REPETITIVE MOVEMENTS

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    REPETITIVE MOVEMENTS

    Repetitive stress injuries or musculoskeletal disorders or overuse injuries are increasingly presented as a challenge for physicians. They consist of a variety of musculoskeletal disorders, usually of the tendons, muscles or joints, as well as some peripheral nerve entrapment and vascular syndromes. These disorders generally affect the back, neck, upper limbs and lower limbs. Although repetitive strain injuries can occur as a result of sports and recreational activities, they are also of an occupational nature, which affect the patients life, which are particularly important. These injuries are the result of repetitive and forceful movements, forced postures and other conditions related to work and ergonomic risks. Occupational injuries are generally expensive, becoming risk factors that can be a source of occupational disease.

    Repetitive strain injuries or musculoskeletal disorders are terms used to refer to a series of discrete conditions that may be associated with repetitive tasks, intense efforts, vibrations, mechanical compression, or sustained positions during a certain time. Examples of these conditions include edema, tendinosis (or less often tendonitis), carpal tunnel syndrome, cubital tunnel syndrome, Quervain syndrome, thoracic outlet syndrome, intersection syndrome, golfers elbow (medial epicondylitis), elbow of tennis player (lateral epicondylitis), trigger finger (called stenosing tenosynovitis), radial tunnel syndrome, and focal dystonia.

    Since the 1970s there has been a worldwide increase in repetitive strain injuries of the arms, hands, neck and shoulder attributed to the widespread use of typewriters, computers, tools and equipment in the workplace that require long periods of repetitive movements in a fixed posture.

    MECHANISM OF ACTION

    The workload, both static and dynamic, along with the psychic and organic factors of the worker, as well as an unpleasant and non-rewarding environment, add up in the formation of muscle fatigue. As fatigue becomes more chronic appear contractures, pain and injury. A vicious circle of pain is formed.8 The research works focused on the study of injuries by repeated movements have revealed the existence of factors that intervene in the appearance of musculoskeletal injuries:

    Biomechanical effect:

    *Forebrain and / or wrist forearm movements, especially if performed against resistance.
    *Repeated extensions and wrist flexions.
    *Repeated radial or cubital deviations.
    *Existence of repeated movements against resistance.

    Predisposing factors:

    Women in menstrual period and pregnancy.
    Anatomical anomalies: larger semilunar.
    Abnormalities in synovial fluid quality.
    Triggers:

    Organizational:

    little autonomy, supervision, workload, manual handling of loads, task cycle.

    Traumatological:

    In the lesions associated with repeated work as well as repetitiveness, there is a set of factors that interact with the repetitiveness and with the duration of work cycles, increasing the risk of injury and fatigue. For example, strength and repetitiveness interact in such a way that high forces and high repetitiveness increase the risk in a multiplicative way. Both epidemiological and experimental data indicate that extreme postures increase the risk of injury. Likewise, the high speeds of the movements and the duration of the exposure, in minutes per day, and in the number of years, influence the risk of injuries in repeated work.