Health in the workplace - Painful work?

How long do practitioners feel comfortable working directly with children before moving on to a less hands-on role? The years of sitting in small chairs, carrying babies, moving equipment and crawling around on the floor all take their toll on our bodies.

Many long-term practitioners accept that pain is something that comes with the job. Carol Beard, manager at Ruardean Acorns Pre-School in Gloucestershire, has had three operations on her knee that left her on crutches for 12 weeks at a time. She also has arthritis in her back, which affects two discs, and has had a back operation. All this since she started working in early years 20 years ago.

She says it is due to 'small furniture, draughty floors and bending over. I still enjoy working in early years, but I do warn new starters to early years to be careful how they sit'. She hasn't enquired about compensation and puts some of the damage down to natural wear and tear.

Elaine Hook, 58, education consultant, has rheumatoid arthritis. She takes anti-inflammatory medication one to two days a week and in some periods takes painkillers every day. She says, 'I have been working in the early years sector for more than 30 years, starting as a junior practitioner crawling around all day on the floor with little ones and sitting on children's chairs.' Now, she adds, 'I can't walk long distances, stairs kill me and I can't sit crossed-legged or stoop any more.'

Previous studies have shown that 71 per cent of early years and primary school staff report pain from kneeling at low tables or on the floor. The Health and Safety Executive (HSE) says about 80 per cent of damage to the hips, knees and legs at work is due to overuse. Symptoms of these 'lower limb disorders' include pain, tenderness or stiffness of the joint, and being unable to straighten or bend it.

Nationally, 4.7 million people aged over 45 have sought treatment for osteoarthritis of the knee, the most common form of knee pain, according to Arthritis Research UK. Women over 50 are most likely to be affected by the condition.

Plumber's knee

Early in 2013 I developed a problem with my knee, which prevented me from getting up and down from the floor and from our tiny chairs quickly and without pain. I was very worried that my career was in trouble. I had to opt out of sessions for several weeks. I think the last straw for my knee may well have been singing time and in particular the children's favourite song, Jig Jog, an action song where one or two children sit on your outstretched legs as you bounce them up and down.

The cause of my pain was infrapatella bursitis, more commonly known as vicar's or plumber's knee. Thankfully, I made a full recovery, two months after being treated.

Peter Marett, an osteopath from Bridgeham Clinic, Ifield, Crawley, says my injury had resulted from too much time spent kneeling on hard surfaces. He explains, 'Bursas are fluid-filled sacs that act as cushions between tendons and bones but can be irritated from direct impact or from repetitive loading and friction. Once the sacs have become irritated, it is not just kneeling and crawling that hurts but also getting up from sitting. The symptoms resulting from this condition will normally have built up gradually.'

Treatment can be difficult and requires avoiding all aggravating factors for a period of time, he adds.

Chartered physiotherapist Lorna Taylor, who is director of back-care company Jolly Back, says, 'Adults working in "child-height" environments are automatically placed at increased risk of developing musculoskeletal injuries. How many workers are expected to sit on child-height chairs, which are not even safe-weight limit tested for adults, kneel on the floor or lift bikes and scooters?

'Staff need to mention to their employers if they are finding some areas of their professional practice difficult. Employers need to know so they can implement changes. Unfortunately, very few employees mention their difficulties so the true extent of the problem is masked.'

Mr Marett adds, 'While for parents the discomfort experienced by these activities usually passes as their children grow older, this is a constant problem for people who work with children. And as the retirement age increases, it is a problem that is likely to get worse.'

The legal framework

The Health and Safety at Work Act places a legal responsibility on employers to protect the health and safety of employees.

Also, Regulation 3 of the Management of Health and Safety at Work Regulations 1999 requires that all employers assess the risks to the health and safety of their employees while they are at work.

According to the HSE, these duties include doing something if there is a problem that is causing or aggravating existing symptoms in an employee, such as providing protective clothing or equipment (for example, knee pads or matting) or referral to an occupational health provider for some medical help.

Employers should thus review their health records, such as sickness absence, accident book records and even staff turnover to see if the workforce is suffering. The risk assessment should then be reviewed accordingly.

If it can be proven that an employer has not complied with the rules set out by the HSE, employees could make an osteoarthritis claim. 'If your work requires you to carry out tasks that involve a lot of repetitive movements that put stress on your joints, your employer should be aware that your health could be at risk. Therefore, they should take steps to prevent you from being injured. If they haven't done this, you could claim compensation,' says solicitor Irwin Mitchel on its website.

But, as Ms Hook says, for many employees knee pain is simply 'par for the course'. 'Once you are employed, you have to fill in a form about your health,' she says. 'I would never put my knee problems in because I would think I could lose my job. None of my staff have ever put that on either, and I think this must be down to a similar mindset.'

Sue Cussen, 54, is former lead practitioner at New Malden Children's Centre

Further information

- Beardsells Personal Injury has a free guide to compensation, www.beardsellspersonalinjury.co.uk

- Irwin Mitchell, www.irwin mitchell.com

- Jolly Back, www.jollyback.com.