Repetitive Motion Injury and Upper Extremity Musculoskeletal Disorders – Interpreters are at Risk
by: Melanie Frye EIPA 4.1 - NIR Interpreter Coordinator
Repetitive Motion Injury/Upper Extremity Musculoskeletal Disorders were first identified as a problem 25 years ago. According to an online medical dictionary, Repetitive Motion Injury can be defined as “Cumulative trauma disorder (Occupational medicine) A work-related illness–e.g., carpal tunnel syndrome caused by overuse of a particular musculoskeletal group to perform a task repeated hundreds to thousands of times/day; it is the fastest growing health problem in the US; it affects textile industry workers, meat-packers, keyboard operators, etc”.
Many interpreters face pain, tendonitis, nerve entrapment disorders, and overuse syndrome which can all be identified as Repetitive Motion Injuries. These produce themselves because interpreters face “Biomechanical Risk Factors”. A study referenced in the Journal of Interpretation (JOI) Volume 25 Issue 1 conducted by Marras and Shoenmarklin in 1993 indicates that people should not exceed 13,000 wrist movements in an eight hour work day. Interpreters are estimated to have 13,600 in 50 minutes. Interpreters also cannot control the speed at which they must work because it is governed by the cadence of the speaker. Interpreters are often forced into awkward postures. Another study referenced in the JOI is that of Drury on the Classification of Upper Extremity Injury Risk from 1987 indicates that levels of injury risk are “severe” and “moderate/severe …for work activity that requires [such high levels] of wrist deviation”. It was also noted that higher cognitive demands in the interpreting process leads higher physical demands. Even small differences in wrist position, flexion, range of motion, wrist velocity, and wrist acceleration can have major impacts.
Other ideas explored in the JOI include the age of which American Sign Language was learned as well as full time work as an interpreter vs. conversational usage among the Deaf Community. These different studies indicated that there was less repetitive motion injury showing in Children and Siblings of Deaf Adults (CODAs and SODAs respectively). This was often in part to a more flowy, casual way of signing as well as having a lifelong experience with the language to make certain comfort adjustments. There is also something to be said about casual vs. formal usage of American Sign Language, with more articulation being needed in the formal usage, which is why interpreters face more risk for repetitive motion injury than Deaf people who use the language conversationally.
The increase of interpreters experiencing Repetitive Motion Injury is greatly affecting the ability to continue to work. More and more interpreters are leaving the field due to injury and constant pain or are facing surgeries to repair damage from injuries caused by the profession. In an article from Science Daily, Matthew Marshall a researcher on this topic from Rochester Institute of Technology is quoted saying, “… the impact of injury on interpreters and its effect on retention is a major issue in the Deaf Community because any reduction in the interpreter population would have an adverse effect on the full societal participation of deaf and hard of hearing individuals”.
Self Care/Prevention/Medical Treatment:
For self care and prevention WebMD recommends applying ice 2-3 times daily for 20-30 minutes each, warm ups and cool downs prior to beginning activities that induce repetitive motion injury pain, avoiding activities that cause flare ups, range of motion exercises, and splints or bands. If those approaches do not prevent repetitive motion injury, non steroidal anti-inflammatory drugs (aspirin, naproxen, ibuprofen), steroid injections, physical therapy, ultrasound, warm water baths, ice, elevation, and pain creams might all be recommended by a physician, as well as possible surgical options.
This blog has been prepared for general informational purposes only. It is not intended to provide and should not be relied on for medical advice. Please consult your physician regarding your specific situation.