Preventing Shoulder Injuries in the Industrial Workforce: Strategies and Insights
Shoulder injuries are prevalent in both the general population and throughout many different industrial settings, often due to high loads, repetitive motions, and high-paced environments which lead to inadequate recovery and unhealthy behaviors. Addressing these issues requires a team approach, a combination of prevention strategies and ergonomic considerations that are grounded in evidence-based practice.
Understanding Shoulder Injuries in the Workplace
Shoulder injuries can be thought of in several different categories: stiff and painful (i.e., frozen shoulder, osteoarthritis), weak and unstable (i.e., shoulder instability), traumatic (i.e., fracture from a slip-and-fall onto the shoulder), and weak and painful.
Most shoulder injuries in the industrial setting can be classified in this weak and painful category, which encompasses such diagnoses as shoulder impingement, biceps tendinopathy, rotator cuff tendinopathy, shoulder bursitis, and strain of the rotator cuff muscles.
It's become popular to coalesce the weak and painful shoulder under the diagnostic label of rotator cuff-related shoulder pain, although rotator cuff tendinopathy and shoulder impingement are still common diagnoses which all mean the same thing: the shoulder hurts, typically with overhead activities, and it’s weak.
The evidence shows that these conditions are multifactorial, influenced not only by biomechanics and overuse, but also lifestyle factors like physical inactivity and smoking.
Preventative Measures for Shoulder Health
There’s no strong evidence to suggest that overhead work increases the risk of shoulder pain or injury, but that doesn’t mean there should not be any effort to make overhead work easier. Not every worker has the same level of health, same level of strength, endurance, resilience or rate of recovery. It would make sense to make tasks more efficient (demanding less energy), allowing them to do more work in a less fatigued state.
Incorporating things like assistive tools, two-person lifts, lowering the heights necessary to lift to, and teaching biomechanics can help accomplish this task.
For example, if a worker tends to flare their elbows out to the sides while lifting overhead, this will put more stress on their rotator cuff (as the rotator cuff works in more than just rotating the arm), whereas if they keep their elbows more in line with their shoulders, this will place more stress on their deltoid. This is not to say one approach to overhead lifting is better or worse; it’s simply a matter of educating workers so they know there is more than one option to complete a task, which is especially helpful if they become sore with a certain lift, or get injured.
Strength and Conditioning Programs
Preventative measures can encompass many different aspects, some of which do not have a primary focus on the shoulder itself.
Strengthening the shoulder and the surrounding muscles can have a positive impact through making the required lifts easier to perform, and building endurance means one can perform optimally before fatiguing – and recover from fatigue quicker.
Example of I, Y, T exercises
Exercises that involve pushing, pulling, rotating the arm with the elbow at the side or at shoulder height, and pushing up overhead, can all be great options. Common examples are pushups, pullups, bands for scaption, ‘I’s, ‘Y’s, ‘T’s, and ‘A’s. The lower body, core, and hips can be forgotten in this, but they too can help play a role in overall strength and efficiency with overhead lifting.
Example of thoracic spine mobilization using a chair
Flexibility is another prime target, which can be accomplished via exercising through a full range of motion. However, stretching can also improve flexibility, and one area that is often neglected is thoracic extension. Improving one's thoracic extension will allow more access to overhead shoulder range of motion. This can be targeted through the simple use of a foam roller placed perpendicular to the thoracic spine, with an individual holding their head with interlocked fingers and gently leaning back into thoracic extension or using the back of a sturdy chair and using the back to help mobilize the thoracic spine.
*Disclaimer: These exercises are for educational and informational purposes only. Please consult with your onsite or near-site Advanced Industrial Medicine athletic trainer, physical therapist, or occupational therapist for more information or if you are experiencing discomfort.
Lifestyle Interventions
How can you be healthier?
For some, it may be meeting the World Health Organization’s recommendation for physical activity, which is 150-300 minutes of moderate cardiorespiratory activity, or 75-150 minutes of vigorous cardiorespiratory activity a week, or a combination of the two, and two days a week of resistance exercise. While these numbers may appear daunting, even doing a little bit more than what one is currently doing can be extremely effective. The benefits increase exponentially for those who are not as active, while they're much more modest for those already meeting the recommendations. Simply put, more is better, but a little goes a long ways.
Having high blood pressure, high blood sugar, diabetes, or being a smoker or overweight (especially around the midsection) increases the risk of shoulder pain and can prolong shoulder pain. Because of this, in the previous section, it was mentioned that one of the preventative measures can have absolutely nothing to do with the shoulder itself, and it’s this.
Encouraging physical activity (e.g., increasing step count by an extra couple hundred every few weeks, biking, yoga) and addressing modifiable risk factors, such as smoking and obesity, can positively impact shoulder health.
Conclusion
Industrial health and safety professionals play a pivotal role in reducing the burden of shoulder pain through proactive prevention and targeted rehabilitation strategies. It is extremely important for there to be open communication among employees, supervisors, and onsite healthcare professionals to ensure early detection and effective management.
By combining ergonomic adjustments, structured exercise and flexibility programs, and lifestyle interventions, organizations can foster a healthier workforce and minimize lost time and other costs due to shoulder pain.
Let’s work together to help you and your team thrive by developing and implementing these strategies to reduce shoulder pain.