Recent scientific research indicates that microtrauma
throughout life may be the precursor to low back pain in the majority of cases.
Cumulative Trauma Disorder is a group of neuro-musculoskeletal syndromes resulting
from the Cumulative Injury Cycle.
The injury cycle may result from acute injury, repetitive motion, and/or constant
Acute Injury; Muscle tearing from an injury causes
immediate inflammation. White-blood-cell proliferation, fibrinogen secretion,
and adhesion formation start. If not treated correctly, the injury cycle begins.
Repetitive Motion Injury is a function of specific
physical factors that can be measured. The model of repetitive motion describes
how these injuries occur.
[Leahy MP, Mock LE Myofascial Release Technique and Mechanical Compromise of Perpherial
Nerves of the Upper Extremity 6:4 ChiroSports Med; Leahy MP Improved Treatments
for Carpal Tunnel and Related Syndromes 9:1 ChiroSportsMed]
- I= Insult to the tissues
- N= Number of repetitions
- F= Force or tension of each repetition
- A= Amplitude of each repetition
- R= Relaxation time between repetitions
Two examples of the Model of Repetitive Motion are;
- Vibration which results in high Number of repetitions with low Amplitude and
low Relaxation time, causing Injury.
- and Poor, Static Posture which produces high Force with nearly zero Amplitude
and Relaxation time, causing Injury.
Constant Pressure / Tension Injury
These two factors decrease circulation and compromise cellular recovery. This
type of injury does not require motion; the muscle tension of poor posture, is
a good examples of this.
The cumulative injury cycle, is self-perpetuating,
therefore simply alleviating the pain symptoms is not enough; to fully correct
the problem you must evaluate and treat the cause of the problem.
Components of the cycle are:
- Weak and Tight Tissues; repetitive effort tends
to make muscles tighten. A tight muscle tends to weaken; a weak muscle tends to
- Friction - Pressure - Tension; as a result of
weak and tight tissues,
- Decreased Circulation - Edema; the result of increased
forces on the tissues is decreased circulation (if pressure is applied over lymphatic
channels the result is edema)
- Adhesion - Fibrosis; cellular hypoxia, from restricted
circulation causes fibrosis and adhesions to occur in and between tissues.