Month: May 2018

Preventing Pain at Workplace

Bukit Timah Branch: 03-04, Sime Darby Centre 896, Dunearn Road Singapore – 589472
Phone : 64630905
 East Coast Branch: 46, East Coast Road, 07-03 East Gate @ Katong Singapore – 428766
Phone : 62822572
 Raffles Branch: The Medical Practice, 1 Raffles Link #01-03A, Singapore – 039393
 Hand phone: 90050135
 Email –


– An original article by Synergy Physiotherapy and Sports for preventing low back and neck pain at workplace

Many years ago, when I was a budding clinician, I encountered a couple of incidences which shaped my approach as a clinician. A middle aged lady did not report any improvement in her neck pain until her computer position was altered and another reported feeling better only when she rotated to a different task within her work environment. It then struck me hard as to how important it is to include work environment of an individual into the treatment process to achieve good clinical outcomes. As clinicians, we address the source and symptoms of a person’s musculoskeletal issues and may overlook the contribution of the work environment in triggering and maintaining a person’s musculoskeletal issue.

It’s now established that people who perform prolonged and repetitive tasks at work are susceptible to develop work related musculoskeletal disorders. The common disorders are low back pain, neck pain, rotator cuff pain (shoulder impingement), tennis elbow, carpal tunnel syndrome, nerve root impingements, Dequarvain’s tendonitis, knee and knee cap pain etc.

The above conditions can be termed as cumulative trauma disorders, repetitive stress injuries or merely as overuse injuries. They are termed as such because they happen in the absence of inadequate rest and recovery of the working muscles. For example, if you sit for only a short duration and change postures frequently, the disc material in your spine will remain resilient. However, if you sit for more than four hours every day in an awkward posture, irreversible changes can happen to the disc material in your spine.

These changes in the body can be picked up during clinical examinations such as X-rays and MRIs as degenerative changes in the spine.

The degenerative changes in the human body happen normally as a result of the normal ageing process. However exposure to awkward and prolonged postures augments the degenerative process. In short, bad postures hasten up the normal ageing process. In essence, the way we move is important.

So how do we get over these issues?

Foremost, good education is important to overcome this issue. The worker needs to consciously overcome negligence and practice good work habits. Whether we like it or not, a large number of jobs are meant to be done in sitting and therefore sitting with good body mechanics is critical in preventing musculoskeletal issues related to sitting tasks. Individuals need to be educated on the importance of ‘neutral sitting ‘a posture in which the ligaments and muscles supporting your body segments are working with relative ease with not much demand on them.The hardware at the individual’s workstation needs to be reorganised so as to facilitate this neutral sitting posture. Simple desk side stretches need to be performed in order to prevent issues arising out of static sitting postures.

Is it enough to re-organise our work environment and improve body mechanics?

Physical reconditioning of the muscles supporting good posture is essential towards the success of any ergonomic intervention. The spinal muscles supporting the low back and neck have to be strengthened to enable to them to work well over long periods of time.

The Top to Bottom Approach:

Often times, the success of any ergonomic intervention depends on the total support of the key stakeholders of the organisation.

There must be support from the management to improve work environment and practices. There must be scope for employees to rotate to a different role within their job as an administrative routine in order to escape the repetitive trauma.

Frequent audits need to be conducted at the worksite to make sure employees follow good work habits and adhere to good ergonomic principles.

Balachandran Sai Ram Kumar is a trained ergonomic and a health promotion consultant. He works as a Principal Physiotherapist for Synergy Physiotherapy and Sports. He conducts the ErgoFit workplace wellness corporate program which combines ergonomics, health and wellness concepts. Synergy Physiotherapy and Sports operates the Medx back and neck fitness systems.

Shoulder Pain in Cricket

Bukit Timah Branch: 03-04, Sime Darby Centre 896, Dunearn Road Singapore – 589472
Phone : 64630905
 East Coast Branch: 46, East Coast Road, 07-03 East Gate @ Katong Singapore – 428766
Phone : 62822572
 Raffles Branch: The Medical Practice, 1 Raffles Link #01-03A, Singapore – 039393
 Hand phone: 90050135
 Email –


– An original article for Singapore Cricket from Synergy Physiotherapy and Sports

Pain from shoulders is common among cricketers. As a sports physiotherapist attending to the needs of cricketers, two of the more common complaints are pain from the shoulder area while bowling and throwing. Evidence from international literature covering cricket injuries identifies shoulder injury as a common disorder afflicting cricketers with fast bowlers being more susceptible.

The objective of this short column is to educate cricketers in Singapore on the causes of shoulder pain and offer simple remedial strategies to overcomechronic shoulder disorders which may otherwise limit their participation in competitive and recreational cricket.

There are two types of injuries that the shoulder sustains. The acute traumatic injury that is sustained on the field and the chronic version which results from a combination of muscle imbalance around the shoulders, poor posture of the upper torso and overuse of structures surrounding the shoulders.

Acute injuries can happen due to direct impact on the shoulders as a result of a fall or due to a collision. There is usually pain of varying intensities associated with soft tissue damage that can last for 1 -3 days and with adequate rest, icing, and protection of the injured area the pain most likely subsides. Medical attention will be necessary for more serious injuries. Following pain reduction with physiotherapy and medical management, a rehab program aiming for return to sports is undertaken and the cricketer is back in action in approximately six to eight weeks. More serious injuries may need a longer time for return to sports.

But can shoulder structures be affected in the absence of trauma? The answer is yes. This is the type of injury that we come across commonly among the recreational cricketers in Singapore.

Failure to pursue an active shoulder rehab is a common cause of recurrent chronic shoulder issues that can limit the cricketer’s ability to throw, bowl and in some circumstances bat with efficiency. Pain results in reduced mobility of the injured area and this in turn leads to deconditioning and weakness of the surrounding muscles.

Muscle imbalances around the shoulder can be brought on by sustained poor postures. This is increasingly common in the recreational athlete who has a desk bound jobduring the week.

Poor throwing and bowling techniques can contribute to developing and maintaining chronic shoulder issues as these activities requires the cricketer to move his or her shoulder girdle in a high velocity.

The action of throwing requires supreme strength of muscles around the shoulder girdle. Often times, this means working the structures around the shoulder beyond their capacity to perform in an abnormal pattern of movement.

A combination of the factors mentioned above can result in injuries to the rotator cuff, sub-acromial bursa, labrum, acromio clavicular ligaments and joints, which are common sources of pain around the shoulder girdle.

Hiding a player with a weak shoulder is a challenge captains face. The cricketer with a weak shoulder is often a liability when fielding in the deep.

So, what can you do to prevent chronic shoulder injuries and improve on field performance?

  • If you have had a traumatic shoulder injury, complete an active rehab protocol following a period of rest.
  • If you are in a deskbound job, make sure you reinforce proper posture of the upper torso and strengthen your postural muscles.
  • Condition your scapular (shoulder blades) stabilizing muscles.
  • Strengthen your rotator cuff muscles.
  • Seek help from a qualified cricket coach to iron out technical deficiencies.
  • Seek advice from your healthcare provider if self- management does not bring about a solution.

Negligence is an attribute that leads to chronic disorders. Never neglect an injury that will limit you from enjoying your game to the fullest. As an important team member, you should take charge of your fitness levels and strive to contribute more to the team’s cause.

Wishing everyone happy Cricket!

Disclaimer :

This is an original educational article from Synergy Physiotherapy and Sports. The information provided does not replace professional care. Please feel free to contact us at 64630905 or email us at should you have any questions on this article.

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