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Work Related Shoulder Injuries –
Cumulative vs. Acute
Bradford L. Boone, MD
SupraspinatusInfraspinatusSubscapularisTeres Minor
Rotator cuff muscle anatomy
Rotator Cuff Function Humeral head depression Humeral elevation/abduction Humeral internal rotation Humeral external rotation
Rotator cuff functions
Repetitive strain Keyboard operators Light assembly line work
Occupational shoulder problems
Chronic tendinitis Impingement syndromeRotator Cuff tear
Most common in moderate to heavy work occupations requiring sustained loads with the shoulder partly abducted and for forward flexed
Occupational shoulder problems
Acute – direct trauma causing fractures and or soft tissue injury –
Rotator cuff tears Fractures Dislocations Instability issues
Occupational shoulder problems
25 years of age45 years of age55 years of age65 years of age75 years of age
“Normal”- Age degeneration in the shoulder
Heavy LaborerOffice workerStockerOil FieldNurseProfessional Athlete
What is “Normal” wear and tear?
Congenital Anomalies of the shoulder
Bony AbnormalitiesMuscular AbnormalitiesNeurovascular Abnormalities associated with Congenital anomalies
Other factors
Previous surgeriesPrevious injuries
Other factors
When is a cumulative trauma to the shoulder work related?
Who is likely to have a cumulative trauma to the shoulder?
Cumulative Vs. Traumatic
ConservativeSurgical
Treatment Options
Thank you!