Thread by @janinamarkidan

Let’s talk about microscope ergonomics! 🔬

Musculoskeletal pathologies among pathologists are very real, and often, quite literally, a giant pain in the neck.

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https://twitter.com/loveturtle9/status/1555741964875841536

A growing collection of studies suggest that #pathologists face far higher risk for musculoskeletal problems.

The most common problem areas tend to be the neck and upper back.

BUT, many of these issues can be prevented!

Img source: (Agrawal, et al., 2014)

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These are *repetitive stress injuries* caused by repetitive or sustained submaximal exertion of the body’s soft tissue structures including muscles, tendons, ligaments, and nerves 🤕

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I’m guessing that these risk factors will sound familiar to #pathtwitter…

Long hours spent sitting at a desk
Repetitive motions
Suboptimal workplace ergonomics

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3 mechanisms of injury have been proposed…

1: High level static contraction

Most wouldn’t associate sitting at a 🔬 with HLSC, but electromyography studies show that neck/back muscles are deeply engaged.

Also: cognitively demanding tasks = higher levels of contraction

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2: Microischemia/Toxic Metabolite

Sitting inhibits blood flow to all muscles due to gravitational forces, lack of movement and increased tension.

Not moving inhibits adequate blood flow.

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3: Bad posture (e.g. flexing the neck while looking through a 🔬 with non-adjustable eyepieces) weakens muscles over time by causing extensor muscles, tendons, & ligaments to become overstretched.

Microscopists tend to develop forward-leaning posture and extensor weakness.

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Nearly all relevant studies found that of musculoskeletal problems reported, the overwhelming majority among microscopists occur in the neck.

We have relatively long necks (with 26 paired muscles) and heavy heads (avg: 14 pounds).

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So how do we protect ourselves?

There are a few things we can do…

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First, SCOPE ALIGNMENT!

Notice in these photos, the microscopist has to unnaturally bend her neck or back forward to look through the eyepieces.

Also, because the table is set too high, she is forced to bend her elbows and shrug her shoulders.

Img source: (Evan, 2010)

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The ideal 🔬position is with the eyepiece extending directly toward the microscopist at a 90 degree angle, with the head aligned over the shoulders and hips, and the elbows resting comfortably at 90 degrees.

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@CDCgov has a few suggestions, too:

1. Adjustable workstations (desk, microscope, computer) for spaces used by multiple people.
2. Don't use a microscope for more than 5 hours/day. (lol)
3. Incorporate movement, stretching, taking the stairs, exercise throughout the day.

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4. Promote neutral spine posture and support your muscles while sitting.

- Pull 🔬and 🪑to edge of table.
- Use tilting/telescoping eyepieces or elevate the 🔬.
- Ensure adequate back and elbow support.
- Feet flat on the ground.

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“Too late, my neck hurts, what should I do?”

Seek evaluation and treatment from the onset of musculoskeletal pain, even if symptoms are mild.

Management might include:

- Eval by OT or PT
- Anti-inflammatory
- Massage therapy

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Ultimately, symptoms may not completely resolve, even with treatment, so prevention is always the best approach.

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