Prevention Practice For Musculo

Skeletal Conditions
Arham Shamsi
 AGING THEORY
Age Related Decline in Viability and Increase in
Vulnerability. Its Reduction in your response to
External Stress and decline to function with age.
No one knows how and why people change as
they get older. Some theories claim that aging is
caused by injuries from ultraviolet light over
time, wear and tear on the body, or byproducts of
metabolism. Other theories view aging as a
predetermined process controlled by genes.
 .
Modern biological theories of ageing in humans
currently fall into two main categories:
1. Programmed
2. Damage or error theories.
 The Programmed theory

Programmed Longevity : which considers ageing to be the result of a

sequential switching on and off of certain genes, with senescence being
defined as the time when age-associated deficits are manifested. (Role
of genetic instability) =>The increased tendency for DNA mutations
(changes) and other genetic changes to occur during cell division.

Endocrine Theory : where biological clocks act through hormones to

control the pace of ageing. 

Immunological Theory : which states that the immune system is

programmed to decline over time, leading to an increased vulnerability
to infectious disease and thus ageing and death.
 The Damage or Error Theory

1. Wear and tear theory, where vital parts in our cells

and tissues wear out resulting in ageing. 
2. Rate of living theory, that supports the theory that
the greater an organism's rate of oxygen, basal
metabolism, the shorter its life span .
3. Free radical theory of aging
4. Protein cross-linking theory of aging
5. Somatic DNA damage theory .
 Terms to Describe Types of Cell Changes

Atrophy:
Cells shrink. If enough cells decrease in size, the entire organ
atrophies. This is often a normal aging change and can occur
in any tissue. It is most common in skeletal muscle, the heart,
the brain, and the sex organs (such as the breasts). The cause
of atrophy is unknown, but may include reduced use,
decreased workload, decreased blood supply or nutrition to the
cells, and reduced stimulation by nerves or hormones.
Hypertrophy:
Cells enlarge. This is caused by an increase of proteins in the
cell membrane and cell structures, not an increase in the cell's
fluid. When some cells atrophy, others may hypertrophy to
make up for the loss of cell mass.
 ..
Hyperplasia: The number of cells increases.
There is an increased rate of cell division.
Hyperplasia usually occurs to compensate for a
loss of cells. It allows some organs and tissues to
regenerate, including the skin, lining of the
intestines, liver, and bone marrow. The liver is
especially good at regeneration. It can replace up
to 70% of its structure within 2 weeks after an
injury.
 .
Dysplasia:
The size, shape, or organization of mature cells becomes
abnormal. This is also called atypical hyperplasia.
Dysplasia is fairly common in the cells of the cervix and
the lining of the respiratory tract.
Neoplasia:
The formation of tumors, either cancerous (malignant) or
noncancerous (benign).
Neoplastic cells often reproduce quickly. They may have
unusual shapes and abnormal function.
 Changes in MusculoSkeletal System

As muscles age, they begin to shrink and lose mass. This is a natural
process, but a sedentary lifestyle can accelerate it.
The number and size of muscle fibers also decrease. Thus, it takes muscles
longer to respond in our 50s than they did in our 20s.
The water content of tendons, decreases as we age. This makes the tissues
stiffer and less able to tolerate stress.
Handgrip strength decreases, making it more difficult to accomplish routine
activities such as opening a jar or turning a key.
The heart muscle becomes less able to propel large quantities of blood
quickly to the body. We tire more quickly and take longer to recover.
The body's metabolic rate (how quickly the body converts food into
energy) slows. This can lead to obesity and an increase in "bad" cholesterol
levels.
 Aging Bone
Throughout life, bones constantly change through a process of absorption and
formation called "remodeling." As we age, the balance between bone absorption
and bone formation changes, resulting in a loss of bone tissue.
The mineral content of bones decreases, so that bones become less dense and
more fragile.
As bones lose mass, osteoporosis develops, affecting both women and men. In
the spine, osteoporosis can lead to crush fractures of the vertebrae, resulting in a
"dowager's hump." Osteoporosis is also responsible for almost all hip fractures
in older men and women.
The chemistry of cartilage, which provides cushioning between bones, changes.
With less water content, the cartilage becomes more susceptible to stress. As
cartilage degenerates, arthritis can develop.
Ligaments, connective tissues between bones, become less elastic, reducing
flexibility.
 Aging Joint
Joint motion becomes more restricted and
flexibility decreases with age because of changes
in tendons and ligaments.
As the cushioning cartilage begins to break
down from a lifetime of use, joints become
inflamed and arthritic.
 Aging changes in hormone production
The endocrine system is made up of organs and tissues that produce
hormones. Hormones are natural chemicals produced in one location,
released into the bloodstream, then used by other target organs and
systems.
Hormones control the target organs. Some organ systems have their own
internal control systems along with, or instead of, hormones.
As we age, changes naturally occur in the way body systems are
controlled. Some target tissues become less sensitive to their controlling
hormone. The amount of hormones produced may also change.
Blood levels of some hormones increase, some decrease, and some are
unchanged. Hormones are also broken down (metabolized) more slowly.
Counteracting the Effects of Aging
Many of the changes in our musculoskeletal system result more from
disuse than from simple aging
Stretching is an excellent way to help maintain joint flexibility. Weight
training can increase muscle mass and strength, enabling people to
continue their daily routine activities without maximal exertion. Even
moderate amounts of physical activity can reduce your risk of
developing high blood pressure, heart disease, and some forms of
cancer.
Long-term regular exercises may slow the loss of muscle mass and
prevent age-associated increases in body fat. Exercise also helps
maintain the body's response time, as well as its ability to deliver and
use oxygen efficiently. Just 30 minutes of moderate activity,
incorporated into your daily routine, can provide health benefits.
 .
An exercise program doesn't have to be strenuous to be
effective. Walking, square dancing, swimming, and
bicycling are all recommended activities for maintaining
fitness as we age.
The 30 minutes of moderate activity can be broken up
into shorter periods. For example, you might spend 15
minutes working in the garden in the morning and 15
minutes walking in the afternoon. It all adds up.
But if you have never attempted an exercise program
before, be sure to see your doctor before starting one now
 Ergonomics
ERGO=“Work”
NOMICS=“Rules” or “Laws
Ergonomics =“The Laws of Work”
 History
Bernardo Ramazzini the father of occupational medicine,
first introduced the common musculoskeletal disorders
that arose from eighteenth century occupations “The
Diseases of Workers”

• OSHA defines ergonomics as the science of “designing

the job to fit the worker, instead of forcing the worker to
fit the job.”
• Occupational Safety and Health Administration
 Ergonomics

Makes the job safer by preventing injury and illness

Makes the job easier by adjusting the job to the
worker
Makes the job more pleasant by reducing physical and
mental stress
Saves money
 Categories of Ergonomic
Environmental
Hearing
Vision
General comfort and health
Evamples >
Sick Building Syndrome
Excessive noise
Improper lighting
Temperature extremes
 Physical
Physical stressors place pressure or stress on parts of the
body:
Joints, muscles, nerves, tendons, bones
“Cumulative Trauma Disorders” (CTDs) or
“Repetitive Strain Injuries” (RSIs)
 CTD’s
Occurring gradually over a period of weeks, months,
or years
Carpal Tunnel Syndrome
Epicondylitis
Tenosynovitis
Bursitis
 .
Avoidable sickness absence at work, promotes the idea
of early access to occupational health, this includes
specialist physiotherapy services.

Physiotherapy is clinically and cost effective at keeping

people at work or helping workers return quickly after
sickness absence
 Prevention Strategies
The elbows should be at a comfortable angle while
"hanging" at the sides from the shoulders. the shoulders
should remain relaxed in a lowered position while
typing.
avoid leaning forward at your desk maintain natural “s”
curve of your spine support lower back keep feet
supported on floor or use a foot rest.
 .
The keyboard should be slightly lower than
normal desk height. If it is not low enough, try
raising your chair height. Prevent your legs from
dangling by using a footrest. Keep "home row"
of keys at elbow level. Adjust your chair!
 .
Do not pound the keys. Use a light touch.
Use two hands to perform double key operations like Ctrl-C or
Alt-F instead of twisting one hand to do it.
Position frequently used equipment so that you don’t have to
reach for it.
Place monitor in front of you, not off at an angle.
Take lots of breaks to stretch and relax.
Hold the mouse lightly.
1. Keep your hands and arms warm
 .
Pay attention to the signals your body provides
you.
If your neck hurts at work, examine your body
position to try to figure out what might be
causing the soreness.
Are you holding your neck at an awkward angle
while you type or talk on the phone
 Cervicogenic Headaches
Many office-related headaches are caused by eyestrain.
Dry eyes
Monitor glare
Tired/strained eye muscles
Position monitor at a comfortable distance
Avoid glare
Adjust VDT brightness and contrast
Keep screen clear of dust
Look up and away every few minutes or so
 . Ergonomic Products
There are a variety of ergonomic products available on
the market, including:
Keyboards
Wrist rests
Mouse pads
Chairs
Adjustable desks
Glare screens
References

Prevention Practice: A Physical Therapist's Guide to

Health, Fitness, and Wellness by Catherine Rush
Thompson.