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Get a grip! Implement fun and effective injury prevention programs
L.L. BEAN MANUFACTURING
Introductions
RANA RIVA, L.L. Bean Manufacturing Engineering Technician, OSHA SGE
JEAN SMAIL, PT , CEAS, InterMed Ergonomic Specialist
ERIC REGO, L.L. Bean Manufacturing “Strengthen & Stretch Break” Employee Leader, Manufacturing Learning Specialist
Agenda
L.L. Bean History
Stretch Break History
Injury Prevention Program Process
MFG “Strengthen & Stretch Break” Program
MFG “Strengthen & Stretch Break” Program Process Improvements
Other L.L. Bean Injury Prevention Programs
How to Develop Injury Prevention Programs for your Industry
Summary/Key Points
Q & A
L.L. Bean HistoryIn 1911, an avid outdoorsman named Leon Leonwood (L.L.) Bean returned from a hunting trip with cold, damp feet and a revolutionary idea. L.L. enlisted a local cobbler to stitch leather uppers to workmen’s rubber boots, creating a comfortable, functional boot for exploring the Maine woods. This innovative boot – the Maine Hunting Shoe® –changed outdoor footwear forever and began one of the most successful family-run businesses in the country.
L.L. began his business in the basement of his brother’s apparel shop. In 1912, he obtained a mailing list of nonresident Maine hunting license holders and prepared a three-page flyer that boldly proclaimed, “You cannot expect success hunting deer or moose if your feet are not properly dressed. The Maine Hunting Shoe is designed by a hunter who has tramped the Maine woods for the last 18 years. We guarantee them to give perfect satisfaction in every way.” The public could not resist the commonsense logic and genuine enthusiasm of his appeal.
One hundred orders came in for his new product. However, L.L. did not meet with immediate success. The rubber bottoms separated from the leather tops and 90 of those first 100 pairs were returned. Although it nearly put him out of business, L.L. kept his word and refunded the purchase price. He borrowed more money, corrected the problem and, with undiminished confidence, mailed more brochures. L.L. had learned the value of personally testing his products, of honest advertising based on firm convictions and of keeping the customer satisfied at any cost.
Customers spread the word of L.L.Bean’s quality and service. L.L. built on his success, using all company profits for advertising. He was so intent on building his mailing list that Maine writer and Freeport resident John Gould was inspired to say, “If you drop in just to shake his hand, you get home to find his catalog in your mailbox.”
L.L.Bean Manufacturing
In keeping with tradition, we still build old favorites – including L.L.Bean Boots and Boat and Tote Bags –in Maine.
Our manufacturing facilities in Brunswick and Lewiston currently employ over 400 people.
Manufacturing achieved OSHA’s prestigious Voluntary Protection Program status for making safety and health a top priority.
Stretch Break History “The mission of the Stretch Break Program is to provide the LL Bean workforce with the appropriate stretches to be completed periodically
throughout the day, as a method of preventing Cumulative Trauma Disorder injuries, increasing productivity and improving general health.”
The Stretch Break program began at L.L. Bean in 1989, as a pilot program for the Data Entry department. Since that time it has been implemented in the following areas: Manufacturing, Distribution, Customer Satisfaction Representatives (i.e. order phones),Various office areas, Retail/Factory Stores
Stretch Breaks are led by employee volunteers who receive an initial 2 hour training from Health & Fitness in proper form, technique and program background. Further training is done on a bi-annually basis or as needs change.
Stretch Breaks are on paid time and performed for 5 minutes twice per shift
L.L. Bean has seen a 70% decrease in the number of lost time injuries since the Stretch Break program began. We feel this is a result of the Stretch Break program working in conjunction with our other injury prevention efforts to produce these outstanding results.
Includes over 500 Stretch Break Leaders
Manufacturing has 70 Stretch Break Leaders
Injury Prevention Program Process
Injury Analysis of department or area that wants an Injury Prevention Program
Types of Injuries
Body Part of Injuries
Timing of the Injuries
Job Physical Demand Analysis
Determine Risk Analysis #
Amount of Force, Repetition, Postures, and Duration at each body part
Benchmarking
Research Exercise Modality Articles for positive outcome measures
Develop Modality and Program that will be most effective in Preventing Injuries
Develop Specific Exercises and Program
Injury Prevention Programming ProcessContinued
Education to Leadership and Industry about how you derived at this program/explain rational for Modality and type of program
Get Leadership and Employee buy-in
Possible Pilot Program with current EEs in the area
Analysis of the Pilot Program
Implementation of full Program if Pilot is successful
Training for Program and Check ins as needed
Follow up testing of Program at 3-9 months
MFG “Strengthen & Stretch Break” Program
Injury Trend AnalysisTypes of Injuries
Body Part of Injuries
Timing of the injuries
Departments with most injuries
Conclusions: Hand/wrist/finger injuries were up
Types of Injuries
1 2 3 4 5 6 7 8 9 10 11 12 Grand Total
JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER
Repetitive Motion 2 5 3 6 5 3 4 7 5 3 1 10 54
Overexertion (acute strain) 2 1 3 2 2 3 5 4 2 1 3 28
Not Classified 1 2 1 1 1 3 2 2 3 5 2 23
Laceration 4 1 2 2 1 1 2 1 14
Contact with irritant 2 2 1 2 3 1 1 12
Struck Against 1 1 1 2 1 1 2 2 11
Struck By 1 2 1 1 1 6
Caught In/Under/Between 1 1 1 2 5
Rubbed or Abraded 1 1 1 1 4
Puncture 1 1 2 4
Contusion or bruise 1 2 3
slip without falling 1 1 2
Exposure to odor 1 1 2
Fall outdoors 2 2
Fall Same Level 1 1 2
Contact with Hot 1 1 2
Respiratory 1 1
Other 1 1
Grand Total 17 12 13 13 13 15 17 14 17 12 13 20 176
Injury Type
36%
21%
13%
7%
5%
3%
3%
2%
2%2%
2%2% 2%
TOP INJURY TYPERepetitive Motion
Overexertion (acute strainor sprain)Not Classified
Struck Against/Struck by
Fall Same Level
Puncture
Strain
Contusion or bruise
Unknown
Burn
Fall outdoors
Animal or insect bite
Pre-existing
Injury by Body Part
Nature of Injury
Job Risk Analysis
Job Risk Analysis categories Light pinch (less than 8 lbs.) Forceful pinch (greater than 8 lbs.) Light grasp (less than 25 lbs.) Forceful grasp (greater than 25 lbs.)Wrist deviated out of neutralWrist out of handshake positionUpper arm non neutralOver shoulder reach Extended reach Lift over shoulder Light push pull (less than 20 lbs.)Heavy push pull (greater than 20 lbs.)Neck out of neutralVibratory Bend -crouch-squat Foot controls Lift- 10-20-30-40 Static Sit-Stand
Job Risk Analysis Ratings1= NEVER
2= INFREQUENTLY (10 minutes an hour)
3= OCCASIONALY (10-20 minutes an hour)
4= FREQUENTLY (20-30 minutes an hour)
5= CONTINTUOUS (40-60 minutes an hour)
Risk Analysis Key FindingsLarge amount of jobs with hand grip and pinch repetition requirements
Large amount of jobs with forceful pinch requirements
Large amount of jobs with awkward postures for the upper extremities
Combination of Postures, Force, Duration and Repetition for the upper extremities put Employees, especially New Employees at High Risk of Upper Extremity Injury
Manufacturing High Risk Jobs (Video)
BenchmarkingBench marked with New Balance factory in Norridgewock, Maine
New Balance saw a reduction of injuries
They used egg shape devices
ResearchEffects of Repetitive Handgrip Training on Endurance, Specificity, and Cross –Education( Physical Therapy May 1999 vol. 79 no. 5 467-475 Shields, Leo, Messaros and Somers)Effect of Submaximal rhythmic handgrip training on rhythmic handgrip work(RHW) 1,232% improvement in RHW
Work Hardening and Work Conditioning Interventions: Do they Affect Disability? (http://ptjournal.apta.org)
Strengthening exercises to improve hand strength and functionality in rheumatoid arthritis: A randomized, controlled trial (https://www.researchgate.net/publication/224918076)
Job Ready Services (www.jobreadyservices.net) Honda implemented a program of work conditioning prior to placing new hires on the job with steady decrease in injury
rates over 2006-2009 by 80%
Hand Grip Strength: age and gender stratified normative data in a ...www.ncbi.nlm.nih.gov/.../PMC31016)
Grip and pinch strength: normative data for adults. (Arch Phys Med Rehabil. 1985 Feb Mathiowez V,Kashman N etal)(http://www.ncbi.nlm.nih.gov/pubmed/3970660/)(https://www.researchgate.net/publication/19190602_Grip_and_Pinch_Strength_Normative_data_for_adults)
Grip and Pinch Normative Data
Why We Chose Hand Strengthening Devices ( HSDs) For Manufacturing
Focused on the HandsVariability of ResistanceAble to do with both hands at the same
time for efficiencyAffordableNeeded a cleanable Injury Prevention
ToolRe-usable
Hand Strengthening Pilot ProgramA twelve week pilot program was developed to test the concept of increasing employee’s hand strength to potentially reduce workplace injuries.
Volunteers were solicited from employees on both shifts who work on tasks that rated high on the risk assessment matrix for forceful pinch and grasp.
Pilot participants were measured for grip strength- key pinch- 2 point pinch and 3 point pinch for both hands before starting the program and re-measured at three week intervals.
Participants were given colored therapy balls based on grip strength (under 55-soft (purple) 55-75- med (yellow) over 75- firm (blue)) and progressed through the levels based on grip improvement.
Exercise routines were done twice a day on company time and additional routines were encouraged at home.
Testing DemoJamar Grip TestingMaximum
Endurance
Pinch TestingKey pinch
3 PT pinch
2 PT pinch
Tips & Reminders for MFG Employees
Strengthen & Stretch DemoGroup Volunteers
Follow Eric
How did it feel?
Hand Strengthening Pilot Questionnaire
All employees who participated in the pilot were asked to fill out a questionnaire
Results were favorable
“My hands feel less fatigued at the end of the day.”
“My hands don’t get nearly as tired while and work and at home. I can open jars much more easily.”
“I don’t get the pain in my thumb anymore when laying tops. I also have more strength in my hands.”
“It helps manage my arthritis.”
“The function and flexibility increased as well s strengthened, and my joint pain decreased.”
“I fly fish/tie flies a lot and it has helped my endurance and strength.”
Testimonials
Pilot Testing Spreadsheet
Pilot resultsResults are based on percentage of participants who improved their grip strength from baseline to 12 weeks. Right grip- 91%
Left grip- 88%
Right key pinch-66%
Left key pinch-59%
Right 2 point pinch-63%
Left 2 point pinch-66%
Right 3 point pinch-78%
Left 3 point pinch-66%
The average grip strength increase is 12 lbs. right hand, 9 lbs. left hand.
Pilot Results
Implementing “Strengthen & Stretch Break” Program in ManufacturingTrained Stretch Break Leaders to Strength portion
Baseline Tested all Manufacturing employeesIndividually on the Floor
Group employee training Groups of 5-6
In Production Environment
3 shifts
Completed within a week
Incorporated into NEW “Strengthen & Stretch Break” ProgramSupport and Feedback to Stretch Break Leaders
Video of “Strengthen & Stretch Break”
MFG “Strengthen & Stretch Break” Process ImprovementsFirst big process improvement to Stretch Break program in 27 years
Incorporation into current company stretch break program for further customization
Increased grip hold from 15-20 sec.
Increased pinch/key pinch/thumb opposition from 3 to 5 seconds
Side squeezes remained the same due to a smaller muscle group
Incorporated dynamic stretches into program
POHI (post offer health inquiry) Testing/Program Instruction for New Hires
Why? Mass hiring and seeing MSD Injuries for the Newer Hired MFG workers
Proactive approach to injury prevention in new hires
New Employees needed Hand work conditioning for the Physical Job Demands
Coordination/Strength/Endurance for Stitching
Not many experienced Stitchers in the hiring work force
“Strengthen & Stretch Break” Results Testing Results
Survey Results
Additional Manufacturing Injury Prevention Programs
Manufacturing Innersole ProgramGoal –Determine if innersoles could improve the foot comfort and health of employees feet.
Determine if innersoles were enough cushion in our Industrial setting to replace anti-fatigue mats
History-Complaints of foot fatigue
Benchmarking Idea from a Conference
MFG innersole vendor offered to supply test innersoles
Physical Therapist was involved in choosing pilot innersoles
Insole Program 1st Pilot1st Pilot- Participants were chosen based on jobs that required walking on concrete along with some static standing with no mat
33 participants
Participants were cleared Pre-test through Employee Health using the POHI process
Three stages of questionnaires were implemented Pre-test, Mid-test, and Post-test, with the constant operative inquiry being “Please rate your current foot fatigue factor at the end of an 8 hr. shift.“ with rating options of 1-Great, 2-Good, 3-Okay, 4-Poor, 5-Terrible
Results were tracked collectively as well as by style. Overall results were positive, however showed no clear style frontrunner
Pilot Questionnaires
Innersole Pilot Instructions
1st Pilot Results
Innersole Program 2nd Pilot
Phase II testing consisted of participants who work with moderate movement and static postures using innersoles without mats
32 participants
We gave participants innersoles of their choice
We allowed participants to change to the alternate innersoles halfway through phase II to try to determine one innersole for the program
2nd Pilot Results Opinions differed in regards to the best style of innersole
Determined that we would offer both styles
Mats are recommended based on questionnaire results
Anyone who walks or stands for more than 75% of their day are allowed 2 pair of innersoles of their choice per year
To date we have given 313 pair of innersoles to employees upon request
Innersole pilot testimonials“My feet feel much better at the end of the day.”
“Found that my back and feet didn’t hurt at the end of the night.”
“They made my shoes feel new. They worked better than store innersoles.”
“These innersoles are the only ones that I have tried that has given me comfort while being on my feet for extended periods of time. I have neuropathy in my feet and the innersoles seem to relieve the numb feeling I experience.”
“My right foot arch normally bothers me and I look for shoes that have minimal arch support because of the pressure it causes on the arch. Wearing these inserts didn’t bother my foot at all. The seem to conform to your foot better than most and having the additional support on my feet helped my hips feel better.”
“I feel it helped align my walking better and provided the correct arch support as needed.”
Additional L.L.Bean Injury Prevention Programs
Order Fulfillment Center Innersole ProgramInjury Analysis
ProgramPicking and FCH employees
100% Cement walking
Performance Sport Innersoles paid by L.L. Bean
Returns Putty Program
Returns Putty Exercise Program PilotOverview
A six week pilot program was developed to test the concept of doing a Putty Strengthen and Stretch Break once a day, to increase employee’s hand endurance and strength in order to improve employee’s tolerance for repetition and force on the hand and arms and reduce workplace injuries. Volunteers were solicited from employees on first shift and who are stretch break leaders.
Specifics Pilot participants were measured for maximum grip strength, key pinch, and 3 point pinch for both hands
before starting the program and re-measured after 6 weeks. Participants were given colored putty, generally yellow resistance for females and red for male. However, tan putty was available for those needing less resistance than the yellow, and one participant did move to tan. The Putty Exercise routine was done once a day on company time immediately after 7am stretch break.
RecommendationsBased on the results stated above, it is our recommendation that this program be initiated Returns wide and
incorporated into Update time, along with continuing the other two stretch breaks as is. Would recommend doing Endurance Grip testing and pinch testing on a group of 20 EEs to monitor results/outcomes.
Returns Putty Exercise Program
Returns Pilot ResultsResults
Grip and Pinch Results: Based on Pre and Post testing and are average percentileimprovement
Right grip- 10%
Left grip- 8%
Right key pinch-7%
Left key pinch-6%
Right 3 point pinch-16%
Left 3 point pinch-14%
Returns Pilot Results
Questionnaire Results:
10 out of 12 noted benefits:Less fatigue, more endurance, increased strength, more flexibility and coordination
Grasping easier for heavier product
3 EEs said specifically less fatigue with shoe refurbishment
No symptoms with doing blazers since doing the putty
Able to process longer without discomfort
11 out of 12 felt should be done Returns wide at “Update”
Putty resistance was fine throughout the 6wk pilot
5 out of the 12 complained of mild symptoms initially, that went away with more use
Putty Demo
EMPLOYEE FEEDBACK- Just a quick note to tell you all that when I first heard of the putty team, I laughed and
thought what will they come up with next? Turns out it really does help. Every year at this time, my hands are tired
and fatigued from the 3 peaks: book pack peak, Christmas peak and Returns peak, all very hard on the
hands. Thanks to the putty program, my hands are not fatigued as usual. At first I did not credit the putty, never gave
it a thought. Then I heard a story of another person coming from another area to help and her hands usually are
fatigued, but because of the putty she made the transition well. I remember saying to my husband that this is the first
year my hands haven't really bothered me. Well now I know why. Thanks to all of you that had their hands in on this
great and simple idea. It has made a great difference in my work life and personal life as well. Thanks for the putty
program my hands say thanks too!!!!
Returns Putty 6th Month Testing Results
Employee Store and Personalized Services Putty Exercise ProgramsL.L. Bean Personalized Services Injury Review
Shoulder, Arm, Elbow, wrist, hand MSD type Injuries Per-Year2011- 12
2012- 9
2013 – 13
2014 – 14
Total Percent of Shoulder, Arm, Elbow, Forearm, Wrist, Hand, and Finger Injuries = 65%
L.L. Bean Personalized Services Job Demand Review Repetitive grasp and pinch
Forceful grasp and pinch
Pull/Push with arms
Extended reaching
JumpStart Program
JumpStart Program HistoryProgram Goal: To Improve the Health and Safety of an Aging Workforce
JumpStart Program Results
Industry Type Injury Prevention Programming based on Job Physical Demands
Core, Shoulder stability,Back,legs,Coordination of UE & LE
Full body coordination exercies, mini bands
Construction Lifting, squatting,push/pullCore, shoulder stab, bands, wt machines,squats, coordiantion
of UE & LE
Police/Fire
Packing
Hand force,repetition,postures,static
Stamina,strength, balance
Backs lifting, bending, pushing
stamina, strength, coordination
move, grasp, full body
Core, Shoulder stability,Back,legs,Coordination of UE &
LE,bands
Manufacturing/Machine
ToolingHand force,repetition,postures,static
Lab
Lineman/Utilities
Paper Making
HSDs,Putty, Dynamic Movement, Innersoles
HSDs,Putty, Dynamic Movement, Innersoles
Core, strength, cardiovascular exercise, coordination
exercises
Core, Shoulder stability,Back,legs,Coordination of UE & LE
Industry Type Injury Prevention Programming based on Job Physical Demands
Industry/Job Type
Office
Material Handlers
Job Physical Demands Injury Prevention IdeasStatic
Lifting, Squatting,push/pull
Sit/Stand stations, Stretching, Dynamic Stretching,Gel
balls,Movement!
Develop the Program Most Effective for Your Industry
Analyze:Benchmarking
Research
Injury Analysis
Risk Analysis
Develop-(with all levels)Use Resources Physical Therapist
Occupational Therapist
Wellness Specialist
Athletic Trainer
ImplementCommunication is key
Results/Outcomes
Summary/ Key PointsProgram needs By-In from Employees up to Senior Management
Program needs to Fit the Physical demands
Senior Leadership Visual Participation
Employee support for the program is key
Make it FUN!!! and EFFECTIVE!!!!
Have a systematic approach of how you want to access the effectiveness of your program
Survey participants for effectiveness
Be open to other possibilities based on program outcomes and feedback
Listen to what employees are telling you what is effective and what they need
Pick the right Employee leaders for internal cheer leading of the program
Continued Communication about benefits and outcomes
Q&A
Contact InformationRana Riva [email protected]
Jean Smail [email protected]
Eric Rego [email protected]
Thank you for coming!!
