Can you remember your first time?
When your colleague walked up to you and complained of knee pain.
Or was it when they called in sick with disc prolapse?
Or you might have heard that shoulder pain is a common injury in your workplace.
How did you feel? Did you know what to do? Or even understand it?
Did you know you were dealing with musculoskeletal disorders?
Yeah! I feel your pain (no pun intended!).
When you think you have heard it all, new names pop up. The latest, ‘Texting Thumb’.
How can you help your workers if you can’t even keep up with all the injuries?
Are you to know all the names?
Maybe best you ignore it. Afterall nobody expects you to be the expert.
But sadly, Ignoring it doesn’t help. Because it’s still there. Workers get injured. And the only way you can be good at dealing with these work-related injuries is to know a fair bit about it.
Why Understanding Musculoskeletal Disorder Is Important
Very simply, it improves your management.
Knowing more about it, first, helps you know what your worker is on about. It helps you know the type of injury they have, (as there are different types in the workplace).
Check out this post: Why understanding musculoskeletal disorders is so important today.
When you know that, it makes managing it easier because you can;
a) classify them better
b) record the injuries appropriately
c) predict the next steps
d) Signpost quicker
e) Liaise better with medical practitioners including GP and Occupational Health Team
f) Investigate with the right tools
g) Put the right controls in place
In fact, you won’t be in the dark anymore because you understand it better. You’d become better at managing and reducing risk in your workplace.
Over the years, I have worked with HR practitioners, Health and Safety, and Office managers. And they’ve in various forms asked about musculoskeletal disorders.
So, without further ado, let’s break this down;
What Is Musculoskeletal Disorder?
To simplify the definition, I’m going to pick each word and explain it.
Musculoskeletal
It’s a combination of two words –
· ‘musculo’ meaning muscles and
· ‘skeletal’ meaning skeleton.
These two words combine to form a system in the body known as the Musculoskeletal System.
Disorders
According to the Oxford English dictionary, disorder means ‘an illness that disrupts normal physical or mental function’. They describe injuries because they skew the order of things in the body.
Therefore, musculoskeletal disorder is a collective term for injuries that affect the muscular (musculo) and skeletal systems of the body including bones, cartilage, joint, muscles, tendons. ligaments, fascia and bursa.
The musculoskeletal system like the other systems of the human body has various structures. These structures work together to give us frame, stability, and movement. Hence, the musculoskeletal system is called the Locomotive System.
The musculoskeletal system is made up of;
1. Muscles
Muscles contract to produce movement. It’s the body’s locomotive engine.
Injuries of the muscles are called Strain or ‘Pulled’.
Common example: Back Strain and Pulled Hamstrings.
2. Bones and Joints (skeletal)
Joints are the junction where bones meet and movement occurs.
Injuries to the bones are called fractures. There are different types of fractures.
Common Examples: Stress Fracture which occurs over time by overuse or repetitive activities, Colles fracture, and fracture of the neck of femur (falls injury in the elderly)
Injuries to the joints are known as Dislocation where the bones in the joint are pulled out of alignment. And called subluxation if there is a partial separation. Another common injury to the joint is Osteoarthritis – wear and tear of the joint.
Common examples: Shoulder Dislocation, Osteoarthritis of the knee.
Connective tissues
Connective tissues protect and connect the muscles to the bones. There are various connective tissues of the skeletal system and they include;
3. Ligaments
these are strong bands of fibres that connect bones to bones. They stabilise and support the joints.
Injuries to the ligaments are called sprains or tears.
Common examples: Ankle sprain and Anterior Collateral Ligament (ACL) rupture of the knee.
4. Tendons
they are strong fibrous pulleys that connect muscles to bones. When the muscle contracts the tendon pulls and moves the bone. They can stretch and help to lengthen the muscle.
Injuries to the tendons are called Tendinopathy, Tendinitis, or Tendinosis. In the hands, tendons are protected and covered in sheaths. These sheaths when injured are known as Tenosynovitis.
Common examples: Achilles Tendinopathy, Rotator Cuff Tendinitis (shoulder injury), and DeQuervian’s Tenosynovitis (wrist injury).
5. Cartilage
they are protective paddings at the end of a long bone that prevent friction in the joints. They also act as shock absorbers in the joint when movement occurs.
Injuries to the cartilage are called Tears.
Common example: Meniscal Tear of the knee.
6. Fascia
these are thin fibrous sheets of covering that envelope group of muscles or organs to keep them in place or bound together.
Injuries to the fascia are called Fasciitis.
Common Examples: Plantar fasciitis (heel injury).
7. Bursa
Bursa is a small fluid-filled sac placed in places where friction would otherwise occur. For example, placed between a protuberance on a bone and a tendon. This would stop the bone rubbing against the tendon preventing a tear to the tendon.
Injuries to the bursa are called Bursitis.
Common examples: Subacromial bursitis (shoulder injury) or Greater Trochanteric bursitis (hip injury).
8. Intervertebral Discs
they are 23 shock-absorbing discs that hold the bones of the spine (vertebrae) in place. They allow movement and are crucial to the health of the spine.
Injuries to the discs of the spine are known as Herniated or Ruptured. And when injured from aging, they are known as Degenerative Disc Disease (DDD).
But the musculoskeletal system doesn’t work alone. It needs the help of the nervous system.
9. Nerve
The nerve is not part of the musculoskeletal disorder, per se, but it lends a hand in allowing movement to occur. They allow you to perceive, comprehend and respond to the world around us.
The nervous system which makes up your brain, spinal cord, and nerves, gathers information from our sensory organs (eyes, ears, skin) and other parts of our body.
It then uses this information to help you react, remember, think, and plan. Then sends out the appropriate instructions and responses to various parts of your body including, the musculoskeletal system.
Why is the Nervous System relevant to the Musculoskeletal System?
In summary, they allow the musculoskeletal system to move.
An electrical signal is transmitted from the brain by the nerves to the muscles, joints, and connective tissues. These signals instruct the musculoskeletal system to, for example:
‘Move to the right’,
‘scratch that itch’
‘pick your nose’
‘pick up the tool’
‘type’
Stayed too long in this bent position, back’s groaning, straighten up’,
‘it’s too hot, take off jumper’
‘Nod to what your manager is saying right now
Seriously, that’s what it says. I bet you’ve heard it. And you are responding now. You are about to smile. Or am I too presumptuous? OK, at least you’re thinking about it.
No matter how buff your muscles are, if there’s a disconnection at the nerve-muscle junction (neuromuscular junction), you won’t move.
Nope! Not even a flicker. Nada.
That why the musculoskeletal system is also called the NeuroMusculoSkeletal System.
There is no one term to describe nerve injury as it is complex. To find out more check out this article.
It’s important to know that all the structures of the musculoskeletal system could be injured. Thus, the musculoskeletal disorder is a collective name for a huge number of injuries.
And every injury has a name.
‘’All structures of the musculoskeletal system are prone to injury’’.
How to Identify Musculoskeletal Disorders
I’m sure you know that your employees would never walk up to you and say they have a musculoskeletal disorder. It’s important that you are able to identify musculoskeletal disorder when they groan with pain or reports an injury.
It also comes in handy when seen in ‘Fit Note’ or medical certificates given to them by their doctors or medical practitioners.
So here is a simple formula to identify musculoskeletal disorder;
a. Pain
Pain describes injuries. For musculoskeletal disorders, the affected body area is mentioned first and then pain is added as the second word.
(body area + pain)
For example:
Back Pain,
Neck Pain,
Knee Pain,
Wrist Pain,
Heel Pain,
Shoulder Pain, etc., you get the gist, right?
b. -ITIS
Inflammation occurs when a body part gets injured. So the term ‘ITIS’ is used as a suffix to describe inflammation to that body structure. I have to also mention that most medical terms have ‘Greek or Latin’ origins.
For example;
Inflammation of the Joints = arthritis (arthron meaning joint and -itis – inflammation)
Tendon injury = tendinitis e.g. Achilles’ tendinitis
Injury of the Fascia = fasciitis e.g. plantar fasciitis (heel pain)
Injury of the Bursa = bursitis e.g. greater trochanteric bursitis (pain on the outside of the hip)
c. -ALGIA
This is another suffix that also means pain. For example, myalgia (muscle pain) or neuralgia (nerve pain)
d. Sprains and Tears
This term describes injuries of the ligament, for example, ankle sprain, wrist sprain, and Anterior Cruciate Ligament Tear (ACL).
e. Injuries of the Spine
This is a common injury in the workplace. Back pain is the most common term used to describe spinal pain. But, also words like Herniated Discs, Slipped Discs, Sciatica, Lumbago, Spondylosis, Sacroiliac Joint (SIJ) injury, and Facet Joint Injury.
f. Syndromes
These are a group of symptoms that always occur together. For example, Carpal Tunnel Syndrome affects the wrist and hand and has a few symptoms that are indicative of the syndrome. Another is Whiplash Syndrome which presents after a road traffic accident and affects the spine and shoulders.
g. Activity + Body Part
This is where Tennis Elbow comes in.
These terms were coined after a doctor noticed an injury in an area of the body prevalent in a set of workers. For example, Dr H.P. Major coined Tennis Elbow. He wrote an article in the British Medical Journal. He described elbow pain suffered by patients taking up lawn tennis. Of course, we now know that tennis elbow is experienced by many other sets of workers, for example, carpenters, plumbers, and chefs, that perform excessive forceful griping. Other names coined over the years include;
Golfer’s Knee – pain on the inside of the elbow. Also common with production line workers
Housemaid Knee – excessive kneeling, Also common workers include plumbers, carpet fitters
Jumper’s Knee – excessive jumping in sports (long jumpers) is Also common in HGV drivers.
Runner’s Knee – common in runners. Also common in office workers (prolonged sitting with knees bent)
Texting Thumb – well you guessed it! – excessive clicking with the thumb e.g. gamers, programmers
Thrower’s Shoulder – common in cricket, javelin throwers. Also with workers that perform overhead activities e.g. construction
Wow! I know that is a lot to take in but if you understand the suffix and names used, it would be easier to identify the injuries.
Yippee! You have passed your Anatomy 101 class!
What are the Most Common Musculoskeletal Disorders?
Now! this has always been a question I find hard to answer.
Not because I don’t know a few to mention.
But musculoskeletal disorder is a common injury (disease) that can affect anyone, from babies to older adults. What is common in children would, without doubt, be uncommon in a different age group of people. For example, Hairline fracture is most common in children. Not so much in adults and osteoporotic fractures are often seen in the elderly. Back pain which is quite common in adults is rarely seen in children.
Another example, Osgood-Schlatter’s disease of the knee found in active teens. Runner’s knee in adults and osteoarthritis in older adults. They are all common diseases of the active knee but for different subgroups.
So the question, in fact, should be,
“What is the most common musculoskeletal disorder in an age group or set of people?”
For example, in sports e.g.footballers – ACL injury), in certain workers, e.g. carpet fitters – housemaid’s knee)
And that’s where work-related musculoskeletal disorder comes in.
Work activities cause or aggravate musculoskeletal injuries. Therefore, that means they are specific to a subset of people, i.e. workers. Find out more about work-related musculoskeletal disorders in this post: All you need to know about work-related musculoskeletal disorders.
