PSR Safety

need to extablish safety training specifically relating to the emergency response working arena. In law enforcement the conditions are constantly changing with reoccurring physical, often awkward demands placed on the officer. However, the law enforcement officer must respond quickly and often reflexively in the interest of public safety as well as self defense.

xxx Public safety agencies are discovering that wellness programs and physical fitness training alone are not the answers to the spiraling cost of workers' compensation of disability injury and retirement losses for these high risk personnel.

xxx In spite of progressive efforts to control injury losses in emergency services, there remains a high incidence of disability injury and related retirement for backs, knees and ankles as well as for physical stress related medical disorders such as high blood pressure and ulcers. The career police officer is a high causality risk. Most retire with a back, ankle/knee, or heart disorder.

xxx The cause of these disabilities to in-field law enforcement officers relates primarily to the changing nature of physical demand in the work areas. The demand is not consistent from moment to moment and often involves awkward conditions like the following: long periods seated in a vehicle; abrupt pursuit and over obstacles such as fences; moving limp and resistant human weight in the form of cardiac victims, resisting offenders; reoccurring tense situations, testing confidence and control, and multiple other physical actions and response requiring spontaneous exertion, stability, and heightened physical awareness.

Current Biomechanics (Body Mechanics) Safety Practices

xxx The problem with standard body response safety education is that it is symptomatic. For example: symptomatic procedural back safety training is - bend the knees, bring the weight close in, work with the legs. However correct these symptoms of safe effort and movement are in ideal conditions, they each in turn or all together may well be inappropriate or produce injury as a first response when used by a police officer as a standard formula in the field. It is, of course difficult to apply clinical back/body safe response of emergency service employees such as police and expect it to be applicable in all the less than ideal conditions in the field.

xxx This is particularly true of the often awkward and unforeseen situation sin the changing work area of law enforcement, for example: a police officer reaching out for a weighty 'cardiac' patient on a couch, our restraining a resistant suspect. In these situations bending the knees as a first response is inappropriate due to the conditions, and it is specifically while reaching for the limp victim in order to bring the weight closer, or when restraining the struggling suspect, that the back injury will occur.

xxx Other examples of some of the unique risk-of-injury exposures in the field of law enforcement include the following:

Back: While exiting the vehicle in an emergency after a long period seated, the spine is compressed and the officer will often jerk himself/herself up quickly and forcefully by reaching for the car door first twisting the back in order to get up and out quickly. The effort is transferred to the legs only as a secondary response. Symptomatic back safety education such as bend the knees, keep the back flat, use the legs, is not appropriate in this case.

Ankle/knee: Pursing a suspect over a fence and landing backwards with momentum requires the ankle to remain stable under the force of body weight and momentum generated. It is in this circumstance that many officers collapse their ankles and injure ankle or knee, for the first of repeated occurrences. The correct response in this situation must occur spontaneously and has to do with a mental perspective of force and effort always in line. Reference to symptomatic safety procedure as in climbing the fence is not the primary problem; it is landing.

Tension reaction: Comtemplating use of side handle baton with body (not just arm/shoulder) power and adequiate enough recoil to be able to contain an aggressor (when for example under the influence of the drug PCP) without having to resort to the use of firearms, has more to do with hip and breath action than most side handle baton training principles taught for certification. It certainly relates little to routine back safety.

xxx Indeed for most people the ordinary act of reaching for a cumbersome object out of an automobile trunk (over the bumper and trunk lip) necessitates reaching for the weight at an uncomfortable distance from the body. This disallows following the first symptomatic back safe rule of maintaining the effort close in to the body with legs underneath the weight in order to avoid injury.

xxx Commonplace in the physical work arena is the reaching for awkward or positionally inaccessible weight in which the employee is conditioned into learning to avoid injury by the discomfort of doing it incorrectly.

xxx A police officer desiring to be disability injury free upon retirement must not be educated by pain or discomfort in the back, knee or ankles, in order to focus on correct procedures.

Cumulative Results of Allowing Effort to be Incorrectly Focused

Example (A) The Back

xxx The smallest amount of back pain during effort may well produce damage. Even if this does not cause serious disability at the time, it will invariably build into later dysfunction.

xxx It is important to note that the discs which separate the vertebrae (the joints of the spinal column) act as shock-absorders. They do not have any blood circulation or nerve endings within them. Therefore the disc does not directly signal when damaged nor does it regenerate significantly afterwards. the pain signal is sent by impinged nerves affected outside the disc, and it is usually after (sometimes split seconds after) the damage has occurred to the disc.

xxx In other words, back pain is not a good warning mechanism to prevent back injury. By the time the pain occurs, it is too late.

xxx Medical studies indicate that one out of three employees working in a physical occupation for over fifteen years (average age 39) such as the emergency services, will probably have degenerated discs in the lower back. There has been repeated damage and in effect, the back condition is becoming chronic. It may well be too late to arrest or reverse the process if it is left to the time that it continues to be uncomfortable. This translates to disability retirement with restricted activities.

xxx At the least the basic causes of most back-related injuries do not disappear with first time recovery, but in fact leave a high probability of reoccurring and becoming a "back" condition.

Example (B) Stability Related Injury, Falls

xxx Similarly, with stability losses of a few repeated knee or ankle injuries, unless the reoccurring reason is corrected the supporting ligaments stretch. Ligaments do not tighten once stretched. This translates to a greater probability of injury with each occurrence, and the injured officer is in effect hurtling towards a cumulative ankle or knee disability or related retirement.

Example (C) Physiological Response, Adrenalin/Anxiety

xxx Tense and stressful physical response in crisis such as holding the breath, therefore holding tension in the chest, neck, and shoulders, has of course been identified as a primary factor in contributing to high blood pressure and in turn ulcers as well as other physical side effects. Included in the down side is the greater potential for error in immediate judgment. In the emergency response work arena, the physical control of breathing and body tension have a significant effect on the psychological control of emotion, rational perspective and, indeed, mental outlook and well-being.

Occupational Work Hardening to Prevent and Control Back-Related Injuries, Loss of Stability/Falls, and Physical Stress

xxx The foremost element the body safety education process must establish is the physical knowlege of where and how the correct effort is spontaneously initiated, experienced, and maintained with the first breath of action and then integrated into the body's functioning as a whole unit. This physical knowledge is a reflex action to the person less prone to injury and relates directly to the first breath of action through the diaphram.

Where Should Body and Back Safe Response Education Start?

xxx There is a basic law of human physiology subjectively clear to the athlete and speaker, boxer or opera singer. They all enter into the respective demands of their work arenas physically and reflexively aware of a common mechanism. Breathing is experienced in the voluntary and (involuntary) muscle action of the diaphragm. The diaphragm controls respiration and initiates body effort bringing the center of gravity low and the power source from the hips.

xxx Diaphragm/breath control can significantly affect the output of adrenalin from the adrenal glands just below it. The more this muscle is voluntarily controlled with the shoulders remaining relaxed, the better the body is working.

xxx In fact everyone uses this muscle to breathe, whatever their physical or athletic capacities. The diaphragm also connects the front of the body to the back of the body and indirectly the top to the bottom. It is pivotal to the different parts of the skeletal frame working in concert.

xxx With physical training beginning with the breath/diaphragm, the control of the body's expression of effort and the margins for successful physical activity improve significantly.

Be Aware of Using The Natural mechanism Correctly to Perform

xxx Every time we push a car, we hold our diaphragm not our breath. It makes the whole body work together - largest muscle groups taking the most effort, i.e. the hips and legs.

xxx Without a very strong diaphragmatic action, the boxer may have the 'punch' to win but be unable to maintain spinal stability or the center of gravity to receive blows. he trains to control this action as well as to not have the "wind knocked out of him."

xxx The defensive linebacker in football works from the same physical starting point to lock in his hips and legs first and then shoulders and arms in order to establish a very low center of gravity with "the whole body behind it." Indeed the football player may be able to leap high in the air to throw or catch a ball but if - when simultaneously tackled by 300 pounds from behind - he is unable to reflexively stabilize his upper body, his spine/back will "give" and he may be seriously injured.

xxx The opera singer and orator maintain the ability to project forcefully, softly, and control other forms of expression and even anxiety by maintaining the effort focused and controlled by the action of breathing. Endurance, voice power and control, as well as stage presence are seriously influenced by such training.

xxx This pivotal first response to action and movement is common to all breathing humans. In other words - it is readily learned since already a natural human function. Simply put - if the mechanism does not already function to some degree, a respirator is needed.

Employees in the physically demanding arena must have a basic physical awareness of the following:

How to focus effort and control anxiety beginning with the first breath of action.

How will this focus be coordinated with stability in order to establish leverage to adapt to job-specific circumstance.

How to maintain force in line with effort in order to allow the body to act as one unit in expressing effort and motion.

How to pre-identify situations which adversely affect leverage, stability, and physical stress controls.

In summary; How to allow a margin for safe response during action and reaction.

xxx This spontaneous mechanism for body preparedness before the action is already there to some degree or injury would occur every instant. This mechanism can be elevated through specialized work hardening training in order to become existing work habit.

xxx For example, if body behavior can be modified enough to maintain the experience of what it feels like to successfully push a stalled car, and this adapted, along with stability and leverage, and used in all circumstances requiring the body to remain as one unit while pushing, we have significantly expanded the employee's margin for body safe response.

xxx The results are body responses initiated with a low center of gravity and all the body anatomy working together. Body power and control are initiated first from the breath and hips, not the arms and shoulders. This establishes a whole body response with greater stability, initiated from the largest muscle groups first and is particularly effective for police officers with less upper body, arm and shoulder strength.

xxx In fact, law enforcement officers normally at a disadvantage due to less upper body strength benefit greatly. This has obvious value for addressing departmental issues of morale relating to affirmative action and physical capability. It is also a factor in controlling the use of excessive force by officers who have insufficient confidence in their strength and control in subduing techniques. Full body power, recoil, and control come from the action of the breath and hips and are not necessarily related to body size and arm strength.

xxx Stability - stationary and moving - is enhanced by coordinating the above systems into a pattern of body force always in-line with efforts (hips and feet in-line with movement.)

xxx The psychological control of effort output, emotion, and body tension, is emphasized by the mechanical actions which discourage arm/shoulder/chest effort as a first response mechanism. The breath and related tension is not held in the chest and shoulders. Breathing is not controlled by the chest but with the action of the diaphragm as it relates to the large muscle group of the hips.

xxx Diaphragmatic/abdominal breathing is a readily learned distinction now taught to pregnant women prior to childbirth in order to better control effort and discomfort during labor. The career police officer has at least as much motivation to prepare for the demands of the "street."

xxx With significantly greater control of the diaphragm, the body's output of adrenalin and control of stress related response is enhanced. The officer's emotional equilibrium in crisis is naturally improved. In a nutshell this means in order to become a veteran of law enforcement, as any veteran will say, the police officer must learn how to stay alert but not get too excited. It's all part of the same training.

spontaneously establish and maintain the body's mechanical advantage prior to and during action - a breath-related autonomic self-safety reaction while still focused on the task at hand. Effort focus and leverage become procedural tools - and the physical pull of gravity and body control, not symptomatic procedure or discomfort, are guidelines of Professional Safeguard Response.

What the Statistics Indicate

xxx Indeed the system works most effectively and in the most demanding range of work exposures. The "physical" occupations are highly receptive and the statistics have been extraordinary.

xxx This system - P.S.R. - Professional Safeguard Response, has produced significant statistical reductions in back-related injury and falling injury losses with emergency services in the municipal, state and federal sectors, along with primary utility companies in their highest risk/loss work arenas.

xxx A substantiating example is the U.S. Department of Energy together with the University of California at Lawrence Livermore National Laboratories (Hazards Control Department). The emergency services/fire considers it statistically "the most effective training for preventing back related injury ever undertaken." Back injuries and falls at the emergency services for the facility of 10,000 have been reduced 95% since implementation.

xxx An average sized law enforcement agencny of approximately 100, such as Alameda Police Department, has reduced back injuries by over 90% in the first year after a one half day training block per twenty police officers.

xxx The system is specialized for the emergency services and other high risk, physically demanding occupatons where results are clear if the system can be retained by the employee while still focused on the task at hand - this is the key to any police training.

On the Advice of Experts - Medical, Insurance, Reinsurance

xxx This tactical safety training is widely respected in the field of loss injury prevention training for the environmentally demanding occupational arena, but does not require a clean bill of health from the employee. It is applied post-injury and surgery to the recovery and return to work of patients of primary neuro-spinal and orthopedic back surgeons. Specialized "critical response" movement stabilization training is given to patients returning to the demands of their occupation subsequent to serious back injury or surgery. These patients include emergency services employees such as firefighters and police officers. Professional football and baseball players are returned to the very real demands of their arena.

Summary

xxx The capacity to recover from body injury has to do with many more variables than the activity of prevention.

xxx In order to control losses of career personnel as well as human and financial resources, public safety agencies must consider the work hardening/loss prevention training of the employee and the risk potential for disability injury.

xxx The average back injury costs a U.S. public agency or insurance carrier $8,000 before surgery or retirement. One in three law enforcement employees will suffer back-related, ankle or knee injury in their career. Five hours of specialized career developmental training in order to trigger the correct ongoing work response in the public safety employee will save an immeasurable amount in human and fiscal resources.

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BY JACK S. KANNER

Jack S. Kanner CEO, is director of engineering work behavior modification and career loss control for the
PSR Corp. , a nationally recognized public-sector oriented training agency based in
Corte Madera, California