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Strains and Sprains Prevention

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Strains and sprains are among the most common causes of lost work time and high workers' compensation claims costs. The impact can be felt for years. No one is immune to sprains and strains, but below are some descriptions, hints, and tips developed by the American Academy of Orthopaedic Surgeons to help reduce your injury risk:

What is a sprain?
A sprain is a stretch and/or tear of a ligament, the fibrous band of connective tissue that joins the end of one bone with another. Ligaments stabilize and support the body's joints. For example, ligaments in the knee connect the upper leg with the lower leg, enabling people to walk and run.

What is a strain?
A strain is a twist, pull and/or tear of a muscle and/or tendon. Tendons are fibrous cords of tissue that attach muscles to bone.

What is muscle soreness?
Sore muscles result primarily from micro-tears in the muscles from muscle overexertion.

What causes sprains and strains?
A sprain is caused by direct or indirect trauma (a fall, a blow to the body, etc.) that knocks a joint out of position, over-stretches, and, in severe cases, ruptures the supporting ligaments. Typically, this injury occurs when an individual lands on an outstretched arm, stops or changes direction suddenly, jumps and lands on the side of the foot, or runs/walks on an uneven surface. Chronic strains are the result of overuse - prolonged, repetitive movement - of muscles and tendons. Inadequate rest breaks during intensive work loads or training can precipitate a strain. Acute strains are caused by a direct blow to the body, over-stretching, or excessive muscle contraction.

How does a damaged muscle heal?
The healing process of a muscle strain begins with an inflammatory response, which can last for three to five days. This is a crucial time during which rest and protection of the injured part is vital in order to prevent any further damage. During the inflammatory reaction, the body produces chemicals and cells which remove dead muscle fibers and start the repair process.

The Repair Process
The repair process consists of three stages:

  • REGENERATION OF MUSCLE FIBERS - New muscle fibers grow from special cells within the muscle.
  • FORMATION OF SCAR TISSUE - There is bleeding in the gap between the torn muscle ends and, from this blood, a matrix, or scaffold, is formed to anchor the two ends together. This matrix eventually forms a scar within the muscle that makes the muscle more resistant to further stretch damage.
  • MATURATION OF THE SCAR TISSUE - The collagen fibers, which make up the scar tissue, become aligned along lines of external stress and are able to withstand more force.

Pre-Activity Warm-Up, Stretch, and Tips

  • All soft tissues (muscles, tendons, joint capsules, fascia, and skin) are more extensible when they are warm. Warm-up prior to exertion is thought to decrease muscle stretch injuries when the tissue temperature has been increased by one or two degrees.
  • All stretching is ineffective if it is performed when the body is cold and should therefore be preceded by a series of warm-up exercises to increase tissue temperature.
  • The total duration of the stretch should be about three to five breaths or 20 seconds.
  • Maintaining good muscle strength and flexibility may help prevent muscle strains.
  • Diet can have an effect on muscle injuries. Well-nourished muscles may be more resilient.

Preventing Muscle Strains
Several factors can predispose you to muscle strains. These include:

  • Muscle tightness - Tight muscles are vulnerable to strain.
  • Muscle imbalance - Antagonistic muscles work together, if one is stronger than the other, the weak muscle can become strained.
  • Poor conditioning - If your muscles are weak, they are less able to cope with the stress of exercise and more likely to be injured.
  • Muscle fatigue - Fatigue reduces the energy-absorbing capabilities of muscle, making them more susceptible to injury.
  • Insufficient warm-up - A proper warm-up is protective because it increases range of motion and reduces stiffness. Stretch slowly and gradually, holding each stretch to give the muscle time to respond and lengthen. You can ask a coach or your physician for help in developing a routine. Condition your muscles with a regular program of exercises.

Source: American Academy of Orthopaedic Surgeons

Steps in Preventing Work Strains and Sprains

  • Analyze tasks performed (movements, weights, duration, etc.) to identify muscle groups and joints at greatest risk first.
  • Write and use functional job descriptions for use in hiring/placement.
  • Have potential employee checked for functional capacity (Can they perform the essential functions of the job?).
  • Take steps to eliminate or reduce inherent/high-risk exposures through:
       - Work/task design changes
       - Providing mechanical interventions (carts, lifts, etc.)
       - Train employees in preventative measures
  • Individuals performing work tasks should:
       - Receive instruction in safe (bio-mechanical) task execution
       - Have muscle groups/joints prepared for work activity

Steps in Implementing a Workplace Warm-Up/Exercise Program
Identify the muscle groups/joints of highest risk first.

  • Review injury history for trends (back, shoulders, etc.).
       - Evaluate work tasks for greatest injury potential (e.g., heavy weights, high repetitions, lifting)
       - Carrying, pulling, pushing, extended reaches, etc.
  • Develop a conditioning routine including:
       - General, whole-body warm-up.
       - Specific higher risk muscle/joint area warm-ups and stretches.
       - Survey employees for needful modifications of the conditioning routines (individual employees’ physicians or therapists may offer appropriate alternative warm-ups or stretches).
       - Assign groups/group leaders and instruct leaders in proper conditioning routines, techniques, times of sessions, etc.

Additional Resources
WCF Insurance Safety Department
385.351.8103

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https://www.osha.gov
http://www.cdc.gov/niosh/

NOTICE: This guide may make reference to the Occupational Safety and Health Administration (OSHA) regulations; however the guide is not legal advice as to compliance with OSHA or other safety laws, codes, or regulations. Compliance with OSHA and other safety laws codes or regulations, and maintaining a safe work environment for your employees remains your responsibility. WCF Insurance does not undertake to perform the duty of any person to provide for the health or safety of your employees. WCF Insurance does not warrant that your workplace is safe or healthful, or that it complies with any laws, regulations, codes, or standards.

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