Greg Schroeder, PT, DPT TEAMWORKS Therapy, LLC Investigating the mechanism of tissue injury, degeneration, and repair in Work-related Musculoskeletal Disorders (MSD) Greg Schroeder, PT, DPT TEAMWORKS Therapy, LLC
MusculoSkeletal Anatomy 12/7/2018 MusculoSkeletal Anatomy Muscle Tendon Joint Bones, muscles, joints, ligaments, nerves, circulation Blood Nerves
12/7/2018 Gradual process of wear that exceeds the bodies ability to heal and repair the musculoskeletal system.
Common MSD’s Tendonitis or tendinosis Tendonopathy 12/7/2018 Common MSD’s Tendonitis or tendinosis Tendonopathy Epicondylitis or Epicondylagia Tenosynovitis DeQuervains Disease Bursitis Low Back Pain Variety of potential causes Ganglion Cysts Muscle Sprains or Strains Nerve Compression CTS Cubital Tunnel Syndrome Thoracic Outlet Syndrome Radial Tunnel Others
Factors Related to MSD Excessive Force High Repetition Prolonged Duration Awkward Postures Compression Vibration Psychosocial Stress at Work Medical Conditions Muscles and tendons most susceptible to repetition Peripheral nerves most sensitive to compression MULTIFACTORIAL
Local Changes in the MusculoSkeletal System Tendons -Injury- microtrauma -Tissue inflammation occurring before overt signs of injury -Fibrosis/scar: Quantity and Quality Muscle -Inflammation -myofiber splitting -fibrotic replacing of myofibers worse with higher force and faster velocity -decreased muscle mass
Systemic Changes in the Musculoskeletal System Release of Immuno-histochemicals Hsp 72 Interleukin-1 Macrophage infiltration Cytokine-mediated systemic inflammatory response Spread of MSD symptoms to other extremities Mistaken for faking
Changes in the Peripheral Nervous System
Changes in the Central Nervous System
Neuroplasticity The ability of the nervous systems to change and adapt throughout life
CNS Changes Dedifferentiation of sensorimotor fields. Repetitive task lead to degradation of the cortex Chronic pain had as much as 11% on brain atrophy when compared to normals.
Early Intervention