment associated with
common occupational injuries
 Active vs. Passive
Common Workplace Injuries
 Strain/Sprain (S/S)
 Most common (40%)
 Special consideration
 Other Injuries
 Musculoskeletal
disorders (29%)

“Ergonomic Injuries”
 Cuts/lacerations (8%)
 Fractures (7%)

* All stats provided by www.OSHA.gov
Strain/Sprain (S/S): A
Special Consideration
 Why a special consideration?
 Preventable
 How/why do these occur?
 Acute vs. repetitive
 Overexertion
 Improper lifting
 Slip and fall
 Etc…
Grading a Strain/Sprain
 All S/S are not created equal
 Literature accepts three grades
 Grade I
 Grade II
 Grade III
 Injury grade and timing are
going to lay out the frequency,
duration, and appropriate type
of treatment
 Passive to Active
Lifting Biomechanics
 Why discuss lifting
biomechanics?
 Education
 Why does improper lifting
cause so much injury?
 SPINE study 2006

Measured the change in load
to the lumbar spine with
external weight, as flexion
occurs

At 30 degrees the force was
approx. four times greater
Takahashi et al. Mechanical Load of the Lumbar Spine During Forward Bending Motion
of the Trunk-A Biomechanical Study. SPINE vol 31, number 1, pp 18-23 2006.
Lifting Biomechanics
 Journal of Occupational
Rehabilitation
 Low back loads vs. positions
resulting in low back pain



Previous studies have looked at
body position in regards to
causation of LBP, resulting in
mixed results.
Looked at cumulative low back
loads and their relation to LBP
Results up to 49% experienced
pain in at least one of the followup years (3 years of follow-up
performed)
Coenen et al. Cumulative Low Back Load at Work as a Risk Factor of Low Back Pain: A
Prospective Cohort Study. Journal of Occupational Rehabilitation. Online 21 June 2012.
Lifting Biomechanics
 SPINE Study 2000
 Compared both cumulative lifting AND trunk position
while lifting
 Correlated time spent in a flexed position, rotated
position, and also compared various load weights and
frequency of lifting.
 Results:
 Increased risk of LBP were noted with workers working
in a 60° flexed position at least 5% of the day, working in
a 30° rotated position 10% of the day, and lifting a load
of 25kg more than 15 times/day.
Hoogendoom et al. Flexion and Rotation of the Trunk and Lifting at Work Are Risk Factors for Low Back. SPINE. Vol 25, number 23, pp 3087-3092, 2000.
Postural Biomechanics
 Why be concerned by postural
biomechanics?
 Second leading cause of
occupational injury
(“ergonomic injury”)
 Very preventable

Weight considerations
 What is considered “good”
postural
biomechanics/ergonomics?
“Good” Ergonomic Position
Manual Therapy Journal
Studies
 2005 Study
 Compared various muscle activities in “postural” muscle
groups through EMG (electromyography), in people
performing monotonous keyboard work.

Even with proper ergonomics the studies subjects noted not
only pain, but increased muscle activity
Szeto et al. A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work-1: Neck and shoulder muscle
recruitment patterns . Manual Therapy 10 (2005) pp 270-280.
 2009 Study
 Compared muscle activity levels through EMG in resting
positions vs. task specific positions.

Muscle activity increased approximately three times with task
specific positions as compared to resting positions
Szeto et al. Neck-shoulder muscle activity in general and task-specific resting postures of symptomatic computer users with chronic neck pain.
Manual Therapy 14 (2005) pp 338-345.
Conservative Treatment
Options
 What is considered a good
trial of Chiropractic care?
 Mercy Guidelines
 How should improvement be
measured?
 If a person is not responding
what should be done next?
 Chronic care considerations
Passive vs. Active Treatment
 Passive Treatment
 What is considered passive treatment?


Manipulation
Modalities
 Active Treatment
 What is considered active treatment?

Rehabilitation
Soft Tissue Healing: What
to Expect?
 Phases of soft tissue healing
 Acute
 Remodeling
 Repair
 Timing plays a key role in the
appropriate treatment of softtissue injuries
 Aggressive treatment early on
can lead to chronic ongoing
problems
 Too much passive treatment
later on can lead to a lack of
progress.
Presented by: Amy Heckman, M.P.T.
Learning Objectives
 Importance of core muscles
 Importance of stretching
 Common core and stretching exercises
Importance of Core Strength
 What is your “core”?
 Girdle of muscles that surround the midsection of your
body
 What is the purpose of your core muscles?
 Support posture (static and dynamic)
 Create motion
 Coordinate muscle actions
 Keep up stable
How does the core help
reduce injury?
 Helps limit stress of movement
 Helps prevent laxity of joints of your spine
 Excess movement of the bones in your spine due to
weak core can result in damage to the joints
Basic Core Exercises
 Diaphragmatic Breathing
 Start lying on your back with feet shoulder width apart and your
hands on your lower abdomen (Be aware of the position of your
back on the floor)
 Take a breath in through your nose for a count of 4 and feel how
your back gently arches off the floor
 Slowly blow out through pursed lips like you are blowing a balloon
for 8 seconds and think of "releasing" your back and notice how it
moves closer to the floor
 After each cycle rest and breathe normally, but notice how your
back feels. Do this before and after your other exercises. To start
you may have to do shorter breathe cycles until your diaphragm is
trained
Basic Core Exercises
 Posterior Pelvic Tilt
 Lie on your back on a firm
surface with knees
comfortably bent (top
picture)
 Then flatten back against the
table while contracting
abdominal muscles as if
pulling belly button toward
ribs (bottom picture)
Basic Core Exercises
 Plank
 Start face down with elbows on a
mat directly below your
shoulder and pull your core up,
creating a plank position on
your toes and elbows. Hold until
you feel a shake then hold for
ten more seconds
 Side Plank on Knees
 Put your weight on the bottom
knee and elbow. Keep neck
straight and abdominals in.
Hold position until you feel your
body shaking then hold for ten
more seconds
Basic Core Exercises
 Curl-Up (Reverse)
 While lying on your back
with your knees bent, raise
up your legs and lift your
buttocks
 Maintain the same leg
position the entire time
Benefits of Stretching
 Decrease Muscle Strain/Sprain
 Decrease Tendonitis/Tendonosis conditions
 Allow Joints to move properly through their range of
motion
How to Stretch Effectively
 Do not stretch a cold muscle
 Warm up 5 to 10 min. prior to stretching (or stretch
after activity)
 Do not bounce
 Bouncing can cause small micro tears in muscle
 Tears produce scar tissue in muscle
 Scar tissue leads to less flexibility
How to Stretch Effectively
 Hold each stretch about 30 seconds
 Repeat each stretch 3 to 4 times
 Stretch until you feel tension, not pain
 Stretch on a regular basis
Static verse Dynamic Stretching
 Static stretches effect the collagen fibers of your
muscles
 Static stretches help reduce injury by maximizing
flexibility and improving biomechanics
 Static stretches help increase and maintain a muscle
length and flexibility
Static verse Dynamic Stretching
 Dynamic stretching effect the golgi tendon organs of a muscle
 The golgi tendon organs measure muscle tension to protect it
from injury
 The structures can over react if not properly prepared for activity
 The golgi tendon organs can stimulate a protective/reflexive
muscle contraction at a time of rapid acceleration
 Dynamic stretches can decrease the reactiveness of the golgi
tendon organs and limit number of muscle strains experienced
during quick acceleration activities common in sports
Important Day-To-Day
Stretches
 Neck Stretches
 Upper Trapezius - Tilt your head
towards the side, then return back to
looking straight ahead. (Be sure to
keep you eyes and nose pointed
straight ahead the entire time)
 Levator Scapulae - Turn your
head towards the side, then return
back to looking straight ahead
 Cervical Retraction - Slowly
draw your head back so that your ears
line up with your shoulders
Important Day-To-Day
Stretches
 Pectoralis Major/Minor Stretch
 While standing at a corner of a wall, place
your arms on the walls with elbows bent so
that your upper arms are horizontal and
your forearms are directed upwards as
shown
 Take one step forward towards the corner
and bend your front knee until a stretch is
felt along the front of your chest and/or
shoulders

Your arms should be pointed downward
towards the ground.

NOTE: Your legs should control the
stretch by bending or straightening
your front knee
Important Day-To-Day
Stretches
 Wrist Flexor Stretch
 Use your unaffected hand to bend the
affected wrist down as shown
 Keep the elbow straight on the
affected side the entire time
 Wrist Extensor Stretch
 Use your unaffected hand to bend the
affected wrist up as shown
 Keep the elbow straight on the
affected side the entire time
Important Day-To-Day
Stretches
 Standing Quad Stretch
 While in a standing position, bend
your knee back behind and hold your
ankle/foot
 Next, gently pull your knee into a
more bent position
Important Day-To-Day
Stretches
 Hamstring Stretch
 While lying down on your back, hook
a towel or strap under your foot and
draw up your leg until a stretch is felt
under your leg calf area
 Keep your knee in a straightened
position during the stretch
 Can also be done in standing
 Keep knee in straightened position
and flex forward at hips

Remember to keep your back
straight
Important Day-To-Day
Stretches
 Gluteal Stretch
 While Lying on your back, hold your
knees and gently pull them up
towards your chest
Important Day-To-Day
Stretches
 Piriformis Stretch
 While lying on your back with both
knee bent, cross your affected leg on
the other knee
 Next, hold your unaffected thigh and
pull it up towards your chest until a
stretch is felt in the buttock
Important Day-To-Day
Stretches
 Standing Calf Stretch (Gastroc.)
 While standing and leaning against a
wall, place one foot back behind you
and bend the front knee until a gentle
stretch is felt on the back of the lower
leg
 Your back knee should be straight the
entire time
References
 1. "Strength and Conditioning Journal"; Core Stability Training for Healthy Athletes:






A Different Paradigm for Fitness Professionals; Jeffery Willardson, Ph.D., CSCS;
December 2007
2. "NSCA's Performance Training Journal"; Connecting the Core; Paul Goodman,
MS, CSCS; November 2004
3. "NSCA's Performance Training Journal'; Core Training for Improved Performance;
Tracy Handzel, CSCS; December 2008
4. Core Muscle Training: Keep Your Abdominal Muscles Strong to Prevent Injuries |
Suite101.com http://suite101.com/article/core-muscle-traininga50442#ixzz26PX3C96W
5. “To stretch or not to stretch: The role of stretching in injury prevention and
performance.” Scandinavian Journal of Medicine and Science in Sports. 2010
6. ACSM's Primary Care Sports Medicine. 2nd ed. Philadelphia, Pa
7. Dynamic stretching warm-up intervention elicits longer-term performance
benefits. Journal of Strength and Conditioning Research. 2008;4:1286.0.Rancour J,
et al.
Presented by: Ellen Stoute, M.P.H, R.D., L.D.N.
Learning Objectives
 Calculate and interpret Body Mass Index
 Identify Health Risks Associated with Obesity
 Recognize the Benefits of a Worksite Wellness
Program
 Strategies to Implement a Health Promotion Initiative
Definition of Overweight and
Obesity
 Body mass index (BMI)
 Math formula used to assess overweight and obesity
 Multiply weight in pounds by 703
 Then divide result by height in inches
 Then divide that result by height in inches again
BMI Table
Underweight
Normal
Overweight
Obese I
Obese II
Obese III
BMI
< 18.5
18.5 - 24.9
25.0 - 29.9
30.0 - 34.9
35.0 - 39.9
≥ 40
Limited because it doesn’t measure body fat or muscle directly
Health Risks
 Obesity is more than a cosmetic problem
 Overweight and obesity are risk factors for













Type 2 diabetes
Coronary heart disease
High blood cholesterol
Stroke
Hypertension
Gallbladder disease
Osteoarthritis (degeneration of cartilage and bone of joints)
Sleep apnea and other breathing problems
Some forms of cancer (breast, colorectal, endometrial, kidney)
Fatty liver disease
Gastroesophageal reflux
Gout
Reproductive problems in women
Obesity is Also Associated
With…
 Complications of pregnancy
 Menstrual irregularities
 Hirsutism (presence of excess body




and facial hair)
Stress incontinence (urine leakage
caused by weak pelvic floor
muscles)
Psychological disorders, such as
depression
Increased surgical risk
Increased mortality
Type II Diabetes
 High blood sugar levels
 Major cause of heart disease,
kidney disease, stroke,
amputation, blindness
 6th leading cause of death in
U.S.
 > 85% of people with Type 2
diabetes are overweight
 Losing 5-10% of your body
weight and doing moderateintensity exercise for 30 minutes,
5 days a week, may prevent or
delay onset of Type 2 diabetes
Coronary Artery Disease
 Arteries become hardened
and narrowed
 Can cause heart attack
 Coronary heart disease is the
leading cause of death in U.S.
 People who are overweight are
more likely to develop risk
factors for heart disease like
high blood pressure and
cholesterol
 Losing 5-10% of your weight
can lower your chances for
developing coronary heart
disease
Cancer
 2nd leading cause of death in U.S.
 Being overweight may increase risk of developing
several types of cancer, including cancers of the colon,
esophagus, kidney, uterine, breast
 It is not known exactly how being overweight increases
cancer risk
Sleep Apnea
 Stop breathing for short periods




during the night
Can cause daytime sleepiness,
difficulty concentrating, heart
failure
Risk for sleep apnea higher for
overweight people
More fat stored around neck
may make airway smaller, which
makes breathing difficult
Weight loss usually improves
sleep apnea
Osteoarthritis
 Extra weight places extra
pressure on joints and
cartilage, causing them to
wear away
 Weight loss of 5% of your
body weight may decrease
stress on your knees, hips, and
lower back
Psychological and Social
Effects
 Emotional suffering may be
one of the most painful parts
of obesity
 Obese often face prejudice or
discrimination in job market,
at school, and in social
situations
 Feelings of rejection, shame,
or depression may occur
BMI and the Workplace
 There is a relationship between higher BMI and
workplace injuries, short-term disability,
compensation claims and lost man-hours.
 In 2008, 335,390 cases were reported when someone
had to take days off from work due to an ergonomic
injury.
 Average length of absence = 9 days
Study Results
 April 2007 study revealed Worker’s Compensation
claims filed by employees with a BMI over 40 were
more than double of those by healthy-weight
employees.
 Lost work days for obese group were 12 times as high as
the healthy-weight group.
 Medical costs were almost 7 times higher
American Journal of
Epidemiology
 85% of all injured employees in a manufacturing plant
were classified as overweight or obese.
 The odds of injury for employees in the obese group
were more than double that of healthy-weight
employees.
Injuries
 Most common injury in the workplace suffered by
employees with high BMI’s occurred in the leg or knee.
 Other frequent injuries were in the wrist, hand and back.
 Common complaints were inflammation, pain, contusions,
strains and sprains.
 One study found patients with a BMI over 29 were 2.5 times
more likely to be diagnosed with carpal tunnel syndrome
than patients with a healthy BMI
Obesity Trends
 Dramatic increase in obesity
in U.S. over past 20 years
 More than 64% of U.S. adults
are either overweight or obese
Obesity Trends* Among U.S. Adults
BRFSS, 1985
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
Obesity Trends* Among U.S. Adults
BRFSS, 1986
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
Obesity Trends* Among U.S. Adults
BRFSS, 1987
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
Obesity Trends* Among U.S. Adults
BRFSS, 1988
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
Obesity Trends* Among U.S. Adults
BRFSS, 1989
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
Obesity Trends* Among U.S. Adults
BRFSS, 1990
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
Obesity Trends* Among U.S. Adults
BRFSS, 1991
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
Obesity Trends* Among U.S. Adults
BRFSS, 1992
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
Obesity Trends* Among U.S. Adults
BRFSS, 1993
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
Obesity Trends* Among U.S. Adults
BRFSS, 1994
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
Obesity Trends* Among U.S. Adults
BRFSS, 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
Obesity Trends* Among U.S. Adults
BRFSS, 1996
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
Obesity Trends* Among U.S. Adults
BRFSS, 1997
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
≥20%
Obesity Trends* Among U.S. Adults
BRFSS, 1998
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
≥20%
Obesity Trends* Among U.S. Adults
BRFSS, 1999
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
≥20%
Obesity Trends* Among U.S. Adults
BRFSS, 2000
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
≥20%
Obesity Trends* Among U.S. Adults
BRFSS, 2001
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
≥25%
Obesity Trends* Among U.S. Adults
BRFSS, 2002
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
≥25%
Obesity Trends* Among U.S. Adults
BRFSS, 2003
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
≥25%
Obesity Trends* Among U.S. Adults
BRFSS, 2004
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
≥25%
Obesity Trends* Among U.S. Adults
BRFSS, 2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
25%–29%
≥30%
Obesity Trends* Among U.S. Adults
BRFSS, 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
25%–29%
≥30%
Obesity Trends* Among U.S. Adults
BRFSS, 2007
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
25%–29%
≥30%
Obesity Trends* Among U.S. Adults
BRFSS, 2008
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
25%–29%
≥30%
Obesity Trends* Among U.S. Adults
BRFSS, 2009
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
25%–29%
≥30%
What Causes Obesity?
 Energy Imbalance
 The same amount of energy IN and energy OUT over
time = weight stays the same
 More IN than OUT over time = weight gain
 More OUT than IN over time = weight loss
 Overweight and obesity happen over time when you take
in more calories than you use
What Causes Obesity?
 Physical Inactivity
 Less than 1/3 of adults do the recommended amount of
physical activity (at least 30 minutes most days)
 Americans aren’t physically active for many reasons

Spending hours in front of TVs and computers doing work,
schoolwork, and leisure activities




> 2 hours a day of regular TV viewing time has been linked to
overweight and obesity
Relying on cars instead of walking to places
Fewer physical demands at work or at home because modern
technology and conveniences reduce need to burn calories
Lack of physical education classes in schools
What Causes Obesity?
 Environment
 Lack of neighborhood sidewalks
and safe places for recreation
 Long hours at work and time
spent commuting
 Oversized food portions
 Lack of access to healthy foods


Neighborhoods without
supermarkets
Healthy foods often cost more
 Food advertising
What Causes Obesity?
 Genes and Family History
 Genes have strong influence
on weight
 Your chances of being
overweight are greater if your
parents are overweight
 Children adopt the habits of
their parents
What Causes Obesity?
 Lack of Sleep
 People who sleep 5 hours a night are much more likely
to become obese compared to people who sleep 7–8
hours
 People who sleep fewer hours seem to prefer eating
foods that are higher in calories and carbohydrates
 Hormones released during sleep control appetite and
body’s use of energy
Weight Loss Goals
 Lose 5-10% of your current weight over 6 months
 Will lower your risk for heart disease and other
conditions
 Best way to lose weight is slowly
 1-2 lbs a week is doable, safe, and will help you keep off
the weight
Measuring Success
 Look at many factors to gauge
success with weight loss
efforts
 Number on scale
 How clothes fit
 Blood pressure
 Cholesterol
 HbA1C
 Fitness level
 Etc.
Worksite Wellness
 81% of America’s businesses with 50 or more
employees have some form of health promotion
program.
 Medical costs can consume half of corporate profits or
more
 Worksite wellness is an investment in your most
important asset—your employees.
Top 5 Reasons for Worksite
Wellness
 #1--Health Care Costs
 We spend over $1 trillion dollars on healthcare
 Average annual cost per person exceeds $3,000
 41 million Americans are without healthcare insurance
 Most of these costs are linked to health habits
Reason #2 - Most Injuries
Can Be Avoided
 Preventable illnesses make up approximately 70% of
the entire burden of illness associated costs in the US.
 Preventable factors include:
 Tobacco use
 High-risk alcohol consumption
 Sedentary lifestyles
 Poor nutritional habits
Reason #3 – The Work Week
is Expanding

Typical American works 47 hours a week

-

164 more hours than only 20 years ago
If trend continues average person will be on the job
60 hours a week
Technology has erased traditional work boundaries
Reason #4 – Technology
Revolution
 Reliance on technology has caused new health
concerns including: repetitive stress injuries, low back
problems, and compromised vision
 One-third of the workforce spends their day seated at
their desks plugged into workstations
 Sedentary lifestyles major concern
Reason #5 – Employee Stress
Levels Are Rising
 Information explosion—more information has been
produced in the last 30 years than during the previous
5,000
 78% of Americans describe their jobs as stressful
 Vast majority indicated their stress levels have
worsened over the past 10 years
Benefits of Workplace
Wellness Programs
 Healthier Employees
 Fewer Injuries
 Improved Productivity
 Lower Absenteeism
 Reduced Medical Costs
 Increased Job Satisfaction
 Decreased Employee Turnover
Journal of Occupational and
Environmental Medicine
 Study published in 2008 focused on a company with
an employee wellness program.
 Researchers evaluated health care costs during a 4 year
period to establish cost-effectiveness.
 Study found the company had saved over $1.3 million
as a result of lower health care costs incurred by
program participants.
Where Do We Begin?
 Establish a Wellness Committee
 Employee involvement is vital
 Assess Employee Needs and Interests
 Employee interest survey
 Conduct a Worksite Organizational Health Survey.
Physical Activity
 Does your worksite have a place for employees to go for
a walk?
 Does your organization have organized physical
activities for employees?
 Access to physical activity facilities for employees?
 Access to an indoor exercise facility?
Physical Activity
 Subsidize memberships to off-site physical activity
facilities?
 Are there stairs employees can use for physical
activity?
 Incentives or rewards to employees who are physically
active?
 Do you offer a health plan which provides discounts for
health club membership?
Nutrition
 Can employees obtain food or snacks at the
workplace?
 Where are the food or snacks offered?
 What types of foods are available through vending
machines?
 Does your organization have written policies or
guidelines to ensure that fruit, vegetables and salads
are offered at catered meetings?
Nutrition
 Do you have a place where employees can refrigerate
and heat meals?
 Do you offer nutrition education programs to your
employees?
 Does your organization offer weight control programs?
 Reimbursement or discounts for dietary counseling?
Smoking
 Does your organization have a written smoke-free
environment policy?
 Are employees who violate the policy penalized in any way?
 Do you offer programs to help employees quit smoking?
 Do you offer reimbursement or discounts to employees who
enroll in programs to quit smoking?
Other Health Programs
 Health education classes, workshops, lectures, or
special events
 Health screening services
 Are employees allowed to use paid work time to
participate in health related activities?
 Solicit feedback from employees on health programs
that would be beneficial to them
In Summary
 Most popular worksite wellness programs are
 Exercise
 Smoking Cessation Classes
 Back Care Programs
 Stress Management
 There are numerous compelling reasons why every
organization should consider developing a worksite
health promotion initiative.