Physical Activity, Exercise, and Musculoskeletal Disorders in Sonographers

Abstract

Sonographers are highly susceptible to work-related musculoskeletal disorders (WRMSDs). Injurious WRMSDs are inflammatory or degenerative processes that affect soft tissues, nerves, muscles, ligaments, and/or tendons and are a leading cause of workforce discomfort, pain, and disability. 1,2 It has been reported that at least 80% to 90% of sonographers scan in pain or have been diagnosed with an WRMSD. 3-6 A WRMSD and/or the pain experienced by a sonographer can limit the ability to obtain quality images and affect overall job performance. 7,8 Secondary effects of WRMSD pain, such as work absences, increased health care costs, and decreased productivity, are costly for both sonographers and employers. 7,9,10 Sonographers may also experience a decreased quality of life as they find it difficult to go about normal daily activities without pain. 4,8,11 It is estimated that 20% of sonographers change careers or seek early retirement because of a WRMSD. 4,6 Muscle strain, shoulder, arm, and back pain in sonographers were first reported by Craig 12 in 1985, but at that time, ultrasound equipment was large and cumbersome. Also, awareness and application of proper ergonomics was not well known. 13 Over the years, surveys highlighting sonographers' WRMSD experiences increased awareness and the need for ergonomic standards. 5,6,14 Research has shown administrative, equipment, environmental, patient, and sonographer factors are associated with WRMSD development. 7,9,15,16 However, even with improvements in technology; smaller, lighter ultrasound machines; greater awareness; and the development of ergonomic guidelines, the incidence of WRMSDs persists. Reportedly, only 10% to 20% of sonographers are pain free. 3,4 At the time of this publication, there are approximately 65,790 working sonographers in the United States, which means 52,632 are scanning in pain. 17 Sonographic procedures involve repetitive motions, forceful exertions, awkward postures, and static positions, which are reasons cited for WRMSD development. 7,18

Knowledge and use of work‐related musculoskeletal disorder (WRMSD) prevention techniques in the daily practice of final‐year Australian sonography students: A cross‐sectional study

“…Pilates have previously been explored for the prevention or alleviation of musculoskeletal pain. 16,18,19,26 Although 84%-90% of participants demonstrated familiarity with stretches before and following scanning, no association was established between their knowledge and use. Although a significant association was suggested between the knowledge and use of Pilates, the numbers were small and may not be representative.…”

“…Our study demonstrates a significant association between ergonomic education and knowledge of prevention techniques; however, three widely reported prevention techniques were not well recognised by the participants of this study. 1,3,7,16,18,30 These included varying the scans performed, taking sufficient breaks between patients, and the use of assistance when moving patients. Only 39%-55% of participants reported they were aware of these techniques, and only 23%-45% reported to used them regularly.…”

“…Mind-body techniques often increase in usage following participation in awareness workshops, but generally decrease again within months. [16][17][18] This highlights the ongoing need to reinforce the benefits of techniques through professional development.…”

“…Some common WRMSD prevention techniques and interventions were collated from the literature for investigation; however this list was not exhaustive. 8,9,[16][17][18][19] Participants were asked about their knowledge and use of these techniques, with recall limited to 30 days, and the aim to reduce the level of recall bias. 22 A combination of multiple-choice and checkbox responses were used to generate categorical data with optional open-ended questions.…”

“…15 Recommendations for WRMSD interventions, and for improvements in education of preventative measures are ample in the literature. 8,9,[16][17][18][19] Nevertheless, there is limited evidence to support the habitual use and lasting effectiveness of individual WRMSD prevention techniques, including ergonomically friendly scanning practices. Previous research found students did not make injury prevention a priority in their daily practice, but instead prioritised diagnostic image production above posture and ergonomics.…”