MSD: Nutrient Pathway Disorder

If we assume MSD overuse disorders are NUTRIENT PATHWAY DISORDERS, then we can envision a range of effective prevention strategies.

Muscles contract, pulling on tendons, working across  joints, as discs and joints undergo weightbearing loads.  All these physical actions create pressure within these tissue… pressures that exceed the perfusion pressure of circulation feeding and cleansing these tissues.

If perfusion is blocked, tissue must work anaerobically (glucose and its precursors are stored in muscle, but oxygen must be continuously delivered during work). Work with inadequate O2 delivery burns way more glucose than work done aerobically, creating way way more metabolic wastes… which are now trapped in these tissue by blocked perfusion.  Metabolites accumulate to the point of creating inflammation.  The pain creates background muscle tension, increasing loads on muscles, tendons, joints.  Viscious cycle.

Recurring Inflammation increases damage-degeneration.  Accumulation of disorganized collagen and reduction in water content reduces elasticity, further increasing damage-degeneration.  These changes reduce work tolerance of hardwprking tissues.

Therefore… the key to preventing (and reversing) these cycles is to restore nutrient pathways to working tissues.  Improving ergonomics to reduce posture strain, repetitive motion, stressful movements, and tissue loading mechanics can reduce the degree of nutrient pathway obstruction (but certainly not eliminate the risks).

Imposing a variety of tasks (job rotation hourly, switch between computer mouse versus trackball hourly, switch between sit versus stand hourly) can redistribute the day’s physical demands across more tissues, thus reducing total loading per tissue, thus reducing physical demands to a non-toxic level.

Hourly micro-stretches that specifically target the hardest-working tissues can directly restore tissue perfusion throughout the workday.  This is key to protecting workers when ergonomics corrections or work task rotation-variety are not available options.  See our essay on micro-stretching.

None of these interventions will occur without everyone in the workplace being educated, not just on WHAT to do, but WHY to do it.  This will motivate everyone to commit to doing what is good to maintain and improve tissue perfusion.  Why will they do it?  A hard day’s work creates fatigue, discomfort, pain.  People don’t want that.  If we explain these tactics will reduce their suffering, people try them, feel better, and commit to keeping up taking care of themselves.  At least that is what we have seen at the last 600 workplaces we have delivered this program.

The “E’s” of MSD Elimination… Ergonomics, Exposure-reduction, Exercises, Education.


Author: laurendpt

Dr. Physical Therapy, Ortho Specialist, Ergonomics Specialist, founder of IMPACC and the No-Lost-Time MSD Prevention & Ergonomics & Aging Worker programs. Home in Dixfield, ME

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