Drew Coulson became interested in physiotherapy after a series of shoulder dislocations experienced while playing hockey. As a physiotherapist, he applies a whole-body approach combining manual therapy, education and functional exercise work.
Statistics Canada data show that, at the beginning of this year, 32 per cent of Canadian employees aged 15 to 69 worked most of their hours from home, compared to only 4 per cent in 2016.
NFP took the time to discuss working from home conditions with Drew to gain a better understanding of the unique issues created by our current work-from-home reality.
Editor's note: This interview has been edited for clarity and brevity.
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NFP: As a physiotherapist, from about March onward 2021, have you seen a shift in the type of patients that are coming to you for physio advice?
Drew Coulson: Yes, definitely. In general, things have trended a bit younger, a lot of my older patients have either opted to stay home or transferred on to virtual physiotherapy. People that are coming into the clinic are your work-from-home office people. And with this group of people, I am seeing a lot less from an acute injury or a traumatic injury and more so from overuse or chronic issues. And a lot of people will come in with pain that they've said they've been putting off for months. I think they've gotten to this point where they can't keep dealing with the pain and must address it now.
NFP: With consultations being more virtualized, how have these gone in comparison to an in-person format?
Drew: It's been interesting to bring that in. Because it's something that, at least in our clinic, didn't really exist prior to COVID. So, to figure out how to market that and who it best suits patient wise, it's been a bit of a challenge, for sure. It's not something that my clinic has been doing a lot of. We haven't seen a big influx, but in talking to some other colleagues, they have a huge portion of their caseload that went virtual. So, it just depends on how well you're able to market it and your caseload. A lot of people that I talked to who are part of an older population, will do more online visits, you know, may be a bit counterintuitive. You would think the younger, more tech savvy folk would be eager to get to get online and do stuff like this. Also, it works well, for anyone with comorbidities or any preexisting conditions that aren't comfortable leaving the house or going into a clinic or something like that.
NFP: Now, when it comes to the younger patients that you're seeing, I know it seems obvious, but I would say a lot of the work from home would be impacting that. What are some of the trends that you're seeing from patients over the course of the past year, in terms of the injuries that they've been coming to you with?
Drew: A greater proportion of repetitive strain type injuries. We get a lot of neck pain and shoulder pain, low back pain or muscle tension complaints. There's a higher proportion of malingering chronic type injuries.
NFP: And is that just a matter of people not having the necessary or the proper setup at their households?
Drew: Yeah, that's a big part of it. One of the main questions that found its way into my assessment is: what does your home desk setup look like? It's astounding, in some cases, people work on their bed, sitting on the couch or sitting on a stool with no back support - hunched over a laptop. And the good thing is, over time, people have started to adjust. And I think companies have realized that they must allow people to get their office supplies, get their desk set up, get their chair, bring in their monitor, things like that. Because working on a laptop long term, it is just not sustainable.
NFP: Have you noticed employers being more accommodating to these employees, the situations that they're dealing with and the injuries that they may be consulting with their supervisors on?
Drew: Yes. I think as time has gone on there are more companies that realize that work from home is not going away. And the more money that we can put towards looking after employees, the less complaints they're going to have. So, I'm always surprised when, like a year later, I will still have initial assessments where people come in and say they've had no support from their company in getting set up at home. I would say that most companies have realized that it is important to support your work from home folks.
NFP: For you, as a physiotherapist, have you had to implement any new techniques on your patients because of this influx in work from home injuries?
Drew: Definitely, you need to get creative and work with what people have at home. It's not like we have the option to go to the gym as much. Right? So, without having any heavy equipment, it's hard sometimes to strength train, so you have to get a bit more creative. Whether you're using, you know, heavy items that you have around the house to make injury or exercises harder, or you're working on dealing with people's desk setup. I mean, I've been talking about desk setup every single day for the past year.
NFP: Are you sick of it?
Drew: Yeah, it really snuck its way into my education. It's just talking about ergonomics, desk setup habits that people need to work on. People realize that they've been spending hours in the same position, and they're not sure why they're so sore when the reality is our body needs variety, and it needs movement. You want each muscle group to be able to share the load. But if you're loading the same ones repeatedly, while sitting at your computer, it's inevitably going to make certain areas angry. So really, really leaning into education about habit forming, and movement and posture and things like that. It's always been a part of physio, but it's dominating the conversation now. I think most patients I see have a much higher stress level than then they would have pre-COVID, which is understandable. I spend a lot of time talking about stress relief, stress management, dealing with any sort of sense of dread and trying to help people manage that and how that affects healing and prognosis. It plays a gigantic role in feeling better.
NFP: Are there a couple of simple tips that people can implement, say today, to help alleviate some of these injuries or some of the stress that you mentioned as well?
Drew: Yeah, I've been preaching habit stacking. That is one of the ways to change behavior. By taking a well-established habit like checking your phone or grabbing some coffee and adding a habit to it. So, let's say if you check your phone, check your posture right after. After doing that, we're able to pair well-developed habits with new habits. And then on top of that, it's important to have visual cues around your desk. For example, sticky notes that remind you to check your posture or move. The one I learned most recently from one of my patients is a virtual commute. Even though they're working from home, every morning they go for a half-hour walk œto work. And then at the end of the day, they go for another half-hour walk œto return home. Disclaimer: Drew Coulson is not affiliated with NFP in Canada.
Sources
Working from Home: Productivity and Preferences, Statistics Canada, 2021.