Close Menu

Live Chat

Cumulative Trauma Conditions

Accommodation and Compliance: Cumulative Trauma Conditions

About Cumulative Trauma Conditions

Cumulative trauma disorders (CTDs) are impairments that are caused by repeated movements. Continuous use or pressure over an extended period of time results in wear and tear on tendons, muscles, and sensitive nerve tissue. The most common parts of the body affected are the wrists, hands, shoulders, knees, eyes, back, and neck. CTDs are groups of disorders with similar characteristics and may be referred to as: repetitive trauma disorders, repetitive strain injuries, overuse syndromes, regional musculoskeletal disorders, and work-related disorders. Examples of CTDs include:

  • Bursitis: Bursitis is a condition where the bursal sac becomes irritated and painful
  • Carpal Tunnel Syndrome (CTS): CTS is a condition that results from pinching of one of the nerves in the wrist and hand. This nerve, the median nerve, is compressed as it passes through the wrist, and because of this compression, the nerve does not function properly.
  • Cubital Tunnel Syndrome: Cubital tunnel syndrome occurs when the ulnar nerve, one of the primary nerves supplying movement directions to the forearm muscles and sensory information from the hand, becomes compressed near the elbow.
  • DeQuervain's: Lateral DeQuervain's, sometimes referred to as tennis elbow, can result from excessive activities such as painting with a brush or roller, running a chain saw, and using many types of hand tools continuously. Medial Epicondylitis, sometimes referred to as golfer's elbow, can result from activities such as chopping wood with an ax, running a chain saw, and using many types of hand tools continuously.
  • Impingement Syndrome: Also known as rotator cuff syndrome, impingement syndrome is a result of the lack of room between the epicondylitis (upper part of shoulder blade bone) and the rotator cuff. Usually the tendons slide easily underneath the epicondylitis as the arm is raised; however, each time the arm is raised, there is a bit of rubbing on the tendons and the bursa between the tendons and the acromion. This rubbing, or pinching action, is called impingement. Continuously working with the arms raised overhead, repeated throwing activities, or other repetitive actions of the arm can result in impingement syndrome.
  • Radial Tunnel Syndrome: Radial tunnel syndrome, also called resistant tennis elbow, is an entrapment or compression of a nerve within the forearm. The symptoms of radial tunnel syndrome closely resemble tennis elbow, although the cause is different. Radial tunnel syndrome is caused when the nerve that operates several muscles around the wrist and hand (the posterior acromion nerve) is compressed or pinched, causing weakness of the muscles supplied by the nerve and pain over the elbow where the compression takes place.
  • Tendonitis: Tendonitis is a common condition that can cause significant pain. Tendonitis occurs when there is inflammation of tendons at the point where a muscle attaches to the bone.
  • acromion: Inflammation of the tendon sheaths that may follow trauma, overuse, or inflammatory conditions.
  • Trigger Finger: Trigger finger is a common condition caused by inflammation of the flexor tendons in the hand.
  • Thoracic Outlet Syndrome: Thoracic outlet syndrome is a condition characterized by pain in the neck, shoulders, and fingers and weakening of the grip.

The symptoms of CTDs are aching, tenderness, swelling, pain, crackling, tingling, numbness, weakness, loss of joint movement, and decreased coordination. There could be one or several causes of CTDs. The repetition of small, rapid movements; working in a static and/or awkward posture for long periods of time; insufficient recovery time (too few rest breaks); improper workstation setup; forceful movements; excessive grasping; and poor work techniques may contribute to injury. Some conditions associated with CTDs are: broken or dislocated bones, arthritis, thyroid gland imbalance, diabetes, hormonal changes from menopause, and pregnancy.  

Cumulative Trauma Conditions and the Americans with Disabilities Act

The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).

Accommodating Employees with Cumulative Trauma Conditions

People with cumulative trauma disorders may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with arthritis will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.

Questions to Consider:

  1. What limitations is the employee experiencing?
  2. How do these limitations affect the employee and the employee’s job performance?
  3. What specific job tasks are problematic as a result of these limitations?
  4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
  5. Has the employee been consulted regarding possible accommodations?
  6. Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
  7. Do supervisory personnel and employees need training?

Accommodation Ideas:

Situations and Solutions:

Events Regarding Cumulative Trauma Conditions