This knowledge of ligament structure, function, injury, and rehabilitation can be used in ergonomic planning. Specifically, measures can be taken that will help prevent ligament-ous injuries and aid in the recovery of workers who have already suffered a sprain. This may entail a job analysis and work-place revisions in order to identify hazardous expos-ures and to eliminate excessive biomechanical stresses associated with the job (Peate, 1994).
Ergonomic or equipment design can be found to be responsible for ligamentous injuries.
With the aim of minimizing ligamentous overload and subsequent reinjury, ergonomic assessment must address both the high-load stress and the low-load repetitive mechanisms in the workplace.
The key to both the prevention and treatment of ligament injuries is the minimization of excessive forces on the joints in question. Prevention and treatment of ligament macro-trauma involves attention to the details of a person’s job description and to the workplace in an effort to minimize the chances that the worker may suffer a sudden forceful loading of any joint. Uneven surfaces, wet or slippery surfaces, and stairs or ladders are the most common sites of a sudden load on the lower extremities. Falls, due to any cause, are the reasons for most upper limb ligament sprains. Attention to the details of the work environment, in an effort to prevent such falls or slips, is obviously critical. Also as noted above, ligament microtrauma is caused by joint overloading; but in the case of these injuries, the cause is most commonly‘‘repetitive joint overloading’’ at subfailure stresses.
Ergonomic measures that can either modify the task to decrease the joint stresses, or alternatively, decrease the number of repetitions that must be preformed sequentially can keep a ligament within its viscoelastic adaptive range, and prevent its injury. Similarly, once injured, the same stress-minimization measures need to be considered in order to optimize ligament healing. The design of the workplace is central to keeping all joints within their physiological, comfortable ‘‘safety limit.’’ As with all areas of medicine, attention to prevention of ligament injuries by paying attention to measures that can be taken to prevent them is preferable to trying to implement these measures after an injury has occurred.
If significant ligament injuries do occur, however, appropriate diagnosis and treatment, implemented quickly, are essential to minimize the possibility of increasing damage, recurrent injury, and ongoing disability. This is likely to involve some form of prescribed rehabilitation with a period of loading modification of the affected joint, with or without splinting, taping, or bracing and a gradual return to work. Major joint injuries can be catastrophic in the long term and ligaments heal very slowly, as noted above, so rehabili-tation and recovery cannot be rushed.‘‘Weeks to months’’ is a reasonable time frame for recovery from any significant ligament injury. A ligament sprain, if serious, can have permanent consequences to the worker. Ligament injuries, ideally, therefore should be prevented if at all possible.
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