It’s 3 a.m. Once again the dull ache stirs you from sleep. The first time was at midnight. Now the ache in your shoulder is telling you it’s time to roll onto your other side. Hopefully this will be the last time this happens tonight.
For far too many lineworkers, this has become a nightly ritual. In 2004, Business Health Resources conducted a symptom survey of 224 overhead electric employees who worked for one public utility, and it revealed that 56 percent of them experienced shoulder pain a couple times a week or more often. Many experienced shoulder pain on a daily basis. Because shoulder problems are so common, most lineworkers have come to believe they are just part of the job. Are they really, or can they be prevented?
Shoulder conditions can occur as a result of acute trauma injuries like falls or car accidents, or they can occur from cumulative trauma, which is the slow wear and tear that takes place over time, usually due to performing repetitive and physically demanding tasks using stressful working postures. The problem with cumulative trauma is that as the damage accumulates, you always feel pretty good – right up to the moment you are in pain. It’s a sneaky problem.
To understand what leads to cumulative trauma, we first need to cover some basic anatomy of the shoulder joint. It is a loose ball-and-socket joint, making it highly mobile so we can put our hands wherever they are needed. The price we pay for all of this mobility, however, is a loss of structural stability.
If you place your fingers on top of your shoulder, the bony little lump you feel is the acromioclavicular – or AC – joint, which is the joint between the collarbone and your shoulder blade. It is the only bone-to-bone connection between your arm and the rest of your body. The AC joint is about the size of the joint at the base of your thumb, and yet it has to safely transmit all of the stresses from your arms to the rest of your body. This design makes the shoulder far more susceptible to wear-and-tear injuries, especially when it is subjected to abnormal stresses, like those that come from performing line work using stressful techniques.