Category: Occupational Health in Covent Garden

Help to return to work after injury

After suffering an injury, the thought of returning to work can seem like a mountain too high to climb. You may have spent time resting, having tests, receiving physiotherapy treatment, seeking the advice of a consultant or possibly having surgery. So what happens when the heat of inflammation settles and you are starting to think about returning to work?


It is well documented that work is good for health and that a return is often advisable as soon as it is safe to do so. This can mean that your symptoms may not have completely resolved at the time of returning to work.


There are few things that you can discuss with your line manager which may make your return to work easier and more successful.


Here are the most common supportive measures:


  1. Phased return of hours

Slowing down the return of hours can be very useful when returning to work after a musculoskeletal injury. This may involve working less hours per day or week for a short period of time, or perhaps mixing up time spent in the office versus time working from home. Phasing your return to work can help you return sooner than when you are 100% better, which allows you to reap all the benefits that working has on your health. The idea is that you would then return to your full contractual hours within a set time period. If this is something you think would benefit you then do speak with your employer as this may affect your pay if there is not a specific sickness absence policy or guidance outlining financial support with this.


  1. Shift adjustments

Shift workers who do a range of short days, long days and night working may need some temporary adjustments to the type and frequency of their shifts. After an injury it may be best to stagger out your shifts so that you have a break in between to allow you to rest and complete your exercises. Alternatively, consideration can also be given to the types of shift as more hands may be on deck to help with tasks in day shift, or some shifts may involve less of your aggravating activities.


  1. Duty amendments

Lastly, but equally important, is having a think about the types of tasks that are required at work and what you physically need to be able to do to complete them. For example, a desk based data entry role requires long duration of sitting or a pushing a wheelchair requires you to be able to push without pain.

Returning to work focusing on what you can do is a positive way to re-enter the work place. It may be sensible to avoid large volumes of tasks that you know aggravate your symptoms. This supportive measure should again be temporary to help you pace back into your work and gradually reintroduce the more difficult tasks.


All of the above strategies need to be discussed and agreed with your employer and it is best to be transparent and forward planning when it comes to what you feel you can manage. Often once you are back to work, you will be surprised as to what you can actually manage.


Here at Bespoke Physiotherapy we have post graduate training and extensive experience in return to work planning, so please do contact us if you would like to utilise our occupational health services.


Author: Clare Henson-Bowen, Director and Principal Physiotherapist

FREE help with work place stress!

What is work place stress?

Many of our patients describe stress as feeling that they are under too much mental or emotional pressure which leads to them feeling like they are unable to cope. The way we react to stress will vary from one person to another, what is stressful for one person may be motivating for another.

Stress can affect how you feel, think, behave and how your body works. Some symptoms that are linked to stress include:

  • Poor sleep health
  • Sweating
  • Loss of appetite
  • Difficulty concentrating
  • Feeling anxious or irritable
  • Low self esteem
  • Constantly worrying or having your thoughts race around
  • Experiencing headaches, muscle pain, or dizziness


So how common is it?

Work related stress, anxiety and depression is extremely common with over 440,000 cases in 2014/2015 alone. It accounts for 35% of work related ill-health and it is therefore a huge area of interest in occupational health. So pretty common …


What is stressing out our workers?

Stress is a very personal thing that can be influenced by a range of factors. Within the work place, the main factors contributing to work place stress, anxiety and depression are:

  1. Tight deadlines and work load pressures
  2. Too much responsibility
  3. Lack of managerial support

When thinking about how to deal and manage work related stress, it is useful to consider the factors which you feel may be contributing to your own levels of stress to see if they can be reduced or changed.


So what can be done?


  • Stress risk assessment

A really good starting point is for you and your manager to open up the lines of communication. If your manager is unaware there is a problem then it is difficult for them to help support you. Also, your manager may have observed some of the above signs and symptoms and may want to talk to you about these.


Employers have a duty of care to provide a safe working environment for their staff and should offer you a stress risk assessment. This will help both of you take a step back look at any work specific factors which may be contributing. A plan can be put together of any reasonable adjustments that can be supported to help you manage the levels of stress you are experiencing. It is always a good idea to meet again 2-4 weeks afterwards to review how things have been since the changes were implemented.


  • Support

Often just talking to someone, whether it is a family member, friend, colleague or GP, can help you understand the reasons for the way you are currently feeling. There are also a range of services available either via your work, GP or as a self-referral. For example, many employers now invest in staff wellbeing and have confidential counselling or employee assistance programmes. There is also counselling and cognitive behavioural therapy services available locally via your GP or as a self-referral. Check out your local IAPT service (Improving Access to Psychological Therapies) for more information.


  • Mindfulness apps

The concept of mindfulness is becoming so popular.  This helps you to pay more attention to the present moment – to your own thoughts and feelings, and to the world around you – can improve your mental wellbeing. There are some excellent apps now out there, such as Headspace, which are FREE to download and use. Give them a try today!


It is extremely important to recognise that stress can affect any body and you are not alone. It is key to talk to those around you about how you are feeling so that support mechanisms can be put in place.


At Bespoke Physiotherapy, we often see a how stress can impact upon your physical health and well being. We always help our patients recognise any emotional or psychological factors that may be affecting their recovery and ensure we include these in our goal setting and treatment plans.


NB/ This blog piece discusses mild stress, anxiety and depression however, please do seek immediate medical attention should you have feelings and / or plans of self-harm or taking your own life.



Further reading…


Labour Force Survey. Work related stress, anxiety and depression statistics in Great Britain 2014/15


NHS Choices. Stress, anxiety and depressions: Mindfulness.


IAPT Services

Musculoskeletal injuries among medics

Work place stress, long shifts and poor workstations have all been linked to musculoskeletal disorders so is it any wonder our medics often pull the short straw when it comes to these injuries? Sound familiar?


Of course it well known that musculoskeletal disorder are extremely common, especially in health care workers, but what about specifically the medics?


In our clinic we often see a range of injuries impacting medics because their roles are so variable and demanding it does not take much to knock them off course. For example, a lower limb football injury preventing them walking endlessly through ward rounds or a chronic neck complaint that makes bending over a surgical patient for hours on end mission impossible.


But what are the most common injuries in medics?


The most common musculoskeletal complaints we see in medics are typically neck, low back and shoulder complaints. Let’s look at these in a little more detail:

– Neck complaints – In medics this is normally postural related tensions which are exacerbated by prolonged awkward postures and high levels of stress during their working role. The thoracic spine and base of the neck become stiff and the surrounding muscles tighten, resulting in symptoms of pain and reduced movement.

– Low back pain – This of course affect 1 in 3 adults but medics are constantly spending long hours on their feet and hot desking around the hospital in chairs not set up appropriately. This results in high prevalence of non-specific mechanical back pain amongst medics.

– Shoulder injuries – Shoulder impingement is the most common shoulder complaint we see in medics and occurs when the rotator cuff tendon becomes inflamed as it travels within the subacromial space. Medics experience pain and weakness, especially with overhead and loaded activities.


Normal tissue healing plays a large role in injury recovery, but why are medics prone to acute injuries not settling down or developing gradual persistent pain conditions?

Well a large part of this comes down to the environment and working demands often placed upon medics.


Here are our top 3 tips for managing musculoskeletal injuries in medics:


  1. Ensure you seek a full musculoskeletal assessment for rapid diagnosis and clear understanding of how best to manage aggravating activities. The sooner this is completed the better, to avoid acute injuries becoming persistent pain complaints.
  2. Engage in physiotherapy treatment and exercise based rehabilitation. This needs to take into account your work and life commitments to help you keep up with the programme.
  3. Adjusting your working role can be useful for a short duration to help you rest from the main aggravating activities to allow symptoms to settle. For example, pacing ward rounds, clinics and desk based working.
  4. Get clued up on how best to set up your chair and desk so that when you use a work station you can quickly spend 30 seconds making it comfortable to you.


Bespoke Physiotherapy specialises in working with medics for large range of acute musculoskeletal injuries and long term health conditions. If you would like to speak to us to see how physiotherapy can help you – please feel free to contact us

pregnant women and physically demanding tasks

Employers often ask us our advice on what is safe for their pregnant workers to continue to do at work. There are of course a variety of factors that are considered hazardous to any worker, but through pregnancy these exposures can be more harmful to the worker as well as affect the developing fetus.

So what does the law say? Well there are a number of regulations that protect the pregnant worker such as the EU Directive-Pregnant Worker (1992), the Management of Health and Safety at Work Regulations (1999) and the Equality Act (2010). The employer has a duty of care assess any risks and to control them.

During pregnancy, any risks identified by an employer means they must try to alter hours or duties to try and control them or to seek alternative work tasks for them.

What physical tasks could affect the pregnant worker? There are varying levels of evidence to suggest that physical factors may be hazardous. For example, noise, vibration, radiation, extreme temperatures and handling loads (European Agency for Safety at Work 1992).

But what evidence is there around handling heavy loads at work whilst pregnant? There are some low quality studies which suggest that prolonged standing, heavy lifting and repetitive bending may affect pregnancy outcomes. However, most evidence is conflicting which is largely due to difficulties in defining what ‘heavy lifting’ actually is.

Restricting heavy physical work demands is therefore not seen as mandatory as the risks appear to be very small. Furthermore, physical activity during pregnancy has also been proven to have some health benefits (Kramer and McDonald 2006) so it is often encouraged that women continue with normal activity where possible.

Are pregnant women more prone to injury? During pregnancy, the hormonal changes affect the ligament elasticity which can predispose them to musculoskeletal injury. Special consideration should therefore be given when asking them to complete heavier tasks at work (HSE 2012).

Important final thought… Employers should always assess their pregnant workers individually to look at their physical capacity. If any difficulties arise during the pregnancy then a review is urgently required and medical advice sought.

The Health and Safety Executive (HSE) offers plenty of information and risk assessment templates for further support.

Click here to find out more information at the HSE website.