Doctor's study came to our attention.
We thought you would be interested. Please read on.
Extremity Injuries in the
Randell Dobbs, DC, and Scott Bjerkness, DC
knows that long-haul truck drivers suffer from low back pain.
I was surprised to discover that, during my nearly four years
as a truck-stop chiropractor, many truck drivers also suffer
from injuries to the upper extremities. These upper-extremity
injuries seemed so prevalent that I became curious about them.
Just how many truck drivers suffer from upper-extremity injuries
and why? To answer these questions for myself, I conducted
a records-based study. I'm writing this article to present
my findings to other interested chiropractors
are approximately eight million commercially licensed drivers
in the United States. Of this number, approximately 2.5 million
are long-haul drivers. The long-haul drivers are usually the
ones that find their way to my office, and so they are the
group I considered for my study. It's logical to assume that
this group of drivers will have a higher degree of work-related
injuries than short-haul drivers, due to their long hours
in the truck and less than ideal living circumstances. The
trucking lifestyle does not allow for easy access to chiropractors
and other health-care providers. Consequently, many injured
drivers never obtain the treatment they need.
Two hundred patient files were chosen at random. All of these
patients were long-haul truck drivers. Of the 200 drivers
studied, 111 (55%) presented with upper extremity complaints.
Of the 111 injured drivers, 93 were male and 18 female. The
study included 160 males and 40 females, allowing us to calculate
that 45% of the female drivers and 58% of the male drivers
presented with upper extremity injuries. This data clearly
shows that the lower back is not the only region of the truck
driverÕs body prone to injury.
111 upper extremity complaints can be broken down to single
and multiple areas of complaint. Forty-nine of the 111 patients
had multiple areas of complaint, with a high prevalence
of scapula and shoulder pain, and arm and hand tingling.
I find this statistic alarming.
likely causes of these extremely prevalent injuries include:
pulling the fifth wheel pin; lowering and raising heavy truck
hoods; slipping while exiting the truck; sleeping on oneÕs
side in a bouncing vehicle; lowering the landing gear;
unloading trucks; driving with one elbow supported on the
window frame; and habitually resting the hand on a constantly
vibrating gearshift lever.
Some explanation is needed. The fifth wheel pin is a heavy
metal pin that fastens the truck tractor to the trailer. To
disengage the tractor from the trailer, the driver must lean
underneath the trailer on top of the wheels and pull up and
outward on the pin. This pin can be extremely difficult to
remove, and the position required to do so is one of mechanical
disadvantage. Anterior/interior subluxations of the humeral
head and supraspinatus rotator cuff damage are common injuries
correlated with this behavior. Lateral epicondylitis and medial
epicondylitis are also common resulting injuries
The engine hood of an 18-wheel truck is both high off the
ground and heavy. The average truck hood weighs approximately
300 pounds. To raise the hood, the driver stands on the front
bumper and leans his/her body weight on the handle. Naturally,
this would put strain on the upper extremities.
Slipping on the truck step and grabbing the hand bar to break
a fall, is among the most common causes of upper-extremity
injury to truck drivers. The rotator cuff, elbow and A/C joint
are damaged during this type of fall.
Team drivers live in a constantly moving vehicle. One driver
is often sleeping on the bunk behind the seats while the other
drives. The bunk is not wide, but the trucker often is, making
a side posture the only comfortable position for sleep. Often
the head is resting on the extended arm. A moving truck not
only vibrates, but bounces. Impact trauma to the vulnerable
shoulder of the relaxed and sleeping victim is common. Arkansas,
Louisiana and Tennessee seem to have roads that are especially
likely to cause injury in this manner. I'm tempted to mail
thank you letters to the governors of these states for sending
me so much business.
refer to the support legs on the trailer as landing gear,
since they must be lowered to disengage from the tractor and
raised to haul the trailer. This raising and lowering is accomplished
by means of a hand crank. This action causes repetitive stress-type
injuries, most often to the elbow and wrist. Any driver who
was once a yard dog (a worker in a truck yard responsible
for swapping trailers between trucks) seems to have a greater
propensity for elbow and wrist injury.
Unloading a truck is self-explanatory. All kinds of injuries
are likely to occur to a sedentary, out-of-shape driver who
has to "lump" or "fingerprint" (trucker
speak for handling) a load.
Postural habits, such as leaning the left elbow on the window
frame or resting the hand or wrist on the gearshift lever,
expose the extremities to injury,
All of the above behaviors cause injuries. Truck drivers are
likely to engage in several, if not all, of the behaviors
every day of their working lives. It's only a matter of time
until the upper extremities become symptomatic. Educating
truck drivers on the dangers of such injuries seems to be
a fairly effective approach. Health-care providers must be
on the lookout for upper-extremity injuries in their truck-driving
patients, who may not complain about their injuries even though
they are in pain. Many people still believe that chiropractors
only treat the spine, and they fail to mention other troublesome
areas during the exam.
If a truck driver walks into your office, examine the upper
extremities. Treating injuries early is always better than
waiting until the patient can't perform the job. Truck drivers
are very important to our way of life. Everything you buy
at a store or use daily is brought to you via a truck. Keeping
truck drivers on the road is good for them and for
the rest of us.