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SHOULDER, ELBOW AND WRIST PAIN:
Are You at Risk for Common Joint Disorders?

 

(September/October 2006)

By Amber Twist

According the Center of Disease Control 42.7 million adults in the United States have been diagnosed by a doctor with joint inflammation, also known as arthritis.   Among them, 31 % (13.2 million) report that they are limited in their work related activities due to pain.  The majority of these cases are attributed to a condition known as Osteoarthritis.  Osteoarthritis is the most common form of joint disorder and is characterized by the dissolve of protective joint cartilage due to years of accumulated wear and tear.

As a window cleaner, you may be in a category of high risk for joint damage due to the stress your joints undergo daily and the repetitive nature of your work-related movements.  You are especially susceptible to joint damage in the shoulders, elbows, and wrists.  Knowing this, it is more important than ever to take care of your joints now before damage occurs.  If you already experience pain in these joints it is vital that you prevent further damage. If left unchecked, joint disorders can result in repeated injury, irreversible damage and permanent loss of range of motion.

The first line of defense against joint damage is to prevent an injury from occurring in the first place.  According to Jeffrey S. Weil, MSPT, a physical therapist and Southeastern Regional Operations Manager of Ancillary Care Solutions, Raleigh, NC, to prevent joint injury it is important to warm up a joint before a day of handling water fed poles and enduring the repetitive motion of a squeegee.  This is especially important in the upcoming winter months. 

Weil says, “In cold weather a person is likely to be stiffer and their joints simply don’t move as fluidly or smoothly.  If the shoulder and elbow joints are abruptly thrust into an overhead motion to squeegee a window, the chance of injury to those joints is greater than if they had been stretched and warmed prior to exertion.”  Pre-warming the joints may seem like an unnecessary step on a busy day, but a few simple stretches can save you from an injury, pain, restricted motion and a possible visit to the doctor.

In addition to a pre-work warm up session, regular exercise might also reduce your risk for developing joint related disorders.  An appropriate exercise program will increase the flexibility, fluidity of motion and overall function of a healthy joint.  Also, exercise helps maintain a proper body weight which is important since excess weight puts additional pressure on the entire body - including joints - and minimizes range of motion. 

Weil also stresses the importance of using the proper tools for the task at hand.  He says, “Make sure that you have the optimal tools for the job.  For window cleaners who are constantly working their shoulders and elbows, this means tools that minimize overhead stretching and reaching whenever possible.”  As window cleaners, reaching overhead is an unavoidable reality.  However, investing in lighter equipment with a wider range may reduce your likelihood of suffering an injury and save you time and money in the long run.

But what if you already experience joint pain?  If you do, you are like many Americans for whom it is too late to prevent joint damage entirely.  For many individuals the primary goal is to prevent further damage to an already painful joint.  If you are living with joint pain it is important to understand that an already inflamed joint is vulnerable to further injury and that repeat injury can cause irreversible damage.  

Dr. John Clough, author of, Arthritis - A Cleveland Clinic Guide, has a warning for window cleaners regarding occupational causes of joint damage related to repetitive movement.  For window cleaners, Dr. Clough says, “The shoulders, elbows and wrists are at risk.  Not only joints, but also tendons and bursae - the soft tissue around the joints - can be adversely affected, leading to tendonitis and/or bursitis.”

Tendons are bands of connective tissue that attach muscles to bones and are a vital component in the stabilization of joints.  Bursae are small, fluid filled sacs that lie between muscles and in the area where tendons pass over bones, allowing tendons and muscles to slide easily over bones.  When the tendons become inflamed this condition is known as tendonitis.  Bursitis is a similar condition in which the bursae become irritated and inflamed.  Both conditions can develop quickly and are often mistaken for arthritis.  However, unlike arthritis, tendonitis and bursitis are normally temporary, especially if treated early.

There are multiple causes for joint pain and finding the appropriate treatment depends on finding the cause of the pain.  Therefore, joint pain should always be evaluated by a physician.  Dr. Clough says, “Any pain lasting for more than 2 hours resulting from an activity should be taken as an indication that the activity may be causing injury.  Joint or soft-tissue swelling is also an indication that damage may be occurring.  These symptoms should lead to an evaluation to determine if some form of joint protection or other intervention is necessary.” 

Dr. Clough goes on to say, “If a person does not seek medical advice he/she is risking loss of joint motion, chronic pain or the development of osteoarthritis.”  It is also important to note that joint pain is not always the result of overuse or injury.  For example, tendonitis and bursitis are in some cases symptomatic of thyroid disease, lupus and diabetes which makes it even more important to have a professional evaluation.

The CDC reports that by the year 2030, nearly 67 million adults will be diagnosed with arthritis.  As a window cleaner you are undoubtedly a busy professional.  But just as you take the time to inspect and maintain your equipment, you should evaluate and care for your most important piece of equipment: your body. By being aware of the fact that your joints are at risk you can take steps to protect them and to seek medical attention in the event that an injury does occur.

  • Before starting any exercise program, first consult a physician.
  • Jeffrey S. Weil, MSPT is the Southeastern Regional Operations Manager at Ancillary Care Solutions.  www.ancillarycaresolutionscom.
  • Dr. John Clough has been a Rheumatologist on the staff of the Department of Rheumatic and Immunologic Disease at the Cleveland Clinic since 1971.

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