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www.teamworkstherapy.com Investigating the mechanism of tissue injury, degeneration, and repair in Work-related Musculoskeletal Disorders (MSD) Greg Schroeder, PT, DPT TEAMWORKS Therapy, LLC www.teamworkstherapy.com MusculoSkeletal Anatomy Muscle Joint Blood Nerves www.teamworkstherapy.com Tendon Common MSD’s • Tendonitis or tendinosis Tendonopathy – Epicondylitis or Epicondylagia • • • • • • • 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 www.teamworkstherapy.com 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 www.teamworkstherapy.com Local Changes in the MusculoSkeletal System www.teamworkstherapy.com 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 www.teamworkstherapy.com Changes in the Peripheral Nervous System www.teamworkstherapy.com www.teamworkstherapy.com Changes in the Central Nervous System www.teamworkstherapy.com Neuroplasticity • The ability of the nervous systems to change and adapt throughout life www.teamworkstherapy.com www.teamworkstherapy.com 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. www.teamworkstherapy.com www.teamworkstherapy.com Early Intervention www.teamworkstherapy.com