Injuries in Hairdressing
As a result of prolonged and repeated lockdowns, we have realised how important our hairdresser or favourite barber is to our health and wellbeing, but we rarely think about the injury and occupational burnout that is highly prevalent in this occupation.
As a result of prolonged and repeated lockdowns, we have realised how important our hairdresser or favourite barber is to our health and wellbeing, but we rarely think about the injury and occupational burnout that is highly prevalent in this occupation.
Hairdressing like any repetitive task comes with its strains and stresses.
A 2019 scoping review by Kozak and colleagues looked at a wide range of studies that assessed the bio mechanical disadvantages this occupation group is subject to, such as spending between 9-13% of total working time with their arms elevated to or above 60 degrees (chest height), of which is a clinically relevant factor in shoulder injuries and persistent severe pain.
There are statistics like this for multiple areas of the body in hairdressing, applicable for both male and female workers, so this spurs the question - “How can you reduce the risk of injuries happening and prolong your career?”
Common Hairdressing Injuries:
Let’s hone in on the more common sites of injury and what structures are being overloaded due to repetitive tasks:
Lower Back (76%) and Neck pain (58%) were prevalent in a twelve month period
Shoulder (60%) and Wrist/Hand pain (53%) were prevalent in a twelve month period
Foot (44%) and Knee pain (41%) were prevalent in a twelve month period
(Kozak, et al. 2019)
What Contributes to these Injuries?
Strenuous hand or arm postures and movements (e.g. arms above shoulder, repetition)
Awkward postures and movements of the spine (e.g. bending and twisting the back)
Workload and biomechanical strain (e.g. mechanical workload, overtime, no breaks)
Prolonged standing and sitting
Other factors (e.g. work experience, mental stress and burnout, gender or low support)
Specific hairdressing tasks (e.g. cutting, dying or styling hair)
(Kozak, et al. 2019)
What Can You Do?
It might seem obvious but taking a break between the stressful activities can prevent or alleviate micro injuries of all the above areas
Occupation specific changes: including but not limited to using a chair for lumbar pain, keeping arms near the body for shoulder pain, and cutting with the wrists in a neutral position for wrist pain
Improving ease of access such as asking customers to turn or bend the head and lowering the customer to an appropriate height
Early introduction of education on injury prevention (Kozak et al. 2019) noted a decrease in shoulder pain with when educating student hairdressers about shoulder positioning while cutting hair.
7 Exercises to Help Prevent Injuries:
Where we come into the prolonging of a work lifespan is through exercise, addressing the positions of extended exposure is through physical preparation and exercise.
Some examples to address these are not limited to the list below but they are a great starting point.
Forearm flexor stretch
Wrist Rolls
Scapula (shoulder blade) Squeezes
Thoracic Extension to the wall or a Foam Roller
Standing Extension or Prone Extensions
Standing Rows
Chin Tuck
If you have an injury or significant pain in one of the above areas please consult your physiotherapist prior to attempting the above exercises, an assessment to provide individualised programs is the best way we can help.
Injuries In Australian Rules Football
Injuries will always be a part of sport and according to the statistics, Australian Rules Football or AFL tops the list nationwide.
Injuries will always be a part of sport and according to the statistics, Australian Rules Football or AFL tops the list nationwide. When looking at these statistics, the classification of an injury is where a minimum of one game is missed due to that specific injury. Sports injuries are something we treat daily at the clinic and work towards both reducing the prevalence through strength and conditioning/preparation programs, as well as recovering from the injury and returning to play.
If we break down the injuries in AFL the most prevalent are:
Hamstring Injuries (19.1 missed games/club/season in 2015)
ACL Injuries (16.7 missed games/club/season)
Shoulder Sprains and Dislocations (11.5 missed games/club/season)
Leg and Football Fractures (8.6 missed games/club/season)
Ankle Sprain/Joint Injuries (7.2 missed games/club/season).
Table 1 below compares the most prevalent injuries across all AFL, Union, Soccer and American Football codes:
| Table 1. Injury incidence and most prevalent injuries across football codes at the professional level | ||||
|---|---|---|---|---|
| Injury incidence | Australian Football | Rugby Union (English) | Soccer (UEFA) | American Football |
| 41.7 injuries per club per season | 54 match injuries, 27 training injuries per club per season* | 2 injuries per player per season** | ||
| Most prevalent injuries | Hamstring strain | ACL | Hamstring strain | Knee ‘internal derangement’ |
| ACL | Concussion | MCL | Ankle sprains | |
| Shoulder sprain / dislocation | Hamstring strain | Quadriceps strain | Concussion | |
| Leg / foot stress fractures | Ankle syndesmosis | Adductor pain / strain | Upper leg contusion | |
| Ankle sprains | MCL | Upper leg muscle-tendon injury |
||
| Groin strains and osteitis pubis | AC joint injury | |||
| Knee cartilage injuries | Shoulder ligament sprain | |||
Top injuries:
AFL - 2015 season. Missed games1
English Rugby Union - 2014-15 season, match injuries only. Days absent21
* includes injuries that do no result in missed matches, limiting comparison
Soccer - UEFA 2001-2008, time-loss injuries. List of most common injuries causing >28 days absent20
** included players unavailable for either training or match. Half of these injuries were classified as 'minor' and resulted in absences of less than 1 week
American Football - most common match injuries were resulting in time-loss, ranked in order of frequency , not time lost14
The average number of matches lost per injury for the most common AFL injuries is outlined in Table 2 below. However, this data should be interpreted with caution, as the AFL Injury Survey only includes injuries that result in missed matches, in addition, if a significant injury (eg, shoulder dislocation requiring surgery) occurs late in the season, the player may miss fewer matches because they are able to recover during the off-season.
| Table 2. Insistence, prevalence and average missed matches from common injuries in the AFL | |||
|---|---|---|---|
| Incidence | Prevalence | Average Missed Matches | |
| Hamstring strain | 5.2 | 19.1 | 3.7 |
| ACL rupture | 0.7 | 16.7 | 23.9 |
| Shoulder sprain / dislocation | 1.6 | 11.5 | 7.2 |
| Leg / foot stress fractures | 0.7 | 8.5 | 12.1 |
| Ankle sprains | 2.4 | 7.2 | 3.0 |
| Groin strains and osteitis pubis | 2.2 | 7.1 | 3.2 |
The mechanism of injury, or the position these tears occur in is knee abduction, lateral trunk motion with the body shifted over one leg and the plantar surface of the foot fixed flat on the playing surface, displaced away from the trunk and low knee flexion.
How did I get this injury?
hamstring
In the swing phase, after you have pushed off and before you make contact with the same foot, the hamstrings are at their greatest length and at this moment, they generate maximum tension. In this phase, hamstrings contract to decelerate flexion of the hip and extension or straightening of the knee. During activities like running and kicking, your hamstring will lengthen with hip flexion and knee extension, this lengthening may reach the length limits of the muscle or lead to the accumulation of repetitive stress at a deep muscle level. Excessive anterior pelvic tilt will place the hamstring muscle group at longer lengths, whereby some studies proposes that this may increase the risk of strain injury.
ACL
These injuries are more commonly sustained in non contact situations, so why is this type of injury so common for this group of athletes? Due to the 360 degree’s of play in Football compared to other sports quick changes of direction are required to react to opponents, increasing the stress in directions the ligaments in the knee are not prepared to handle. The mechanism of injury or the position these tears occur in is knee abduction, lateral trunk motion with the body shifted over one leg and the plantar surface of the foot fixed flat on the playing surface, displaced away from the trunk and low knee flexion.
Shoulder
Anterior dislocation, where the ball portion of the ball and socket joint exits the front of the shoulder joint, is the most commonly seen type of dislocation: The mechanism of injury is usually a direct blow to the athletes arm while in a combination of out to the side, rotated backward and raised in the air. Such as going up for a marking contest and being spoiled. Alternatively it may also occur with a fall on an outstretched arm that causes the arm to go out to the side and behind the body.
The Table below shows the incidence, prevalence and average number of matches missed according to injury type:
| Incidence | Prevalence | Average Missed Matches | |
|---|---|---|---|
| Knee cartilage injuries | 1.1 | 6.5 | 5.9 |
| Calf strains | 2.9 | 5.9 | 2.0 |
| Concussion | 1.5 | 4.2 | 2.8 |
| PCL sprains | 0.5 | 3.2 | 6.4 |
| Quadriceps strains | 1.0 | 2.2 | 2.2 |
HOW LONG WILL I BE OUT FOR?
Hamstring
Timeframes for rehabilitation and return to sport vary depending on the nature and severity of the strain. As a general rule, Grade 1 hamstring strains should be rested from sporting activity for about three weeks and Grade 2 injuries for a minimum of four to eight weeks. In the case of a complete rupture (Grade 3), the muscle may have to be repaired surgically and the rehabilitation to follow will take a minimum of three months. Premature return to sport and inadequate rehabilitation will increase the risk of re-injury. Full range of motion, strength and control of the leg should be achieved to train in your chosen sport in full. Detailed sport specific assessment should be evaluated to clear the athlete to play, this should include weight bearing, twisting, jumping, reactive strength and speed related tasks.
ACL
Similarly, no clear and agreed upon timeframe for return to play is advised. Early return to play has been associated with increased risk of the repaired ligament to fail, with added risk to the opposing knee becoming injured. Recent trends adopt a more conservative rehabilitation protocol with considering returning to sport at 8-12 months.
Shoulder
For anterior dislocations the recovery time will vary depending on the associated structures damaged such as the ligaments supporting the joint or the labrum. Both of which you can find out more information on our Website Blog “Common Shoulder Complaints”. An artheroscopically repaired shoulder will generally take a minimum of 3 months rehabilitation to be able to return to sport. This timeframe can be severely affected by age, as the chance of reoccurrence is higher in our under 25 year old population
In Summary, if we look at the statistics for the game of Australian Rules Football, it is highly likely that you may sustain an injury of some sort through the season requiring you to miss one or more matches. The recovery time’s can vary but largely depends on hitting key goals and requirements to return safely to play. If you suspect you have sustained an injury or have a current injury that you would like to ensure you treat in the appropriate way, please contact one of our staff members.
References:
Brukner P. Khan, K. (2010) Clinical Sports Medicine (4th ed., p.362). Sydney: McGraw-Hill.
West, R. and Bryant, B. (2019). ACL injuries in female athletes. St Louis: Elsevier, pp.1-4.
Common Shoulder Complaints
Jesse Dean (Physiotherapist) talks us through the basic anatomy of the shoulder complex.
He discusses the top 3 shoulder complaints that he sees in the clinic and shows us his top 5 favourite shoulder exercises.
We’ve seen a large number of shoulder complaints come through the clinic recently, so we have put together some basic info about shoulder anatomy, common conditions, symptoms to look out for and exercises to help strengthen your shoulders, recover from and prevent shoulder pain and injuries.
Scroll down to read more and watch the videos with our Physiotherapist Jesse Dean!
LEARN ABOUT Shoulder Anatomy
The shoulder is a complex joint involving the humerus (upper arm bone) shown in purple, scapula (shoulder blade) in blue & the clavicle (collarbone) in green.
The cup (glenoid) of the humerus is relatively shallow and rimmed with a cartilage known as the labrum. The labrum acts to improve the stability of your shoulder, while the glenoid allows for a large range of movement.
Watch the video below for more:
Top 3 Shoulder Complaints
1. Subacromial Bursitis
Common Symptoms:
Pain reaching overhead, behind the back or taking your arm out to the side
Tenderness on the top of the shoulder
Aching pain down the side of the upper arm
2. Labral Tears
Common Symptoms:
A deep aching pain in the shoulder joint
Feelings of instability or not trusting your shoulder
Difficulty with weight bearing on the affected shoulder
3. Acromioclavicular (AC) Joint Injuries
Common Symptoms:
Pain reaching across your body or when the arm is reaching overhead
Tenderness on the tip of the shoulder blade and end of the collar bone
How Can You Strengthen Your Shoulders?
Jesse has collated his top 5 exercises to help his patients regain their shoulder function. Though we believe that exercise is an essential component in maintain musculoskeletal health, there are no ‘one size fits all’ exercise strategies. Please consult with your physiotherapist if you’re currently experiencing shoulder pain or have concerns about your shoulder function.
1. Wall Angels
Thoracic extension & scapula control are important components in using your arms overhead. Often people can have restrictions in these areas, as we often see patients using compensatory strategies which don’t work in the long term.
Try this deceptive exercise and discover how it can help with your overhead movements.
2. Behind The Back Towel Pull
Restricted shoulder mobility can greatly impair the function of your shoulders. Stiffness can decrease your ability to reach behind you, put on a jacket or reach for the top shelf.
This simple mobility drill will help you maintain and improve your shoulder mobility allowing you to function at your best.
3. Clock Face Wall Touches
Strengthening your back or shoulders involves more than a cable row & shoulder press. This exercise will challenge your ability to maintain scapula organisation while strengthening your posterior shoulder in a varied range of directions.
If you’re looking to feel the burn, increase shoulder stability and improve your overhead strength, don’t be afraid to add this exercise to your shoulder routine.
4. Single Arm Ball Circles
Scapulothoracic & Glenohumeral control are essential in keeping your shoulders happy. The Serratus Anterior plays a pivotal role in both functions, though many people don’t know what it is.
This exercise is fantastic for developing your Serratus control and improving your shoulder function with pushing movements, while increasing your shoulder muscle endurance at the same time!
5. Resisted Y - T - W’s
Strengthen your scapulothoracic stabilisers (Rhomboids & Trapezius) and glenohumeral stabilisers (Rotator Cuff).
This dynamic exercise can help keep you strong for overhead movements and help you maintain shoulder control under load.
Have you recently suffered a shoulder injury? Are you Experiencing shoulder pain? Book in to see Jesse today.
What’s Inside Our Shoulder?
The shoulder joint is one of the more complex joints in the body. This blog post explains what exactly goes on in the shoulder joint, the structures inside, problems that can occur and exercises to prevent injury.
Our shoulder joint is known as the Glenohumeral joint and is traditionally referred to as a ball and socket joint as the rounded head of the humerus (the upper arm bone) slots into the cavity of our scapula (shoulder blade) seen in the image here.
The head of the humerus is able to pivot in all directions by two structures: synovial fluid and a fibrocartilage structure called the labrum. The labrum is a smooth structure that allows movements between to bone structures while the synovial fluid reduces any friction during movement.
Structures within the joint
Muscles and tendons
When talking about the muscles of the shoulder complex we usually refer to the 4 rotator cuff muscles which stem off the shoulder blade and attach on the humerus.
These muscles are:
Supraspinatus: This is responsible for shoulder abduction and the origin (the muscles fixed attachment) of the supraspinatus is at the supraspinatus fossa of the scapula where the insertion (bony attachment that moves with contraction) is at the greater tubercle of the humerus.
Infraspinatus: Responsible for external rotation of the shoulder and originates at the infraspinatus fossa of the scapula and inserts into the greater tubercle of the humerus.
Teres Minor: Responsible for external rotation and assists in adduction. The origin is the lateral border of the scapula and inserts into the greater tubercle of the humerus.
Subscapularis: Responsible for internal rotation of the shoulder and originates at the subscapularis fossa of the scapula and inserts into the lesser tubercle of the humerus.
The shoulder complex also has a meaty muscle that caps over the top of the joint known as the deltoid. The Deltoid is responsible for shoulder flexion, abduction and internal rotation. The deltoid has two heads that attach at the lateral aspect of the clavicle (anterior head) and the acromion process at the end of the spine of the scapula (middle head) and inserts into the deltoid tuberosity of the humerus.
Ligaments
Superior glenohumeral ligament
Middle glenohumeral ligament
Inferior glenohumeral ligament
Coracohumeral ligament
Transverse humeral ligament
Coraco-acromial ligament
Blood Supply:
The shoulder complex receives blood supply from four arteries:
Anterior circumflex humeral artery
Posterior circumflex humeral artery
Suprascapular artery
Scapular circumflex artery
Nerve Innovation:
The nerves that supply the joint are found in the bundle of nerves that stem off the back of the neck and travel over the first rib, under the collarbone and into the armpit. Specifically these nerves are:
Suprascapular nerve
Axillary nerve
Lateral pectoral nerve
Capsule
The glenohumeral joint capsule forms between the neck of the humerus and the glenoid fossa (where the labrum attaches against). The front of the capsule is reinforced by the three glenohumeral ligaments mentioned above and the rotator cuff muscles support the joint both posteriorly and superiorly while also assisting anteriorly.
Bursae:
A Bursa is a synovial fluid filled sack located at joint sites to allow for muscle tendons (attachment sites for muscles) to slide over with no bony rubbing or friction. There are five bursae in the shoulder complex: subacromial-subdeltoid bursa, supra-acromial bursa, subscapular bursa, coracoclavicular bursa and the subcoracoid bursa.
Common shoulder injuries seen at the clinic:
These include general overuse injuries leading to inflammation and wear & tear, traumatic injuries, postural deformities, shoulder instability and arthritis.
Overuse injuries:
Specifically in the gym caused from repetitive movements can lead to inflammation of the muscle tendons or the surrounding structures and unless treated correctly, can lead to wearing of the tendon.
Trauma:
Such as Falling on out-stretched hands (FOOSH injuries), dropping a weight that is supported by one of the shoulders or direct trauma. This can lead to muscle tears of the rotator cuff group, ligament sprains, labral tears or bone fractures.
Postural deformities:
We see a lot of desk sitters with an excessive upper back hunch/ kyphosis that encloses the space in the shoulder joint especially on shoulder abduction/ laterally raising one arm causing jamming within the shoulder joint together with muscle tightness and muscle imbalances caused from poor posture.
Shoulder instability
Weak shoulders allows for excessive movement within the joint from poor rotator cuff muscle strength and loose ligaments. This usually occurs after a fall causing a ligament sprain where the ligaments never go back to their original length and stay laxed, together with weakened shoulder muscles, the person will present with pain, deformed shoulder joint on appearance and reduced range of movement.
Arthritis
Osteoarthritis will affect the smooth cartilaginous structure (the labrum) between the ball and socket causing the degeneration resulting in bone on bone during certain movements. This traditionally affects people over the age of 50 and a treatment program will be prescribed for pain management that may result in surgery.
Strengthening the shoulder joint
To strengthen the shoulder joint we strengthen both the rotator cuff muscles and the shoulder joint in general.
To strengthen the rotator cuff we work on 3 pain movements: external rotation, shoulder blade retraction and internal rotation. These movements are in the image below with the photos on the left column being our starting position and the photo on the right being our finishing position.
To strengthen external rotation we start with our elbow tucked in to our torso and we pull the theraband across our body as if we are opening a newspaper.
To strengthen shoulder retraction we bring the theraband around our back and cross it over from our front and pulling both arms out keeping your elbows tucked in. You should feel a squeeze between the shoulder blades and holding the contraction at end range.
To strengthen internal rotation we start with our elbow tucked in to our torso and we pull the theraband towards our body as if we are closing a newspaper.
For general shoulder strengthening we get a swiss ball and stand far enough back from the wall that our arm is straight out infront of us holding the ball against the wall. From here we do circular movements both clockwise and anticlockwise, then move the ball higher, lower, to the left and to the right from our initial starting position so the ball is further away from our midpoint and repeat the circular movements.
Kyle Michelle
MYOTHERAPIST
This article has been prepared by Kyle Michelle. If you have any questions for Kyle or would like to know more about the glenohumeral joint, please leave your comments below.
Neck and Back Pain
Our most common condition we see at our clinic is neck and shoulder issues. Bec has written a short blog on how to avoid pain here through regular movement, exercise and treatment.
People who work long hours driving, sitting at a desk, or hunching over a workbench often suffer from neck and back pain. This may be the result of muscle imbalances from incorrect posture. Muscle imbalances occur due to inactivity in some areas and over activity in the areas that are required to hold you in that same position for long periods of time. The areas that are over active have an increased risk of muscle tension and spasm, which may lead to neck or back pain.
Regular Movement
Set an alarm to get up regularly and walk around, even if it’s just a lap of your desk. This allows your body to have a break from the position it has been in as well as encouraging movement through areas that otherwise remain stationary and increase the risk of muscle tension.
Regular Exercise
Keeping up a regular exercise program can assist with keeping muscles and joints in peak condition. Posture correcting exercises that re-educate the body, like Pilates, can also help prevent neck and back
Regular Massage
Massage treatment is effective for relieving muscle tension and spasm, as well as helping loosen up stiff joints. Your therapist can provide stretches for you to do at home or work and advise on posture correcting techniques that can assist with reducing muscle tension to help prevent neck and back pain.
Rebecca May
MYOTHERAPIST
This article has been prepared by Rebecca May. Please leave your comments below if you have any further questions about neck and back pain