Gravesham Borough Council Case Study
Bespoke Manual Handling Training
My Experience on our 2 Hour Manual Handling Practical Skills Course for Gravesham Borough Council
In March 2019, I (Emma Farrell) attended a day of 3 x 2 Hour Manual Handling Workforce Practical Skills Courses on site for the Building Services team at Gravesham Borough Council, Kent. Osteopathic Solutions’ intensive, highly practical 2 Hour Manual Handling Course was run by Osteopathic Solutions Manual Handling Expert Trainer Jonathan Simmonds. This training took place onsite at their depot within the attendee’s working environment.
I arrived at the depot to meet our Instructor Jonathan before making our way up to our allocated training room. We had a short chat about the Course content before he commenced the 2 Hour Course. By this point Jonathan had had a site tour with Gravesham’s Service Delivery Manager to view tasks, loads and depot working environments. When all 10 attendees had gathered in the training room it was time to commence the first part of the course, the engaging and jargon free classroom theory. As I had previously attended our Public 2 Day Manual Handling Instructor Assessor Course at the Harlequin Centre (Redhill, Surrey) I already had a solid base of manual handling knowledge so I found this day of 3 x 2 Hour Courses to be a great form of CPD/ Refresher training for myself within my role for Osteopathic Solutions.
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To commence the theory of our Bespoke Manual Handling Course, our Expert Instructor Jonathan Simmonds introduced himself by speaking briefly about his background as an Osteopath and how he clinically treats musculoskeletal disorders (MSDs) including back injuries on a daily basis in his private clinic. 70 percent of them, he admitted, were due to work related manual handling injuries. He told us that many of his clients in clinic have been lifting, lowering or carrying items hazardously within their job for many years resulting in painful back injury. These injuries are due to cumulative strain which Jonathan explained is ‘’Progressive degeneration or stiffening of body and muscle tissue due to habitual, excessive or prolonged exertion or loading. It is the result of actions and movements that build up tissue damage over time, eventually leading to injury and pain.’’
Jonathan had an imitation spinal model with him to demonstrate the most common musculoskeletal injuries and how these injuries often take place, giving everyone a great knowledge of basic anatomy and biomechanics of the spine. He asked the group (as part of their role) if they would ever carry items on top of their shoulder. Most of the group agreed that this was common for them. This was followed with a detailed description of the damage this hazardous manual handling practice can do to the shoulder, which Jonathan mentioned, can often result in a bowed collar bone. He also told us that even people who work in non-physical jobs which don’t commonly require heavy manual handling such as office workers are susceptible to back injury, as in many cases they have drawers in the side of their desk therefore meaning hazardous bending and twisting of the spine to reach down.
Jonathan summed up this interesting session in simple terms by saying that many of us perform manual handling tasks on a daily basis thinking we can get away with it, but in turn it gradually destroys our backs over time, which eventually will lead to back pain.
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I found the short, 20 minute theory part of our Course to be very interesting due to Jonathan’s captivating teaching method. Linking the theory of Osteopathic Solutions’ Manual Handling Course Booklet (see above) alongside some interesting facts about the musculoskeletal system, relating it to stories which he encounters in daily life allowed all attendees and myself to be fully engrossed in the session.
Next, it was outside for some practical, hands on training. We all made our way to the car park in the depot where Jonathan had lined up some useful loads for the team to practise lifting, carrying, lowering, pushing and pulling. Firstly BackSafe lifting and lowering of loads between waist and floor level. Jonathan instructed the group to stand around in a circle with their feet spread, slightly wider than shoulder width apart, as he said it is one of the most important parts of lifting and lowering loads in having a wide base of support.
They were then instructed to get into a full-squat position (photo above right). This is the technique of choice to reduce spinal strain when lifting and lowering a load below the knee level. Looking at the basic biomechanics of the full-squat, this is a lifting position where the quadriceps, hamstrings and gluteal muscles are overstretched and compromised in their ability to generate power. However, overstretched leg muscles are far more powerful than overstretched lower back muscles as in a fully forward bent posture. The hips should not go below the level of the knees as shown in the right photos. When carrying out the lift, it is recommended for neck positioning to be neutral.
Jonathan then asked one of the attendees to provide a load they would regularly lift on a daily basis. One of the group members went to their van and returned with his toolbox which Jonathan chose to use as a load for the group to practise with. One by one, he instructed each team member to perform a squat lift with the toolbox from a pallet. He encouraged them to ensure a good hold on the load, remembering to keep it in line with the body’s centre of gravity (put across to them in a jargon free way). He analysed their posture and full body positioning as well as encouraging them along the way. Combined with Jonathan’s passionate teaching and the group being fully engaged and very quick learners, they all picked up this best practice technique very quickly!
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The next manual handing task to perfect was the semi-squat which involves more moderate hip and knee bending and is indicated for lifting and lowering at upper thigh height or loads with handles like buckets. Similar to the full squat, it is required to power up, ‘pushing the floor away’ with one smooth movement, keeping the load controlled and close, focusing the lift on the leg muscles. One attendee asked about carrying of awkward loads and used a kitchen cupboard as an example. Jonathan informed him a 2 person lift, carry and lower was indicated and best manual handling practice.
He then asked attendees to practise carrying the toolbox as it is designed, using one handle and to take a walk around the pallet, before alternatively carrying it with both hands wrapped around its corners, close to the body. All attendees agreed that the more comfortable positioning was to carry it in front of the body, close to the body’s centre of gravity, using both hands wrapped around its corners. An attendee was then asked to step forward, where Jonathan placed the toolbox on his shoulder (pictured on the 2nd image of the gallery to the left) to display a common, hazardous manual handling practice. Jonathan spoke about the musculoskeletal hazards of how carrying on the shoulder greatly increases the risk of injury to the shoulder (especially to the rotator cuff muscles), neck and collar bone.
Jonathan then began to discuss an alternative to the squat technique; The Lunge Lift. The lunge to lift and lower loads is commonly preferred by people who have a current or previous spinal disc injury. As shown in the photos below the technique involves the following: Lunge forward with one leg placing the foot to the side of the load, the front knee will be in a position of approximately 90 degrees in flexion. The rear leg kneecap is now touching the floor. The rear foot is extended across the toe joints. The load is then lifted with both arms and held close to the stomach/ lower chest. The lift is then powered predominantly by the front leg quadriceps and glutes with an additional push off from the rear foot.
To lower the load down take a controlled, large step forward with the same leg that was the front leg during the lift, keeping the load close to the body. Bend through the front leg hip and knee, with the rear leg knee cap resting on the ground, with the rear foot toes again extended. The load is then lowered with both arms with a moderate forward bend of the back.
The last (but not least) area of this Bespoke Manual Handling Course to cover was pushing and pulling of a commercial bin which many of the attendees regularly performed within their daily tasks. As with the squat lift, the power in pushing and pulling of loads comes from the legs. Jonathan encouraged all attendees for BackSafe pushing of loads to face the load with one foot in front of the other, keeping feet at normal hip width position apart, bending the knees slightly before driving the whole body forward with their leg muscles. He reminded attendees as he demonstrated the technique to keep elbows tucked in, close to the body, as if they have a wad of cash under their arm! One attendee questioned the best positioning of the feet. Jonathan encouraged attendees to position their feet as a sprinter would stand on a starting line, separated and facing forward.
For BackSafe pulling of loads attendees were again reminded to face the load, which enables them to control the load movement more, and generally does not involve as much use of bodyweight. Again using principally leg power to get the load moving, once the load is moving after 2-3 steps, turn away from the load with one arm continuing its motion.
Before analysing attendees' performances of best practice pushing and pulling of a commercial bin, Jonathan also ran through the musculoskeletal hazards of common pushing and pulling techniques. He detailed the most common hazardous pulling technique which is: taking a narrow stance sideways to the load, gripping the load with one hand, forward bending and twisting the spine, leaning away from the load as well as using bodyweight and the shoulder or arm muscles to pull the load. Common injuries due to hazardous pulling of loads include spinal muscle strains and disc injury, as well as shoulder and forearm muscle strains and tendonitis. For hazardous pushing of loads the most common technique people tend to use is: leaning on the load with their bodyweight, forward bending the spine, stretching out their arms taking their elbows away from the body. This hazardous yet common practice places mechanical strain through the neck, shoulders and the lower back, increasing the risk of muscle strains and disc injuries in the spine.
In the photos to the left and above, Jonathan is guiding Course attendees through best practice pushing of a Commercial Bin, paying close attention to their posture and stance. What error in stance do you notice in the attendee to the left? Email us at the bottom of this page with your thoughts. All attendees absorbed Jonathan’s advice very quickly and by the end of the 2 Hour Course appeared to be fully confident in their abilities to perform their daily manual handling tasks in a 100% BackSafe manner. Due to Jonathan’s long experience in teaching Manual Handling nationally within a variety of industries (as of March 2019 Jonathan had covered training for Brentwood, Kings Lynn & West Norfolk, South Kesteven, Derbyshire Dales, Lincoln City, Southend on Sea, Gedling, Ipswich and Gravesham Councils), I felt he was a true Manual Handling Expert.
His knowledge of the musculoskeletal system combined with his habit-changing ability to convert people’s hazardous manual handling techniques to Osteopathic Solutions’ evidenced based, BackSafe methods along with his good sense of humour, made this a truly interesting and productive session. I wouldn’t hesitate to attend a day of his Practical Skills sessions again, as I truly enjoyed the training so much and learned a lot.