Avoiding work-related musculoskeletal disorders

The Ultrasound Advisory Group are planning a series of short learning activities for sonographers to help with their CPD. To start off with, for medical ultrasound awareness month (#MUAM), this one is for anyone practising ultrasound.

Six key points:

• Both the employer and employee have a responsibility to reduce the risk of harm from work-related musculoskeletal disorders (WRMSD). This includes offering and engaging with training, risk assessments and safe use of equipment.

• The cause of WRMSD is multifactorial; poor posture, repetitive movement,transducer grip and pressure, psychosocial factors, physical factors and workload management can all impact.

• Ergonomics plays an important role in reducing the chance of injury. Adjusting the equipment to YOU and your needs is crucial. Remember we are all different.

  • Have the patient as close as possible to reduce arm abduction

  • Face the monitor, to reduce spinal rotation

  • Keep your scanning arm humerus vertical, definitely no posterior extension

  • Keep your scanning forearm horizontal

  • Have all fingers on the probe, don’t grip tightly and don’t push unless absolutely necessary to the clinical examination.

• Take micro-breaks during the scan, to relax the muscles and tendons

• Dynamic warm up exercise before scanning and stretching between cases and list can help.

• Be body aware; if you have any symptoms of WRMSD change your position or technique. If all else fails, get advice

Reflection prompts:

• Do you have any aches and pains that you think are caused by ultrasound scanning?
• Have you changed your way of working or posture to see if this makes a difference?
• What warm up exercises and stretches between scans can you do to keep yourself supple and prepared for the scanning list?
• What are the optimal positions for the patient, sonographer, sonographer’s arm, hand, wrist, neck to reduce risk?
• Have you observed colleagues or had them observe you to give advice? If not, use the checklist to see if you can give each other advice on potential changes that might reduce the chance of injury.

Further reading

ASA and ASUM (2020) ASA and ASUM joint Guidelines for Reducing Injuries to all Ultrasound Users. 

Harrison, G. and Harris, A. (2015) Work-related musculoskeletal disorders in ultrasound: Can you reduce risk? Ultrasound. 23(4): 224–230.  

Health and Safety Executive https://www.hse.gov.uk/msd/msds.htm

Monnington et al (2012) Risk management of musculoskeletal disorders in sonography work

SDMS (2018) Work Related Musculoskeletal Disorders In Sonography 

SDMS (2016)  Industry standards for the prevention of work related musculoskeletal disorders. 

SoR (2019) Work-related musculoskeletal disorders (Sonographers)