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DISORDERS
Musculoskeletal problems arise from the responses
in the human body to physiological and
biomechanical demands of physical activity.
The nature of those demands (and the responses)
changes with the type of task performed, across the
spectrum of jobs from those which require very
static posture to be held for long periods (by
keyboard operators, for example) to the heavy
dynamic work of brewery draymen or forestry
workers.
Method of assessing
Muscle activity
work demands
Dynamic work Energy - Heart rate
demands - O2 consumption
- Borg RPE scale
Psychophysic - Maximum acceptable weight of load
s (MAWL)
- NIOSH Equation
Muscle - EMG
activity
Biomechanica - Strength
l load - Modelling (Spine compression, joint
torques)
- Stature changed
Posture - Notation classification of joint
analysis - movement
RULA
- OWAS
Discomfort or - Body map
Static work pain - Pain scale
Types of Musculoskeletal Disorders
Tendon disorders Shoulder tendinitis, epicondylitis, de
Quervain’s tendinitis, Dupuytern’s
contracure, Achilles tendinitis
Nerve disorders Carpal tunnel syndrome, thoracic outlet
syndrome, radiculopathy, vibration
Muscle disorder neuropathy
Tension neck syndrome
o Acute Trauma
o Chronic Disease
o Use of birth control pills
o Circumstances of Pregnancy
Few Occupational
Factors Of CTDs
o Repetition:
o Force:
o Duration of exposure: increased duration
exposure causes high prevalence of CTD (Jonsson
et.al., 1988)
o Awkward Posture
o Static Posture
o Mechanical stress
o Contact Stress
o Temperature Extremes
o Vibration
o Psycho Social
REPETITIO
N
Participation rate
Physical examination
Investigator blinded
How to calculate Odds
ratio?
An example of calculation for odd ratio for
retrospective Epidemiological Study
Phalan’s test
General Appearance
Observation of patient’s
movement
Look for asymmetry between
sides
Swelling
Deformities
Atrophy
Erythema
Palpation
Symptoms to be observed
Point of discomfort
Causes of de Quervain’s
syndrome
Swelling of the compartment lining of the tendon
Repetitive motion of the thumb constantly being
required to move up and down,
Pinching
gripping or squeezing
Gardening
Knitting
keyboarding
Awkward use of thumb muscles/tendons.
Muscle imbalance
How to
diagnose?
By physical examination of the wrist
The wrist can be examined for Tenderness, and occasional
swelling along the thumb extensor tendons
Specific tests (A positive Finklestein's test)
Ultrasonic diagnosis
• Finkelstain’s test
(Mcmurtry,1978): the patient
is instructed to grasp the thumb of
the affected hand with the other
fingers and actively pull the thumb
towards the small finger.
Tennis
Elbow
Tennis Elbow is actually tendinitis of the wrist
extensor muscles. A sprain of elbow tendons between
forearm and upper humerus causes Tennis elbow.
Micro tears in part of the tendon surrounding the
elbow and muscle coverings are the first stages in
Tennis Elbow development. It is the lateral elbow pain
and tenderness over the lateral epicondyle.
Causes of Tennis elbow
Repetitive throwing
Overhead racquet sports
Swimming This type of injury
results from repetitive stretching of
the rotator cuff during the follow-
through phase of the activity. The
tear that occurs is not caused by
impingement, but more by a joint
How to
diagnose?
Pain, weakness and loss of motion are the
most common symptoms reported
A careful history taken and reviewed by the
physician
An x-ray to visualize the anatomy of the
bones of the shoulder
Physical examination
Special impingement tests
An MRI (magnetic resonance imaging) scan
frequently gives the final proof of the status
of the rotator cuff tendon.