Working Without Pain
From carpal tunnel to tendinitis -- cumulative injuries and the building trades.
Synopsis: If you’ve ever wondered why your wrist is constantly sore or your shoulder always seems stiff, here’s a place to learn why. The author describes several cumulative trauma disorders that affect the building trades and offers tips for avoiding them.
A carpenter saws off a finger. A painter or roofer falls from a ladder. Most people in the building trades are well aware of the risks they take everyday (regardless of whether they take precautions). Construction, in fact, is one of the most dangerous industries.
But in recent years, there has been a growing awareness of a different class of injuries: those known as cumulative trauma disorders. Unlike a sudden injury such as a broken bone, cumulative traumas are caused by the gradual accumulation of small, sometimes unnoticeable, injuries that eventually result in pain. These disorders damage nerves and tissues resulting from long-term repetitive activities, such as years of swinging a hammer or picking up bricks. In fact, more than 16 million workdays are lost in the U. S. each year because of cumulative trauma disorders. But such injuries are not inevitable if you know the proper work methods
This article will focus on the most common cumulative trauma disorders faced by people in the home-building trades: injuries to the upper extremities (hand, arm and shoulder). Most upper-extremity problems can be understood once you understand a bit of anatomy and the nature of connective tissues.
The body’s shock absorbers
The main victim of cumulative trauma disorders is the body’s system of connective tissues—muscles, bones, tendons and ligaments. Muscles are the body’s active suspension system. By contracting and relaxing, they move the bones —the body’s framework. They also absorb the stress of impact, protecting the bones from damage. Muscles are attached to bones by tendons—tough, dense, elastic tissue. But tendons are more than mere fasteners: they transfer muscle power over a distance. The muscles that control your fingers, for instance, are in your forearm and palm; packing them into the fingers would make fingers too stubby to be useful. Long tendons make the connection, acting much like the strings of a marionette. Ligaments connect bones to one another and hold organs in place. They are pliable but strong, letting the joints move but keeping that movement within safe limits.
There is a fine balance between damage and repair in this system. Although the body can safely adapt to strenuous work, it cannot do so overnight. Connective tissue may need weeks or months to adjust to a new task. But it may take only take a few days—or even a few hours—for a worker to do appreciable microscopic damage to underdeveloped soft tissue. Even a conditioned worker can be injured when the frequency or force of activity increases too much.
Particularly susceptible are workers who have to perform the same task all day long. It’s the same kind of problem that develops when a three-times-a-week runner begins training for a marathon by running on a daily basis; without a one or two day lay-off, the runner feels pain and sees redness arid swelling in the injured area. If such a program is not instituted slowly, it can easily cause permanent damage.
For more photos and details on cumulative trauma disorders in the construction field, click the View PDF button below.