Issue link: https://www.massageandbodyworkdigital.com/i/72093
@WORK entrapment pathologies, such as carpal tunnel syndrome. A look at some of the key activities of housekeeping workers clearly indicates the numerous biomechanical challenges they face for upper-extremity work. Many of the cleaning activities include grasping handles such as brooms, mops, or vacuum cleaners, which places excessive demand on the flexor tendons of the hand. Overuse of the flexor tendons can frequently lead to medial or lateral epicondylitis, tenosynovitis, or various upper-extremity nerve entrapment problems (Image 3). Conditions such as carpal tunnel or pronator teres syndromes occur frequently in housekeeping workers, and both involve entrapment of the median nerve in the distal upper extremity. Chronic overuse of the forearm and hand makes these nerve entrapment syndromes far more likely to develop. Chronic overuse tendon disorders, such as tendinosis, involve constant and repetitive overload on the proximal tendons of the flexor and extensor wrist tendons. These tendinosis complaints take a long time to heal. Consequently, it is a frequent pattern for the individual to develop a condition like this and have it persist for a very long time without adequate healing. Research on chronic tendon disorders has indicated that one of the most beneficial methods of encouraging tissue healing is pressure and movement applied to the tendon in order to encourage fibroblast proliferation during the healing phase. Massage is a highly beneficial means of applying pressure and movement specifically to these tendons to encourage this increased fibroblast activity and promote optimal healing. Techniques such as deep-friction applications to the tendons, along with active engagement methods, will be particularly helpful. Deep-friction applications to the tendon apply pressure and movement, while active engagement methods encourage a reduction in chronic muscle tightness. SELF-CARE PRACTICES Of key importance for the housekeeping worker is a means of reducing the cumulative stresses that build up over each day. Workers can be taught many convenient and easy self-massage and stretching techniques that help reduce the impact of the upper-extremity work. • Self-massage of the forearms. Performed with the hands, the opposite forearm, or a massage tool so one does not overuse one hand/ arm while working on the other. • Self-massage of the upper and lower back with tennis balls or other appropriate trigger- point massage tools. • Stretching (passive and active) the affected areas is of key importance to reduce cumulative stress loads. • Strengthening activities, such as squeezing a racquetball or using resistance bands for injury prevention. • Learning appropriate body mechanics for injury prevention (like proper lifting). Massage therapists can play important roles in the prevention and treatment of the pain and injuries that affect the people in this occupation. Reaching out to the workers in this often overlooked but highly critical occupation may be challenging, but it Whitney Lowe is the author of Orthopedic Assessment in Massage Therapy (Daviau-Scott, 2006) and Orthopedic Massage: Theory and Technique (Mosby, 2009). He teaches advanced clinical massage in seminars, online courses, books, and DVDs. Contact him at www.omeri.com. is an important goal and would be very much appreciated by those experiencing real pain and dysfunction. Notes 1. E. Frumin et al., "Workload-Related Musculoskeletal Disorders Among Hotel Housekeepers: Employer Records Reveal a Growing National Problem," accessed April 2012, www.hotelworkersrising.org/pdf/hskpr_ analysis0406.pdf. 2. Canadian Centre for Occupational Health and Safety, "Hotel Housekeeping: OSH Answers," accessed April 2012, www.ccohs. ca/oshanswers/occup_workplace/hotel_ housekeeping.html; 8,000 different body postures every shift assumes 16 rooms per eight-hour shift, with a five-minute break between each room. 3. T. Scherzer et al., "Work-Related Pain and Injury and Barriers to Workers' Compensation Among Las Vegas Hotel Room Cleaners," American Journal of Public Health 95, no. 3 (2005): 483–8. 4. K. Salwe et al., "Nonfatal Occupational Injury Rates and Musculoskeletal Symptoms Among Housekeeping Employees of a Hospital in Texas," Journal of Environmental and Public Health 2011. doi 10.1155/2011/382510; N. Krause et al., "Physical Workload, Work Intensification, and Prevalence of Pain in Low Wage Workers: Results from a Participatory Research Project with Hotel Room Cleaners in Las Vegas," American Journal of Industrial Medicine 48, no. 5 (2005): 326–37. 5. Salwe, "Nonfatal Occupational Injury Rates." 6. Frumin, "Workload-Related Musculoskeletal Disorders." Celebrate ABMP's 25th anniversary and you may win a refund on your membership. ABMP.com. 107