Chiropractic in the Workplace: Combating Repetitive Motion Injuries

Journal of the American Chiropractic Association, Aug 2004

A few other design and environmental options to minimize repetitive motion injuries, Dr. Sweere suggests, include the following:

* Allowing, even encouraging, worker rotation from one workstation or series of activities to another;

* Providing appropriately sized tools (all workers' hands are not the same);

* Powering systems with motors, not with muscles, whenever possible;

* Designing tasks to allow the worker to use his or her strongest posture;

* Providing shock mats for standing workers; and

* Providing sit/stand options for workers when possible.

What Qualifies as Repetitive?

But just what are "repetitive" motion injuries? According to occupational health expert Scott Bautch, DC, DACBOH, the definition can vary worker by worker. "We've struggled for years to define 'repetitive.' If you look at what decreases the recovery time from repetitive strain injuries-occupational or otherwise-there is a certain percentage of the population who have added risk factors," he explains. "As a consequence, they may not recover from the same amount of trauma that another worker would recover from. Or we may have a repetitive motion injury with very little trauma."

Dr. Bautch explains that there are other factors that have to be taken into consideration. Think about it: if you've been working with your hands a lot and have strong, callused hands, you can chop wood or rake leaves for hours and not get a blister. Someone with pampered hands and soft, smooth palms could rake leaves for an hour and get an enormous blister. "The joints are the same way," says Dr. Bautch. "If they're not in good shape going into an activity, they become problematic in a hurry."

Among the lifestyle and health factors that may set the bar significantly lower for repetitive motion injury are:

* Smoking

* Poor nutrition

* Low fitness levels

* Existing illness

* Pregnancy

* Structural imbalance (subluxation)

* Inadequate hydration

* Emotional stress

* Sleep deprivation.

The Army learned this lesson the hard way, Dr. Bautch says. Running recruits through the same standardized training program led to too many medical discharges. "A lot of young people who joined weren't in good shape when they started," he explains. "They had to establish a ramped-up training program that dealt with the fact that people come in at all different levels of ability. It's the same whether it's an industrial setting, an office, a sports setting, or whatever: each person comes in at a different level of susceptibility to injury. You need to start your training at a level that the most susceptible person can handle, then ramp it up to train more aggressively."

When Dr. Bautch consults with a company, he uses a standard scale to score new employees based on their susceptibility to injury. "We also rank jobs, from low to medium to high intensity, depending on how long it takes to ramp the average person up to the speed you need from them." For example, someone who has to type 10 words per minute probably doesn't need a lot of preparation, but a worker who must type 100 words per minute for 8 hours a day will.