Physically demanding professions and related problems

People who work dailly manually are under a physical as well as psychological stress, which can lead to pain of the musculoskeletal system. This pain is usually caused by the repetitive movements, manipulations with heavy burdens or forced working position, in which people have to work for longer periods of time holding heavy tools above their heads or below their waist and with time needed for regeneration. Working with machines is also not ideal, since vibrations can affect the musculoskeletal system as well. The working tempo also plays a key role. Specific problems are to a certain extent dependant on the performed activity.
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PAIN CAUSED BY PHYSICALLY DEMANDING PROFESSIONS

Pain in the lower back area


Pain in the lower back area affects usually carpenters, construction workers or farmers, but also nurses. This type of pain is caused especially by overloading the back muscles during an incorrect stabilization of the spine, it is a result of incorrect manipulation with heavy objects, staying in the same position or constantly repeating movements. As a prevention against formation or worsening of the problems, it is optional to adjust your working position and working approach. Physiotherapist can help you to remove the problems that are troubling you, as he can evaluate the origin and range of the problem, and offer you an ideal treatment option. That usually includes manual therapy and various exercises, in order to relax the overloaded muscles and activate the core muscles of the spine.

Exercises during pain in the lower back >>
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Pain in the area of the thoracic spine


Pain in the area of the thoracic spine and shoulder blades is mainly caused by manual work and keeping the arms above the head for a longer period of time or in an isometric position of the trunk and upper extremities especially during an insufficient fixation of the shoulder blades. Weakened muscles which fix the shoulder blade from below, tend to cause other muscles in the area of the shoulder blade to get overworked. To that can be related pain in the nape and cervical spine. Within the physiotherapy we try to activate the weakened lower fixing muscles of the shoulder blade, relax the overloaded muscles and involve newly learned movement stereotypes into daily activities. Pain in the thoracic area can be caused by blockages of the thoracic spine, ribs or clavicle. Therefore it is important to undergo a thorough examination of the musculoskeletal system.

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Pain in the shoulder girdle


Physically demanding professions often times lead to long lasting overloading of the structures in the area of the shoulder girdle but also acute injuries of the shoulder. The most common problems in the area of the shoulder joints is the so called frozen shoulder or impingement syndrome. Frozen shoulder syndrome is manifesting with sharp pain in the shoulder area during movement as well as in peace and by restricted movement of the shoulder. Lifting the arm vertically becomes impossible and outer rotation of the arm is also restricted. But any movement at all can be restricted. Impingement syndrome can lead to restricted inner rotation of the arm in the shoulder joint and lifting arms vertically. With pain in the shoulder you should consider also that it can be caused by disorders in the area of the neck or thoracic spine. Within the therapy can be used mobilizing technique, relieving the soft tissues in the area of the shoulder girdle, as well as adjusting the coordination of the muscles around the shoulder girdle. Combination of physiotherapy and shock wave has proved to be highly effective.

Exercises against pain in the shoulder >>
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Pain in the elbow and forearm


Pain in the area of the elbow is often caused by overworked muscles on the front or back side of the forearm (flexor and extensor muscles of the wrist and fingers). Tennis elbow or javelin thrower’s elbow is the most common diagnose and it occurs due to an incorrect movement stereotype in the hand or constantly repeating motions. It can specifically affect construction workers and plumbers. Prevention again contains adjustment of the working technique and some sort of compensating exercises. Physiotherapist will be able to relieve the soft tissues of the arm, mobilize the peripheral joints and spine as well as stabilize the shoulder blades. Focused shock wave can be used as an additional treatment to support the healing process in the affected areas. Kinesio tape can be also used as an supportive aid.

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Exercises against pain in the elbow >>
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Pain in the wrist and hand


One of the most frequent illness affecting the wrist and hand is the carpal tunnel syndrome.. Fairly recent surgical scar should be separately covered, as should a split skin graft that has not yet healed or even relatively fresh wound caused by injury. Internal comorbidities (such as COPD, arterial hypertension or medical anticoagulation) may necessitate breaks in treatment, repositioning or intermediate clinical checks. Complications in arthrodesis healing: Where elbow compression arthrodesis is performed by means of an external fixator and a cancellous bone graft (with delayed fracture healing and where sclerotherapy of the osteotomy zones had commenced) it is actually surgical revision that is indicated.

The pressure is involved on the median nerve, which is followed by a subjective symptoms such as a tingling feeling or insensitivity in the 1st - 3rd and part of the 4th finger and feeling of having a heavy hand, especially at night or during a manual work. Worsened mobility of the hand is another symptom. Shooting pain to the forearm or shoulder is also typical, different temperature or changed color of the skin in the affected area may also occur. Overloaded muscles of the hand with excessive and long lasting, one sided activity can also cause occurrence of the syndrome of the carpal tunnel. Vibrations transferred into the arm have also effect on the occurrence.

After recommendation of a targeted therapy it is necessary to determine the etiology. Generally we are trying to relieve the area of the carpal tunnel, where the nerve is pressured and coordination of the muscles of the shoulder girdle are restricted. General manual techniques can be used for relieving the soft tissues, mobilizing the joints of the hand, as well as relieving and stabilizing exercises. For accelerated healing you can use focused shock wave therapy, soft tissues can be relieved with radial shock wave therapy. For supported relief of the soft tissues and mechanical relief of the carpal tunnel, you can apply kinesio tape.
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Carpal tunnel syndrome - exercises >>

Pain in the knee joints


In the area of the knee joints is a connection between physically demanding profession usually resulting in degenerative changes in the joint, such as arthrosis of the knee joints. Among the most afflicted ones are carpenters, joiners, but also tilers and generally jobs where you are required to kneel. The problems are caused mainly by inadequate positions during work, burdening our knee joints. In connection with generative changes in the knee joint there are frequent reflexive changes in the surrounding muscles, especially on the back and inner side of the thigh, the rest of the muscles are usually stiff. Within physiotherapy it is necessary to relax the overloaded muscles and activate the weakened muscles. After the acute pain retreats it becomes optional to include in the therapy also exercises on unstable surfaces, which increase the stability and strength of the joint, as well as the whole body. If the arthrosis is followed by inflammation, it is ideal to treat the affected area with focused shock wave therapy. It is also ideal to apply radial shock wave on the muscles or muscle groups which are in bigger tension.

Exercises against pain in the knee >>


Author: FYZIOklinika physiotherapy Ltd., Prague, Czech Republic
Sources: - GRZYWIŃSKI,W., WANDYCZ, A., TOMCZAK A., JELONEK T., SZABAN, J. a M. JAKUBOWSKI. Occurence of musculoskeletal disorders in woodcutters . In: FORMEC, 2010. Forest Engineering: Meeting the Needs of the Society and the Environment [online]. 2010, Padova – Italy [cit. 2017-10-13]. http://intra.tesaf.unipd.it/formec2010/Proceedings/Ab/Ab089.pdf
- HORSLEY, R. Factors that affect the occurrence and chronicity of occupation-related musculoskeletal disorders. Best Practice & Research Clinical Rheumatology [online]. 2011, vol. 25, no. 1, p. 103-115 [cit. 2017-10-13]. DOI: 10.1016/j.berh.2011.01.006. ISSN 15216942. http://linkinghub.elsevier.com/retrieve/pii/S1521694211000118
- LEMASTERS, G.K., ATTERBURY, M. R., BOOTH-JONES, A. D., BHATTACHARYA A., OLLILA-GLENN N., FORRESTER C. a L. FORST. Prevalence of work related musculoskeletal disorders in active union carpenters. Occupational and Environmental Medicine [online]. 1998, vol. 55, no. 6, p. 421-427 [cit. 2017-10-13]. ISSN: 1536-5948. http://oem.bmj.com/content/55/6/421.short
- WALKER-BONE K. a K.T. PALMER. Musculoskeletal disorders in farmers and farm worker. Occupational Medicine [online]. 2002, vol. 52, no. 8, p. 441-450 [cit. 2017-10-13]. DOI: https://doi.org/10.1093/occmed/52.8.441. https://academic.oup.com/occmed/article/52/8/441/1404412/Musculoskeletal-disorders-in-farmers-and-farm
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