Musculoskeletal Injuries Research Paper

Preventing Musculoskeletal Injuries

The ultrasound field is a very physically involved field, from having to help move a patient into the proper position for scanning, having to hold awkward positions to work around a patient that is unable to move, and scanning itself is physical. The physicality of scanning is often the reason why the ultrasound field is commonly plagued with many musculoskeletal disorders. The diagnostic medical sonography field has a prevalence of musculoskeletal injuries of 81 percent. For this reason it is important to know the proper technique and exercises that can be done to help prevents musculoskeletal injuries. My goal in this paper is to bring understanding to what musculoskeletal disorders are and what can be

done to prevent the possibility of developing a musculoskeletal disorder.
The musculoskeletal system consists of muscles, tendons, ligaments, and bones.

Together it provides stability, protection, and shape to the body. Musculoskeletal disorders (MSDs) cover a wide range of injuries or disorders that affect the human body’s movement or musculoskeletal system. “The most common musculoskeletal disorders include: Carpal Tunnel Syndrome, Tendonitis, muscle and tendon strain, Tension Neck Syndrome, Rotator Cuff Tendonitis, and Radial Tunnel Syndrome, among many others.” (Middlesworth) These disorders can involve any form of damage to tendons, tendon sheaths, joints, muscles, blood vessels, and peripheral nerves. Symptoms of MSDs usually occur in the upper limbs and torso. Pain is the most common symptom it can occur either localized or general, usually in the neck, shoulders, and arms. Numbness usually occurs in the hands, wrists, and elbows. Weakness in the arms and swelling mostly in the wrist and hand are also symptoms. In severe cases, when the disorder becomes advanced loss of function can also occur. Most sonographers suffer a combination of symptoms and they are often related to high task repetition, forceful exertions, and repetitive and awkward positions that sonographers adopt during their

jobs.
In the field of diagnostic medical sonography, about 81% of sonographers suffer from some form of MSD. “There are two main processes that cause musculoskeletal injuries in sonographers. The overuse or strain of muscles may cause micro-tears at tendon insertions, resulting in ischemia and soft tissue breakdown. Venous return can also be obstructed causing enlargement of tendon sheaths resulting in scarring and compression if the nerves. When there is compression of the nerves loss of function can occur.” (Gregory 2) There are various factors that can cause musculoskeletal disorders in sonographers. Poor equipment design contributes to MSDs because of keyboard/ screen height, equipment maneuverability, and poor transducer grip. Poor posture and awkward scanning techniques can cause MSDs especially when having to work around a patient that is unable to move and having to stretch in order to scan certain parts of the body. Another cause is having to constantly sustain pressure and force to get a better image. Also, repetitive motions can cause MSDs. Scanning is a constant and repetitive motion and most of the time there is a repeat of the same exams that a sonographer has to perform daily. “Advances in technology, mostly the automatic film developing and filmless storage devices, have increased the time that sonographers are spending actually scanning because these advances have reduced the amount of time needed in between patients. (Sound Ergonomics 1) Inadequate work breaks that do not allow enough recovery time for the sonographer increases the risk of MSDs occurring. And finally, job stress.
It is important to know what can be done in order to prevent MSDs from occurring. Using supportive cushions or wrist bands can help to alleviate some pain or prevent the injury from worsening. There are many strengthening exercises and stretches that can be done to prevent injuries from occurring. According to the journal article Sonographer Occupational Musculoskeletal Disorders: What They Are and How Can They Be Prevented by Sound ergonomics, 76% MSDs occur in the shoulder, 74% in the neck, 59% in the wrist, 55% in the wrist/fingers, and 58% in the upper and lower back. The risk for MSDs in the shoulder is mostly likely due to the awkward positions, mainly right shoulder flexion and abduction, being done when maneuvering the transducer. Placing one arm slightly away from the body and trying to raise the arm out to the side while resisting the motion with the other arm is an exercise that can be done to strengthen the muscles used during shoulder abduction. Hand and finger strengthening can be done by squeezing progressive putty, which increases resistance as squeezing strength increases. Wrist flexor and extensor stretching can be done by grasping one hand and slowly bending the wrist up or down until a stretch is felt. The neck is also an area most affected by MSDs. “Standard positioning of equipment results in twisting of the neck to view the mon¬itor, flexion and abduction of the shoulder, and extension of the elbow while operating the controls.”(CDC) An exercise that can be done to stretch the neck and spine is to sit upright and clasp both hands around elbows. Retract the cervical spine then slowly bend forward, one segment at a time, until neck and upper back are rounded and elbows are dangling toward the floor. Let shoulder blades separate and reach for the floor. There are other exercises that can be done to help prevent injuries in the neck, back, shoulder, hands, and wrists. It is recommended to do these exercises at least three times daily or as recommended by a physician. An important step in preventing musculoskeletal injuries is becoming aware of what activities are causing the pain, learning to change those activities, and learning what can be done to prevent future injuries from occurring.