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!