2. Greg Schroeder, PT, DPT TEAMWORKS Therapy, LLC
Investigating the mechanism of tissue injury, degeneration, and repair in Work-related Musculoskeletal Disorders (MSD)
Greg Schroeder, PT, DPT
TEAMWORKS Therapy, LLC

3. MusculoSkeletal Anatomy
12/7/2018
MusculoSkeletal Anatomy
Muscle
Tendon
Joint
Bones, muscles, joints, ligaments, nerves, circulation
Blood
Nerves

4. 12/7/2018
Gradual process of wear that exceeds the bodies ability to heal and repair the musculoskeletal system.

5. Common MSD’s Tendonitis or tendinosis Tendonopathy
12/7/2018
Common MSD’s
Tendonitis or tendinosis Tendonopathy
Epicondylitis or Epicondylagia
Tenosynovitis
DeQuervains Disease
Bursitis
Low Back Pain
Variety of potential causes
Ganglion Cysts
Muscle Sprains or Strains
Nerve Compression
CTS
Cubital Tunnel Syndrome
Thoracic Outlet Syndrome
Radial Tunnel
Others

6. Factors Related to MSD Excessive Force High Repetition
Prolonged Duration
Awkward Postures
Compression
Vibration
Psychosocial Stress at Work
Medical Conditions
Muscles and tendons most susceptible to repetition
Peripheral nerves most sensitive to compression
MULTIFACTORIAL

7. Local Changes in the MusculoSkeletal System
Tendons
-Injury- microtrauma
-Tissue inflammation occurring before overt signs of injury
-Fibrosis/scar: Quantity and Quality
Muscle
-Inflammation
-myofiber splitting
-fibrotic replacing of myofibers worse with higher force and faster velocity
-decreased muscle mass

8. Systemic Changes in the Musculoskeletal System
Release of Immuno-histochemicals
Hsp 72
Interleukin-1
Macrophage infiltration
Cytokine-mediated systemic inflammatory response
Spread of MSD symptoms to other extremities
Mistaken for faking

9. Changes in the Peripheral Nervous System

11. Changes in the Central Nervous System

12. Neuroplasticity
The ability of the nervous systems to change and adapt throughout life

14. CNS Changes Dedifferentiation of sensorimotor fields.
Repetitive task lead to degradation of the cortex
Chronic pain had as much as 11% on brain atrophy when compared to normals.

16. Early Intervention