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18 Wheels, 23 Discs: A Pathological Look at Workplace Musculoskeletal Injuries

It's November, and everyone is working hard, so that they might be able to take a few days off during the Christmas holidays, myself included.

It’s November, and everyone is working hard, so that they might be able to take a few days off during the Christmas holidays, myself included.

My job involves varying degrees of physical activity, mostly those involved with the adjustment or manipulation of the spine.

Most readers of this magazine have physical jobs that involve other types of repetitive movements and activities.

The use of my joints and muscles to manipulate a vertebral segment, while not forceful, can lead to severe joint and muscle problems in my own body if proper form and biomechanics are not used.

The same is true of most workplace injuries.

There is a proper way to do most physical activities, so the body experiences the least amount of musculoskeletal stress.

I will begin this article by discussing the basis for injury assessment and prevention and then discuss what health care practitioners try to look for when we are assessing an injury.

One of Murphy’s lesser known laws states that, if anything is used to its full potential, something will break.

This statement reminds us that all structures have a breaking point.

A high enough force will cause disruption with one application.

Lesser forces repeated over time will eventually cause fatigue fracture.

The same is true of biologic tissue: bone, ligament, tendon, etc. Repetitive stresses cause cumulative strain with eventual disruption.

We can only learn about the strength of a material by ripping it apart! The one main difference and advantage that biologic tissue has over inert physical material is that is can heal itself.

One interesting aspect of this healing is a phenomenon in bone called Wolff’s Law: when stress is applied to a bone, it becomes stronger.

This means that if a tissue is damaged, but not to the point of breaking, it will heal and become stronger if done repetitively.

This is the same of all tissues.

However, if the stress that is applied is stronger than the tissues tolerance, instead of becoming stronger, it breaks down.

For those problems that affect the musculoskeletal system, the term “repetitive strain injury” (RSI) is used or “cumulative trauma disorder” (CTD).

A well-known arena for RSI is in athletes, where it is evident that what is too much for one person is not so for another.

The same should be true for workers in industry.

However, there are differences the greatest of which may be motivation.

Most workers are highly motivated, and where compensation for working (psychological and financial) exceeds that for not working, that motivation is guaranteed.

The health care practitioner must help determine the extent of the injury, arrange treatment and take the appropriate preventative steps.

The onset of injury is generally preceded by a long series of reactions in the tissues.

Through knowledge of these various stages involved in such a developmental process, it is possible to initiate prevention before the injury arises, and before it becomes a chronic condition.

Understanding pain and fatigue are two key criteria in determining the cause and location of the injury – or pending injury – and designing a treatment – or prevention plan – for it.

So far, I have focused on how health care practitioners begin to look at RSI or work-related musculoskeletal disorders, and also mentioned the initial steps for you to begin to understand why injury prevention is just as important as injury treatment.

When I use the term work-related, it is generic, and can be applied to any industry.

The differences are in the types of injuries and in the different preventive strategies, based on relieving some of the stresses of work.

To reiterate from the beginning, my work stress is very different from yours, but understanding this and understanding how to best approach your job physically and psychologically can greatly reduce the likelihood of injury or further exacerbation of a current condition.

Prevention is truly the key and the most appropriate person to initiate this is you!

The first step is always the most difficult, but you health care provider will be proud of you for taking the initiative and the necessary steps to ensure your recovery and well-being.

Most health care practitioners must focus a good part of their energy trying to get the patient to realize that they must help themselves.

When a patient already knows this, the provider can focus more on the problem.

Those Christmas holidays may become more of a reality in the future, as you have not missed many days of work and you can really enjoy those breaks, because you are not injured!

In the next issue, I will expand on this topic a little more and give some examples of actual industry related injuries and treatments. Until then, have a great month and drive safely!

– Dr. Marc Blackstone is a chiropractor at City Health Chiropractic & Massage located in the RoadKing Truck Stop in Calgary, Alberta. Any questions or comments may be directed to him through his e-mail: or via telephone at 403-204-1205 or Toll-Free at 1-866-466-0026. You may also view this article and others on the clinic Web site:

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