Preventing and Treating CTD, the Physical Disorder that Almost Everyone Has (or will have at some point in their life)!

By: David Thompson, BCTMB
Board Certified in Therapeutic Massage and Bodywork, Certified Active Release Techniques Provider

Have you ever experienced a nagging ache or pain that won’t go away, or returns frequently? Recurring tingling, numbness, pins and needles? Sharp or shooting pain, weakness, loss of dexterity or ability to perform a function? These are some of the signs of Cumulative Trauma Disorder (CTD), a condition that affects an ever-growing portion of the population. With the proper preventative steps and/or early intervention via soft-tissue therapy, significant pain (and surgeries and RX’s) can be avoided!

CTD is a broad category that is also referred to as Repetitive Stress Syndrome, Repetitive Strain Injury, Overuse Syndrome and many other names. It includes injuries to muscles, tendons, ligaments, joints, nerves, and blood and lymph vessels. These injuries are caused by:

  • repetition
  • awkward postures/poor ergonomics
  • long held body positions without movement
  • excessive force or overstretching while performing work/activity
  • excessive pressure from a tool or piece of equipment, or even from ill fitting garments
  • excessive vibration such as from a grinder or polisher
  • or initiated by a blunt force, tear, or crush injury such as whiplash, a bad fall, or just ‘overdoing it’ at the gym

Everything from working at a computer, to house cleaning, fabricating, brick laying, driving, running (with less than perfect form), sewing/stitching, playing a sport or an instrument, to using a smart phone can cause these injuries.

Common CTDs include: Carpal Tunnel Syndrome, Thoracic Outlet Syndrome, Shin Splints, Compartment Syndromes, Golfer’s Elbow, Tennis Elbow, Tendonitis, Tenosynovitis, Bursitis, Planter Fasciitis, Trigger Finger, Sciatica, Headaches, TMJ and many more.

It is important to know that CTDs are very common and are cyclical by nature. This means that once initiated, a downward cycle begins; fibrosis within a tissue/adhesion between tissues, weakness and tightness, swelling and inflammation, and decreased circulation and hypoxia (lack of oxygen) leading back to more fibrosis/adhesion… and the cycle continues.

Prevention is best (more on that in a second), early intervention is next best. As time goes on, without intervention or the cessation of insult to the tissue, the tissue will undergo a predictable series of changes. First- inflammation, then a palpable stringy texture, then lumpy with adhesion to adjacent tissues, then leathery and thickened (and slow to respond to treatment)!

And now for prevention. Here are two key principles to apply in any situation:

  1. Check your ergonomics! We’ll keep it simple for this post: When engaged in an activity that you routinely do for long periods of time, take a moment to assess what your body is doing. What muscles are you tensing that don’t need to be tensed? Is your ‘core’ engaged? Do you feel a good connection to your feet (and the ground) and are you balanced in your center of gravity even when seated? Explore and play around with modifications to see if you can improve any of these factors. It can pay great dividends to allow a muscle to stop contracting for hours on end.
  2. Take frequent (micro) breaks! If you work at a computer, make a habit of dropping your hands in your lap, completely limp, while you read a body of text or ponder your next move. In manual labor drop your hands and shoulders when switching between tasks or waiting even for a moment for something. No matter what you do or whether you can sneak in those moments of muscle relaxation, you should reasonably be able to take a 30 second stretch break a few times an hour. Due to the physiology behind CTD, it is far more beneficial to stretch for 30 seconds every 15 minutes than for any length of time once or twice a day. That’s a total of 2 minutes per hour of repetitive activity or fixed position and it could change your life!

Sometimes the situation gets beyond a free and easy resolution. Sharp, shooting pains, tingling, numbness, headaches, weakness, fatigue, loss of dexterity, decreased range of motion, persistent aches and pains; these are all common symptoms of cumulative injury. If you experience these symptoms, you should go to the doctor to identify or rule out a more serious underlying condition.

You may, then, also want to see a bodywork practitioner with training in advanced soft tissue treatment techniques. Usually, even in the presence of more serious conditions (i.e., disc degeneration, autoimmune disease, arthritis, or neurological disorders), your situation can safely be improved or resolved through appropriate and skillful application of soft tissue manual therapies (i.e., advanced myofascial release, assisted stretching or active isolated stretching, active release techniques, targeted exercises).

These therapies will generally work by identifying the exact structure that is injured or stuck (muscle, tendon, ligament, joint capsule, nerve or, usually, combination of tissues) through assessment and palpation, then perform specific work on that tissue usually combined with specific movements performed by the client/patient to release the tissue or break scars and adhesions and simultaneously stimulate the body to heal itself. After the tissue is released, it is often prudent to be taught simple corrective exercises to restore strength to the region. An appropriately applied treatment can correct the problem rather quickly and permanently—so long as you move forward in life following the prevention principles!

Keep in mind that many of the most effective, cutting edge treatment modalities (such as Active Release Techniques, more on this in future posts from this author) have not made their way into ‘core’ curricula for any profession, be it massage, physical or occupational therapy, chiropractic, or even sports or orthopedic medicine. When choosing a provider, it is pertinent to ask about their continuing education and what they have learned since completing their original training; you will find that those who are both passionate and experienced (and most likely able to help) will have an answer to that question! At Cashman Center, as with all our practitioners, our massage and bodywork therapists strive to bring you the best available treatments and have completed numerous advanced treatment modality trainings.

I cannot stress it enough- prevention and early intervention are game changers! If you wait too long, surgery may be unavoidable, permanent damage and loss of function may have already occurred, you may have to completely stop the activity for a long period of time in order to heal. Further, it will take many more treatment sessions, time, and money to resolve. If you get checked out by a qualified health provider right away and proactively seek treatment, you may resolve the issue in as little as one or two sessions and walk away empowered with new insights as to how your specific problem arose and how to prevent it from reoccurring in the future!