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Physical Task Demands
A research study aimed to identify the types and severity of musculoskeletal disorders of serving staff in restaurants. Specific risk factors to strain and or injury of the arm include lifting and transferring large and heavy loads, reaching for items, and repetitious tasks. The researchers quantified the physical demands of the servers throughout an entire shift by recording the frequency of tray carrying and the postures of specific joints in the body. Results of this study showed that the servers would carry trays for an average of 3.4 hours during their shift and methods of carrying trays included in front of the body, on the shoulder, flat hand, or lifting and carrying with finger tips. Participants reported a 35% increase in pain in their arm, hand and wrist after their shift.

Proper technique to carry trays from the Occupational Safety and Health Administration, state the elbow should be kept at 90-degree angle and close to the body while maintaining neutral wrist and flat hand with flat fingers to balance the tray. Improper technique of holding tray with elbow fully flexed with fingers in extension that are carrying majority of the weight can lead to pain and injury when overused. .

Pain and Trigger Points
Food servers may have a tendency to narrow their shoulders which causes overuse of the flexors of the arms and or fingers. Because of this, strain of the elbow flexor muscles can lead to pain and injury in other parts of the body. Trigger points in a muscle can cause this type of pain for food servers specifically. Pain felt in the hand or arm can be a direct result of strain of the elbow joint. Pain associated with the brachialis may be felt at the base of the thumb, and is caused by lifting heavy objects while the elbow is bent. Biceps brachii pain will often restrict available range of motion and is felt in the anterior shoulder and lower arm. Strain of the brachioradialis can cause an aching pain that can be felt at the web of the thumb on the backside of the hand, the lateral epicondyle, and down the muscle of the inner forearm. Pain at the brachioradialis is also known as “tennis elbow” and is caused by forceful and repetitive gripping of large or wide objects and unfortunately pain will be accompanied by weak or unreliable grip.

Preventing Pain
Food servers in restaurants can prevent pain and strains in their muscles by recognizing and avoiding unsupported posture when carry items. Instead of carrying items like plates or heavy trays with a fully flexed elbow and extended fingers, carrying a tray with the elbow kept close to the body at a 90-degree angle with a neutral hand is best practice. Bringing items closer to the body rather than overreaching and extending the elbow joint constantly will help to avoid injury. To also prevent pain, it is important to stretch muscles that are constantly being used like the biceps brachii, brachialis, and brachioradialis.

Strengthening Exercises
To maintain a healthy and pain free body it is important to stay strong. To strengthen the muscles of the elbow joint, bicep curls starting with the arms down with palms facing outward or palms towards the body and with light weights make an acceptable exercise.

Mobilization Techniques
Voodoo Elbow Mobilization is an effective technique for someone who is suffering from “tennis elbow” pain. Once the arm is voodoo wrapped above and below the elbow various exercises to mobilize the elbow joint can begin. Forced flexion and extension is an exercise a person can do alone by getting on all fours and then placing palm on the ground to encourage the arm to flex and then extend while it is wrapped.