Kimber Roderick has worked as a PT Assistant for 21 years. In this post, she discusses the types of patients a PT may see and some common injuries they face. Hint: it’s not who you expect.

Author: Kimberly Roderick

Working as a Licensed Physical Therapist Assistant for the past twenty years, I have worked with a variety of diagnoses. They range from acute sports-related injuries (ex: torn ACL) to ergonomic injuries (ex: carpal tunnel). Some of the most common ergonomic injuries I treated were from professionals you probably wouldn’t assume need physical therapy.

As a licensed or aspiring PT, you’ll come across all kinds of patients and all kinds of injuries. First, let’s look more at how important ergonomics are to the wellbeing of your patients.

The Ergonomics of it All 

Most people aren’t aware of how important ergonomics are to staying injury and pain-free. As a PT, you can educate your patients on the importance of correct ergonomics. According to the U.S. Bureau of Labor Statistics, 33% of all reported work injury and illness cases are related to ergonomic injuries.

Tell them to watch out for things like:

  • Forceful exertion
  • Repetitive motion
  • Abnormal temperatures or vibration
  • Prolonged periods in awkward positions
  • Prolonged pressure on a particular body part

In the clinical field, these risk factors can lead to injuries classified as:

  • Repetitive Stress Injuries (RSI)
  • Repetitive Motion Injuries (RMI)
  • Musculoskeletal Disorders (MSD)
  • Cumulative Trauma Injuries (CTI)
  • Cumulative Trauma Disorders (CTD)

So how does this manifest in the real world? Some examples of ergonomic injuries that you may see in your patients include:

  • Tendinitis
  • Trigger finger
  • Muscle strains
  • Carpal tunnel syndrome
  • Epicondylitis/elbow injuries
  • Rotator cuff/shoulder injuries
  • Lower back injuries such as pinched nerves

So is everyone doomed? No. But there are some professions that put people at higher risk for ergonomic injuries. Don’t be surprised if you treat the following professionals for ergonomic issues.

Who Are Your Patients?

1. Plumbers

Plumbers may have to spend long periods in cramped spaces in either extreme cold or extreme heat, depending on the time of the year. Working in cramped spaces means having to work in awkward positions (ex: think about the last time you had to crawl under a sink.)

Plumbers may also be at high risk for repetitive motion injuries as they do the same repetitive motions daily. These factors put plumbers at increased risk for all of the above listed ergonomic injuries.

Consulting with a physical therapist regularly would be extremely beneficial for a plumber. Some recommendations might include:

  • Stretches for muscle tightness
  • Changing hands for repetitive motions
  • Specific exercises for postural stability
  • Take regular breaks (5 min. break every 30 min.)
  • Awareness of joint and spine alignment while working

2. Surgeons

Surgeons spend many hours bent over an operating table, performing repetitive motions. They will often have back to back surgeries with little time in between. While conditions aren’t cramped like those of a plumber, the amount of moving they can do is limited. Also, operating rooms are often extremely cold or extremely hot, depending on the type of surgery.

Leaning forward as surgeons do puts excessive strain on the neck and upper back.

In fact, for every inch the head moves forward, it gains about 10 pounds of weight for the muscles of the neck and upper back to hold up. These factors put surgeons at risk for injuries to the neck, shoulders, thoracic spine, and low back.

Surgeons could also benefit from ongoing consultation with a physical therapist. Some recommendations that a therapist might make to optimize a surgeon’s work area:

  • Appropriate lighting
  • Anti-fatigue floor mats
  • Compression stockings
  • Adjusting monitor height
  • Adjusting operating table height
  • Having equipment within close reach
  • Using a step stool for changing weight distribution
  • Specific exercises for posture & to reduce tension

3. Professional Musicians

As cool as it seems to be a big name professional musician, they are at a very high risk for ergonomic injury. Especially repetitive motion and forceful exertion. Aside from the fact that their arms are often reaching out in front of them for long periods, which often leads to muscle strain and back injuries.

Willie Nelson and Ringo Star are just two prominent musicians who have reported having surgery due to ergonomic injuries. The physical demands of playing an instrument coupled with the adrenaline produced by playing for an adoring crowd creates a recipe for injury. This recipe puts professional musicians at risk for all types of ergonomic injuries.

Some recommendations a physical therapist might make for a professional musician include:

  • Warm-up properly
  • Good instrument fit
  • Maintain proper posture
  • Maintain a healthy shoulder and wrist position
  • Take regular breaks (5 min. break every 30 min.)
  • Specific exercises for posture & to reduce tension

4. Auto Mechanics

Try standing with your head tilted back and your hands over your head. That starts to feel uncomfortable in approximately one minute. Now add the twisting motion of using a ratchet or screwdriver coupled with the force it takes to unscrew a car’s nuts and bolts. Ouch! That is just one of the many awkward positions that an auto mechanic must assume during their workday.

Bending forward over a car’s engine while trying to get their hands into tight spaces can be equally as painful. Yes, cars are primarily computerized today, and diagnostics have become easier for the auto mechanic; however, there are still many working parts to tune up and fix.

Auto mechanics are at risk for every ergonomic injury on the list. A physical therapist for an auto mechanic might recommend:

  • Take regular breaks (5 min. break every 30 min.)
  • Regular stretching of tight muscles
  • Using a step stool for weight distribution
  • Changing hands for repetitive motions

5. Dental Hygienists

Dental hygienists spend their days sitting in a chair bending forward while performing repetitive fine motor motions. The precision of working on teeth while taking care not to cause pain to their patients can create a lot of stress on their neck and back.

Proper ergonomics also play a crucial role in preventing injuries in this profession. Some suggestions that a physical therapist might make:

  • Using a magnifying lens
  • Using lightweight instruments
  • Stretching in between patients
  • Using the most efficient instruments
  • Staggering patients with longer procedure times
  • Learning to reduce the muscle pinch force during treatment
  • Using tools with a good grip surface and a larger handle diameter

What Kind of Physical Therapy is Helpful for High-Risk Professions?

Manual Therapy

Massage, joint mobilization, and gentle stretching to muscles and joints provide increased blood flow. Manual therapy also helps carry away built-up toxins and improves joint range of motion. Keeping muscles and joints healthy and free from restriction can significantly reduce the incidence of injury.

Ultrasound/Phonophoresis  

Ultrasound and phonophoresis are used to improve circulation and decrease inflammation. Both can be very effective treatments for repetitive use and sustained posture injuries, including:

  • Bursitis
  • Tendonitis
  • Frozen Shoulder
  • Muscle strains and tears
  • Sprains and ligament injuries
  • Joint contracture or tightness

Electrical Stimulation/TENS

Electrical stimulation and TENS are used for pain relief, to relax muscle spasms, and to improve circulation. These are also excellent treatments to relieve muscle pain and tightness as a result of ergonomic injuries.

Iontophoresis

Iontophoresis provides a more direct treatment to a smaller surface area about the size of a half-dollar, so it is more appropriate for smaller areas of overuse such as:

  • Bursitis
  • Tennis Elbow
  • Golfers Elbow
  • Trigger Finger
  • Carpal Tunnel Syndrome

Body Mechanics Education 

Educating patients on proper body mechanics is essential to preventing ergonomic work injuries. As each profession provides a different set of circumstances, the physical therapist must be able to troubleshoot with the patient to find out what positions they work in and how best to maintain proper body mechanics in those positions.

Patients must also learn the importance of:

  • Regular stretching
  • Taking frequent breaks
  • Changing positions often
  • Knowing the signs of repetitive use injuries
    • Tingling
    • Numbness
    • Persistent pain
    • Heaviness in extremities

Therapeutic Exercise 

Stretching tight muscles and strengthening muscles that have stretched out due to prolonged sustained posture is pivotal in preventing muscle imbalance. When one muscle group is working harder than its opposing muscle group, the risk of injury increases dramatically.

Targeting the muscles involved in work posture and general fitness will decrease the incidence of work-related muscle pain and tightness and increase the patient’s overall well being.

PTs Have Your Back

While these five professions won’t make up your entire patient roster, keep an eye out for these people who may not think they need or would benefit from PT. All of your patients will benefit from regular stretching, position changes, and knowing the signs of muscle fatigue and overuse.


What’s Next

If you’re currently in or looking to begin a career in physical therapy, getting certain certifications are an important step. Pocket Prep has you covered with study support through the convenience of a mobile app.

Our Medical Pocket Prep app features study prep for several PT certifications including the NPTE-PTA and the NPTE-PT. It’s free to download and all premium accounts feature a three-day free trial period. When you’re ready to study, we’re here to help.

Author Bio:

Kimberly Roderick is a Licensed Physical Therapist Assistant with 21 years of experience in the medical field. She is also a freelance writer in the health and wellness realm. In her spare time, she enjoys boating, fishing, and playing with her two Boxers, Letty and Finn. Visit her at www.krwrites.com.