Farmer Health: Preventing Pain By Jack Wax The animals that should be treated with the greatest care on most farms aren’t getting the attention they need, and farmer health should be a priority. Farmers start out young and strong, but as they age they are more likely than other groups to suffer from joint problems, painful backs and bad knees and hips. Young farmers practice yoga at Dripping Springs Farm, located near Fayetteville, Arkansas. Everyone already knows that farming is one of the most dangerous ways to make a living. Safety around large animals and heavy equipment is a life and death matter, but few farmers consider the long-term health effects of day-to-day lifting, kneeling, stooping, twisting, shoveling and weeding — the activities that define the workload of most organic market farmers. The result? Approximately one-third of farmers and ranchers are limited by arthritis, according to the USDA AgrAbility Project. Surveys of farmers in the United States and other countries show that as farmers age they not only suffer musculoskeletal problems, but their aching, damaged joints make them more prone to serious accidents. The flip side is that the physical demands of farming can be a good thing. Young farmers can grow into old, healthy farmers. Back pain can be avoided, arthritis can be prevented or delayed, and daily aches and pains can be tolerated without developing into major joint or muscle disorders. But it won’t happen by chance. Experts agree that to stay healthy, farmers such as 26-year-old Eric Elderbrock and his peers need to be aware of the potential damage they are inflicting on themselves and prevent it. Elderbrock, a fresh market vegetable producer who follows organic practices, farms three acres outside of Madison, Wisconsin. At 26, he’s strong enough and committed enough to work from sunup to sundown. And that’s part of the problem. “In the last year or two, I’ve noticed at the end of a 14-hour day when I’ve been crouching a lot, like when I’m transplanting, that I have some soreness in my knees or wrists. I definitely think about what that’s going to look like down the road if I keep doing it.” During a routine physical, his doctor warned him that he could be at risk for carpel tunnel syndrome. The idea that farming could lead to the same physical problems that plague office workers was new to Elderbrock. Although the younger generation of farmers — especially those who have small, organic operations — try to take better care of their bodies, they have other priorities, such as making a living. Farmer Health: Toll on the Body David Douphrate has degrees in physical therapy, ergonomics and business. He teaches at the University of Texas School of Public Health (Deptartment of Epidemiology, Human Genetics and Environmental Sciences). He has seen how farming, like many other professions, can take a toll on the body. “The big three risk factors for the development of musculoskeletal disorders are awkward postures, high repetitions and high muscle loads. Cold environmental conditions and whole body vibrations also can lead to problems.” That’s a good description of the life of most farmers, who don’t think twice about their aches and pains after a long day. But there’s more to a sore muscle or aching joint than just pain. Whether from wear and tear or acute injuries, pain indicates different degrees of damage to the body. “At the cellular level, you find tearing of the tissue or simple inflammation, which is a natural response to stress being placed on the tissue,” said Douphrate. “The inflammation can cause pain or pressure on nerves — like in carpal tunnel syndrome.” Most of that damage is minor, but some of it is extremely serious. “When you compress a nerve, especially for a prolonged period of time, you can have irreversible injury to the nerve. If you neglect a herniated disc, you run the risk of possibly having nerve damage down the leg, and that can lead to loss of muscle and muscle strength. It all depends on which muscles are damaged.” Farmer Health: Prevention Here are some potential problems and strategies that Douphrate advises: Stooping and squatting for long periods of time (awkward positions) – Try to vary your posture, especially when bending over or when your hands are over your head.Moving heavy loads – Lift properly: keep the load near to your body.Fixing heavy farm equipment – Use proper, well-maintained tools that minimize stress on muscles. Watch out for unexpected loads.Riding a tractor for an extended time – Use vibration-dampening seat cushions. Older tractors may have hard metal seats.Using ladders – Make sure you’re on a good base of support and that the steps of the ladder are dry and free of debris. If your work involves keeping your arms above your head, rest them regularly. Change your routine and frequently alter the position of your arms.Milking animals – Take adequate rest breaks and do not maintain postures for a long period of time. Unlike other medical problems or diseases, there’s not much mystery to musculoskeletal disorders. For instance, many people have experienced fairly serious pain and difficulty after apparently doing nothing more than picking up a light object. That aching shoulder or hip isn’t actually caused by one incident of bending or awkward stretching. To understand how this can happen, one has to look at the underlying physical changes. “Cumulative wear and tear on the body is like watching your tires wear on your car. It doesn’t happen all at once. If our bodies don’t get enough time to rest and heal, we get little adhesions that form between the muscle fibers and sometimes between the muscle and skin. The tissues don’t slide and glide like they should. They start losing strength, flexibility and function. So now you go and lift something very minor and you get that same acute trauma as if you were lifting something really heavy,” said chiropractor Jennifer Hess. In addition to her years of private practice in Eugene, Oregon, Hess has a Ph.D. in human physiology. Regardless of whether you experience pain caused by an acute injury (such as a fall) or from overloading your body over time, it’s important to take care of the problem. “The first thing you should do if you feel that you’ve hurt yourself is to ice the area,” said Hess. “Stop the activity. Rest it, and if it needs to be compressed and elevated, do so. If the pain goes on longer than two weeks, you probably ought to be seeking care. If it goes on for as long as two months, it’s considered chronic and becomes more difficult to heal.” The best way to avoid needing a doctor, a chiropractor or a physical therapist is to pay attention to ergonomics. “That’s defined as fitting the job to the worker,” said Hess. “Any type of equipment that will save your body is first and foremost. Secondly, if the job doesn’t depend on equipment, make sure you use good body mechanics. And finally, be sure to stay fit.” Proper body mechanics means using your body in a way that reduces stress on joints and the spine. Hess explained, “You want to use a neutral spine posture where you’re keeping your head over your shoulders while keeping your trunk over your pelvis while keeping the curve in your lower back. The trouble is that we don’t always remember to do it. We cut corners and start stooping and that’s where we really get injured.” Farmer Health: Better Tools Helping farmers avoid injury is the focus of the UC Davis Agricultural Ergonomics Research Center. “The theme of the center is to find simple solutions that farmers and farmworkers can use in labor-intensive agriculture to reduce the likelihood of musculoskeletal disorders or injury,” said Fadi Fathallah, a professor who directs the center. Over the years, the center has tested or introduced a number of devices that have taken some of the pain out of agriculture. One tool, a pneumatic cutter, is saving nursery workers from carpal tunnel syndrome. Although the tool wasn’t designed for fieldwork, Fathallah is concerned about farmers who have to harvest by hand-cutting crops. “When you see people cutting more than a thousand times a day, you get worried. We see that quite a lot in agriculture.” Something as apparently low-tech as a plastic tub can, and does, make a major improvement in the lives of thousands of farm workers who harvest grapes. By introducing a smaller grape tub, “we made a huge difference in the pain and discomfort of field workers,” said Fathallah. The tub lightened workers’ loads from 57 pounds down to 46 pounds. It may not seem like a big difference, but it hit an ergonomic sweet spot. NIOSH, the National Institute of Occupational Safety and Health, considers lifting any weight above 50 pounds as a risk factor for injury or development of musculoskeletal disorders. As the UC Davis tub shows, low-cost ergonomically designed tools can be as effective as higher-priced solutions. low-cost ergonomically designed tools can be as effective as higher-priced solutions. Fathallah noted that even the common kneepad can reduce stress on a body. Bucket carriers, carts, wagons and stools all can make farming less physically challenging. The simple stool can reduce stooping, which can be detrimental to your spine. “Stooping elongates your ligaments and dehydrates your discs. Usually around two hours of stooping is where things start getting bad.” Anyone who has spent a day or more hand-harvesting or weeding vegetables will appreciate the advantages of several of the ergonomic devices being studied at the UC Davis Center. Among these devices are motorized and human-powered carts that can be ridden in a nearly prone position, allowing farmers and their workers to harvest low-growing crops while on their bellies. Other ergonomic aids include a motorized weeding tool and a personal load transfer frame (a little bit like an exoskeleton) that shifts the stress of repeated or prolonged stooping from the back to the hips and legs. More than 1,000 devices that can make farming less of a physical challenge can be found at agrability.org. The National AgrAbility Project assists farmers with all types of disability, including musculoskeletal disorders such as arthritis. Amber Wolfe is the AgrAbility Project coordinator for the Arthritis Foundation-Indiana Chapter. Raised and still living on a farm, Wolfe has firsthand understanding of the needs of farmers. The osteoarthritis she has in both of her knees gives her additional insight into the challenges confronting farmers with arthritis. “A lot people think of arthritis as just aches and pains, but it is actually a disability,” said Wolfe. “Some people are lucky enough to go through life without arthritis pain while others can’t get out of bed.” Arthritis is one disease, but it can take more than a hundred different forms. Some people are destined to develop rheumatoid arthritis, which runs in families. But osteoarthritis, which is the common, everyday variety affecting most people, is preventable. “It’s caused by injury or overuse and by abusing your joints,” said Wolfe. “It’s not inevitable, and you don’t have to get it because you work on a farm or simply because you are getting older.” The key to preventing osteoarthritis is simple: take care of your joints. The earlier in life that farmers get that message the better, according to Wolfe. “Even after you have a diagnosis of arthritis, you can change your farm operation and the way you work to manage your pain.” Farmers who develop arthritis or who have injured a joint are more prone to eventually sustain serious injuries on the farm. “Arthritis weakens the joint, and because it’s painful, people tend not to use those joints as much. So they rest them, which means that the ligaments, muscles and tendons around the joint also weaken. Anytime you have a weak part of the body, it’s more susceptible to additional injury.” Osteoarthritis affects male farmers more frequently, while rheumatoid arthritis “follows the women’s side of the family,” said Wolfe. Although women farmers are as hard-working and capable as men, they work at a disadvantage because their tools and implements aren’t designed with a woman’s body in mind. Ann Adams and Liz Bensinger, former small-acreage farmers with healthcare backgrounds, are changing this in a big way. After several years of scientific studies, their company, Green Heron Tools (greenherontools.com), began manufacturing the first shovel designed with ergonomic features especially for women. Their extensive research — which consisted of everything from focus groups, analysis of videotapes of women shoveling and studies of women’s carbon dioxide output while shoveling — resulted in their unique shovel. “Of course, people understand that women are shorter and most women have smaller hands,” said Bensinger. “But the most important variable for tools and equipment use is upper body strength, and, on average, women have 60 to 70 percent less upper body strength than men. Our body strength is in our lower bodies.” Their shovel, the HERShovel, comes in three sizes to match different heights. Its grip is oversized, allowing it to be used with one or two hands. Designed to minimize bending, it weighs less than 4.5 pounds. Its blade has an enlarged step that takes advantage of women’s greater lower-body strength. Additionally, the blade is built at an angle because their research showed that women compensate for their comparative lack of upper-body strength by putting the blade into the ground at an angle. Other ergonomic tools that Bensinger and Adams sell through Green Heron Tools include a Japanese weeding sickle and a Korean hand plow. The grips on these tools are smaller. The two women not only develop, manufacture and market ergonomic tools — they also lead workshops for farmers on how to stay healthy and avoid musculoskeletal disorders. A healthy life on the farm is built on awareness of risks and taking actions based on that awareness. “Exercise before working prepares your muscles,” said Bensinger. “While exercising, you can be thinking and planning your day. One of the things that research shows is that when people aren’t in the present moment, they are more prone to have an accident.” Adams added: “When farmers go out in the field to weed — and we’ve been guilty of this — you keep weeding and weeding because you’re focused on the outcome. But the process is very important also — how you’re changing your position, how you use your body.” Farmer Health: Mind/Body Connection The mind/body connection is at the heart of Dawn Jansen’s work. A yoga instructor in the Seattle area, she has developed several yoga routines especially suited for farmers and has led yoga sessions at a variety of farm conferences. “For farmers, yoga is not just about getting into postures — it’s about learning ways to strengthen the core muscles of their trunks, which makes their bodies more stable,” she said. “Yoga is a way to teach people to use their bodies optimally. It builds strength, mobility and stability.” Although millions of people devote hours each week to yoga practice, it can benefit even those farmers who can spare only five minutes a day. “There’s this misunderstanding that you have to set aside an hour, but just a few movements or stationary poses might give you the rest and revitalization to make your work better.” Mark Cain is living proof that yoga can contribute to a farmer’s long and healthy career. For the past 30 years, Cain has worked on the successful organic farm that he co-owns. Dripping Springs Farm, located near Fayette, Arkansas, produces organic vegetables, culinary herbs, blueberries and specialty cut flowers. “I think most people think that yoga is a soft, mildly relaxing activity that is best pursued by women and twenty-somethings,” he said. “But the system I practice and teach, Ashtanga vinyasa, is an athletic, incredibly challenging system.” Cain tries to squeeze an hour or more of yoga into his day, even during the busy growing season. He loves the physical and psychological boost that yoga gives him. Cain, who just turned 61, isn’t plagued by aches and pains, despite the daily demands of farming. “I hate to think what I’d be like without yoga. My back is very flexible; my legs are strong and flexible. Yoga has helped me be more body-aware, so that when I’m doing things around the farm, I don’t tend to hurt myself by doing stupid things with my body, like trying to lift too much.” Not only does yoga help Cain work smarter, but it also helps “to relieve excess mental strain and worry. It helps you focus on what needs to be done and then to just get to it.” Like Cain, farmers can have a better future by making a conscious effort to maintain a healthy lifestyle. This article appeared in the May 2015 issue of Acres U.S.A. magazine.