Between Two Rocks and in a Hard Place: Reflecting on the Biomechanical Basis of Shoulder Occupational Musculoskeletal Disorders

2020 ◽  
pp. 001872081989619
Author(s):  
Clark R. Dickerson ◽  
Alison C. McDonald ◽  
Jaclyn N. Chopp-Hurley
Keyword(s):  
Injury Risk ◽  
Integrated Approach ◽  
Task Demands ◽  
Work Design ◽  
Subacromial Impingement Syndrome ◽  
Shoulder Injury ◽  
Work Requirements ◽  
Shoulder Complex ◽  
Primary Focus ◽  
Physical Exposures

Objective The aim was to review the biomechanical origins of occupational shoulder damage, while considering the complexity of shoulder mechanics and musculoskeletal consequences of diverse task demands. Background Accessible measures of physical exposures are the primary focus of occupational shoulder assessments and analyses. This approach has led to guidelines and intervention strategies that are often inadequate for mitigating shoulder disorders amongst the complexity of modern workplace demands. Integration of complex shoulder mechanics into occupational assessments, analyses, and interventions is critical for reducing occupational shoulder injury risk. Method This narrative review describes shoulder biomechanics in the context of common injury mechanisms and consequent injuries, with a particular focus on subacromial impingement syndrome. Several modulators of shoulder injury risk are reviewed, including fatigue, overhead work, office ergonomics considerations, and pushing and pulling task configurations. Results Relationships between work requirements, muscular demands, fatigue, and biomechanical tissue loads exist. This review highlights that consideration of specific workplace factors should be integrated with our knowledge of the intricate arrangement and interpersonal variability of the shoulder complex to proactively evaluate occupational shoulder demands and exposures. Conclusion A standard method for evaluating shoulder muscle exposures during workplace tasks does not exist. An integrated approach is critical for improved work design and prevention of shoulder tissue damage and accompanying disability. Application This review is particularly relevant for researchers and practitioners, providing guidance for work design and evaluation for shoulder injury prevention by understanding the importance of the unique and complex mechanics of the shoulder.

scholarly journals Incidence of Shoulder Injury in Elite Wheelchair Athletes Differ Between Sports: A Critically Appraised Topic

2019 ◽  
Vol 28 (3) ◽  
pp. 294-298 ◽  
Author(s):  
Jessica R. Fairbairn ◽  
Kellie C. Huxel Bliven
Keyword(s):  
Injury Risk ◽  
Sport Participation ◽  
Current Data ◽  
Shoulder Injuries ◽  
Shoulder Injury ◽  
Bottom Line ◽  
Injury Rates ◽  
Wheelchair Athletes ◽  
Epidemiology Data ◽  
Shoulder Complex

Clinical Scenario: Until recently, injury epidemiology data on elite Paralympic athletes were limited. Current data suggest high rates of shoulder injury in wheelchair athletes. Differences in shoulder injury rates between sports have not been reported in this population. Clinical Question: Is the incidence of shoulder injury in elite wheelchair athletes different between sports? Summary of Key Findings: Shoulder injury rates are high in elite wheelchair athletes, particularly in sports such as field events and fencing that require a stable base (eg, trunk, core control) from which to perform. Wheelchair racing requires repetitive motions that contribute to shoulder injuries, but rates are lower than field sports and fencing. Wheelchair curling and sledge hockey have low shoulder injury risk. Clinical Bottom Line: Shoulder injury rates vary based on sport in elite wheelchair athletes. In addition to incorporating shoulder complex specific rehabilitation for overuse shoulder injuries, clinicians should focus on core and trunk stabilization in elite wheelchair athletes competing in sports, such as field events and fencing. Strength of Recommendation: Grade C evidence exists that reports shoulder injury rates among elite wheelchair athletes differ based on sport participation.

What Can a Jump Tell Us About Elbow Injuries in Professional Baseball Pitchers?

2020 ◽  
Vol 48 (5) ◽  
pp. 1220-1225
Author(s):  
John Mayberry ◽  
Scott Mullen ◽  
Scott Murayama
Keyword(s):  
Test Performance ◽  
Injury Risk ◽  
Reaction Force ◽  
Professional Baseball ◽  
Shoulder Injury ◽  
Injury Rates ◽  
Elbow Injury ◽  
Increased Risk ◽  
Elbow Injuries ◽  
Baseball Pitchers

Background: The incidence rate of elbow injuries has been rising in recent years among professional baseball pitchers. Determining valid screening procedures that allow practitioners to identify pitchers at an increased risk of such injuries is therefore of critical importance. Purpose: To validate the use of countermovement jump (CMJ) tests as a diagnostic tool for pitcher conditioning. Study Design: Case-control study; Level of evidence, 3. Methods: More than 500 pitchers at a single professional baseball organization performed preseason CMJ assessments on a force plate before the 2013 to 2018 seasons. Three measurements were extracted from ground-reaction force data during the test: eccentric rate of force development (ERFD), average vertical concentric force (AVCF), and concentric vertical impulse (CVI). Athletic trainers at the organization collected detailed information on elbow and shoulder injury rates as well as workload (pitch count) throughout the rest of the season. Poisson regression models were fit to investigate the dependency of injury rates on CMJ test performance. Results: ERFD, CVI, and AVCF were all significant predictors of elbow injury risk after accounting for pitcher age, weight, and workload. The analysis identified 3 specific indicators of heightened risk based on the results of a CMJ scan: low ERFD, a combination of low AVCF and high CVI, and a combination of high AVCF and low CVI. In contrast, shoulder injury risk was roughly independent of all 3 CMJ test measurements. Conclusion: This study supports the hypothesis of the entire kinetic chain’s involvement in pitching by establishing a link between CMJ test performance and elbow injury risk in professional baseball pitchers. CMJ assessment may be a powerful addition to injury risk alert and prevention protocols. Pitchers in high-risk groups can be prescribed specific exercise plans to improve movement imbalances.

Relationships and Mechanisms Between Occupational Risk Factors and Distal Upper Extremity Disorders

2019 ◽  
pp. 001872081986068 ◽  
Author(s):  
Peter J. Keir ◽  
Amanda Farias Zuniga ◽  
Daanish M. Mulla ◽  
Kumara G. Somasundram
Keyword(s):  
Risk Factors ◽  
Upper Extremity ◽  
Dose Response ◽  
Injury Risk ◽  
Epidemiological Studies ◽  
Task Demands ◽  
Laboratory Studies ◽  
Occupational Risk Factors ◽  
Upper Extremity Disorders ◽  
Extremity Injuries

Objective:The relationships between workplace risk factors and upper extremity injuries from epidemiological and laboratory studies were examined.Background:Epidemiological studies are associated with several limitations, affecting the strength of association between risk factors and the development of injuries.Method:In this narrative review, we identified epidemiological and laboratory studies (published primarily since 1997) investigating exposure to workplace risk factors (force, repetition, posture, vibration) and risk of hand/wrist tendon–related disorders, epicondylitis, and carpal tunnel syndrome (CTS).Results:Forceful exertions are strongly associated with hand/wrist tendon–related disorders, epicondylitis, and CTS. Dose–response relationships were found for epicondylitis (repetition) and CTS (posture). Interactions demonstrate multiplicative effects of risk factors for injury risk. Laboratory studies display clear associations between task demands and biomechanical measures linked to mechanisms for upper extremity injuries with animal models providing further evidence of a dose–response between risk factors and injury.Conclusion:Forceful, repetitive work requiring non-neutral postures are associated with increasing risk of hand/wrist tendon–related disorders, epicondylitis, and CTS as evidenced by epidemiology studies and laboratory-based investigations of humans and animals.Application:Understanding the relationship between exposure levels of workplace risk factors and upper extremity disorders can improve injury prevention and rehabilitation strategies.

Community Ergonomics and Quality Work Design in the 21st Century

2000 ◽  
Vol 44 (12) ◽  
pp. 2-776-2-779 ◽  
Author(s):  
William J Cohen
Keyword(s):  
Work Environment ◽  
Task Demands ◽  
Work Design ◽  
Central Feature ◽  
Quality Work ◽  
Safety And Health ◽  
The Us ◽  
The Face ◽  
Life Improvement

Community ergonomics (CE) was first described as a process to implement useful solutions for very poor inner city communities in the US. Its central feature is the creation of implemented solutions to meet target purposes and aspirations of participants in an effort to improve something. The CE process is based upon notions of industrial engineering, human factors and ergonomics, behavioural cybernetics, and Breakthrough Thinking™. Naturally, it is a process well-suited for the work environment and can help to discern both the need for better work design and the opportunity for quality of life improvement through stage-dependant, purpose driven solutions. Design solutions vary across and within industries depending upon unique circumstances of individuals, technology, task demands, work environment, and organizational structure. It is the process of people and resources interacting in a structured manner over a period of time that leads to logical target solutions and purposeful achievement. The CE process can be effectively applied to the work setting where manual labour tasks can exact a high physical toll on employees, especially in the face of decreasing resources. The purpose of the application is to demonstrate that CE can redesign tasks and use of tools and technology to improve efficiency while enhancing the safety and health of employees.

scholarly journals Biomechanics Related to Increased Softball Pitcher Shoulder Stress: Implications for Injury Prevention

2021 ◽  
pp. 036354652110551
Author(s):  
Kenzie B. Friesen ◽  
Michael G. Saper ◽  
Gretchen D. Oliver
Keyword(s):  
High School ◽  
Injury Risk ◽  
Linear Regression Analysis ◽  
Elbow Flexion ◽  
Shoulder Injury ◽  
Trunk Flexion ◽  
Stepwise Linear Regression Analysis ◽  
Kinematic Data ◽  
Maximum Effort ◽  
Distraction Force

Background: Softball pitchers exhibit high throwing shoulder distraction force, which is a theorized mechanism of throwing shoulder overuse injury. Windmill pitching involves a variety of highly individualistic pitching styles, and certain kinematics preceding ball release likely influence the amount of shoulder stress that a pitcher accrues. Purpose: To examine the association of trunk and throwing arm kinematics, kinetics, and timing variables with peak throwing shoulder distraction force in high school softball pitchers. Study Design: Descriptive laboratory study. Methods: A total of 37 high school pitchers (mean ± SD; height, 1.71 ± 0.06 m; weight, 75.53 ± 16.12 kg; age, 16 ± 2 years) threw 10 fastball pitches at regulation distance (43 ft [13.1 m]) and with maximum effort. Kinematic data were collected at 240 Hz using an electromagnetic motion capture system synced with motion analysis software. The 3 fastest pitches were averaged and analyzed. Kinematic, kinetic, and timing variables were entered into a stepwise linear regression analysis. Results: Four variables were included in the significant model ( F4,39 = 147.51; P < .001) and explained peak shoulder distraction force ( R2 = 0.944; adjusted R2 = 0.938; SE = 0.036): increased peak elbow distraction force ( t = 19.90; P < .001) and extension moment ( t = 3.63; P = .001), as well as decreased elbow flexion velocity ( t = −2.37; P = .023) and trunk flexion at foot contact of the pitch ( t = −3.00; P = .005). Conclusion: Elbow kinetics and angular velocity, as well as trunk positioning at foot contact, are associated with peak throwing shoulder distraction force in high school softball pitchers. Clinical Relevance: Variables associated with peak throwing shoulder distraction force provide information regarding injury mechanism and coachable cues that might reduce shoulder injury risk among pitchers.

Integrated Gas Turbine Technology Education at Durham University

1996 ◽  
Author(s):  
Harry Marsh ◽  
Robert Dominy ◽  
David Gregory-Smith ◽  
Li He
Keyword(s):  
Technology Education ◽  
Gas Turbine ◽  
Unsteady Flows ◽  
Integrated Approach ◽  
Secondary Flows ◽  
Work Design ◽  
Project Work ◽  
Industrial Training ◽  
Flow Prediction ◽  
Research Programmes

Gas turbine technology is a major component in the teaching and research programmes at Durham University. In 1993, the change from the three-year degree course to the four-year Master of Engineering course provided an opportunity to strengthen the teaching of turbomachinery through closer integration of lectures, laboratory work, design, investigative project work and the use of computers for flow prediction. The undergraduate projects link with research in turbomachinery aerodynamics, secondary flows, and unsteady flows. The integrated approach provides graduates with a broad based education and a good understanding of turbomachinery. Wider aspects include the placement of students for a year of industrial training with a European turbine manufacturer and the organisation of an two-week course for industry on turbine technology. An unusual feature of the Durham approach is the development of turbomachinery based projects to introduce the challenge of engineering into schools and colleges.

KNEE AND SHOULDER INJURY RISK ASSESSMENT IN SCHOOL LEVEL FEMALE BASKETBALL PLAYERS: A CROSS – SECTIONAL STUDY

2015 ◽  
Vol 3 (1) ◽  
pp. 905-910
Author(s):  
Deebak Kumar Srinivasan ◽  
◽  
Santosh. K. Sahanand ◽  
Anoop Narayana Dev ◽  
David. V. Rajan ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Injury Risk ◽  
Cross Sectional Study ◽  
School Level ◽  
Sectional Study ◽  
Shoulder Injury ◽  
Basketball Players ◽  
Cross Sectional

Circadian Rhythms as a Basis for Work Organization

2012 ◽  
Vol 55 (1) ◽  
pp. 204-217 ◽  
Author(s):  
Lia Buarque de Macedo Guimarães ◽  
Jose Luis Duarte Ribeiro ◽  
Tarcísio Abreu Saurin ◽  
Paulo Ivo Homem de Bittencourt
Keyword(s):  
Circadian Rhythms ◽  
Human Performance ◽  
Work Organization ◽  
Task Demands ◽  
Work Design ◽  
Biological Clocks ◽  
Mental Demands ◽  
Physiological Markers ◽  
New System ◽  
The Ideal

Objective: With the assumption that circadian rhythms influence human performance, the work of live line electricians was reorganized and evaluated. The hypothesis was that in highly physical and attention-demanding work, the organization of tasks, according to the ideal period of day and day of week, should diminish stress and consequent work risks. Background: There are only a few studies reporting the work of electricians and even fewer approaching work organization. Moreover, these investigations often do not consider human physiological limitations and capabilities as well as task demands. Method: A new work system was proposed with consideration of (a) the circadian cycles and homeostatic processes; (b) the effect of heat, which is a zeitgeber (synchronizer) for the biological clocks; and (c) the degree of physical and mental demands of the different performed tasks, which was assessed on the basis of opinions of the electricians and physiological markers of stress that are controlled by circadian rhythms. The traditional and new systems were compared on the basis of two cognitive indices (the arrangement of matchsticks and the perception of a minute) and three physiological markers of mental-to-physical loads (heart frequency and the level of adrenaline and noradrenaline). Results: Both physical and mental loads were reduced in the new system. Conclusion: Work organization should include consideration of human circadian rhythms, mainly when stressful and high-risk tasks are involved. Application: The findings can be applied in any work design, but they are especially suited for highly demanding work carried out outdoors.

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