builder elbow pain

How a physio can help with the five most common work related injuries

Twenty years ago, Repetitive Strain Injuries (RSI) were mostly associated with wrist and elbow problems in typing. The term refers to any injury caused by a repetitive task leading to a minor strain or injury. A lot of our patients come to us to seek help from our physios, sports therapists and osteopaths, not just to help them recover from sporting injuries but also from work related injuries. In today’s world, many of us spend 35 hrs a week doing the same repetitive task, which could be from being at a desk, factory work or tradespeople doing the same repetitive task. RSI injuries can now be found from head to toe.

The funny thing about work related injuries is that they often first reveal themselves in our sport or hobby time, so finding out the true cause of the issue is key to resolving it. For example, suppose you have a problematic lower back caused by long periods of sitting at a desk. It can suddenly become acute when playing golf because of the explosive force and optimal movement needed for the swing.

Work related injuries range from low-grade and annoying muscular pain to sudden-onset acute high-pain conditions. They can wear away at you – leading to low mood, fatigue and depression, and, ultimately, time off work. The Health & Safety Executive report states 7.3 million workdays were lost to musculoskeletal disorders in 2021/2, and 17 million days were lost to stress, depression and anxiety.

Here are our 5 most common work related repetitive strain injuries that our physios, sports therapists and osteopaths regularly treat:

1. Lower Back Pain

If we were to hazard a guess, we would estimate that about 30% of the patients we see come to us with some form of sudden or longstanding lower back pain either caused directly or exacerbated by their work. Prolonged periods of forward bending, such as with car mechanics, sitting for long periods of time at a desk or lifting and side-bending movements as with manual workers, are common movements that impact the 5 vertebrae in your lumbar spine. A disc, like a cushion, in between each vertebra absorbs force and helps with movement. A herniated lumbar disc can wear down and degenerate over time, leading the inner core can leak out through the outer part of the disc, creating a bulge and pressure on a nerve root.

The nerves run directly down the legs, so any issue in the spine can cause pain to radiate down the legs. A herniated disc is often called a prolapsed disc, slipped disc, or bulging disc, and there are several grades of injury. Believe it or not, it is estimated that as much as 75% of the population would show a disc herniation on x-ray, without being symptomatic, at any point in time.

Muscular back pain

Muscle pain is common and usually a result of fatigue or muscle aching. They are almost always caused by an imbalance of muscular strength attributed to poor posture. Our lives now involve a lot of forward bending – we lean over, sit for long periods, and then go home and sit on the sofa. We bend to look after our children, pick things up, and do our jobs, but we rarely extend or arch our backs. Similarly, our spines are designed to twist and side-bend too, and these movement patterns rarely feature in our modern day-to-day lives. Without a regular and full range of motion, our minor muscles need to support a lot of weight for long periods of time, which can lead to back pain.

2. Shoulder Impingement Syndrome

Warehouse workers, assembly-line workers, plasterers, window cleaners, and computer users regularly require treatment and rehabilitation for symptoms of an impinged shoulder. When minor, repetitive, and innocuous injuries to the shoulder’s rotator cuff tendons occur, such as repetitive tasks, the tendon responds by swelling. As the tendon swells, there is less clear space under the acromion bone at the top of the shoulder blade, and when lifting your arm, the tendon can catch or impinge under it. This causes further injury, inflammation and swelling, leading to vicious pain.

3. Neck Pain

In a work environment, neck pain is often contributed to by a ‘forward head’ posture, such as those of us who work at a desk or laptop. Our heavy heads are in advance of our centre of mass – the supportive framework of our necks, which places additional force on the structures of the neck and increases the demand on the neck muscles, back and shoulders, causing them to overwork and fatigue. This leads to a restricted range of motion of the neck, a posture that can’t be ‘stretched out’, and tight and painful bands of muscles that are commonly referred to as ‘knots’. Symptoms can worsen over time, contributing to headaches, shoulder and upper back issues, and nerve pain (see below).

Cervical radiculopathy (nerve pain)

Some people suffer neck pain that radiates down into the shoulder and arm. Most of the time, this pain is caused due to an injury near the spinal nerve root – often called a pinched or trapped nerve in lay terms. As with the lower back, the vertebral discs of the neck can wear down and degenerate over time, and the inner core can leak out through the outer part of the disc, creating a bulge and pressure on the nerve resulting in pain, pins and needles, numbness and strange sensations to the arm and hand.

4. Tennis Elbow (Lateral Epicondylitis)

Tennis elbow (lateral epicondylitis) is a painful condition caused by overusing the elbow. Playing tennis and other racket sports can cause this condition. Still, we commonly see patients suffering from tennis elbow because their jobs involve lots of gripping and twisting, such as plumbers, painters and carpenters. Nationally, research has shown that cooks, car workers and butchers get this condition more than the rest of the population.

Tennis elbow is when the tendons joining the forearm muscles along the outside part of the elbow become inflamed or degenerate because they respond negatively from overusing the joint. Repeatedly using the same muscles over and over can irritate the tendon insertions, which leads to tenderness and pain on the outer part of the elbow. Golfer’s elbow (medial epicondylitis) is a similar, less common condition affecting the inside of the elbow and is commonly suffered by those who use paint brushes, screwdrivers or a hammer.

5. Heel pain and plantar fasciitis

Those who stand for long periods, especially with limited opportunity to walk with a normal and full stride, can experience pain in the heels and soles of the feet. Warehouse workers, production line operatives, and people wearing stiff steel-capped boots often report heel pain and problems with the foot’s plantar fascia. Plantar fasciitis tends to be the most common cause of heel pain. The plantar fascia is a flat band of tissue that connects the toes and the heel bone together. It supports the arch in your foot. When the plantar fascia becomes too tight or short, it can pull against your heel bone, causing pain and inflammation. Your heel will end up hurting whenever you walk or run. Commonly it is worse in the morning, where it has healed overnight and reinjures as you start to bear weight and move around for the first part of the day.

How to avoid work related injuries

Many of our patients experience injuries due to repetitive actions they make as part of their job. It is key that you start by understanding what work related injuries you are at risk of developing. A physio, sports therapist, or osteopath can assess, guide and prescribe some mobility and strength work to help keep problems away. Whilst you are not training as you would for sporting activity, it is important to be fit and strong to do physically intense work. Whatever you do for work, ensure you take regular breaks and keep moving. If you work at a desk, don’t forget to regularly review the ergonomic nature of your workstation.

Need help?

And finally, don’t overdo it! It is so easy to bring work home these days and allow the boundaries between work and home life to blur. Our physiotherapists, sports therapists or osteopaths are on hand to help alleviate most work related injuries and prescribe a course of treatment. Get in touch to see how we can help.