Why and which work-related injuries occur in sonographers?

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What happens in practice?

Sonographers often have to carry out excessively long stretches of arms and trunks while working with patients. This happens when a chair is badly positioned compared to the other equipment which is being used during the examination (examination table, ultrasound …). An inappropriate position is often also related to the lack of space under the examination table, which forces the sonographer to sit too far away.

One of the main problems is also insufficient support for the legs. When the seat is positioned too high or too low compared to the patient or ultrasound console the sonographers are forced to work with a hand flexion that leads to permanent injuries and pain.

Ergonomic equipment (ultrasound, chair, examination table …) and the correct body posture are two factors that can largely contribute to prevention of MSK disorders and injuries.

Types of injuries related to sonography

There is a high risk for these injuries in sonographers:

SHOULDER GIRDLE  | The most common injuries in sonographers are the injuries in shoulder girdle (bursitis, tendinitis, rotator cuff injury). Rotator muscles usually get poor blood supply and activities that further reduce blood supply to the shoulder girdle reduce the flow of the oxygen and nutrients as well. This results in higher risk of rotator cuff injury. With age, the risk of injury increases. This injury is prevalent in occupations that involve excessive extensions of arms and static posture.

ARMS AND WRISTS | Inflammation of the tendons (tendinitis) and the tendon sheath – synovioum (tenosynovitis) in arms and wrists are another common injury in sonographers. These injuries occur because of the gripping of the ultrasound probe, which can lead to the development of the trigger finger, when the tendon sheath becomes swollen and the finger remains in a flexed (bent) position. Another type of injury is De Quervain syndrome, which occurs at the end of a thumb and is also connected to the gripping of the ultrasound probe and the pressing of the thumb to the probe while performing an examination.

PINCHED NERVE | Syndromes of pinched nerve, such as carpal tunnel syndrome, cubital syndrome. Sonographers also experience thoracic outlet syndrome, which affects the muscles and tendons, as well as the nerves and the blood circulation in the arm and wrist. It is proven that the carpal tunnel syndrome occurs in occupations where there is a lot of flexing and stretching of hands, which increase the pressure to the median nerve in the wrist. During the various ultrasound examinations, sonographers flex and stretch the wrists while gripping the ultrasound probe. Cubital syndrome can be a result of repeating stretching, friction and puling of the elbow or mechanical pressure on the ulnar nerve. This occurs when sonographers rest their arms on the examination table during the examination.

Boleče zapestje
Bolečina v vratu
Bolečina v komolcu
Bolečina v rami
Boležina zapestja
Bolečina v ledvenem delu

What causes the musculoskeletal disorders and injuries related to the work of sonographers

 POOR ERGONOMICS IN WORK EQUIPMENT | height and position of the keyboard/monitor, flexibility of the equipment, poor grip of the ultrasound probe, poor adjustment of the chair or non-adjustable ultrasound chair, poor adjustment of the patient examination table.

POOR BODY POSTURE  | Poor body posture is a result of the nature of work sonographers perform. Especially the shoulder girdle is constantly in a forced position, also the spine in an unnatural position.

AWKWARD SCANNING TECHNIQUES | Awkward scanning techniques, when arms, legs and trunks are in an unnatural static position, especially in endocavitary, cardiac, musculoskeletal and vascular examinations.

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– Feel comfort and ergonomics –

HELPING PATIENTS MOVE  | Assisting patients which have difficulties in movement.

BUILD AND GENDER  | Studies show that higher, heavier and male sonographers have less problems with the work-related injuries.

INSUFFICIENT BREAKS | Insufficient breaks from work with not enough time for regeneration.

WORK STRESS | General stress in the workplace.

Dangeres body postures for sonographers during the examination

Arm abduction.
Arm abduction.
Scanning with arm behind the shoulder.
Scanning with arm behind the shoulder.
Arm abduction, trunk bending and neck flexion.
Arm abduction, trunk bending and neck flexion.
Chair is too low or table is too high.
Chair is too low or table is too high.
Wrist Flexion.
Wrist Flexion.
Trunk flexion.
Trunk flexion.
Kneeling on the floor.
Kneeling on the floor.
Trunk and neck twist.
Trunk and neck twist.

Factors connected to the development of work-related injuries in sonographers

There are many factors that cause the work-related injuries in sonographers. In general, they can be divided into the following groups.

 Biomechanical/environmental factors:

These include an examination table, ultrasound, equipment in the clinic where the scans are performed, and the placement of the equipment in the clinic. In an effort to increase the number of scans and standardize the scan procedure, the ultrasound machine was added a management protocol software, which shortens the examination time and on thus increases the number of checks a sonographer can perform.

 Administrative factors:

These are related to managing patient appointments and rotating schedule of sonographers. Working conditions have changed. Due to staff shortage and a large influx of appointed patients, sonographers often face greater workload than expected. This means sonographers have less time for muscle recovery. Rapid technological progress has changed the nature of work.

Staff shortage and reduced health insurance reimbursements contributed to a larger number of patients. There is also an increasing tendency to perform ultrasound checks of hospitalized patients on their beds instead of bringing them to the ultrasound clinic. Performing an ultrasound scan on a hospital bed poses major ergonomic challenge for a sonographer, because these are demanding examinations of patients in an unsuitable environment.

 Working practice:

This includes the postures maintained by sonographers when performing examinations. Job satisfaction plays an important role in work-related injuries. Pressures and stress at work are recognized as potential factors that affect the health of a sonographer. Automated work gives sonographers the impression that they have no control over their workload. Although job satisfaction is more connected to psychological health, there are some correlations between job satisfaction and musculoskeletal disorders in sonographers.

Bolečina v križu.

Injuries are also connected to the average age of sonographers. After the age of 35 muscle strength no longer reaches its maximum-capacity anymore, especially if the body is exposed to incorrect body postures for several hours a day and in the long-term. Overweight patients also pose a challenge for sonographers, as they require more force and strength when performing the scan as well as excessive stretches of arms and trunk to reach the scanning area in patients.

What does The SonoErgo Chair offer?

With The SonoErgo Chair your sitting is ergonomic.

Ergonomic sitting is the basis for well-being of a sonographer and successful ultrasound examination.
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What does that mean?

Ergonomic sitting means that the chair enables the kind of sitting where your spine, buttocks and legs have good support. It is important that the chair offers support to all of the above-mentioned parts of the body.

The important areas of the ergonomic sitting:

HEIGHT / The seat height is adjustable, enabling the sonographer to adapt to the patient on the examination table and the ultrasound machine.

What is the optimal adjustment of the chair height for the sonographer?

The optimal adjustment of the height for a sonographer is such that:

the elbows are close to the trunk and the forearms are parallel to the floor. In case the forearms are raised for 20 centimetres, it leads to tiredness in less than 7 minutes.

the spine stays in the straight position and is supported by the backrest.

the wrist is in the same line as the forearm.

SEAT / The seat of The SonoErgo Chair is made of quality upholstery. This means that the seat does not depress with use. The size of the seat is extremely important and it should be such that offers support to buttocks and thighs. Undersized seats cause discomfort and pain because they do not offer proper support. The seats are adjustable in height and the seat tilt is adjustable as well.

SUPPORT / The SonoErgo Chair gives support to all the important parts of the body (buttocks, trunk and legs) which are affected during the sonographer’s work. When a chair does not give the right support, the body is in a wrong position and that leads to constant pain and later on to permanent injuries.

BASE / The SonoErgo Chair is adjustable in height as well. This is very important because in special positions it enables good support to legs and consequently to the rest of the body. The base is strong and stable, it enables quick and easy movements. The adjustable ring for supporting feet is especially welcome in cases when sonographers cannot reach the floor with their feet. 

BACKREST / The SonoErgo Chair has a quality upholstered backrest that is height adjustable and offers proper support to the spine. The tilt of the backrest can be adjusted as well, thus enables support in specific body postures. The dimensions of the backrest are carefully selected, not too big and not too small. The backrest enables agile, simple and at the same time comfortable work to a sonographer. All the sonographers who tested the chair during its development stages confirmed this.

MATERIAL / When developing The SonoErgo Chair, special attention has been paid to the selection of materials. All the materials are high quality and are of the EU origin. The chairs are made in the EU. They hold the Certificate of Conformity and comply with all EU directives. The seat and the backrest of The SonoErgo Chair are upholstered in dedicated materials, suitable for intensive use and thus provide maximum durability. Alongside durability, the materials are also suitable for cleaning in a medical environment. There is a wide range of colours to choose from, meaning the chair can fit in the general look and design of the work environment.

ARMREST / The SonoErgo Chair does not have armrests. The studies have shown that the sonographer chair should not have armrests because these disturb the work process and access to the patient and the ultrasound equipment.

Where can I buy The SonoErgo Chair?

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