Massage & Bodywork

November/December 2012

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technique CLASSROOM TO CLIENT | @WORK | ENERGY WORK | MYOFASCIAL TECHNIQUES Delivering Care for Delivery Workers By Whitney Lowe Delivery workers have one of the highest rates of musculoskeletal injury compared to other occupations. The television show King of Queens might portray Doug Heffernan as a lighthearted, rarely debilitated delivery worker, but in reality, this occupation is physically and mentally demanding, with injuries comparable to those experienced by professional athletes. The unique biomechanical Approximate axis of rotation challenges of this occupation put these workers at significant risk for a host of musculoskeletal complaints, including injuries to the shoulders, neck, back, head, and knees. Delivery workers have several work-related challenges: long periods of seated driving, repetitive lifting and bending, heavy lifting, reaching, jumping out of vehicles, going up and down stairs, opening and shutting cargo doors, and being on a hectic time schedule. Poor posture during these activities adds to the risk of injury. Of course, there are particularly high rates of injury and pain in the 1 The approximate axis of rotation for spinal flexion and extension. Note how close the axis is to the lumbar extensor muscles, making it difficult for them to generate large forces. 3D anatomy images. Copyright Primal Pictures Ltd. neck and back, but shoulders, upper extremities, and lower extremities are also at risk. My previous articles on musicians (January/February 2012), dentists (March/April 2012), and hotel workers (May/June 2012) covered shoulder injuries; here I focus on low-back and knee problems. Massage treatment is very effective for addressing these disorders, but more importantly, massage helps relieve the cumulative stresses that can lead to more debilitating conditions. BIOMECHANICS OF LOW-BACK MUSCLE INJURY The primary action of the torso in lifting is lumbar extension, mainly with the lumbar extensor muscles. Other muscles contribute to lumbar extension, but the main extension force is generated by the erector spinae muscle group. Improper lifting routinely puts stress on these muscles, which leads to muscular injuries such as strain, spasm, or chronic hypertonicity. One of the reasons back injuries are so frequent is that the lumbar muscles are in a poor mechanical position for lifting heavy loads. In relation to the lumbar spine, the lumbar muscles have a poor "moment arm," 106 massage & bodywork november/december 2012

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