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

An overuse injury occurs as a result of cumulative tissue damage resulting from repetitive demands over a period of time. This is different from an acute injury which is a result of a single, identifiable traumatic event. Tissue damage can involve muscle, tendon, ligament, nerve, bursa and bone. Because Occupational Overuse Syndrome (OOS) is caused by repetitive movements and/or awkward postures, changes to the workplace design and workflow can reduce or even prevent issues.

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.

An example is carpal tunnel syndrome, an OOS of a nerve associated with the use of a keyboard and wrist position. The median nerve is the nerve which provides strength and sensation to the thumb, index, long and ring fingers. As this nerve runs down the arm into Since everyone is built differently, some people can type all day no matter what position and have a normal pressure. Other people have unacceptable nerve pressure if they must extend or flex their wrists while keyboarding. If keyboarding is painful or causes numbness, many times adjusting the workstation to make sure that the wrists are in a neutral position while typing can alleviate symptoms and avoid CTS. This can be done by adjusting the height of the keyboard, the chair and or a wrist foam support in front of the keyboard.

Tennis elbow, aka lateral epicondylitis, is an OOS of a tendon and also associated with repetitive use the wrist. Tendons that extend or elevate the wrist are attached to muscles that are attached to the bone on the outer aspect of the elbow. That muscle attachment to the bone can suffer small traumatic tears if there is repetitive powerful wrist extension against resistance or with gripping of heavy items including power tools in non-ergonomic positions repeatedly. While from time to time, tasks must be done in an awkward position, if the workplace can be adapted to allow the worker to perform standard repetitive wrist motions in an ergonomic position, the risk of developing this tendonitis can be lessened.

Ways to Reduce Risk of OSS

• Mindful ergonomic workplace design including frequently used items within easy reach and a work environment that allows for relaxed shoulders and comfortable mild bending at a worker’s elbows and wrists.

• Alternation of repetitive tasks.

• Deadlines that allow for adequate rest breaks.

the hand along with the finger tendons, it passes through a tight space located just over the wrist (carpus in Latin), hence the name “carpal tunnel.” Everyone has a carpal tunnel; people who have pain and numbness in those fingers associated with pressure in the tunnel have “carpal tunnel syndrome (CTS).” Pressure in that tunnel can be increased with repetitive finger motions while the wrist in either hyperextended or flexed. • Proactive identification of worker physical complaints with means to evaluate individual worker daily task performance, work environment and worker postures with early collaborative workplace adjustments and coaching on ergonomic motions.

• Tracking patterns of OOS to identify opportunities for workplace and workflow improvement.

Occupations that the work involved has caused or exacerbated the injury

Bricklayer Electricians

Machine Drivers

Carpenter Ground Worker Plasterers

Foreman

Labourer

Plumber