Introduction to Warm-up Stretching

Peyton Manning’s work ethic is legendary.

Yes, he’s been blessed with all the prized physical attributes most Hall of Fame quarterbacks possess. Some people would be satisfied to rely on those physical gifts to get them through, but not Peyton. He has an insatiable desire to find the next level. And the next level, and the next level…

When Sunday comes around, he is ready for work.

He’s put in his mental homework. He’s watched countless hours of game film. He’s had the playbook memorized in and out for years. He knows the defense and the tendencies of the players on the defense. He’s ready for work mentally.

He’s put in hours of physical preparation. He’s done a countless amount of repetitions in the gym. His nutrition regimen is as impressive as his work ethic. He’s put in so many throwing reps over the years, his body remembers just what to do to get that perfectly tight spiral. He’s ready for work physically.

Are your team members ready for work?

The employees at your company (we call them team members) probably aren’t Hall of Fame bound quarterbacks.

But they are athletes ­– they are workplace athletes, and they must be mentally and physically ready for work. Like Peyton, their health, safety and work performance depends on it. And, in turn, so does your company’s health, safety and productivity.

Like Peyton, the workplace athlete is ready for work mentally. They understand their role in their company’s (team’s) success. They have studied the playbook on good fitness and nutrition so they can be fit for work. They understand proper body mechanics and how to perform their job correctly. They understand why they need to be physically ready for work and how to physically recover from each work day.

Like Peyton, workplace athletes must be ready for work physically. They put their education into practice by staying fit, healthy and prepared for work. They use proper body mechanics and do their job correctly. They are physically ready for work and utilize injury prevention best practices to physically recover from each work day.

The final work preparation ritual

What is the last thing Peyton Manning does before he takes the field on Sundays?

He goes through his pre-game stretching and warm-up routine to prepare his body and mind for the game. It’s the final ritual in his preparation for work, and he never misses it. Neither do any of his teammates or other teams around the league. They would never miss their pre-game stretching and warm-up routine.

Workplace athletes prepare themselves for work in a similar way with “pre-shift stretching” or “pre-shift warm-up stretching”. They take a few minutes before they begin their work day by preparing their body and mind for work with a pre-shift warm-up routine.

Well-designed pre-shift warm-up programs (Work Readiness Systems℠) ensure workplace athletes are physically ready for their work day.

Benefits of Warm-up Stretching

Making sure your team members are physically ready for work reduces injury risk and promotes a health, safety and team culture.

What’s the first thing you’ll do before your Saturday morning tennis match?

I’ll bet it’s the same thing you do after a long car ride.

You’ll stretch.

You’ll move and loosen up and warm up your muscles. And you’ll feel great after you do it.

Warming up your body and stretching are very natural things to do, and there are many benefits to doing them.

Just as you benefit from stretching and warm-up exercises in your day-to-day life, companies and their team members both benefit from a Work Readiness program consisting of stretching and warm-up exercises, which helps prevent Musculoskeletal Disorders (MSDs).

MSDs are common and costly – to the tune of roughly $50 billion a year for companies (BLS), and cause unnecessary pain and suffering for your people.

It’s very clear that prevention is the answer. Proactive prevention is always better than reactive treatment – everybody wins in the prevention scenario and nobody wins with painful surgery, medication, lost work days, a ruined safety culture and a fortune spent on preventable injuries.

First, the importance of a complete prevention strategy

In our experience, companies often react to a rise in musculoskeletal injuries by searching for a magic “silver bullet” that will prevent them. They might conduct an ergonomic assessment or have a training session or institute pre shift stretching.

These are all good actions to take, but a common mistake is to expect one of these tactics alone to produce long-term health and safety gains.

Given that human beings are multi-dimensional and the interaction between people, equipment and work processes is complex, there is no “silver bullet” to prevent soft tissue injuries.

Risk factors that cause these injuries are numerous and many different problems can arise over the course of time to contribute to them, so it’s often difficult to determine the exact cause when an injury does occur. Without identifying the underlying causes of the injury, it’s impossible to put the correct control measures in place.

You don’t need a silver bullet. You don’t need to reactively implement one or two tactics and hope for the best. Rather, you need a complete and well thought out prevention strategy designed for long-term health and safety gains.

The smart way to prevent MSDs is to proactively implement a comprehensive process that reduces all causative risk factors. Safety leaders that do this will prevent musculoskeletal injuries in a consistent and predictable way.

Following is an outline of the elements of a complete Musculoskeletal Disorder (MSD) prevention process.

Workplace Ergonomics

Ergonomics is the science of designing the workplace to fit within the capabilities and limitations of team members. The goal is to make sure the work fits the worker, thereby reducing injury risk and promoting safety, productivity and quality of work.

The ergonomics process identifies and controls risk factors related to the workplace. Stretching and warm-up exercises do not replace an ergonomics improvement process – they enhance it.

Education and Training

Education and training programs develop the knowledge and skills of your team members. Ergonomics, proper body mechanics, proper work technique and good health/hygiene habits all need to be taught in your education and training programs.

Educated decisions and actions by team members require education and training to develop team member’s knowledge and skills. Stretching and warm-up exercises do not replace team member education and training – they enhance it.

Early Intervention

Early intervention is a proactive way to discover early warning signs of MSDs and put control measures in place to prevent an injury from occurring. Team members are encouraged to report early warning signs (excessive fatigue and discomfort) of MSDs. When the early report is received, a qualified professional should conduct an early intervention consultation to identify root causes and consult the team member on injury prevention best practices (work readiness and work recovery methods).

Early intervention is a vital tactic that should be included in your MSD prevention strategy. Stretching and warm-up exercises do not replace an early intervention process – they enhance it.

The physiology of stretching and warm-up exercises

Stretching is a vital part of a healthy fitness regimen. Pre-shift stretching and warm-up exercises reduce the risk of musculoskeletal injuries by reducing fatigue, improving muscular balance and posture, and improving muscle coordination.

Stretching Reduces Fatigue

• Stretching increases blood supply and nutrients to joint structures and soft tissues.
• Stretching increases soft tissue temperature and allows for greater elasticity of tissues.
• Stretching increases joint synovial fluid (lubricant for bones and articular cartilage) that allows greater range of motion and reduces joint degeneration.
• Stretching increases a joint’s ability to move through a greater range of motion with less energy required to do so.
• Stretching decreases tightness and resistance in tendons and muscles.

Stretching Improves Muscular Balance and Posture

• Soft tissue structures often adapted poorly to effects of gravity and poor postural habits.
• Stretching realigns soft tissue structures, thus reducing effort to achieve & maintain good posture in activities of daily living.

Stretching Improves Muscle Coordination

• Stretching enhances nerve impulse velocity (the time it takes an impulse to travel to the brain and back to the muscle).
• Stretching helps opposing muscle groups work in a more coordinated fashion.

Promoting a health, safety and team culture

Instituting a Work Readiness System promotes a health, safety and team culture day in and day out.

In other words, the Work Readiness System works hard for you. Every day your team members come to work, they are reminded that you put their health and safety above everything else. You provided them the precious time to prepare their body and mind for work. You care about them and you care for them.

Companies across the U.S. are facing an employee engagement problem. This is partially due to the fact that many employees don’t believe the company they work for has their best interest in mind.

So let’s call them “team members” because they are a part of your team. And let’s make sure their bodies and minds are ready for work – after all, taking care of your people is also taking care of your business – and that’s priceless.

Just as you benefit from stretching and warm-up exercises in your day-to-day life, companies and their team members both benefit from a Work Readiness program consisting of stretching and warm-up exercises, which helps prevent Musculoskeletal Disorders (MSDs).

The Warm-up Stretching Debate

Workplace stretching programs are a hotly debated topic – so what are the arguments against these programs, and do they have any basis?

The bottom line: you’ll need to decide for yourself whether or not the value of instituting a workplace stretching program exceeds the costs. Please do not blindly accept someone’s analysis (including ours) and make your decision based solely on their assumptions. Instead, do your own research, apply it to your facility/industry/environment and make your decision based on that.

You want to do the right thing for your people.

You understand the value of a comprehensive MSD prevention plan that includes pre-shift stretching and warm-up.

You know that MSD prevention is a long game and the sooner you get started, the better.

You’re proactive and have a bias toward action so you’d like to get the ball rolling on this.

At your next health and safety committee meeting, you bring up the topic for discussion and next-action steps. Everyone is on board… except for one of your committee members who says he thinks he remembers an ergonomics guru say that pre shift stretching was a bad idea – that it may or may not be effective and that you’d be better off doing more ergonomics.

Now what?

The Debate on Pre-Shift Stretching

Pre-shift stretching programs are a hotly debated topic in the ergonomics community. There are two main arguments against pre shift stretching programs;

• there is inconclusive scientific evidence that pre shift stretching programs effectively reduce injury risk, and
• the cost of pre shift stretching is prohibitive and these resources should be re-allocated to ergonomics instead

I’ve read every study, article and report I can find about workplace stretching programs. The narrative of the authors who are against-pre-shift-stretching is nearly always the same.

They point out many of the same studies, demonstrate the cost of workplace stretching programs, and urge the reader to reallocate workplace stretching time and resources towards ergonomics initiatives.

Interestingly, in nearly every case, these authors come to the conclusion that, “while stretching alone may not reduce the risk of Musculoskeletal Disorders (MSDs), it does have a few benefits and should be implemented as part of a comprehensive injury prevention program that includes an ergonomics improvement process.”

I’m paraphrasing and not directly quoting a source, but I hope you get my point. Even those who don’t recommend workplace stretching often recognize the value of a comprehensive MSD prevention process that benefits from workplace stretching.

It should also be noted that we agree – ergonomics should be a core element of your MSD prevention process – as discussed in the previous post in this series. Improving the work environment to fit within the physical capabilities of workplace athletes is (of course) a focus of the work we do for clients. But should we stop there? Absolutely not.

Now let’s examine the anti-pre-shift-stretching narrative in more detail so you can make the case for your pre shift stretching program, and so you’ll have the right answers if someone on your health and safety committee or management team has doubts about the program.

Argument 1 Against Warming Up For Work: Inconclusive Evidence

Workplace stretching and warm-up exercises have not been studied exhaustively.

The studies we do have on workplace stretching are inappropriately extrapolated to fit every situation, every workplace and every industry. Many of the studies used to discount workplace stretching aren’t about the workplace at all, but rather athletic performance during intense physical exercise or competition, which is clearly much different in nature than the workplace setting.

Here are a few of the studies often cited:

Study: Static stretching prior to an athletic event will lower endurance and performance.

This study investigated the effects of static stretching on energy cost and endurance performance among trained male runners. (Injury prevention wasn’t even part of this study, yet it is one of the most often cited studies regarding workplace stretching and warm-up.)

Ten trained male distance runners with an average VO2-max of 63.8 6 2.8 ml/kg/min were recruited. Participants reported to the laboratory on 3 separate days. On day 1, anthropometrics and VO2-max were measured. On days 2 and 3, participants performed a 60-minute treadmill run randomly under stretching or nonstretching conditions separated by at least 1 week.

Stretching consisted of 16 minutes of static stretching using 5 exercises for the major lower body muscle groups, whereas nonstretching consisted of 16 minutes of quiet sitting. The run consisted of a 30-minute 65% VO2-max preload followed by a 30-minute performance run where participants ran as far as possible without viewing distance or speed. Total calories expended were determined for the 30-minute preload run, whereas performance was measured as distance covered in the performance run.

The study concluded that performance was greater in the nonstretching group vs. the stretching group. The authors of the study suggest that static stretching before an athletic endurance event may lower endurance, performance and increase the energy cost of running.

Study: Static stretching leads to reduced power in cycling athletes

The purpose of this study was to examine the time course of static stretching on cycling economy. The subjects consisted of 5 men and 5 women highly trained endurance cyclists. The first of 3 visits was baseline testing of their cycling VO2max. The second and third visits were either stretching or no stretching before a 30-minute stationary ride at 65% of their VO2max. The stretching condition consisted of four 30-second repetitions of 5 stretches with an average total stretching time of 16 minutes. VO2 demonstrated a significant condition by time interaction with the 5-minute time point being significantly less in the nonstretching condition (32.66 ± 5.35 ml·kg(-1)·min(-1)) than stretching (34.39 ± 5.39 ml·kg(-1)·min(-1)). No other time points were different.

According to the authors, “The results of this study demonstrate that static stretching yielded an acute increase in submaximal VO2; therefore, coaches and highly trained endurance cyclists should exclude static stretching immediately before moderate intensity cycling because it reduces acute cycling economy.”

What can we learn from these studies on athletic performance and stretching?

We need to be extremely careful about how we interpret these studies and apply them in the workplace. You must take into consideration the differences in intensity, repetition and duration of the physical activity.

While stretching is a natural and beneficial activity for all of us, running to exertion over a 30-minute period of time or engaging in an intense cycling endurance event is far different than working an 8 hour shift on an assembly line. We’re mostly concerned with injury prevention in the workplace – not physical performance at very high exertion levels for short periods of time.

These studies contain different types of athletes, different stretching protocols, and different conditions. To conclude from these studies that all stretching is bad for you would be a mistake. If stretching is bad for you, then why does every athlete include stretching and warm-up activities before an athletic event? Why do we naturally stretch our bodies when we wake up, get out of the car after a long ride or engage in physical activity?

If we can learn anything from these studies, it’s that it’s best to include a general warm-up activity instead of only using static stretching – something we already knew and has been included in countless workplace stretching programs for many years.

Study: Do stretching programs prevent work-related musculoskeletal disorders?

This study reviewed seven often cited workplace stretching studies. The subjects of these studies ranged from computer workers (data entry, computer operators), athletes, military servicemen, firefighters, manufacturing operators (pharmaceutical), and construction workers. It’s also important to note that the stretching protocols were different in each study.

Here is the author’s conclusion after reviewing the available studies, emphasis added:

“While research does support that stretching improves flexibility/ROM and self worth, stretching alone might not prevent work-related musculoskeletal disorders and injuries. Some studies (e.g., Thacker, 2004) also suggested that strength training, conditioning and warm-up could play an important role in preventing WMSDs.

As pointed by OSHA (1993), implementing a comprehensive ergonomic program that includes both engineering and administrative controls to reduce the ergonomic risk factors should be the first choice in reducing work-related MSDs. The main focus of a comprehensive ergonomic program is to make tasks, jobs, products, environments and systems compatible with the needs, abilities and limitations of people, as opposed to making the people compatible with the work characteristics and demands (in Costa and Vieira, 2008).

Overall, this review study illustrates some favorable outcomes of stretching & exercise programs in different occupations, but there is still controversial evidence to accomplish a definite response about the exploit of stretching in preventing work-related musculoskeletal disorders and injuries.”

What can we learn from this study?

As mentioned earlier, this review study consisted of different study subjects under different stretching protocols over different periods of time. This lack of consistency presents several challenges if we are to find any meaning or draw any conclusions from this study.

• Different study subjects – From computer entry workers to firefighters to military servicemen, the study subjects are night and day.
• Different stretching protocols – Frankly, the stretching protocols studied are poorly designed and far from typical workplace stretching protocols.
• Different periods of time – In fact, the longest period of time studied was only six months and several of the studies lasted only 4 weeks – hardly long enough to study or observe a reduction of musculoskeletal disorders, which can form over long periods of time.

If this is one of the most widely cited studies on workplace stretching, we desperately need more studies.

We need more studies in the manufacturing and distribution environment.

We need more studies done with better stretching protocols.

We need more studies done of comprehensive MSD prevention programs that include workplace stretching, ergonomics, team member education, and early intervention.

We need these studies badly and I believe that someday we will have them.

But until then, you’ll have to consider the research and draw your own conclusions.

Also consider this – the (incomplete) research on workplace stretching is inconclusive, at best. Yet there are bright spots contained within the research. There are successful workplace stretching programs.

The hardcore evidence-based crowd tends to be skeptical about most new ideas, and we occasionally encounter those who object to implementing a Work Readiness System because it’s not backed by “enough” research. It seems important (to me at least) to consider that research-backed certainty is rare. Evidence-based practice is important, but we shouldn’t combine it with rigid pessimism. While we wait on the researchers to do their thing, let’s not make the mistake of completely discounting the plentiful anecdotal evidence that exists in support of warm-up stretching in the workplace. There’s nothing wrong with a healthy level of skepticism, but if we wait around for the peer-reviewed literature to “approve” warm-up stretching programs – we’ll miss out on the many benefits and great value that it offers.

You want to be successful, right?

Then let’s make your pre shift stretching programs one of the successful ones.

Argument 2 Against Warming Up For Work: Cost and Resource Allocation

Another common argument against workplace stretching is cost and resource allocation. The cost of workplace stretching programs should be reallocated to the company ergonomics program, argue these authors, because engineering and administrative controls are the best methods to reduce injury risk.

We agree that ergonomics should get the resources it deserves. But it doesn’t have to be an either/or situation. Applying resources to a comprehensive MSD prevention process is an investment that returns value many times more than the cost.

In a paper titled, “The Myth Behind Stretching Programs”, one author attempts to outline the cost of workplace stretching programs. The author estimates that a stretching program costs $286.22 per employee per year (see paper and calculations here). So for a facility with 100 employees, the annual cost of the program would be $28,622. This cost is reflecting the time it takes to conduct the stretching routine every day. The calculations assume $10,000 in cost savings and end up with with an ROI of $.35 per dollar invested.

In my opinion, there are several things wrong with this calculation:

• Indirect costs are not included: According to OSHA, indirect costs can be up to 4.5 times the direct cost of injuries. This part of the cost reduction is not included.
• The success rate of the stretching program was made up: The calculation assumes a 10% success rate, but you could easily redo the calculation using any number you wanted.

After reading this paper, I went over to OSHA’s Safety Pays estimator and plugged in a few common injuries to find out what they cost. Here is the screenshot:

Source: OSHA Safety Pays

According to Safety Pays, the total cost of a single sprain is $60,618, a strain is $70,408 and carpal tunnel syndrome is $63,000. At a 3% profit margin (the standard measure on Safety Pays) it takes millions of dollars in additional sales to make up for the cost of these injuries.

The $28K for the stretching program doesn’t feel as expensive after that. Prevent just one of these injuries every two years and you’re breaking even. (Institute a comprehensive MSD prevention process and the cost savings really start to add up.)

Surprisingly, I agree with most of the conclusion from the paper titled The Myth Behind Stretching Programs (emphasis added):

“While stretching alone does not appear to be the most effective mechanism for managing WRMSDs, it does take a step in the right direction to increase awareness concerning the benefits of movement, circulation, and posture. Even the most advanced use of equipment and design possible in new facilities requires human interface and vigilance. Adding a warm-up and exercise as part of an overall safety and leadership program can stimulate blood flow and movement when the job calls for static postures, it can activate overstretched and tired muscles to reduce fatigue and improve postural awareness, and it can go a long way to support company loyalty. And loyalty can be priceless!”

The bottom line: you’ll need to decide for yourself whether or not the value of instituting a workplace stretching program exceeds the costs. Please do not blindly accept someone’s analysis (including mine) and make your decision based solely on their assumptions. Instead, do your own research, apply it to your facility/ industry/environment and make your decision based on that.

The importance of engaging your people

While we believe in the power of ergonomics to reduce injury risk, our approach is different. We involve the people doing the job and part of that involvement is through our pre-shift Work Readiness programs.

Why do we involve workers in the process? Well, the reason is simply because there are numerous MSD risk factors that are related to the individual worker themselves. These are well documented in research and include:

• Chronic health conditions (such as obesity)
• Body mechanics and work technique
• Fitness, nutrition, recovery and general health of the worker

(see NIOSH Total Worker Health)

Remember that behind the data and the numbers at the end of your injury column are individual people who give a portion of their life to meet your company’s objectives. It’s important to involve them in the process and let them know they’re being cared for. After all, it’s their body and health at stake.

A Work Readiness Program is a great example of involving them in the process and helping them take responsibility for their part in the MSD prevention process. Ergonomic controls are important, but so are the individual workers themselves. Involving people in the process not only reduces risk, but helps create a positive culture of safety, health and teamwork.

Remember that beyond simply doing the right thing, the value proposition of creating a culture of health, safety and teamwork is that it is a competitive advantage for your business and a more fulfilling experience for your employees. And you can’t put a price tag on that.

Warm-up Stretching Best Practices

Learn how to design a practical, effective and sustainable workplace stretching program.

Do you want to institute a workplace stretching program at your facility?

Do you want to know how to implement a best-practice program that is practical for your needs, effective and sustainable over the long term?

We’ve been implementing workplace stretching programs for clients since 1989. In that time, we’ve learned what works and what doesn’t. That isn’t to say it’s always easy or that we don’t still experience challenging situations, but we can point you in the right direction.

Here is What You’ll Need

You’ll need these six core elements to successfully implement a workplace stretching program:

1. Program guidance and leadership support
2. Work Readiness Coaches
3. Program Rollout and Marketing Plan
4. The Right Warm-up Stretching Protocol Effectively Implemented
5. Review and Continuous Improvement
6. Passion, Enthusiasm and Perseverance (Most Important)

1. Program Guidance and Leadership Support

Your entire MSD prevention process should be guided by a program guidance document. Your workplace stretching program, along with all other elements of your comprehensive prevention plan, should be included in this document.

The following should be outlined in the workplace stretching section:

• Goals and objectives for the program
• Roles and responsibilities
• Stretching protocol and guidelines
• Annual audit criteria for review and continuous improvement

Leadership commitment to the workplace stretching program is important – we all know what leadership is sincerely committed to is what gets done. Leadership should demonstrate their support for the program in a visible and consistent way.

2. Work Readiness Coaches

Members of management and employee leaders (such as safety and/or ergonomics committee members) should be selected as warm-up stretching coaches to lead employee groups through the pre-shift program.

The company should select individuals who are well respected by the workforce and are suited for this type of leadership position. This group of coaches should attend a special training program conducted by the Injury Prevention Specialist / Athletic Trainer to be qualified to lead the pre-shift warm-up program.

Upon completion of this training, the coaches will be able to:

• Clearly communicate and deliver the reasons and benefits behind the program.
• Effectively lead pre-shift warm- up stretching program.
• Instruct team members on the techniques of the warm-up exercises and caution against poor techniques.
• Review the “important points to remember” listed above with team members.

We recommend to our clients that stretch coaches achieve a certification upon demonstrating competency in the stretches, training and communication/leading team members in the stretches correctly.

3. Program Rollout and Marketing Plan

A site wide initiative like workplace stretching needs a carefully crafted program rollout and marketing plan in order to be a huge success and maintain momentum.

Be excited about it! Stress the benefit to your team members in all communication channels. The company cares enough about them to allocate precious time to put their health and safety first — let them know about it.

Use any and all communication channels you have available to stress these benefits in the weeks leading up to the program launch.

4. The Right Warm-up Stretching Protocol

Program design and execution is everything.

• Program design: In the end, the success of this program will depend on how effective the program design is. If you implement a poorly designed program, you will get below par results. Make sure that you implement a warm-up and stretching program developed by a professional with experience in designing stretching programs for the workplace. Only a properly designed program will insure that your team members are effectively prepared to perform the demands of their job.
• Program execution: It is imperative to perform the pre work stretching routine consistently. Professional football teams neverskip their stretching and warm up routine, and workplace athletes never should either. If your pre work stretching program becomes inconsistent, your program will lose all credibility in the minds of employees and your efforts will be wasted. Don’t allow this to happen!

5. Review and Continuous Improvement

Gather feedback from team members on the stretching program and use that feedback to find continuous improvement opportunities.

Team member survey questions:

• Do you feel the pre-shift warm-up stretching program is effective in preparing your body for work?
• Do you feel the pre-shift warm-up stretching program is effective for improving the overall health and performance of your body’s movement system?
• Do you feel that your coach is doing an effective job in leading the pre-shift warm-up stretching program?
• Which stretches do you feel are the most effective for you?
• Which stretches do you feel are the least effective for you?
• How do you feel we can improve the warm-up stretching program?

When the initial excitement of the program wanes, spice things up by incorporating new stretching exercises into the program, bring in a new trainer with high energy, or add a video element to the stretching routine. Always be improving.

6. Passion, Enthusiasm and Perseverance (Most Important)

Above all else, passion and enthusiasm wins. In companies where the leadership is passionate about health and safety are the companies where we see the most success with workplace stretching and the overall MSD prevention process.

Follow these best practices to implement an effective and sustainable Work Readiness System.