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Can in-plant exercise control musculoskeletal symptoms?

After 1 year of an on-job exercise program to control musculoskeletal symptoms in the neck and upper limb, there were no statistically significant differences in localized postural discomfort scores or in the proportion of those whose discomfort decreased based on exercise participation. Although no clear reduction in discomfort was achieved by the exercise program alone, at least 67% of respondents who participated in the exercise program reported that the program made them feel better.

Adult↗

Prevalence of carpal tunnel syndrome and other work-related musculoskeletal problems in cardiac sonographers.

Cardiac sonographers at a regional medical center have experienced carpal tunnel syndrome symptoms and other work-related musculoskeletal injuries. The nationwide incidence of these problems was not known. A questionnaire pertaining to possible causes of work-related injuries was developed and distributed to 225 cardiac sonographers. A 47% response rate was achieved with 72% female respondents. Eighty-six percent reported one or more physical symptoms. Only 3% of respondents had been diagnosed with carpal tunnel syndrome. Posture correlated significantly with other work-related musculoskeletal injuries. High-pressure hand grip correlated significantly with carpal tunnel syndrome symptoms. No other strong relations with physical symptoms were found. The contribution of specific factors to musculoskeletal problems experienced by cardiac sonographers was difficult to determine.

Adult↗

Relationship between occupation and episodes of headache that match cervical origin pain patterns.

The relationship between headache that matches cervical origin pain patterns, occupation, gender, age, and hours of work is examined in a randomly sampled, never-injured population. Although gender was established as a significant factor in the association between occupation and headache, age and hours of work were shown to have no effect. Women working in managerial and professional occupations had a significantly higher risk of cervical origin headache when compared with women working in either clerical or blue collar occupations. A similar association for men was not noted.

Adolescent↗

Risk factors for injury during basic military training. Is there a social element to injury pathogenesis?

A retrospective case-control study into the risk factors for injury during basic military training was conducted at the Recruit Training Unit, Royal Australian Air Force Base Edinburgh, South Australia. Case subjects were recruits suffering a musculoskeletal injury during the course, severe enough to result in backcoursing (being delayed and joining a later course) and usually requiring the loss of 5 days of training. Control subjects were 629 recruits selected randomly from recruits who were not case subjects from the same period of Jan 1, 1985 to Dec 31, 1990. Two hundred thirty-eight cases were identified (2.7% of the recruit population), of which 123 were overuse-type injuries and 115 acute-type injuries. Most injuries occurred in the first 2 weeks of training. Bivariate and logistic regression analysis of possible risk factors for injury was conducted, both for all case subjects and for the subgroup of case subjects with overuse injuries. Statistically significant associations were identified for female gender, body mass index > 26.9, winter training, a history of lower limb injury, and the presence of a lower limb deformity. All these associations were stronger for overuse injury, and preenlistment physical activity was also significantly associated with overuse injury. No significant association was found for height, weight, age, smoking, or gender makeup of courses. Most striking was a large rise in overuse injury incidence in women over the period of study, from 0.2% in 1985 to 8.8% in 1990. Reasons for this increase may include "social pathogenesis."

Adult↗

Occupational repetitive strain injuries and gender in Ontario, 1986 to 1991.

Repetitive strain injuries (RSIs) in Ontario were examined with respect to gender for the period 1986 to 1991, using data from Ontario Workers' Compensation Board systems. Technical issues surrounding analysis of workplace injuries and theoretical suggestions raised by the data are discussed. Analyses revealed that the risk of RSIs for women is greater than that for men. Furthermore, women receive compensation benefits because of RSIs for a longer period than do their male counterparts, which may indicate a longer-term effect of RSIs on women.

Cumulative Trauma Disorders↗

The value of in-house physical therapy.

This article describes the benefits of an in-house physical therapy pilot program. The program was initiated in 1994 to improve employees' functional capacity after occupational and nonoccupational musculoskeletal injury, shorten total disability time, use restrictive duty more productively, and reduce total disability costs. The pilot program's initial success led to the establishment of a permanent program.

Accidents, Occupational↗

Bernardino Ramazzini: the father of occupational medicine.

Bernardino Ramazzini was born on October 4, 1633, in the small town of Capri located in the duchy of Modula, Italy. He is credited with establishing the field of occupational medicine during his lifetime. His major contributions came after 1682, when Duke Francesco II of Modena assigned him to establish a medical department at the University of Modena. He was installed in the title of professor "Medicinae Theoricae." In 1700, Ramazzini was appointed chair of practical medicine in Padua, Republic of Venice, the premier medical faculty in Italy. In 1700, he wrote the seminal book on occupational diseases and industrial hygiene, De Morbis Artificum Diatriba (Diseases of Workers). Although Ramazzini is perhaps most well known for his work on exposure to toxic materials, he wrote extensively about diseases of the musculoskeletal system. In particular, he warned of the problems of inactivity and poor postures inherent in some jobs.

Cumulative Trauma Disorders↗

Exercise and its effects on the central nervous system.

Exercise can have profound effects on numerous biologic systems within the human body, including the central nervous system (CNS). The inherent complexity of the CNS, and the methodologic difficulties in evaluating its in vivo neurochemistry in humans, provide challenges to investigators studying the impact of exercise on the CNS. As a result, our knowledge in this area of exercise science remains relatively limited. However, advances in research technology are allowing investigators to gain valuable insight into the neurobiologic mechanisms that contribute to the bidirectional communication that occurs between the periphery and the CNS during exercise. This article examines how exercise-induced alterations in the CNS contribute to central fatigue and the overtraining syndrome, and how exercise can influence psychologic wellbeing and cognitive function.

Affect↗

Medical concerns of marathons.

One must remember that the first marathon runner, Phidippides, collapsed and died at the finish of his race. Fortunately, death has been an infrequent occurrence in modern day marathons. However, the physical exertion required to complete a marathon coupled with exposure to often harsh environmental conditions and an increase in the number of novice participants makes injuries inevitable. The medical team's main goal is to implement strategies to prevent serious injury and illness through pre-event planning, race day preparedness, and postevent evaluations. The three general categories of injuries encountered with marathon participation include medical conditions, musculoskeletal injuries, and dermatologic complaints. The focus of this article is on the evaluation and management of the varied medical concerns encountered on race day along with the essentials in prerace planning and preparedness.

Athletic Injuries↗

Medical coverage for track and field events.

Providing medical coverage at a track and field event is similar to other spectator events, but there are some important differences. With simultaneous events occurring over a large area, reliable communication with quick access to all event sites is mandatory. Preparation needs to include a prearranged emergency response plan for each event. Because field events involve throwing heavy and sometimes sharp objects (discus, hammer, shot put, and javelin) or landing in a cushioned pit (high jump, pole vault), sites need well-demarcated, constantly monitored boundaries with properly installed, well-maintained safety equipment. All personnel involved in monitoring these events should be educated on proper procedure in managing potential head or neck injuries. Event officials must also remained focused on their tasks, avoiding the distractions that simultaneous events can cause. Because most events are outdoors, appropriate protection and recovery sites for heat, cold, and sun exposure should be arranged.

Arm Injuries↗

Training principles and issues for ultra-endurance athletes.

Ultra-endurance competition is defined as events that exceed than 6 hours in duration. The longer events rely on long-term preparation, sufficient nutrition, accommodation of environmental stressors, and psychologic toughness. Successful ultra-endurance performance is characterized by the ability to sustain a higher absolute speed for a given distance than other competitors. This can be achieved through a periodized training plan and by following key principles of training. Periodization is an organization of training into large, medium and small training blocks which are referred to as macro-, meso-, and microcycles, respectively. When the sequencing of training is correctly applied, athletes can achieve a high state of competition readiness and during the months of hard training, avoid the overtraining syndrome. A plan is executed in accordance with the following principles of training: all-around development, overload, specificity, individualization, consistent training, and structural tolerance. Training relies heavily on the athlete's tolerance to repetitive strain. Today's ultra-endurance athlete must also follow appropriate nutritional practices in order to recover and prepare for daily training and remain injury free and healthy. Rehydration after exercise, together with the timing and method of increased food intake to cope with heavy training, are essential for optimal performance. Furthermore, the treatment of soft tissue after training or racing is necessary to control inflammation.

Adaptation, Physiological↗

Diagnosis, treatment, and rehabilitation of the thrower's elbow.

The overhead throwing motion generates enormous force in the elbow. Repetitive near failure loads lead to chronic adaptive changes and occasionally acute injury. The physician caring for the thrower must understand the complex anatomy and function of the elbow joint, along with the biomechanics of throwing, to accurately diagnose and treat elbow pathology. Evaluation of elbow pain in the throwing athlete must begin with a thorough and detailed throwing history including duration of symptoms, location of pain, timing during the phases of throwing motion, and associated symptoms. Physical examination should include inspection, range of motion, palpation, and specific tests to better define the pathology. A detailed history and physical examination will allow the astute clinician to obtain the proper diagnosis and start the appropriate operative or nonoperative treatment often without reliance on ancillary testing. Treatment and rehabilitation of these injuries must be tailored to the pathology present and focused towards a return to the athlete's activity.

Athletic Injuries↗