Preventing Work-related Injuries: Soft Tissue Injuries

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Where does it hurt?

Sore shoulders. Aching arms, legs or feet. Bad backs. These aches and pains aren't just the result of getting older or being out of shape. They are often related to our work, especially for women.

In 1998, "strains and sprains" accounted for 40 percent of all injuries reported to Canadian workers' compensation boards. More women than men report these soft tissue injuries as a result of their work. For example:

  • Health care workers get bad backs.
  • Sewing machine operators have shoulder and neck problems.
  • Bank tellers and cashiers standing on the job get leg or foot injuries.
  • Computer users get hand, wrist, neck and shoulder problems.

These injuries usually sneak up on us. Women often get on with their jobs, trying to "work through" the pain or ignore night time tingling in their hands. But the injuries can become very painful and, sometimes permanent, disabilities. Depending on what is injured, other tissues can be affected. Work and other activities may be difficult: women may not be able to brush their teeth, hold their children, open doors, prepare food or carry groceries.

What are these injuries called?

  • cumulative trauma disorders (CTDs);
  • overexertion/overuse injuries; and
  • repetitive strain injuries (RSIs).

Specific names include:

  • carpal tunnel syndrome (nerves going through wrist);
  • degenerative disk disease (backbone);
  • epicondylitis (tennis or golfer's elbow);
  • myofascial pain/myalgia (tissue covering muscles);
  • rotator cuff syndrome (shoulder tendons);
  • sciatica (nerve to leg from discs);
  • tendinitis (tendons); and
  • tenosynovitis/de Quervain's (tendon sheath/covering).

What makes it hurt?

Work-related soft tissue injuries can be caused by these risk factors, often working in combination:

  • repetition: especially for fine movements;
  • force: lifting, pulling, pushing, vibration, contact pressure;
  • posture: awkward and static (in one position);
  • work environment: temperature, light, noise, humidity; and
  • work organisation: how hard, fast and long people work, how much say they have about their work and the equipment/tools they use, and social relations at work.

Women may have the same job titles as men but their actual work can be very different. Women's jobs often involve lots of repetition, precision work, static and/or awkward positions and tasks that are heavier than they look. For example:

  • Repetition is common for word processors, data entry operators, lab techs, garment workers and cashiers.
  • Most tools, workstations and equipment are designed for the "average" male. Desks, benches and conveyor belts are often too tall and/or wide for women, forcing them to reach or stretch. Static load -- holding any posture for a time -- further taxes the body. This includes standing, a position in which many women work (eg. cashiers, bank tellers, retail workers).
  • Women's work isn't always "light." Health care workers move patients, whatever their weight. Lifting many light objects can add up to a heavy load. For example, on average, a grocery cashier bags and lifts 11,000 pounds of groceries each day.

Work organization affects all other factors. For example:

  • Time pressure is important when dealing with people, packing boxes or keying data -- it can increase the amount of repetition and force used if you have no breaks or time to do the job properly.
  • Many women workers lack control (say) about everything from how they do their job to how long they have to do it.
  • Lack of proper equipment forces health care workers to put themselves at risk of back injuries while moving people.
  • Lack of respect and sexual harassment and/or stereotyping are additional stressors, combined with generally lower wages.

Studies show that being stressed by things like this increases the odds of having some soft tissue injuries, especially for the back, neck and shoulders.

How are soft tissue injuries prevented?

Prevention is the best way to tackle any occupational health and safety problem. For soft tissue injuries, prevention is based on ergonomics -- the science and art of fitting the job and the workplace to workers. For this we need:

  • fully-adjustable surfaces, equipment and work stations;
  • a choice of tools for different hands and tasks;
  • accessible mechanical devices for lifting people or materials;
  • fully-adjustable chairs or sit-stand stools; and
  • to prevent stress by such things as:
    • having more say about your job and how you do it;
    • doing a variety of tasks;
    • reasonable schedules, hours of work and breaks;
    • adequate staff levels; and
    • proper training about the job and using ergonomic equipment.

How can I deal with a work-related soft tissue injury?

By law, employers must provide healthy and safe work for everyone in their workplace. They are in the best position to make necessary changes to prevent injuries. But sometimes individual workers and/or their unions must argue for solutions. Individuals can:

  • File a workers' compensation claim.
  • See if others have similar problems: use body or workplace maps, surveys or just ask around.
  • Adjust your work area/equipment to do tasks in the most neutral/relaxed position possible.
  • Get help to lift people or things report injuries to your employer (and union).
  • Ask your employer, union and/or government health and safety department to investigate your job and recommend changes.
  • Use your legal right to refuse a task that you think may hurt you.
  • Take care of yourself:
    • See your doctor about getting time off, "light duty," splints, referrals.
    • Go to a specialist (rheumatologist, physical/rehab medicine) or occupational health centre.
    • Investigate massage, physiotherapy, chiropratic treatments, exercise (eg. yoga, Pilates, Alexander technique, Tai Chi).
    • Take your breaks, walk at lunch and/or do exercises on the job (eg. shoulder rolls, stretching).

For the rising number of women who are self-employed, the responsibility rests on the women themselves to ensure their workspace is set up to avoid work-related injuries.

Where can I go for more information?

Revised June 2006.