Overuse Injuries in the Workplace Can Be Eased or Eliminated By Gina C. Del Savio, MD
Dr. Gina C. Del Savio is Chief Medical Officer at Montefiore St. Luke’s Cornwall and is Attending Orthopedic Hand Surgeon at MSLC with board certification in both Hand and Orthopedic surgery. gdelsavio@montefioreslc.org
A
n overuse injury occurs as a Since everyone is built differently, worker to perform standard repetitive result of cumulative tissue some people can type all day no wrist motions in an ergonomic damage resulting from matter what position and have a position, the risk of developing this repetitive demands over a period normal pressure. Other people have tendonitis can be lessened. of time. This is different from an unacceptable nerve pressure if they Ways to Reduce Risk of OSS acute injury which is a result of a must extend or flex their wrists while single, identifiable traumatic keyboarding. event. If keyboarding is painful • Mindful ergonomic workplace Tissue damage can involve muscle, or causes numbness, many times design including frequently used tendon, ligament, nerve, bursa adjusting the workstation to make sure items within easy reach and a and bone. Because Occupational that the wrists are in a neutral position work environment that allows for Overuse Syndrome (OOS) is caused while typing can alleviate symptoms relaxed shoulders and comfortable by repetitive movements and/or and avoid CTS. This can be done by mild bending at a worker’s elbows awkward postures, changes to the adjusting the height of the keyboard, and wrists. workplace design and workflow can the chair and or a wrist foam support reduce or even prevent issues. in front of the keyboard. • Alternation of repetitive tasks. Because symptoms may have a slow insidious onset, workers often work through discomfort rather than identifying that there may be an issue and correcting an underlying posture, position or workplace design which is contributing to the injury.
Tennis elbow, aka lateral epicondy• Deadlines that allow for adequate litis, is an OOS of a tendon and also rest breaks. associated with repetitive use the • Proactive identification of worker wrist. Tendons that extend or elevate physical complaints with means to the wrist are attached to muscles evaluate individual worker daily that are attached to the bone on task performance, work the outer aspect of the elbow. That environment and worker postures muscle attachment to the bone can An example is carpal tunnel syndrome, with early collaborative workplace suffer small traumatic tears if there an OOS of a nerve associated with the adjustments and coaching on is repetitive powerful wrist extension use of a keyboard and wrist position. ergonomic motions. against resistance or with gripping of The median nerve is the nerve which heavy items including power tools in • Tracking patterns of OOS to provides strength and sensation to the non-ergonomic positions repeatedly. identify opportunities for thumb,index,longandringfingers. While from time to time, tasks must workplace and workflow As this nerve runs down the arm into be done in an awkward position, if the improvement. thehandalongwiththefingertendons, workplace can be adapted to allow the it passes through a tight space located just over the wrist (carpus in Latin), hence the name “carpal tunnel.” Occupations that the work involved has caused Everyone has a carpal tunnel; people or exacerbated the injury who have pain and numbness in those Bricklayer Plasterers fingersassociatedwithpressureinthe Electricians Foreman tunnel have “carpal tunnel syndrome Machine Drivers Labourer (CTS).” Pressure in that tunnel can Carpenter Plumber beincreasedwithrepetitivefinger Ground Worker motions while the wrist in either hyperextendedorflexed. ON THE LEVEL:
W I N T E R 2 0 2 2 Q U A R T E R LY P U B L I C AT I O N
27
