A Sports Medicine Approach to Overuse Injuries in
- Slides: 40
A Sports Medicine Approach to Overuse Injuries in the Workplace Presented by Jeffrey Pearson, D. O. San Marcos, California www. medicine-in-motion. com
Sportsmedicine u Medicine in motion
The “Industrial Athlete” u Applying the principles of sportsmedicine to the evaluation and treatment of injured workers.
The “Industrial Athlete” u Advantages v Faster, more efficient return to participation v enhances self-esteem of injured worker v Team physician concept
Humans are machines u Underlying structure u electrical system u plumbing u pulleys u energy plant u thermostat
Review of anatomy u bones v joints/synovial linings u ligaments u muscles/tendons v synovial sheaths
The Cycle of Overuse Overloading Tissue injury Continued activity Inflammation Pain Rest - healing
Overuse: force vs. time u Effects of force (intensity) v jumping from chair to floor v jumping from significant height u acute overuse
Overuse: force vs. time u Effects of time (duration) v walking around the block v hiking the Continental Divide u chronic overuse v cumulative trauma
Common types of overuse injuries u Tendons v de Quervain’s tenosynovitis v extensor tendonitis/lateral epicondylitis v rotator cuff impingement u Nerves v carpal tunnel syndrome v cubital tunnel syndrome
Common types of overuse injuries u Bone and joints v stress fractures v degenerative arthritis u Connective tissues v plantar fasciitis
Grading overuse injuries u Grade I (most mild) v symptoms occur generally only after activity or at night. u May keep hands under pillow.
Grading overuse injuries u Grade II v symptoms occur during activity, but do not interfere with performance of tasks.
Grading overuse injuries u Grade III v symptoms occur during activity and do interfere with performance.
Grading overuse injuries u Grade IV v symptoms so bad unable to use the affected part.
Treatment of overuse injuries u General principles v flexibility v strength v endurance
Treatment of overuse injuries u Acute phase v PRICES u Protection u Rest u Ice u Compression u Elevation u Support
Ice is Nice!
Treatment of overuse injuries u Grade I v Reduce intensity or duration of activity by 25%. More diligent stretching. Ice following activity. v Follow the 10% per week rule. u Sudden, excessive overtime is a sure-fire recipe for overuse complaints because the workers do not have an opportunity to build up their endurance prior to the extra work.
Treatment of overuse injuries u Grade II v Reduce intensity or duration of the activity by 50%. v NSAIA’s v Counterforce bracing v Consider physical therapy u flexibility, endurance, eccentric strengthening
Treatment of overuse injuries u Grade III v "Active" rest: the worker should stop performing the offending tasks, but is allowed to move the affected part for his daily activities. v Physical therapy v Consider steroid injection
Treatment of overuse injuries u Grade IV v Complete rest of the affected part, usually involving the use of some sort of sling or splint v If all else fails, consider surgical options.
Sports Medicine Pearls u Healthy people perform better than sick people. v Difficult to win Super Bowl with team of injured athletes u Athletes perform better when using the right equipment v Difficult to run marathon if shoes too big or too small
Sports Medicine Pearls u Training/conditioning v Should progress gradually v Example: return to running program u cycling 45 minutes u walk 2 miles in 30 minutes u alternate jogging/walking u gradually increase speed/intensity/distance – increase by 10% per week maximum
Sports Medicine Pearls u Training/conditioning v In the workplace, consider: u Increase duration of a specific task gradually, e. g. an hour/day/week. u alternating tasks/departments every few hours.
Sports Medicine Pearls u Work smartly with proper ergonomics v concept of neutrality
Sports Medicine Pearls u Maintain flexibility v stretches every 2 hours (approximately) v slow and controlled movements
Sports Medicine Pearls u Decrease unnecessary forces to body v footwear u Vibram rubber soles v shock mats
Summary u We have only one body/machine that needs to last us for our entire lifetime. u Taking good care of the machine helps to ensure that it will not break down as much and last a long time.
Thank you! (And enjoy your stay in San Diego!)
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