Work related musculoskeletal disorders, or WRMSDs, are what we use to describe a group of painful disorders of muscles, tendons and nerves. Unfortunately, within the field of ultrasound disorders such as these have a higher than normal incidence in the workplace. In most cases, experience will tell you that the risk is not just theoretical. Most sonographers will know of one or many colleagues that have had, or are suffering with, pain due to scanning. In some cases, career ending pain and discomfort.
Recent statistics from the Australian Sonographer Safety Initiative show that 80-90% of sonographers will experience WRMSD’s and, of those, approximately 20% will have career ending symptoms. Given the time, cost and effort required to train as a sonographer it is therefore crucial to be well educated on how to minimize or even reduce the risk of these types of injuries occurring.
Prevention is better than cure
Now, while we can’t completely eliminate the risk of injury, there are many things that we can do to help ourselves that can help to stave off or reduce the likelihood of injury in the long run. It’s easy to fall in to bad techniques, especially when learning as there are so many other aspects to think about. However, bad techniques form bad habits which lead to injury in the long term. A lot of our training focuses on anatomy, pathology and driving the machine but it is often the case that very little attention is given to how to prevent injury. And given the risk of career ending injury and increasing workloads, this has to change. In meantime, you can take responsibility for your minimizing your own risk with good education and techniques.
Work from Salford University, UK, showed that the most common causes for WRMSD’s include:
- Poor posture
- force or pressure used in scanning
- repetition of movements
- sustained isometric muscular contraction
- joints frequently used beyond 50% of their range of movement
- long reaches
- inefficient grips
Before the scan
- Adjust the bed height
- Adjust the control panel height and position
- Adjust the seat height – your knee height should be just slightly less than your hips
- Ensure you have a seat with lumbar support
- Position the monitor height so that you are not stooping to see it.
During the scan
- Continually adjust the seat and bed height to ensure they are optimally positioned.
- Ask the patient to closer to you to avoid overreach.
- If possible, ask the patient to do the moving rather than you. It’s a rare event for them but it’s a repetitive one for you.
- Do not raise your elbow above 45 degrees – above this is the danger zone which leads to increased risk of injury
- If at all possible, rest the ball of your hand or wrist on an appropriate part of the patient rather than letting it hover in the area when while scanning
- Try to avoid prolonged periods of sustained pressure. If something is proving difficult to see, move on and return to it later when it might be easier to see.
After/away from the scan
- Try to build stretching into your daily routine between scans
- Try to take more frequent minibreaks rather than a single larger break
- Go for a 10-15-minute walk on your break rather than just sitting where it is more common for the head to slouch forward.
- Consider getting a workplace ergonomic assessment and make/fight for any amendments necessary to reduce the risk of injury, even if they appear small and insignificant.
- Attend ergonomic training at the next regional event – the small cost of these can pay for itself ten times over it means you are able to avoid a career-ending injury.
The Alexander Technique
The Alexander Technique is a well documented educational process that is used to retain habitually poor habits in posture and movements and has also been shown to have benefits on mental health and stress reduction. See our full article on the The Alexander Technique for me information.