What if the manager of tendonitis and shoulder pain in women was work?

Shoulder pain, elbow tendonitis, numbness of the fingers, knee bursitis: these ailments are common in active women.Very often they incriminate their age, or think of presenting a very personal vulnerability.Without questioning their working conditions.However, these ailments which affect the joints, muscles and tendons rarely occur by accident or accident.

Musculoskeletal disorders (TMS), of their official name, are generally linked to repetitive gestures, uncomfortable postures or excessive tensions.These problems are well known to supermarket cashiers, for example, which handle the articles all day long.Today, they are no longer asked to move the water packs, simply to scan the label.But in many other professions exercised by women, the appearance of these disorders has so far caused any questioning of the way of working.

The fine analysis of available studies makes it possible to think that MSDs are underdiagnosed in France in women.They often result from a lack of reflection on the adaptation of the position to female morphology.And are less easily recognized as an occupational disease, because the analysis grids of work situations are designed essentially from the experience of men.

Night nurse, in a sub-efficient service

To show how collective blindness is on this subject, take the recent case of this caregiver, Cécile (her first name has been changed), aged 47, who has 20 years of seniority in hospital.Before joining the public hospital, she worked as a home help for the elderly.Cécile is a night nurse in a geriatric service.The workload is high, the service in chronic sub -staffing.The necessary equipment is not always available.Due to these degraded working conditions, there is a high rate of turnover in the team.

Cécile has suffered from tendonitis in the shoulder for two months.She opens with her superior of her difficulties in moving elderly patients alone to provide them with care.When she evokes this pain, she talks about it as an age -related pathology, to physical wear.Its supervision therefore puts this pathology on the account of individual fragility and does not push reflection further.

Cécile takes painkiller drugs and organizes herself with a colleague with whom she gets along well to lift the heaviest patients in two.But this is not enough.His shoulder pain increases.She was arrested by her doctor for more than three weeks.When he resumes her post, she sees the occupational doctor who issues her "aptitude restriction".This document indicates that it can now do its job only partially.It can no longer be alone to lift heavy patients.

Risk factors unknown to the official list

His pathology is not recognized as a occupational disease, because the constraints linked to his nurse work are not included in the official list of factors of a risk of MSD.French legislation provides indeed descriptive "tables" for each disease, detailing the nuisance taken into account, the diseases or symptoms linked to this nuisance and the type of tasks exposing the individual to it.

Cécile comes to think that her shoulder is less solid than that of other caregivers.His superior now finds that Cécile's health problems are problematic to distribute the workload within the team fairly.As for the occupational physician, he believes that the pathology of this employee is inadequate personal characteristics.Thus, everyone agrees to say that Cécile does not make the right gestures in the tasks incumbent on him.No one calls into question the organization of work in the service, nor the constraints relating to the exercise of the profession of nurse.And even less the descriptive tables of occupational diseases ...

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The cases like that of Cécile are not taken into account in the statistics.Overall, in Europe, women obtain less recognition in professional sickness of their MSDs than men, as shown by the cases of Italy and Switzerland or the work of Laurent Vogel, researcher at the European Union Institute (Etui) and at Paris 13 University.

Too few women in recognized cases in occupational disease

In France, the number of cases of musculoskeletal disorders recognized as an occupational disease was almost as high in women in women (26,438 cases) as in men (27,577 cases), according to the study carried out by Florence Chappert and PatriciaTherry, researchers at the National Agency for improving working conditions.But women, more vulnerable to these disorders, should logically be in greater numbers.Proof that a lot of TMS cases remain invisible at home.

In France, as elsewhere, the majority of occupational diseases recognized in women are MSDs.These disorders are indeed well identified today in certain trades as a cleaning lady, cashier, worker to make or assembly of small elements.But a study carried out in 2009 by the researcher at the University of Ottawa (Canada) Katherine Lippel shows that the compensation statistics of occupational diseases do not reflect all the attacks of professional origin.We can therefore think that recognized cases are only the emerged part of the iceberg of musculoskeletal pain.

Women and men are not affected by MSDs in the same circumstances.Because they do not often occupy the same jobs.Take the example of the carpal tunnel syndrome, this compression of a nerve causing wrist pain.Among men, it affects 70 % of workers in handling trades, worker in industrial, craftsmen and farmer, according to a 2006 study. In women, it affects 70 % of workers in the workforce tradesequipment, farmer and commercial employees.

Shoulder pain for women, lumbar for men

It happens, of course, that an identical task is entrusted to men and women.But they do not accomplish it in the same way and do not struggle at the same time, because of their differences in morphology and physiology.In the farm, for example, the milking of cows exposes women to pain in the shoulders when wearing milk pipes.Men are subject to low back pain when they decrease to place the tray sleeves on the pies of the cow.

Women will preserve themselves from this pain by modifying their movements in the stable to wear the pipes without getting tired, while men will seek to position themselves differently, for example by folding the knees so as not to force on the back muscles.I presented these results on February 13 in Brussels during the work and gender conference organized by the European Union Institute (ETUI).They made it possible to set up, with the Mutualité Social Agricole, training specially intended for farmers.

Most studies on occupational health do not take sufficient account of gender effects in risk and prevention of MSDs.Thus, stereotypes are built on biased knowledge of the links between health, work and gender.This leads to diagnostic errors on the part of the doctor, to a blindness of the employer and the employee herself, as in the case of Cécile.

Better reappearing the work constraints for women

And if we were trying to better understand the real work constraints for women.Many recognized arduous factors mainly concern men: vibrations, noise, warmth, cold, exposure to toxic, radiation, heavy loads, night work.Other factors, generally at work in women, are less identifiable: repetitiveness, the impossibility of interrupting your work, work under pressure with emotions that we prevent from expressing themselves - especially inservice activities.

Even today, musculoskeletal disorders in women are too quickly put on the account of hormones, the approach of menopause or the tasks that they perform in addition to the house, after their working day.The challenge will be to better understand, tomorrow, the specificity of women's work in this "gendered" distribution of exposure to the risk of MSDs.And to implement suitable and equitable prevention for all, men and women.

The original version of this article was published on The Conversation.

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