The Silicon Valley Forum of The Commonwealth Club of California

Here are some notes I took at the subject meeting that may be of general interest as well as the related article noted at the bottom of this message.

How to Treat and Prevent this Postmodern Affliction
The Silicon Valley Forum of The Commonwealth Club of California, met at 6:00 pm on Thursday, 2/5/98, at Hyatt Rickeys (Camino Ballroom D) at 4219 El Camino Real in Palo Alto. The occurrence of painful, disabling repetitive stress injuries to the upper extremities, back and neck is increasing, despite – and in some cases, due to – faster, improved workstations. What can be done to prevent the musculo-skeletal damage that can bring the most creative worker to a frustrating standstill? Bob Teller Da, kinesiotherapist and founder of the group For Those In Pain, Inc. moderated a discussion by a panel of experts which shared their insights on how to treat and prevent this serious, modern day affliction, and answered questions from attendees. The panel consisted of:

  • Dennis Ettare, developer of the successful training protocol Muscle Learning Therapy
  • Michelle Neufeld, physical therapist
  • Dr. Stephen Nord, specialist in occupational medicine

Dr. Stephen Nord – Introductory Statement
Cumulative Trauma Disorders (CTDs) consist of daily damage that is not healed while resting at night. He related people as machines human tissues also have wear characteristics, such as blisters. CTDs affect muscles, tendons, bones, sheaths. The injury mechanism is not clearly understood but he mentioned three basic issues consisting of failure of lubrication, mettle fatigue, and relative lack of blood supply.
CTD treatment problem (medical vs mechanical)
* Splints/rest/return to work – same work that injured
* Biofeedback to train worker to use less effort

Michelle Neufeld – Introductory Statement
RSI is the greatest PT dilemma being 60% of injuries costing $20 billion a year. Medical protocols are not adequate – driven workers without employer support results in workers compensation cases. Proactive measures such as software and open communications for early intervention is imperative. Companies and medical must react fast. Must keep people working (bedrest vs reduced duty). Strengthening? Overusing inappropriate muscle groups and too vigorously.

The most effective approach is gentle stretching, aerobic exercises (blood flow), PT modalities, contrast baths, alternate work, and an ergonomics evaluation. RSI sufferers continue to have pain after treatments and need training and self management skills. Dennis Ettare – Introductory Statement. Why more injuries now? We need to train to reduce muscle loading during work.

What is really going on and what we can do about it? Researchers are not sure how muscle tension leads to muscle pain. Treating trigger points by injection and massage are just bandages and not treating the real cause. With increased workloads and restricted worksites, we must take control ourselves. Information and feedback is needed. The sympathetic nervous system feeds into the skeletal system. Are we dealing with the signal or the problem? (Warning system vs problem). Nervous system provides early warning system. The workstations are not the problem but the pressure to do more work in less time. All tools were slower before and we need ways to be taught to reduce the muscle tension in the working environment.

Muscle Learning Therapy (MLT) is a unique training methodology. Biofeedback is used to measure forces put into soft tissue injuries. Our best workers are getting this injury. Humans are the weakest link in the chain. With social and work pressures, and ergonomic changes, workers work harder to keep up. Instead of removing our early warning system, we need to reduce muscle loading. Ergonomics and worker training are needed; otherwise we are seeing the quiet before the storm.


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