Repetition is the Mother of... Injury!

What do the following people have in common: a musician practicing his cello for several hours a day, an assembly line worker performing a given arm motion over and over, a tennis player refining her skills and a materials handler lifting heavy boxes all day? They are all at risk for musculoskeletal stress in the form of overuse and repetitive motion injuries.

Overuse and repetitive motion injuries

Our bodies are made for movement, but they are not designed to withstand the repetition of a given motion over and over, all day long. When you repeat the same motion for extended periods, you may overstress the joint or joints responsible for that motion. This can result in damage to associated muscles, tendons, nerves and other structures. In athletics, these injuries are known as overuse injuries, while in the workplace they are known as repetitive motion injuries.

Risk of repetitive motion injury increases when repetitive motions are coupled with poor posture and body mechanics (such as lifting heavy objects improperly), which put excess strain on joints. Joint stress also increases when you apply force with motion, such as when returning a powerful serve in tennis, or lifting heavy materials.

What are the most common joints involved in these injuries?

Joints at highest risk are those that are the weakest. Wrists, backs, elbows, shoulders and necks are the most common sites of repetitive motion injuries.

What are the symptoms of a repetitive motion injury?

Repetitive motion injuries usually develop slowly over a long period, and are similar to overuse injuries such as "shin splints" and tendinitis, which are associated with exercise. They typically begin with mild to moderate discomfort in the affected joints, especially at night. Other symptoms include swelling in the joint, muscle fatigue, numbness and tingling. Early symptoms may come and go at first, gradually becoming constant.

Symptoms of more advanced damage include more intense pain, muscle weakness and nerve problems. If left untreated, repetitive motion injuries can be extremely painful and severely limit movement. Fortunately, since they develop slowly, most repetitive motion injuries are discovered early enough to be successfully treated. The earlier treatment begins, the faster your recovery.

What treatment is recommended for repetitive motion injuries?

Each injury is different, so if you suspect you are developing an overuse or repetitive motion injury, it's important to see your physician for an accurate diagnosis. If your injury appears to be due to repetitive motion, you will want to determine which motions or activities are causing the stress. Be sure to look at your exercise program, as well as the demands imposed by your work; both can produce or exacerbate joint stress.

Some workplaces hire specialists in ergonomics to help workers analyze the physical demands of their jobs and to perform their jobs more efficiently with less physical strain. Just as coaches help athletes use correct biomechanics to avoid injury, specialists in ergonomics train workers to perform their jobs in ways that avoid injury. For example, they teach workers how to lift correctly, so that the least amount of musculoskeletal strain is produced. They teach good posture and typing mechanics to people who sit at a computer terminal all day.

Medical treatment is often required for repetitive motion injuries, and usually includes use of pain relievers, ice, rest and physical therapy to increase the strength and flexibility of the injured area.

Does exercise help?

Exercise should be used as treatment only when prescribed as part of a comprehensive rehabilitation program. Exercise can exacerbate the injury and delay healing if it places additional stress on already overstressed tissue. If you are treating an injury, be sure to follow the instructions of your health care providers. If exercise therapy is part of your rehabilitation program, proceed slowly and gently. Once the injury is fully healed, an appropriate conditioning program that includes exercises for increasing strength and flexibility can help prevent repetitive motion injury in the future.

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