The wrist
Ashley W. Blom, David Warwick, Michael R. Whitehouse in Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Inappropriate terms such as repetitive stress injury and cumulative trauma disorder have been used in the past for a controversial syndrome comprising ill-defined and unusually disabling pain around the wrist and forearm (and sometimes the entire limb) which is usually ascribed to a particular work practice. There is no good evidence to suggest that using the hands causes harm – after all, training makes muscles and tendons less vulnerable to damage. Exceptions include excessive vibration which can lead to carpal tunnel syndrome and hand–arm vibration syndrome (neurological damage to the fine nerves supplying the fingertips and Raynaud’s phenomenon). Other defined and treatable conditions such as carpal tunnel syndrome, thumb base arthritis, tenosynovitis from sudden unaccustomed use and de Quervain’s should be excluded and treated accordingly. Epidemiological studies suggest that these conditions are no more common among keyboard operators than in the general population. What has fuelled the controversy surrounding the ‘occupational’ disorders is their apparent severity and intractability compared with other types of overuse syndrome and the potential rewards for successful litigation. There are often social and psychological aspects which confound the picture. The term ‘work-relevant upper limb disorder’ is preferred as it acknowledges that the symptoms are noticed at work but it does not imply causation.
Standard Quality Control Testing, Virus Penetration, and Glove Durability
Robert N. Phalen, Howard I. Maibach in Protective Gloves for Occupational Use, 2023
Other findings have implications for the design and conduct of cyclic fatigue tests, especially in terms of the correctness of simulating actual clinical tasks. Powell et al.70 were concerned about the impact of glove fit on the progression of transient hand discomfort to a cumulative trauma disorder (CTD). Their experimental design was to have dental hygienists (n = 176) successively don an appropriately sized ambidextrous glove and have the first-to-the-fourth interknuckle distance measured while simulating prehensile grasp of an instrument; then repeat the procedure with a fitted glove. Although the Powell et al. results do not lead to a position about cyclic fatigue of glove material per se, their results contribute to a better understanding of the difference in relative risk of crack nucleation (or propagation) between ambidextrous and fitted examination gloves. Their compressive force calculations suggest that the ambidextrous gloves impose a 32.7% additional load onto the material area of concern as compared to their paired, fitted counterparts. They found that the percent elongation across the knuckles of an ambidextrous glove—with the hand in prehension—was 32.9% greater than that measured across a fitted glove (α > 0.9999).
Fascia and the Circulatory System
David Lesondak, Angeli Maun Akey in Fascia, Function, and Medical Applications, 2020
Fascia plays an important role in vascular regulation in the lower leg; the pressure created by fascia compartments and blood supply requires a stable balance. The deep fascia of the leg, especially that of the posterior compartment, constrains the muscles as they contract to generate pressure that pumps blood through the valved veins.29 Muscular and fascial weakness can diminish the pump and result in venous insufficiency.30 Conversely, compartment syndrome develops when venous drainage is impaired, but arterial flow remains normal. This can be due to acute or repetitive strain injury. Increased fascial thickness and stiffness has been found in conjunction with chronic anterior compartment syndrome.31,32 Although fasciotomy is indicated in some cases of chronic exertional compartment syndrome, it does diminish the calf muscle pump action and may increase the risk for venous insufficiency.33 Another interesting connection between fascia and the vasculature in the lower leg is the uncommon case of muscle herniation through the epimysium, suggested to occur at sites of vein perforation, which is often mistaken for varicosity or hematoma.34 Although usually asymptomatic, a case report of peroneus longus herniation resulted in burning sensations.35
Measuring static muscular strength among female operatives: a cross-sectional comparison in different handicraft occupations
Published in International Journal of Occupational Safety and Ergonomics, 2021
Ashish Kumar Singh, Makkhan Lal Meena, Himanshu Chaudhary
Handicraft manufacturing is a traditional artistic activity and shares some common work characteristics such as the involvement of the lower arm, hand–eye coordination and fine dexterity of the worker [1]. Depending on the nature of the job and design of the hand tool, handicraft operatives can be exposed to awkward posture, forceful gripping, high repetitiveness and hand–arm vibration (HAV) hazard. These variables are directly associated with the symptoms of cumulative trauma disorder (CTD) [2–5]. Safety guidelines for the upper extremities could prevent workplace injuries and reduce the risk of CTD [6]. This research is concerned with the relative causes for the loss of static strength that are associated with holding a poorly designed hand tool or materials against a mechanical process.
Evidence of rotator cuff disease after breast cancer treatment: scapular kinematics of post-mastectomy and post-reconstruction breast cancer survivors
Published in Annals of Medicine, 2022
Angelica E. Lang, Stephan Milosavljevic, Clark R. Dickerson, Catherine M. Trask, Soo Y. Kim
Rotator cuff disease is most often a repetitive strain injury, with onset due to overuse and cumulative damage to the rotator cuff tendons [9]. Shoulder biomechanics are considered to play an important role in the development rotator cuff disease, with the injury often initially appearing as supraspinatus impingement [10]. Both humeral and scapular kinematics may contribute to impingement, with the accepted notion that altered kinematics may reduce the subacromial space, causing repeated damage to the bursal side of the tendon [9]. Humeral kinematic changes are often a result of fatigue and lack of endurance of the rotator cuff muscles causing the humeral head to migrate upwards [11], while scapular kinematic changes, often termed “dyskinesis”, can manifest in altered scapular motion in all scapular angles. Reduced upward rotation and increased scapular internal rotation are the common alterations observed in persons with rotator cuff disease [12,13]. However, results are inconsistent [12,14,15] and it is not clear if the scapular kinematic alterations are the cause or result of the injury and pain.
An exploratory ergonomic evaluation of musculoskeletal risks for ophthalmic photographers who use ophthalmic imaging equipment plus user equipment trials
Published in Journal of Visual Communication in Medicine, 2023
Repetitive Strain Injury (RSI) is a general term used to describe the pain felt in muscles, nerves and tendons caused by repetitive movement and overuse. There are certain areas that are thought to increase the risk of developing RSI which include repetitive activities, performing high-intensity activity without a break, and poor posture that involves working in an awkward position. The symptoms of RSI can range from mild to severe. They usually develop gradually and often include pain, aching or tenderness, stiffness, throbbing, tingling or numbness, weakness, and cramp. The symptom may only be noticeable when repetitive actions are being carried out (NHS Repetitive Strain Injury (RSI), 2022). The HSE lists Upper Limb Disorders (ULD) as aches and pains in the shoulders, arms wrists, hands, and fingers and the neck. Working environments that might cause ULDs include assembly line and work with computers where the task involves prolonged repetitive actions, particularly using the same hand or arm action, uncomfortable or awkward working postures and carrying out tasks for a long time without suitable breaks (Health and Safety Executive - Upper limb disorders, 2022). MSD’s can comprise of Work-Related Upper Limb Disorders (WRULD) due to repetitive tasks. WRULD are listed as chronic injuries such as tenosynovitis and carpal tunnel syndrome as a result from performing repetitive tasks (Health and Safety Executive Musculoskeletal disorders (MSDs), 2022).
Related Knowledge Centers
- Musculoskeletal System
- Nervous System
- Musculoskeletal Disorder
- Tendinopathy
- Carpal Tunnel Syndrome
- Ulnar Nerve Entrapment
- De Quervain Syndrome
- Thoracic Outlet Syndrome
- Intersection Syndrome
- Golfer'S Elbow