CUMULATIVE TRAUMA DISORDER

BY AMRITA L. TOMAR MPT (CBR)

DEFINITION
CTD is described as wear and tear on joints & surrounding tissue because of overuse It is a reverse term for acute injuries Cumulative means accumulate through time

 Most common CTDs are: Finger digital neuritis Trigger finger DeQuervains disease Wrist Tendinitis Carpal tunnel syndrome Guyon tunnel syndrome

 Elbow Epicondylitis Radial tunnel syndrome

Shoulder
Thoracic outlet syndrome Rotator cuff tendinitis

 Neck Tension neck syndrome Posture strain Back Degenerative disc disease Herniated discs Mechanical back syndrome Ligament sprain Muscle strain

 legs
suprapatellar bursitis

Patellar synovitis
Phlebitis

Shin splints
Planter fascitis Trochanteric bursitis

Symptoms of CTDs in general include :

Soreness, pain & discomfort

Limited ROM
Stiffness in joints Numbing, tingling sensation Popping and cracking noises in the joints Burning sensations

Redness & swelling

Weakness & clumsiness

Risk factors:
developing a disorder)

(greater

the exposure to each,the higher is the chance of

Factors Working conditions (physical) repetition force Awkward postures Contact stress vibration Temperature extremes

Risk

no. of motions made per day by a particular part of body Exertion required to make these motions Position of the body that deviate from neutral in making these motions Excessive contact between sensitive body tissue & sharp edges or surfaces or tools Exposure to vibrating tools either hand held or whole body Excessive heat or cold

Factors

Risk

(Work organization)

Stressful condition

Stressful situations related to management & administrative systems

Personal issues

Off-the-job activities

Home or leisure activities

Physical condition

Poor personal fitness

Other diseases

e.g. Gout or diabetes mellitus

Other factors
Gender Previous injuries Physical stature Stress / attitude

Cost of cumulative trauma

Workers compensation Turnover Absenteeism Morale Product defects Production barriers Red tape OSHA fines

Prevention/Management
Ergonomics Medical management

Ergonomics
1. Retention of natural spine curvature : to protect the spine by absorbing shock & preventing it from undue compression & shearing forces. 2. Rolling in bed : rolling with maintaining neutral spine by performing drawing-in maneuver and then roll the trunk as a unit

3. Supine to sit : turn side lying by log maneuver Flex the hip & knee simultaneously & draw bend knees forward over the edge of the bed Gradually lift trunk to sitting by supporting on both

the hands & simultaneously bridging the legs

down keeping the knees and feet together. Head & feet remain in straight line throughout & trunk forward bending should be strictly avoided

4. Sitting : Seat should be of the length of the thigh & buttock Height of the seat = dist. From heel to knee so hip & knee should be at right angle Allow the feet to comfortably rest on floor or foot stool

Contour of chair back should match the neutral spinal

curve Avoid legs to dangle Chair should have arm support If the person has exaggerated lumber lordosis then

5. Standing from chair:

use arm chair as it reduces wt. on lumber

region
While getting up from sitting position first

move to the front of the seat, stand up by

straightening the knees

Maintain lumber lordosis without bending

forward

7. Forward bending
8. Lifting 9. Carry weight

10. Crouching
11. Avoid sustained wrong postures

12. Standing (long period)

13. Walking 14. Pushing

15. Reaching
16.Sleeping

17.Activities in mid range

18. Alternate activities 19. warm-up and stretching before activities 20. Take frequent breaks 22. Respect pain 23. Recognize early signs of inflammation

Work-station exercises

Warm-up stretching

MEDICAL MANAGEMENT
Drugs NSAIDs, Surgeries