Injury Prevention Principles for the Shoulder Joint:

1. Reduce High Repetition. Reducing high repetition will both reduce tissue stress and allow increased blood flow to the working muscle tissues, thus preventing tissue overload and microtrauma. This is especially critical in high stress activities such as; overhead lifting and reaching; forward lifting; forward reaching; and activities that require shoulder abduction and horizontal abduction positions.

2. Reduce Forceful exertions. Reducing forceful exertions will both reduce tissue stress and allow increased blood flow to the working muscle tissues, thus preventing tissue overload and microtrauma. The proper use of body mechanics is important to reduce the strain on the shoulder structures. Use the whole body and larger shoulder muscle groups to exert force and accomplish work tasks as opposed to using the smaller shoulder muscle groups or the shoulder joint only, when generating a force.

3. Reduce Static Work and Static Muscle Contractions. Reduce static work and static muscle contractions to allow increase blood flow to the working muscle tissues, thus preventing tissue overload and microtrauma. If static work is required, emphasize good posture and the use of the stronger, larger shoulder muscles. Rehabilitation should focus on the strength and endurance of the stabilizing muscles including the scapular stabilizers and the rotator cuff. If dynamic work is required, emphasize good posture and the use of the stronger, larger shoulder muscles. Rehabilitation should focus on the strength and endurance of the stabilizing muscles including the scapular stabilizers and the rotator cuff.

4. Dynamic Work-rest Cycles. Ensure dynamic work cycles are adequate to allow sufficient blood flow to working tissues to prevent tissue overload and microtrauma.

5. Reduce Postural Joint Forces and Awkward Positions. Reducing postural joint forces and awkward positions this will both reduce tissue and joint stress while allowing increased blood flow to the working muscle tissues, thus preventing tissue overload and microtrauma. For the shoulder joint, promote and maintain, as much as possible, the ideal positions of the shoulder joint that produce the least amount of exertion and compressive stresses to the joint and shoulder structures. Minimize lifting and reaching over 90 degrees of shoulder abduction, flexion and horizontal abduction. In addition, minimize shoulder extension activities beyond the midline. It is important to promote good postures of the neck, elbow and wrist joints, as awkward positions at adjoining joints may result in awkward positions and excessive tissue strain in the shoulder region. By minimizing the awkward postures at the joints above and below the shoulder joint, proper postures of the shoulder joint will be encouraged and therefore the risk for CTDs will be reduced.

6. Reduce Environmental Risk Factors. Reducing environmental risk factors to acceptable exposure limits will reduce tissue stress, enhanced worker performance and allow increased blood flow to working tissues, thus preventing tissue overload and microtrauma.

7. Reduce Confounding Risk Factors. Reducing confounding risk factors will enhance worker performance and reduce local tissue fatigue, thus preventing workplace injuries.

If a job task involves high repetition; the risk factor is high repetition, the injury prevention principle is to reduce the tissue stress and allow increased blood flow to the working tissues, the control measure will be to reduce the repetition rate or work rate and/or implement more frequent rest breaks. In effect, reducing the tissue stress and allowing a better recovery phase for the working tissues, thus preventing the CTDs from developing.

If the job task involves static postures; the risk factor is static work or static postures, the injury prevention principle is to reduce the tissue stress and allow increased blood flow to the working tissues, the control measure is to reduce the amount of static work by implementing dynamic work or by changing the work-rest cycles and allowing a longer tissue recovery time.

If the job task involves awkward postures; the risk factor is awkward postures, the injury prevention principles are to reduce the joint strain and promote a more neutral joint position, the control measure may be to implement ergonomic tools to improve the position of the joint to a more neutral position. This will reduce the joint stress and reduce the likelihood of tissue microtrauma from occurring, thus preventing the CTD.

Workplace Injury Prevention Checklist
A workplace injury prevention checklist provides a safe and effective tool in evaluating the basic ergonomic risk factors and providing suggestions on some possible control measures. The checklist should contain background information including date and location of the checklist evaluation in addition to a brief description of the job. The checklist should contain a list of identified ergonomic risk factors and the proposed solutions or control measures for reducing the risk factors. The checklist form can be used to screen a job task for ergonomic risk factors. It provides a basic look at the risk factors that are present that may increase the likelihood for the development of shoulder CTDs in the workplace. For a more thorough evaluation a formal ergonomic evaluation or job task analysis should be performed.


** For a copy of a Shoulder Injury Prevention Checklist, contact ErgoRehab, Inc at Inquire@ergorehabinc.com


Nicole Matoushek MPH, PT, CEES, CSHE
www.ergorehabinc.com


ErgoRehab, Inc.

More information about ErgoRehab, Inc. courses

Other articles by Nichole:

Prompt Return to Work

Injury Prevention: The Shoulder Joint

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The History of Ergonomics

Why Offer Return-to-Work Programs?

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The Cost of Work Related Injuries

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