Jan 29, 2015Personal Injury Protection
As an athletic training student, you are learning a lot about injury prevention in athletes. You should also know how to avoid injuries to your own body in this often strenuous profession.
By Greg Frounfelter
Greg Frounfelter, PT, DPT, ATC, CSCS, is an Athletic Trainer and Physical Therapist in the Physical Medicine Department at Agnesian Healthcare-Waupun Memorial Hospital in Waupun, Wis. He can be reached at: [email protected].
By now, you already know that athletic trainers spend long hours covering sporting events, treating athletes, and performing administrative tasks. But what you may not know is that the job can come at the expense of your own well being.
A former classmate told me about her 22-year-old brother-in-law who recently graduated with a bachelor’s degree in athletic training and was recovering from spine surgery. He had injured his L5-S1 disc transferring an injured athlete off the field.
My first thought was that he was far too young to have such an injury. But when I thought about it further, I realized it’s quite easy for an athletic trainer of any age to incur an injury on the job.
The risks to athletic trainers are not limited to such acute injuries. In many cases, cumulative conditions such as shoulder or back pain result from years of overuse and poor body mechanics. Risk factors include sustained stressful postures, repetitive movements, overhead and extended reaching, and faulty body posture. For athletic trainers, the primary trouble spots are the lower back and shoulders.
When completing any task, the body can be used in ways that minimize or maximize the strain placed on it. As an athletic trainer, you would never encourage someone to bend at the waist to pick up a heavy load or stoop over a task for prolonged periods. We know these activities increase the load on a back and heighten the risk of injury. Likewise, repetitive bending can wreak havoc on the lower back.
Now consider the tasks athletic trainers repeat every day. For example, think about the last time you helped tape a team before practice. Did you slouch forward, especially on your fourth or fifth ankle? Did your back feel a little sore? And how were you positioned the last time you helped stretch a hamstring? It’s easy (sometimes painfully easy) to forget about proper body mechanics in the flurry of athletic training room activity.
Fortunately, ergonomics can reduce repetitive strain on the body and decrease the risk of injury. Ergonomics provides us with safety zones we can use to reduce injury risk. Using these zones keep joints at their midrange, where they are strongest and can best handle loading.
In the spine, the safety zone is considered the neutral position, which is the same position we take in proper upright posture. The cervical and lumbar spines should have lordotic curves, and the thoracic spine should have its typical kyphotic curve.
One motion we do all the time is getting something out of an athletic training kit. When you do so, do you squat down or bend at the waist? From our biomechanics courses we know that we should strive to maintain the lordosis in our lumbar spine during functional activity (i.e., we should squat or kneel down to reach objects that are below our knees). The key is getting in the habit of doing so now, when you are starting your career.
A second part of maintaining a neutral spine is avoiding rotation. Most lumbar injuries occur during forward bending and rotation. It is simply best to avoid excessive use of these positions whenever possible.
Another vulnerable area is the shoulder. We are able to reach quite far from our bodies with our arms, but overreaching forward or overhead can cause problems for the shoulder such as rotator cuff tendonitis or bursitis. It is recommended that you perform 80 to 90 percent of your reaching tasks within an arm’s length of the body. By keeping the elbow close to the body, you can provide improved mechanics for the rotator cuff musculature and prevent microtrauma. Step stools and ladders can minimize extended overhead reaching, and heavy objects should never be carried overhead.
Making use of safety zones may require changes to your working environment. For example, locate taping supplies where you do not need to bend or overreach to get them. And make step stools easily available for the times when you need to reach objects on higher shelves.
You may also want to consider the design of your computer workstation. While the hustle and bustle of an athletic trainer’s day can tax the body in several ways, improper mechanics while typing can lead to wrist, neck, and eye problems, as well as muscle-tension headaches.
To avoid these types of injuries, be sure to set up your computer workstation properly. You should directly face the computer while sitting in an upright position. The top of the screen (minimum size of 15 inches) should be level with your eyes and 18 to 24 inches from your face.
Your forearms should be parallel to the floor and elbows bent roughly at a 100- to 110-degree angle and your keyboard should have a wrist support. Your feet are best positioned flat on the floor or resting at a 10- to 20-degree slant. Your chair should have lumbar support and allow your knees to rest at an angle between 100 and 110 degrees. And arrange your desk so the things you need the most—especially your computer mouse—are within a forearm and hand length from your torso.
Environmental changes will not eliminate all risks, however, especially since some tasks require you to stay in prolonged static positions. Two common examples are performing evaluations on the field and taping athletes. Even with the use of proper environmental modifications, in both cases we will tend to lean forward at the waist and spine. When you find yourself leaning forward a lot, try a reverse-body positioning stretch, such as bending backward into spinal extension and scapular retraction. Do this every one to two hours or whenever you find yourself slouching for any length of time. This simple strategy does a lot to unload the mechanical strain of forward bending.
In addition, bending your knees and widening your stance when standing will lower your center of gravity and help you get closer to your work without slouching. I find this very helpful when taping at a station.
While much of your education has focused on taking care of student-athletes, it’s never too soon to start taking care of yourself. Repetitive stress injuries often go unnoticed for years while slowly doing damage that can last a lifetime. Some of these suggestions may seem awkward to incorporate, but they are worth the effort. Take care of yourself so you can optimally take care of those in your charge