Musculoskeletal injury

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Musculoskeletal injury
Rotator cuff tear.jpg
A rotator cuff tear injury results in the muscles, ligaments and tendons being disturbed which in-turn restricts regular movement.
Specialty Physiotherapy
Symptoms Mild to severe aches and pains, numbness, weakness, tingling and atrophy
Complications Loss of movement, disability
DurationDependent on injury, 2-10 weeks [1] [2]
Types Bone, muscle, ligament and tendons
Causes overuse, incorrect posture, car accidents, high impact collisions
Risk factors Long term disability
Diagnostic method Pain and numbness
PreventionMaintain correct posture, limit
TreatmentHeat and cold packs, immobilisation, rest
DeathsUnknown

Musculoskeletal injury refers to damage of muscular or skeletal systems, which is usually due to a strenuous activity and includes damage to skeletal muscles, bones, tendons, joints, ligaments, and other affected soft tissues. [3] [4] In one study, roughly 25% of approximately 6300 adults received a musculoskeletal injury of some sort within 12 months—of which 83% were activity-related. [3] Musculoskeletal injury spans into a large variety of medical specialties including orthopedic surgery (with diseases such as arthritis requiring surgery), sports medicine, [5] emergency medicine (acute presentations of joint and muscular pain) and rheumatology (in rheumatological diseases that affect joints such as rheumatoid arthritis).

Contents

Musculoskeletal injuries can affect any part of the human body including; bones, joints, cartilages, ligaments, tendons, muscles, and other soft tissues. [1] Symptoms include mild to severe aches, low back pain, numbness, tingling, atrophy and weakness. [1] [2] These injuries are a result of repetitive motions and actions over a period of time. [6] Tendons connect muscle to bone whereas ligaments connect bone to bone. [7] Tendons and ligaments play an active role in maintain joint stability and controls the limits of joint movements, once injured tendons and ligaments detrimentally impact motor functions. [2] [8] Continuous exercise or movement of a musculoskeletal injury can result in chronic inflammation with progression to permanent damage or disability. [9]

In many cases, during the healing period after a musculoskeletal injury, a period in which the healing area will be completely immobile, a cast-induced muscle atrophy can occur. Routine sessions of physiotherapy after the cast is removed can help return strength in limp muscles or tendons. Alternately, there exist different methods of electrical stimulation of the immobile muscles which can be induced by a device placed underneath a cast, helping prevent atrophies [10] Preventative measures include correcting or modifying one's postures and avoiding awkward and abrupt movements. [1] It is beneficial to rest post injury to prevent aggravation of the injury. [11]

There are three stages of progressing from a musculoskeletal injury; Cause, Disability and Decision. [12] The first stage arises from the injury itself whether it be overexertion, fatigue or muscle degradation. [12] The second stage involves how the individual's ability is detrimentally affected as disability affects both physical and cognitive functions of an individual. [12] [9] The final stage, decision, is the individual's decision to return to work post recovery as Musculoskeletal injuries compromise movement and physical ability which ultimately degrades one's professional career. [12]

Repetitive use injuries

Injury can be described as a ‘mechanical disruption of tissues resulting in pain.' [13] Despite the fact tissues can self-repair, muscle degradation occurs after repeated and prolonged use. [13] Overuse and strain injuries can occur at work, physical activity and daily life. [11] Repetitive motions strain our musculoskeletal systems, if continued in an improper form can result in chronic inflammation with progression to permanent damage. [1] [6] These injuries can compromise an individual's posture or other physical abilities, including fine motor movements. [6] [1]

Nerves play an important role in repetitive strain injuries as it is nerves that get pulled in injured soft tissues ultimately affecting motor functions. [2] Pressure on the nerve will impair blood flow which can impair either distal or proximal points to the first injury and cause pain. [8] Tendons connect muscle to bone whereas ligaments connect bone to bone. [7] Tendons and ligaments play an active role in maintain joint stability and controls the limits of joint movements, once injured tendons and ligaments detrimentally impact motor functions. [14] [2] Injuries associated with repetitive-use activities include: tennis elbow, tendonitis, wrist injuries, myelopathy, low back injuries and lower leg and ankle injuries. [1]

Repetitive use injuries are a result of rapid and continuous movements, long duration postures without adequate support. [1] Excessive muscle use results in fatigue which limits movement of limbs. [14]

Forms of musculoskeletal injuries

An acute injury can be traced back to a specific incident, causing immediate pain and often swelling. [15] [16] On the other hand, a Chronic injury does not have a distinct origin, it develops slowly, is persistent and long lasting, and it is accompanied by dull pain, aches or soreness. [15]

Broken Metacarpals from a high impact fall. Metacarpal fractures.jpg
Broken Metacarpals from a high impact fall.

Neck and shoulder injury

The shoulder is a joint which allows your arm to move [2] Poor posture can lead to nerve damage. [2] Repetitive shoulder movements, overhead, swinging, throwing or circling movement can cause musculoskeletal injury. [16] Some cases can result in spinal cord damage at the C3-C5 levels, producing a myelopathy which can dramatically compromise overall movements in arm and legs as well as other fine motor functions. [1] Injury to the rotator cuff Is a result of trauma and old age, complete and partial tears are more frequent in older patients caused by degeneration of the tendons. [7]

Wrist and hand injury

Wrist mobility is often restricted due to inflammation of the forearm muscles as they contract and tighten due to injury. [2] Most wrist dislocations occur between the capitate and the lunate. [17] [18] Carpal fractures are caused by falling on an outstretched hand the wrist is hyper-extended in ulnar deviation with a component of rotation. [18] Swelling of the Median nerve tissue leads to nerve entrapment ultimately resulting in restriction of movement, other symptoms include; pain, numbness and weakness. [1] DeQuervain's Tenosynovitis is a form of tendinitis of the muscles that move the thumb. [2]

A neck injury associated with high impact vehicle crashes Whiplash Injury.jpg
A neck injury associated with high impact vehicle crashes

Leg and foot injury

Most leg pain is transferred pain from our backs or hips. [1] Foot injuries including plantar fasciitis is another source of pain which is associated with-standing for long periods. [1] [6] There are three major tendons that maintain stability at the ankle joint; anterior extensors, medial flexors and lateral peroneal, these tendons facilitate movement around the ankle, foot and toes. [18] Malleolar fractures are related to ankle twisting or shearing injury, these fractures are often associated with ligament injury. [18] An ankle sprain can lead to a spectrum of soft tissue impingement reducing motion in the ankle. [18]

Spinal and neck injury

The spinal column has five sections consisting of thirty three individual vertebrae separated by cushioning discs, the upper three sections are movable and the lower two are fixed. [2] Nerve compression is a result of poor posture, prolonged computer use is an example of repetitive strain injury which affects the musculoskeletal system. [16] [2] Whiplash injury, whereby the force causes strain to the capsule and ligaments of the apophyseal joints of the cervical spine. [7] Hyper-flexion is a common mechanism of injury in the cervical spine associated with an anterior compression vector and a posterior distraction vector. [18] These injuries are associated with diving injuries, falls and car accidents. [18] Anterior compression vector results in mild height loss, whereas hyper-extension often occurs with the posterior displacement of the head in car crashes. [18] Severe hyper-extension injury leads to pinching of the spinal cord along the posterior margin of the body. [18]

A common form of strain on ligaments and tendons in the arm. Tennis Elbow.png
A common form of strain on ligaments and tendons in the arm.

Elbow injury

The upper arm and the forearm meet to form the elbow joint. [2] Examples of injuries affected on an elbow include; Carpal tunnel syndrome, Radial Tunnel Syndrome and tennis elbow, all of which are due to tendon and ligament damage from overuse or strain. [7] [2] Distal humeral fractures are related to high energy trauma from falling from a height or in a motor vehicle accident, this results in stiffness and restricted range of motion. [18] Elbow dislocation and radial head or neck fractures are common when one falls on an outstretched hand. [18] Elbow Dislocations are divided into two categories; Simple and complex. Simple dislocations are defined as soft tissue injury whereas complex involves a fracture. [18]

Injury prevention

This demonstrates (A) a well-aligned person whose balance is maintained and whose line of gravity falls within the base of support. Diagram (B) demonstrates how balance is not maintained when the line of gravity falls outside the base of support, and diagram (C) shows how balance is regained when the line of gravity falls within the base of support. Centre of Gravity.png
This demonstrates (A) a well-aligned person whose balance is maintained and whose line of gravity falls within the base of support. Diagram (B) demonstrates how balance is not maintained when the line of gravity falls outside the base of support, and diagram (C) shows how balance is regained when the line of gravity falls within the base of support.

Preventing injuries to workers is essential to maintain an effective organisational management. [20] Repetitive injuries can be prevented by early medical intervention as an effective way to prevent permanent injury. [1] Injuries can be prevented by understanding proper body mechanics. [19] Correcting one's postures, avoiding abrupt and awkward movements will avoid acute injury. [1] Taking breaks to change your position and moving about instead of remaining static can also reduce risk of injury. [21] Daily body stretches can help elevate pain from hamstrings, back and neck. [16] Creating healthy awareness through social media and celebrities further allow individuals to create healthy practices which ultimately prevent injury. [22] [23] It is essential for a work environment to comply with safety standards. Workplaces should have upper management implement safety precautions making health and safety the primary goal. [20] Implementation of company policies and procedures in case of serious incident or fatality. [20] Other strategies such as substances abuse programs are effective at reducing the potential for injuries. [20]

If musculoskeletal injuries are not prevented, they can develop and become debilitating. [1] Heat and cold are used to facilitate the healing process, if applied immediately after an acute injury or overuse strain, it will reduce pain and swelling. [8] A healthy workspace is also substantially important including; floor surfaces, ergonomic seating, working heights, working rates and task variability. [16] Understanding the symptoms of repetitive strain injuries such as; Numbness of arms, hands or legs, aches and pains of joints, shoulder and back pain and tingling or burning of arms, legs and feet, allow an individual to self-diagnose and seek medical attention to prevent further aggravation. [1] Pain is the body's natural way to alert an individual to rest. [2] It is important to rest, if ignored can lead to further problems. It is crucial not to further aggravate the injury and compromise one's physical movement as it can detrimentally impact general health. [16] Sustaining a secondary injury has a large risk whilst recovering from an initial injury. [21]

Injury recovery

Injuries often limit physical activity and result in immobilisation which is a significant factor in recovery. [16] [15] Symptoms vary from, numbness, tingling, atrophy and weakness which can ultimately lead to permanent damage and disability. [9] [2] Neural injury recovery in acute strokes are compensated with the help of medical drugs. [24]

Stretching promotes blood circulation and decreases muscle tension. Pilates-hamstring-stretch.jpg
Stretching promotes blood circulation and decreases muscle tension.

Repeating motions and actions whilst performing an activity increases an individual's risk of accumulating acute musculoskeletal injuries. Factors that affect sustaining these injuries include; duration of activity, the force required to complete the activity, the environment of the workplace and work postures. [1] [16] Although, specially advised exercises with stretching promotes blood circulation and increase range of motion and ultimately help decrease muscle tension. [14]

Our immune system is our natural mechanism which manages injuries to the musculoskeletal system. Inflammation, redness, swollen tissue are all part of the healing process, during this process new cells are generated to form new tissue. [15] [8] Macro-nutrients are essential components for tissue regeneration. [15] Proteins, carbohydrates and fats are crucial for new muscle tissues. Water allows all biochemical processes to take place including, elimination of waste and toxins via sweat and urination. [16] [15]

On the other hand, Micro nutrients include; vitamins, minerals, enzymes, protect cells and DNA from oxidation damages which is evident in the inflammation response and recovery process. [15]

Decision to return to work

Recovery is enhanced by doing activities that make an individual feel better. [25] Recovery from an injury also consists of returning to work or physical exercise. Employers are legally required to provide suitable duties for the person returning to work. [26] It is important to get medical advice on when to return to work. [12] It is important to consider the physical demands of the job, the work environment when deciding to return to work. [27] Once you are approved to return to work or physical exercise it is crucial to maintain both physical and psychological relapse. [12] [1]

See also

Related Research Articles

<span class="mw-page-title-main">Repetitive strain injury</span> Medical condition

A repetitive strain injury (RSI) is an injury to part of the musculoskeletal or nervous system caused by repetitive use, vibrations, compression or long periods in a fixed position. Other common names include repetitive stress injury, repetitive stress disorders, cumulative trauma disorders (CTDs), and overuse syndrome.

<span class="mw-page-title-main">Sports injury</span> Physical and emotional trauma

Sports injuries are injuries that occur during sport, athletic activities, or exercising. In the United States, there are approximately 30 million teenagers and children who participate in some form of organized sport. Of those, about three million athletes age 14 years and under experience a sports injury annually. According to a study performed at Stanford University, 21 percent of the injuries observed in elite college athletes caused the athlete to miss at least one day of sport, and approximately 77 percent of these injuries involved the knee, lower leg, ankle, or foot. In addition to those sport injuries, the leading cause of death related to sports injuries is traumatic head or neck occurrences.

<span class="mw-page-title-main">Knee</span> Leg joint in primates

In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia, and one between the femur and patella. It is the largest joint in the human body. The knee is a modified hinge joint, which permits flexion and extension as well as slight internal and external rotation. The knee is vulnerable to injury and to the development of osteoarthritis.

<span class="mw-page-title-main">Tendinopathy</span> Inflammation of the tendon

Tendinopathy is a type of tendon disorder that results in pain, swelling, and impaired function. The pain is typically worse with movement. It most commonly occurs around the shoulder, elbow, wrist, hip, knee, or ankle.

<span class="mw-page-title-main">Shoulder problem</span> Medical condition

Shoulder problems including pain, are one of the more common reasons for physician visits for musculoskeletal symptoms. The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. This instability increases the likelihood of joint injury, often leading to a degenerative process in which tissues break down and no longer function well.

<span class="mw-page-title-main">Sprain</span> Damage to one or more ligaments in a joint

A sprain is a soft tissue injury of the ligaments within a joint, often caused by a sudden movement abruptly forcing the joint to exceed its functional range of motion. Ligaments are tough, inelastic fibers made of collagen that connect two or more bones to form a joint and are important for joint stability and proprioception, which is the body's sense of limb position and movement. Sprains may be mild, moderate, or severe, with the latter two classes involving some degree of tearing of the ligament. Sprains can occur at any joint but most commonly occur in the ankle, knee, or wrist. An equivalent injury to a muscle or tendon is known as a strain.

<span class="mw-page-title-main">Human musculoskeletal system</span> Organ system that gives humans the ability to move by using their muscular and skeletal systems

The human musculoskeletal system is an organ system that gives humans the ability to move using their muscular and skeletal systems. The musculoskeletal system provides form, support, stability, and movement to the body.

A soft tissue injury is the damage of muscles, ligaments and tendons throughout the body. Common soft tissue injuries usually occur from a sprain, strain, a one-off blow resulting in a contusion or overuse of a particular part of the body. Soft tissue injuries can result in pain, swelling, bruising and loss of function.

<span class="mw-page-title-main">Strain (injury)</span> Injury due to slight tearing of a muscle or tendon

A strain is an acute or chronic soft tissue injury that occurs to a muscle, tendon, or both. The equivalent injury to a ligament is a sprain. Generally, the muscle or tendon overstretches and partially tears, under more physical stress than it can withstand, often from a sudden increase in duration, intensity, or frequency of an activity. Strains most commonly occur in the foot, leg, or back. Immediate treatment typically includes five steps abbreviated as P.R.I.C.E.: protection, rest, ice, compression, elevation.

<span class="mw-page-title-main">Flexibility (anatomy)</span> Anatomical range of movement of a joint or series of joints

Flexibility is the anatomical range of movement in a joint or series of joints, and length in muscles that cross the joints to induce a bending movement or motion. Flexibility varies between individuals, particularly in terms of differences in muscle length of multi-joint muscles. Flexibility in some joints can be increased to a certain degree by exercise, with stretching a common exercise component to maintain or improve flexibility.

<span class="mw-page-title-main">Sprained ankle</span> Medical condition

A sprained ankle is an injury where sprain occurs on one or more ligaments of the ankle. It is the most commonly occurring injury in sports, mainly in ball sports such as basketball, volleyball, football, and tennis.

Cold compression therapy, also known as hilotherapy, combines two of the principles of rest, ice, compression, elevation to reduce pain and swelling from a sports or activity injury to soft tissues and is recommended by orthopedic surgeons following surgery. The therapy is especially useful for sprains, strains, pulled muscles and pulled ligaments.

<span class="mw-page-title-main">Musculoskeletal disorder</span> Medical condition

Musculoskeletal disorders (MSDs) are injuries or pain in the human musculoskeletal system, including the joints, ligaments, muscles, nerves, tendons, and structures that support limbs, neck and back. MSDs can arise from a sudden exertion, or they can arise from making the same motions repeatedly repetitive strain, or from repeated exposure to force, vibration, or awkward posture. Injuries and pain in the musculoskeletal system caused by acute traumatic events like a car accident or fall are not considered musculoskeletal disorders. MSDs can affect many different parts of the body including upper and lower back, neck, shoulders and extremities. Examples of MSDs include carpal tunnel syndrome, epicondylitis, tendinitis, back pain, tension neck syndrome, and hand-arm vibration syndrome.

<span class="mw-page-title-main">Orthopedic pathology</span>

Orthopedic pathology, also known as bone pathology is a subspecialty of surgical pathology which deals with the diagnosis and feature of many bone diseases, specifically studying the cause and effects of disorders of the musculoskeletal system. It uses gross and microscopic findings along with the findings of in vivo radiological studies, and occasionally, specimen radiographs to diagnose diseases of the bones.

<span class="mw-page-title-main">Elbow</span> Joint between the upper and lower parts of the arm

The elbow is the region between the upper arm and the forearm that surrounds the elbow joint. The elbow includes prominent landmarks such as the olecranon, the cubital fossa, and the lateral and the medial epicondyles of the humerus. The elbow joint is a hinge joint between the arm and the forearm; more specifically between the humerus in the upper arm and the radius and ulna in the forearm which allows the forearm and hand to be moved towards and away from the body. The term elbow is specifically used for humans and other primates, and in other vertebrates forelimb plus joint is used.

<span class="mw-page-title-main">Knee pain</span> Medical condition

Knee pain is pain in or around the knee.

Muscle strain is one of the most common injuries in tennis. When an isolated large-energy appears during the muscle contraction and at the same time, bodyweight applies huge amounts of pressure to the lengthened muscle, which can result in the occurrence of muscle strain. Inflammation and bleeding are triggered when muscle strain occur which resulted in redness, pain and swelling. Overuse is also common in tennis players from all levels. Muscle, cartilage, nerves, bursae, ligaments and tendons may be damaged from overuse. The repetitive use of a particular muscle without time for repair and recover in the most common case among the injury.

<span class="mw-page-title-main">Ergonomic hazard</span> Physical conditions that may pose a risk of injury

Ergonomic hazards are physical conditions that may pose a risk of injury to the musculoskeletal system due to poor ergonomics. These hazards include awkward or static postures, high forces, repetitive motion, or short intervals between activities. The risk of injury is often magnified when multiple factors are present.

Running injuries affect about half of runners annually. The frequencies of various RRI depend on the type of running, such as speed and mileage. Some injuries are acute, caused by sudden overstress, such as side stitch, strains, and sprains. Many of the common injuries that affect runners are chronic, developing over longer periods as the result of overuse. Common overuse injuries include shin splints, stress fractures, Achilles tendinitis, Iliotibial band syndrome, Patellofemoral pain, and plantar fasciitis.

Elbow pain generally refers to discomfort in the joint (elbow) between the upper arm and forearm. Elbow pain is a common complaint in both the emergency department and in primary care offices. The CDC estimated that 1.15 million people visited an emergency room for elbow or forearm-related injuries in 2020. There are many possible causes of elbow discomfort but the most common are trauma, infection, and inflammation. Pain may be acute, chronic or associated with a number of other symptoms. Treatments range from conservative measures, such as ice and rest, to surgical interventions, depending on the underlying cause and severity.

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