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Reducing the 52,600 foot-related injuries that occur yearly across the nation is something employers take seriously. And they should: It costs them an average of nine working days per incident, and claims for a slip and fall range from $30,000 to $50,000.

The actual number of injuries is likely much higher. A 2008 study found that two-thirds of occupational injuries may not be officially tallied. This is due to the fact that many low-income workers (especially those under the age of 25 and a large percentage of those employed in construction) either do not have either workers’ compensation or health insurance.

The National Floor Safety Institute reports that simple slips and falls account for more than 1 million hospital emergency room visits, with fractures being the most serious consequence, occurring in 5% of all people who fall. Slips and falls are also the primary cause of lost days from work and the leading cause of workers’ compensation claims.


Two Types of Foot Injuries

In fact, foot injuries at the workplace are common enough that they are categorized into two groups by the Canadian Center for Occupational Health and Center (CCOHS). The first includes foot injuries from punctures, crushing, sprains, and lacerations; the second is mainly those resulting from slips, trips and falls.

Construction sites and warehouses usually won’t even let you on the premises unless you’re wearing appropriate safety footwear, which includes slip- and puncture-resistant soles. While safety boots can protect feet from puncture wounds and crushing injuries, other factors need to be considered.

For example — and this is relevant whether you’re dealing with a properly-shod construction worker or a regular-shoe-wearing retail employee — common foot conditions (ranging from calluses and bunions to ingrown toenails) as well as simple foot fatigue can actually cause further injuries or have the afflicted person become involved in a workplace accident.

The CCOHS argues that a person whose feet already hurt and/or are tired from standing all day will experience discomfort and pain in addition to fatigue. That means that you have a worker who is set up for further injuries affecting the joints and muscles as well as one who is distracted and thus more likely to act unsafely.

Although employee education is urged when it comes to overt safety issues at the workplace, proper foot care is not usually addressed. Individual employers would have to add this to their literature, and also ensure that workers have breaks in which they are able to sit down.


Fix Your Floors

While construction sites leap to mind as dangerous work environments, foot and ankle injuries can occur just as easily in sedate office settings or luxury retail boutiques. In fact, two million fall injuries annually could be avoided if floors and flooring materials were improved, says the Consumer Product Safety Commission.

One of the leading causes of accidental falls are tripping hazards such as torn carpets and uneven tiles, which can lead to serious injury, Parker Beauchamp at the insurance and risk management company INGUARD writes.

And don’t forget outside of your place of business, Beauchamp continues. “Keep parking lots and sidewalks free of oil, cracks, potholes or other hazards, and salted and plowed in the event of snow.”


Ergonomic Issues

In 2012, managers at a label manufacturing company in Pennsylvania contacted the Health Hazard Evaluation Program of the CDC (Centers for Disease Control and Prevention). The employer was concerned about the number of employees in its finishing department reporting ankle sprains and back pain.

After visiting the facility and evaluating ergonomic concerns, the CDC issued several recommendations which included:

  • Redesign workstations and work tables.
  • Educate employees and implement safety training program.
  • Rotate employees.
  • Reduce mandatory overtime to allow employees time to rest and fully recover.
  • Cross-train employees to increase the number who can cover shifts as needed.

In its safety training program on preventing workplace injuries, the Minnesota Department of Health writes that as “it is easier and more reliable to change the workplace than the worker, the most important prevention strategies will be those that involve engineering controls.”

Mark Middlesworth, the founder of Ergonomics Plus, says a growing concern for occupational safety is an increasingly obese workforce. In fact, he quotes ergonomist Vicki Missar as calling the trend of heavier workers “an epidemic for the field of ergonomics.” Medical risks aside, people who are obese experience decreased lower limb mobility and may be more vulnerable to falls.

There are some office workspace ergonomic design considerations specific to foot and ankle health and the wellbeing of overweight workers that should be considered:

  • Supply chairs that give necessary support and desks that allow enough space for feet, knees and legs.
  • Plan reasonable walking distances with respect to supplies and restrooms.
  • Consider sitting versus standing workstations.
  • Install anti-fatigue matting where applicable.

You don’t actually have to fall to be injured. The University of Waterloo Safety Office writes that musculoskeletal disorders (MSDs), have related pain and discomfort occurrences in the knees, legs and feet. A fixed and awkward position alone is enough to cause injury, and if you add long duration or force to that, you certainly increase the risk of MSD.

Low-cost solutions can be as simple as changing the height of a work surface or using an ergonomic chair at your desk. Of course, you need to know how to properly use the chair, need to adjust it throughout the day to relieve tension in specific muscle groups if necessary, and need to use a footrest if your feet don’t reach the floor.

Even with an ergonomic chair, you should change your seated position occasionally, and stand up and stretch when you start to feel tired. The body simply is not designed to sit still for long periods of tie, even in an ergonomically correct position, OrthoInfo writes. Take breaks whenever possible.

Sitting without foot support is one of the possible causes of strain and pain, the University of Michigan Health Service writes. They suggest keeping your legs parallel to the floor and your feet flat when sitting at your desk. They also recommend a footrest if needed.

Finally, in addition to shoulder rolls and wrist flexing to ease tension in your upper body, try toe curls and foot rotations to keep your feet from cramping.


Keep It Clean

Any walking areas should be debris-free. If there’s a spill or other hazard on a walkway or stairwell at work, for instance, it should be immediately reported.

Risk Management Monitor argues that being proactive and reporting unsafe conditions is a relatively easy fix that was underutilized, mainly due to apathy. People are just too busy, over-worked and generally loathe to go the extra mile, so they’ll step over spilled coffee instead of either cleaning it themselves or reporting it to maintenance.

Safety products and services provider Arbill not only takes issue with poor housekeeping practices, saying slip-and-trip hazards must be taken care of as soon as they arise, but also the tendency to take shortcuts.

“It’s natural to want to get the job finished on schedule — or even ahead of time — but with a ‘get it done quick’ attitude, accidents happen,” the company writes.


Women in Heels

If you are a woman and work in an office, there may be another source of foot and ankle injury that you are forced to contend with: Your shoes.

“A successful work uniform does much more than save time and brain space,” Lisa Miller writes in New York Magazine. “It tells the world what kind of work you do, how seriously you take it, and — here’s the complicated part — what kind of woman you are. It’s the costume in which you perform that most central role in your life; it defines your public-facing self.”

One example of such dress is the corporate suit with killer heels.

And not only do women fall more in heels than flats, but up to a third suffer permanent foot problems because of their heels, according to the American Osteopathic Association.

“Extended wear of high heels and continually bending your toes into an unnatural position can cause a range of ailments, from ingrown toenails to irreversible damage to leg tendons,” says Dr. Natalie A. Nevins, an osteopathic physician, who is quoted in the AOA article.

“Additionally, cramming your toes into a narrow toe box can cause nerve damage and bunions. High heels have also been linked to overworked or injured leg muscles, osteoarthritis of the knee, plantar fasciitis and low back pain.”

Even when you go barefoot, the difference between those who habitually wear high heels and those who wear flat shoes is striking, with the foot in a flexed, toes-pointed position.

The solution here is to wear shoes with a wide heel base and height of less than an inch and a half, together with soft insoles. Stretch your calf muscles and feet daily, limit the amount of walking you do even in a low heel, and don’t wear your heels all day long — switch to athletic shoes or walking shoes for your office commute.


Watch That Back

The back pain you’re experiencing now may well have been caused by a foot or ankle injury. Foot Health Facts says that when walking hurts, we alter our gait. This leads to changing the mechanics of the ankle joint, eventually causing ankle pain, and in turn affecting the whole chain of the lower body, including the lower back.

The process works in reverse, too. If you’ve hurt your back, you may hunch over or move differently, which will inevitably lead to changes in how the bones and joints in your legs move with each other, right down to your ankles, feet and toes.

There’s an app for that, reports Jonah Comstock for MobiHealthNews.

It’s an FDA-cleared, clinical grade activity tracking system that’s been successfully used in Australia and the UK. The data it collects from a worker is analyzed, and it provides recommendations about the types of movement the worker should reduce or avoid.

“From those recommendations,” the company’s US president, John Kowalczyk, told MobiHealthNews, “we would work with the client or the insurer to say how would we ergonomically change the areas of risky movement to reduce the cumulative effect over time, which we believe will then translate to a reduction in injury, which then translates to a reduction in workers’ comp costs and the associated challenges with work-related injuries.”


Images by:
Steve Buissinne
Public Domain Pictures
Jaeyeon Lim

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