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Investigating the mechanism of tissue injury,
degeneration, and repair in Work-related
Musculoskeletal Disorders (MSD)
Greg Schroeder, PT, DPT
TEAMWORKS Therapy, LLC
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MusculoSkeletal Anatomy
Muscle
Joint
Blood
Nerves
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Tendon
Common MSD’s
• Tendonitis or tendinosis
Tendonopathy
– Epicondylitis or
Epicondylagia
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•
•
•
•
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• Tenosynovitis
– DeQuervains Disease
• Bursitis
• Low Back Pain
– Variety of potential causes
Muscle Sprains or
Strains
Nerve Compression
•
CTS
Cubital Tunnel Syndrome
Thoracic Outlet Syndrome
Radial Tunnel
Others
• Ganglion Cysts
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Factors Related
to MSD
1.
2.
3.
4.
5.
6.
7.
Excessive Force
High Repetition
Prolonged Duration
Awkward Postures
Compression
Vibration
Psychosocial
Stress at Work
8. Medical Conditions
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Local Changes in the
MusculoSkeletal System
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Systemic Changes in the
Musculoskeletal System
• Release of Immunohistochemicals
– Hsp 72
– Interleukin-1
– Macrophage infiltration
• Cytokine-mediated systemic
inflammatory response
– Spread of MSD symptoms to other
extremities
– Mistaken for faking
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Changes in the Peripheral Nervous
System
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Changes in the Central Nervous System
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Neuroplasticity
• The ability of the
nervous systems
to change and
adapt throughout life
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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.
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Early Intervention
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