a sports medicine approach to overuse injuries in the workplace presented by jeffrey pearson, d.o....
TRANSCRIPT
A Sports Medicine A Sports Medicine Approach to Overuse Approach to Overuse
Injuries in the WorkplaceInjuries in the Workplace
Presented byPresented by
Jeffrey Pearson, D.O.Jeffrey Pearson, D.O.
San Marcos, CaliforniaSan Marcos, Californiawww.medicine-in-motion.comwww.medicine-in-motion.com
SportsmedicineSportsmedicine
Medicine in motionMedicine in motion
The “Industrial Athlete”The “Industrial Athlete”
Applying the principles of Applying the principles of sportsmedicine to the evaluation sportsmedicine to the evaluation and treatment of injured workers.and treatment of injured workers.
The “Industrial Athlete”The “Industrial Athlete”
AdvantagesAdvantages Faster, more efficient return to Faster, more efficient return to
participationparticipation enhances self-esteem of injured enhances self-esteem of injured
workerworker Team physician conceptTeam physician concept
Humans are machinesHumans are machines
Underlying structureUnderlying structure electrical systemelectrical system plumbingplumbing pulleyspulleys energy plantenergy plant thermostatthermostat
Review of anatomyReview of anatomy
bonesbones joints/synovial liningsjoints/synovial linings
ligamentsligaments muscles/tendonsmuscles/tendons
synovial sheathssynovial sheaths
The Cycle of OveruseThe Cycle of OveruseOverloading
Tissue injury
Inflammation Continued activity
Pain
Rest - healing
Overuse: force vs. timeOveruse: force vs. time
Effects of Effects of forceforce (intensity) (intensity) jumping from jumping from
chair to floorchair to floor jumping from jumping from
significant heightsignificant height acuteacute overuse overuse
Overuse: force vs. timeOveruse: force vs. time
Effects of Effects of timetime (duration) (duration) walking around the walking around the
blockblock hiking the Continental hiking the Continental
DivideDivide
chronicchronic overuse overuse cumulative traumacumulative trauma
Common types of overuse Common types of overuse injuriesinjuries Tendons Tendons
de Quervain’s tenosynovitisde Quervain’s tenosynovitis extensor tendonitis/lateral epicondylitisextensor tendonitis/lateral epicondylitis rotator cuff impingementrotator cuff impingement
Nerves Nerves carpal tunnel syndromecarpal tunnel syndrome cubital tunnel syndromecubital tunnel syndrome
Common types of overuse Common types of overuse injuriesinjuries Bone and joints Bone and joints
stress fracturesstress fractures degenerative arthritisdegenerative arthritis
Connective tissuesConnective tissues plantar fasciitisplantar fasciitis
Grading overuse injuriesGrading overuse injuries
Grade I (most mild)Grade I (most mild) symptoms occur generally symptoms occur generally only after only after
activity or at night.activity or at night. May keep hands under pillow.May keep hands under pillow.
Grading overuse injuriesGrading overuse injuries
Grade IIGrade II symptoms occur symptoms occur
during activity, during activity, but but do not interfere do not interfere with performance with performance of tasks.of tasks.
Grading overuse injuriesGrading overuse injuries
Grade IIIGrade III symptoms occur symptoms occur
during activity during activity and do interfere and do interfere with performance.with performance.
Grading overuse injuriesGrading overuse injuries
Grade IVGrade IV symptoms so bad symptoms so bad
unable to use the unable to use the affected part.affected part.
Treatment of overuse Treatment of overuse injuriesinjuries General principlesGeneral principles
flexibilityflexibility strengthstrength enduranceendurance
Treatment of overuse Treatment of overuse injuriesinjuries Acute phaseAcute phase
PPRICERICESS ProtectionProtection RRestest IIcece CCompressionompression EElevationlevation SupportSupport
Ice is Nice!
Treatment of overuse Treatment of overuse injuriesinjuries Grade IGrade I
Reduce intensity or duration of activity by Reduce intensity or duration of activity by 25%. More diligent stretching. Ice following 25%. More diligent stretching. Ice following activity.activity.
Follow the 10% per week rule.Follow the 10% per week rule. Sudden, excessive overtime is a sure-fire recipe Sudden, excessive overtime is a sure-fire recipe
for overuse complaints because the workers do for overuse complaints because the workers do not have an opportunity to build up their not have an opportunity to build up their endurance prior to the extra work.endurance prior to the extra work.
Treatment of overuse Treatment of overuse injuriesinjuries Grade IIGrade II
Reduce intensity or duration of the activity by 50%.
NSAIA’s Counterforce bracing Consider physical therapy
flexibility, endurance, eccentric strengthening
Treatment of overuse Treatment of overuse injuriesinjuries Grade IIIGrade III
"Active" rest: the worker should stop performing the offending tasks, but is allowed to move the affected part for his daily activities.
Physical therapyPhysical therapy Consider steroid injectionConsider steroid injection
Treatment of overuse Treatment of overuse injuriesinjuries Grade IVGrade IV
Complete rest of the affected part, usually involving the use of some sort of sling or splint
If all else fails, consider surgical If all else fails, consider surgical options.options.
Sports Medicine PearlsSports Medicine Pearls
Healthy people perform better Healthy people perform better than sick people.than sick people. Difficult to win Super Bowl with team Difficult to win Super Bowl with team
of injured athletesof injured athletes Athletes perform better when Athletes perform better when
using the right equipmentusing the right equipment Difficult to run marathon if shoes too Difficult to run marathon if shoes too
big or too smallbig or too small
Sports Medicine PearlsSports Medicine Pearls
Training/conditioning Training/conditioning Should progress graduallyShould progress gradually Example: return to running Example: return to running
programprogram cycling 45 minutescycling 45 minutes walk 2 miles in 30 minuteswalk 2 miles in 30 minutes alternate jogging/walking alternate jogging/walking gradually increase gradually increase
speed/intensity/distancespeed/intensity/distance– increase by 10% per week maximumincrease by 10% per week maximum
Sports Medicine PearlsSports Medicine Pearls
Training/conditioning Training/conditioning In the workplace, consider:In the workplace, consider:
Increase duration of a specific task Increase duration of a specific task gradually, e.g. an hour/day/week.gradually, e.g. an hour/day/week.
alternating tasks/departments every alternating tasks/departments every few hours.few hours.
Sports Medicine PearlsSports Medicine Pearls
Work smartly with proper Work smartly with proper ergonomicsergonomics concept of neutralityconcept of neutrality
Sports Medicine PearlsSports Medicine Pearls
Maintain flexibility Maintain flexibility stretches every 2 hours stretches every 2 hours
(approximately)(approximately) slow and controlled movementsslow and controlled movements
Sports Medicine PearlsSports Medicine Pearls
Decrease unnecessary forces to Decrease unnecessary forces to bodybody footwear footwear
Vibram rubber solesVibram rubber soles shock matsshock mats
SummarySummary
We have only one body/machine We have only one body/machine that needs to last us for our entire that needs to last us for our entire lifetime.lifetime.
Taking good care of the machine Taking good care of the machine helps to ensure that it will not helps to ensure that it will not break down as much and last a break down as much and last a long time.long time.
Thank you!(And enjoy your stay in San Diego!)