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Intrapersonal Demand Controls Part I: Taking Care of Your Body. KCD Workshop March 3, 2012. Welcome & Introductions. Introductions. Your name Primary interpreting setting What you hope to learn today. D. Drawing!. Disclaimer.
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Intrapersonal Demand ControlsPart I: Taking Care of Your Body KCD Workshop March 3, 2012
Introductions • Your name • Primary interpreting setting • What you hope to learn today D
Disclaimer • I understand that I should seek the advice of a medical professional in regards to the application of these activities to my body. • I accept full liability for my participation in this activity and I will not hold the instructor (HRL) or sponsoring body (KCD) in any way liable for outcomes resulting from this activity. • I understand if I become uncomfortable with the activity, I may stop the hands-on portions at any time and observe and still receive full credit for participation.
Agenda • Welcome • Demand-Control Schema • Body Awareness • Pain Journal • Ergonomics • Taking Care of Ourselves • Anatomy
Agenda (cont.) • History of Trigger Points • Trigger Points • Techniques • Trigger Point Massage • Trigger Points in Muscles • Tools • Hands-On Application • Ethical Decisions • Closure
Pre-Test • Take 5 – 10 minutes to complete. • Please use your knowledge, not info from the handouts! B A
Demand-Control Schema Robyn Dean & Robert Pollard
Intrapersonal Demands • Physical • Fatigue • Pain • Hot/cold • Intellectual • Preparation • Lack of knowledge • Emotional • Personal issues • Compassion Fatigue/Vicarious Trauma
Intrapersonal Pre-Assignment Controls • Physical (Part I) • Body Awareness • Trigger Points • Intellectual (Part II) • Extra-Linguistic Knowledge (Feeding your ELK) • Preparation • Emotional (Part III) • Self-Talk • Supervision/Case-Conferencing
Body Awareness • Find a comfortable position. • Draw attention to different parts of your body. From Yoga Journal website A
“Hot Spots” Cumulative Trauma Disorder Workbook from NTID A
Care Journal Heather R Lawson
Taking Care of Ourselves • Your turn! D
Interpreter Injury & Pain Woodcock & Fischer (2008)
Interpreter Diagnoses • Tendinitis • Bursitis • Neuralgia • DeQuervain’s Disease • Carpal Tunnel Syndrome • Thoracic Outlet Syndrome • Tennis or Golfer’s Elbow • Arthritis • Rotator Cuff Injury • Frozen Shoulder • Adhesive Capsulitis • Repetitive Stress Injury • Repetitive Motion Injury • Cumulative Trauma Disorder • Overuse Syndrome • Occupational Myalgia
Ergonomics & Biomechanics • Posture • Movements & holds (CTD Manual) • Pace, ballistic signing, & contact force • Hand/wrist deviations • Work envelope & static loading • Rest breaks • Work & rest • 50% duty cycle • Rest at least 50% of length of interpreting time (Woodcock & Fischer, 2008) (Woodcock & Fischer, 2008)
Anatomy • Muscle structure • Everything is connected • Insertion points • Stretching, pain http://training.seer.cancer.gov/anatomy/muscular/structure.html
Anatomy • Name as many muscles as you can. • Locate & palpate muscles (not massage yet) • Neck • Upper back • Arms D B
History of Trigger Points • Janet G. Travell & David G. Simons • Travell first coined “Trigger Point” in 1942 • Trigger Point Manual, 1992 & 1999 • Trigger point identified on MRI, 2007, and MRE (modified MRI), 2008 • Mistaken for acupressure points, pressure points, tender points
Trigger Points (TrPs) • A trigger point is "a highly irritable localized spot of exquisite tenderness in a nodule in a palpable taut band of muscle tissue." - Travell & Simons • Constantly contracted points of muscle • Reduces blood flow to the area • No new oxygen & nutrients • Toxins (wastes) are left in the area • Highly sensitive • “Giving the jump sign” • Pressing on a bruise
Pathogenesis Causes of TrPs Perpetuating Factors • Overuse • Sports injuries • Falls/accidents • Immobilization/inactivity • Surgery • Injections • Prescriptions • Stress/Tension • Body Types • Bone Structure • Postural Stress • Repetitive Movement • Metabolic Disorders • Psychological Factors • Allergies • Infections • Lack of Sleep • Vitamin & Mineral Deficiency
Techniques • Injection with Procaine/Novacain (Travell & Simons) • Spray and Stretch/Ice and Stretch (Travell & Simons) • Ischemic Compression (Prudden) – “TrP Pressure Release” or “TrP Therapy” • Trigger Point Massage (Davies) • Quicker results • Less damage to hands • Less irritation to TrPs • Less risk of bruising muscle & skin
Trigger Point Massage • Use a tool, if possible • Pressure – 7 on pain scale of 1-10 • Time – 2 sec per stroke • Amount – 5-15 strokes • Stroke – “milking”, 1”-1 ½” stroke, one direction • Frequency– 4-6 times • morning & night, each meal • morning & night, before & after work, lunch • morning & night, before each assignment
Most Common Trigger Points Alvarez, D. J. & Rockwell, P. G. (2002). Trigger points: Diagnosis and management. American Family Physician, 65(4), 653-660. Retrieved from http://www.aafp.org/afp
Massage Tools Tools • Balls • Tennis ball • Racquet ball • Rubber ball • High bounce ball • Knuckles • Knobble • TheraCane • Backnobber • Body Back Buddy Body Parts • Supported Fingers • Supported Knuckles • Supported Thumbs • Elbows • Knees • Heels
Your turn! Hands-on Application
Ethical Decisions • Pre-Assignment Controls • Knowing our limits • RID CPC 3.2 Decline assignments or withdraw from the interpreting profession when not competent due to physical, mental, or emotional factors. • Taking care of ourselves • If we don’t, who will? • Staying healthy and in shape • Preparation • Analyzing demands & controls
Closure • Questions • Post-Test & Evaluations • RID Evaluation Form • Notecards • Is this what you expected from this workshop? • What more would you like to learn on this topic? • How will you apply what you learned to your work? www.terptap.org/proj/yidci.shtml
References • Davies, C. (2004). The Trigger Point Therapy Workbook: Your self-treatment guide for pain relief. Oakland, CA: New Harbinger. • Davies, C. (2006). The Frozen Shoulder Workbook: Trigger point therapy for overcoming pain & regaining range of motion. Oakland, CA: New Harbinger. • Finando, D., & Finando, S. (2005). Trigger Point Therapy for Myofascial Pain: The practice of informed touch. Rochester, VT: Healing Arts Press. • Travell, J. & Simons, D. (1999). Myofascial Pain and Dysfunction: The trigger point manual. Baltimore: Williams & Wilkins.
References • Netter, F. (1989). Atlas of Human Anatomy. Summit, NJ: CIBA-GEIGY Corp. • CTD: Cumulative Trauma Disorder. Manual. Rochester, NY: Rochester Institute of Technology. (undated). • Woodcock, K. & Fischer, S. L. (2008). Occupational Health and Safety for Sign Language Interpreters. (Workplace Safety and Insurance Board Research Advisory Council Grant #0523). Toronto, Canada: Ryerson University.