Musculoskeletal Disorders and Hidden Risks in Rehabilitation Workplaces

It is the ultimate irony that healthcare workers are in the business of improving the health and enhancing the well-being of the general public and yet they are more at risk of injuries – specifically musculoskeletal disorders – than people in any other profession. That’s right. Healthcare workers – including occupational and physical therapists – sustain more injuries and damage to their health than even construction workers.

Many of these injuries can take place at rehabilitation hospitals and involve lifting and moving patients. The most common causes of physical impairments at rehab facilities are the following:

• Patient Movement
• Transferring Patients 
• Repositioning Patients

Just by the nature of their jobs, physical therapists are quite susceptible to developing musculoskeletal disorders that can lead to even more severe health maladies. Because they are in the healthcare profession, occupational and physical therapists often suffer in silence while typically little attention is placed on the threats to their health. 

How Pervasive are Musculoskeletal Disorders Among Physical Therapists?

The National Institute for Occupational Safety and Health has reported that manual patient lifting is associated with high rates of injuries for healthcare workers, while also causing labor shortages, decreased quality of care, diminished patient safety and comfort, and decreased patient satisfaction. The most common form of injury to therapists while performing their job duties is back injury.

The lower back is the body part most commonly affected by physical therapy practices, according to numerous studies in recent years. Female physical therapists and physical therapists working in hospitals have a higher prevalence of work-related musculoskeletal disorders, or WMSDs. Among more than 800 unduplicated articles published recently found that up to 90 percent of physical therapists have WMSD during their careers, and 50 percent experience WMSD within five years of practice. Some studies reveal a one-year incidence (WMSD) rate of 20 percent for physical therapists.

In another study from 2020, overall, 38.5 percent of physical therapists reported having sustained an injury due to a musculoskeletal disorder.

According to the National Institute for Occupational Safety and Health (NIOSH), occupational back injury is the second leading occupational injury in the United States. Lower back injuries account for a lifetime prevalence as high as 79.6 percent of all musculoskeletal injuries. The costs associated with back injuries alone in the healthcare industry are estimated to be $20 billion.

Other typical injury areas for physical therapists are the following:

• Neck
• Wrists
• Hands
• Thumbs
• Upper Back
• Elbows

Causes of Musculoskeletal Disorders for Physical Therapists

Musculoskeletal disorders among physical therapists in all practice settings have been related to job duties that include patient handling, frequent trunk movements, awkward positioning, increased patient contact time, clinician skill level, size discrepancies, and strength of the physical therapist.

The biggest instigators for musculoskeletal disorders are manually lifting and transferring patients. Physical therapists are most vulnerable to injury or an accident when they transfer patients on rehab equipment. In fact, healthcare workers consistently rank among the top occupations with disabling back injuries – primarily from manually lifting patients.

The national epidemic of morbid obesity in the U.S. has contributed to putting physical therapists at risk in their jobs. Moving patients heavier than 300 or 400 pounds puts great strain on the bodies of physical therapists.

Risk factors for Musculoskeletal Disorders

Repetitive Motion:  Bending, lifting, reaching, twisting, pushing, and pulling

Heavy Lifting:  Handling loads, especially when bending and twisting

Awkward Postures:  Prolonged sitting or standing in the same position

Psychosocial Stress:  Work patterns that don’t allow enough recovery between movements

Consequences for High Rates of Musculoskeletal Disorders Among Physical Therapists

Musculoskeletal disorders are having a significant impact on physical therapists. Various studies have shown that physical therapists have reported taking extensive sick time, have changed practice habits, changed work settings, or even left the profession due to WMSDs. Nearly a third of physical therapists lost work time as a result of musculoskeletal disorders.

Another study indicated that 18 percent of physical therapists with WMSDs changed their work setting and 12 percent of physical therapists reduced their patient care hours. What’s more, another study reported that one in six physical therapists changed settings or left the profession because of WMSDs. Nearly a third of physical therapists with WMSDs lost work time, according to a different study. These studies drew from members of the American Physical Therapy Association. 

Ways to Prevent Musculoskeletal Disorders

There are many reliable ways to prevent workplace injuries to physical therapists and that includes musculoskeletal disorders. Much of WMSD prevention begins with heightened awareness of how the body performs.

For example, being aware of and utilizing proper body mechanics is pivotal when it comes to avoiding musculoskeletal disorders. Proper mechanics for healthcare simply refers to “using specific techniques and muscles to carry out high-risk tasks without causing strain or injury to the body.” An example of this practice is remembering to lift with your legs and not your back.

Tips for Properly Lifting or Transferring Patients

1. Be as close to the patient as possible.
2. Stand with your feet shoulder-width apart. Provide yourself with a good base of support. 
3. Face the patient as you prepare to lift her. 
4. Avoid bending or twisting at the waist.
5. Bend with your knees, and not your back or waist.
6. Lift with your legs and not your back. You should feel the activation of your muscles in your legs, for example. 
7. Utilize a mechanical lift whenever possible. 

Preventing musculoskeletal disorders among physical therapists and other healthcare workers calls for specific key strategies. They include proper ergonomics training, maintaining good posture, utilizing patient handling equipment when available, practicing safe lifting techniques, stretching, and strengthening exercises.

Important Elements of WMSD Prevention

Equipment and Workplace Modifications

• Using patient lifting devices such as hoists and slide boards for patient transfers. 
• Adjustable treatment tables and chairs to accommodate various patient heights and postures. 
• Ergonomic workstations with proper positioning for documentation and computer use. 

Education and Training 

• Comprehensive ergonomics training to understand proper body mechanics, lifting techniques, and posture adjustments for different patient situations. 
• Regular training updates on safe patient handling practices and equipment usage. 
• Patient assessment skills to identify potential risks and adjust treatment plans accordingly. 

Physical therapists will also put themselves in a favorable position in preventing musculoskeletal disorders by practicing ergonomics at their rehab hospital. Here are three recommendations for applying ergonomic practices to stave off musculoskeletal injuries.

1. Adjust treatment table height to comfortably match the therapist’s stature. 
2. Utilize supportive surfaces such as gel pads or cushions for patient positioning. 
3. Optimize the placement of equipment to minimize reaching or awkward postures. 

How Barihab Equipment Can Help to Prevent Musculoskeletal Disorders

Therapeutic Industries is an industry pioneer for innovative designs with its Barihab therapy tables. These tables play a pivotal role in reducing the physical burden on therapists and helping them to avoiding developing musculoskeletal injuries.

Our rehabilitative tables bring efficiency and ease of use to physical therapists so they can meet the needs of their patients while protecting their bodies from wear and strain. Therapeutic industries’ advanced physical therapy treatment tables and rehabilitation equipment significantly reduces the strain on therapists by minimizing patient handling. This lowers injury risks and allows therapists to focus on delivering efficient and personalized care without physical fatigue.

All of this means that the chances of a workplace injury are greatly diminished. 

Conclusion

Despite being in the business of making people healthier and enhancing their well-being, healthcare workers in general, and physical therapists specifically, are often at great risk for workplace injuries, especially musculoskeletal disorders. Their very profession puts them at risk for severe injuries but because they work in healthcare, they seem to receive minimal attention when it comes to the daily wear and tear on their bodies.

Fortunately, there are measures that physical therapists can take to prevent or mitigate musculoskeletal disorders. Ergonomics and proper body mechanics play huge roles in setting physical therapists up for success when it comes to protecting their bodies. Some physical therapists enjoy the benefits of assistive patient handling equipment that is characterized by the simultaneous reduction of the risk of musculoskeletal injury while also improving the quality of care for patients.