Cumulative Trauma Disorder

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Physical Therapy for Cumulative Trauma


Cumulative Trauma Disorder, also known as CTD, is a wide array of diseases that encompasses many common illnesses that target soft tissues throughout the body. The important thing to remember is that CTD is a broad category of diseases and is not itself a disease. Medical professionals will often use this concept to explain to their patients what may have contributed to, or even caused, certain medical maladies. Examples of illnesses that can be a cause of or agitated by CTD include lower back pain and carpal tunnel.

Apart from CTD, many other terms are utilized to describe this concept including, but not limited to, overuse strain, repetitive stress injury, and occupational overuse syndrome. For purposes of simplicity, this helpful guide will utilize CTD as a general category.


This CTD guide will assist patients in understanding the following:

  • Ways to prevent CTD
  • The ways in which medical professionals diagnose illnesses related to CTD
  • Individual factors that can potentially contribute to CTD
  • Medical treatments that are available to patients


What is the cause of CTD?

While there is a wide array of opinions regarding what causes CTD, there truly is limited agreement. Potential theories as to how CTD begins are as follows:

  • Extended use
  • Tension located in muscle groups
  • Tension located in nerve groups
  • Psychosocial contributors
  • Interaction between the mind and body
  • Extenuating contributors


Utilizing muscle groups once fatigue has already set in raises the chances of a substantial injury. When muscles and soft tissues are worn past their limits, proper rest is needed. When this rest is not possible, the muscles have no opportunity to recover to their original state. Problems such as these often affect athletic individuals who utilize repetitive movements. In this same vein, individuals whose jobs have repetitive motions are also affected by a potential lack of rest.

As the soft tissues of the body are in a constant state of flux, minor damage is commonplace. This damage occurs without notice. Often times, the body will repair itself throughout the day. When muscles suffer extended use, damage occurs at a quicker rate than what the muscles and tissues can be repaired. This leads to muscle weakness and soreness. The more overworked these muscles are, the more likely they are to be damaged further, which can potentially begin a cycle that may lead to lifelong injuries.


Muscle Tension

Some medical professionals theorize that tension within muscles is a cause of CTD. In order to properly function, a healthy blood supply needs to be supplied to each part of the body. Nutrients present in blood, such as glucose, are utilized as fuel for the body. When a healthy blood supply distribution is slowed in the body, the soft tissues are harmed.

When muscle tension occurs, it is believed by a few medical professionals that muscles contract to such a point that the oxygen and nutrients supplied by blood cannot be distributed properly. While muscles can still receive energy in other ways, these alternative processes lead to the production of lactic acid. As some may know, lactic acid is a chemical that causes pain in muscle groups. It is often associated with a burning sensation within muscles when they are overused. Medical professionals believe that lactic acid, produced by muscle tension, can be a contributing factor to some of the symptoms of CTD.

As the pain escalates, the affected muscle tightens even more in an attempt to guard the area. Guarding is a generalized term that is utilized to describe a reflex that all the muscles throughout the body share. When pain occurs, regardless of its location, muscles around the affected area tend to spasm (i.e., they contract uncontrollably) in an attempt to limit any movement in the area. When this occurs, the blood flow is restricted to an even further degree, which leads to more of an ache. It can lead to such a severe pain that muscles can tingle or even go numb.

Nerve Tension

It is theorized that when nerves become irritated and shortened, they have a tendency to become extremely sensitive. Through poor posture over a lengthy space of time, muscles bulk up and disturb the body’s normal blood flow. When this happens, the nerves that run throughout the body can become shorter and will potentially adhere to close tissues. When a limb is moved, tension is placed on the nerve, causing pain to radiate out.

Psychosocial Factors

For individuals who suffer from cases of boredom, have less-than-ideal relations with coworkers, have low job satisfaction, and those who have a less-than-happy social circle tend to have CTD more commonly than others. The exact link between these situations and CTD is unclear. Apart from this, the overall number of CTD cases that are reported may have a potential to be influenced by that state’s compensation laws for workers. When compensation claims have better benefits and are processed in a speedy matter, CTD cases tend to occur in larger volumes. These findings indicate that CTD may be influenced by an individual’s view of their situation. These individuals may either knowingly, or unknowingly, justify their symptoms in part due to the numerous social factors as opposed to the medical ones.

Mind-Body Interaction

A newly created theory posits that there is no injury within the supposedly affected soft tissues of the body, but there are, instead, false injuries created by the brain. This theory suggests that the brain creates pain signals to hide deep-seeded emotional issues from the past. Despite being potentially hard to believe, medical professionals who have utilized this theory purport a 95% rate of success. This 95% of patients claim that the treatment provided to them, aimed at the emotional triggers, provided speedy relief.

Contributing Factors

When individuals perform certain tasks, the risk of CTD can increase. These tasks carry potential risk factors that can include:

  • Force
  • Poor or stagnant posture
  • Using tools that may not be crafted properly
  • Tiredness
  • Repeated movements
  • Hot or cold environments
  • Shaking

While one individual risk factor may not lead to CTD, multiple factors present a significantly increased risk. The longer length of time an individual spends exposed to these risk factors, the higher the chances of developing CTD are. Remember, a variety of symptoms can present themselves as small injuries and add up. As mentioned before, CTD is not a disease in and of itself, but it is a response by the body when numerous physical demands have been placed on it without proper rest time.


What does it feel like to have CTD?

For most individuals, any symptoms appear slowly. More often than not, no one single symptom can be recalled as the start of CTD. Generally, tightness in specific muscles and an overall feeling of tiredness appear first. Other common symptoms at first include a tingling sensation, numbness, and nonspecific pain. Some individuals will also report a swelling feeling in the affected limb. Those whose symptoms are located in the arm notice a drop in strength and may accidentally drop whatever they are holding due to coordination issues. All of these symptoms can be made better with rest.


Upon your first visit at Hicksville Physical Therapy, our certified team of physical therapists will perform a detailed evaluation of any and all issues you may be suffering from. Our staff will most likely ask questions such as your line of work, what type of tasks you perform regularly, the conditions at your place of employment, common postures you are in, and if you perform any repetitive tasks. Further evaluation may focus on you personally and will commonly include questions about job satisfactions and your relationship with your coworkers.

Our team will then perform a physical exam. Both your verbal descriptions and this exam will be the biggest factors in helping us here at Hicksville Physical Therapy determine your diagnosis of CTD. Our primary goal is to determine what maladies are causing you issue, such as carpal tunnel. Our secondary goal is to determine if repetitive injury to the area led to your condition. If this is determined to be the case, a portion of the treatment we provide will be an attempt to rid you of the source of your repetitive injury.

Since there is no one test to determine CTD, our team of physical therapists utilize a variety of tests as we look for specific issues.


What are the ways I can prevent issues associated with CTD?

The #1 way to treat CTD is to prevent it from ever happening. In order to do that, utilize a proper posture and body alignment throughout your day. Posture specifically can play a large role in the development of CTD. By utilizing healthy posture and body alignment, the possibility of CTD decreases. When incorrect posture is practiced, issues such as muscle imbalances or nerve pressure can occur. This can lead to pain and/or a variety of other symptoms. When working, keep good posture in mind, as many individuals (while working) unconsciously practice poor posture during long hours, increasing the possibility of CTD.


The process of assessing both where and how an individual does their work is called ergonomics. Extremely small changes in the way a workstation is set up, or even how a job is performed, can lead to both pain and injury.

Rest and Relax

Becoming one of the best practices in the prevention of CTD, rest and relaxation is one of the simplest preventers. Things such as deep breathing, napping, and walking can be done to help relax and prevent CTD.

The aforementioned strategies can be helpful during periods where an individual is working and, yes, even during their off time. Regardless if it is at home or at work, the human body must have the appropriate amount of time to recover, i.e., giving it a chance to heal. By participating in some rest and relaxation, the body has the necessary time to recover and repair any injured tissues.

Below are listed just some of the many ways that individuals can promote rest and relaxation while at work:

  • Make an effort to relax. Taking frequent work breaks, not procrastinating by staying ahead of any deadlines, and pacing yourself is a great way to relax your body and stay ahead at the same time.
  • Take time to exercise. By gently exercising throughout the day, the soft tissues are able to remain flexible, easing tension in the process.
  • Frequently change your position. Make plans to change up how you work throughout the day. This can include utilizing a chair if you don’t or standing if you sit too much.
  • If possible, rotate jobs or share your duties. This approach can make work exciting as it presents something new. At the same time, it allows the body to recover from any strenuous work it just suffered.
  • Stay away from both caffeine and tobacco. Both of these are stimulants which can raise stress levels, minimize blood flow, and heighten the reaction of pain receptors.

Our Treatment

During my treatment, what can I expect?

By undergoing treatment right after diagnosis, the recovery time from CTD can be shortened dramatically. Symptoms that you may be experiencing could dissipate in as little as two to four weeks. On the opposite hand, individuals who keep participating in the activities that caused CTD can expect a long, nerve-wracking recovery process that could take up to a year.

Here at Hicksville Physical Therapy, we provide a variety of non-surgical treatment options that are utilized by our team of both physical therapists and occupational therapists to reduce, or rid ourselves of, CTD symptoms. As previously mentioned, our team will gather a range of information to determine the best course of action for your tailored treatment program.

Our team of physical therapists will often start by teaching our clients a variety of relaxation methods. These methods may include deep breathing that utilizes the diaphragm. When the proper time is taken, deep breathing can both ease muscle tension and assist with speeding healthy blood to affected tissues.

Initially, we recommend that you wear a brace to both protect and rest the affected limb. Medications such as ibuprofen, along with heat, ice, gentle stretching, and ultrasound, can be utilized to help reduce pain and alleviate any other symptoms. Our team of physical therapists may use gentle stretching to help our clients restore their muscular balance and improve overall posture and spinal alignment. Sometimes these stretches work nerves from where they start, at the spine, down the arm or leg. Other exercises, such as strengthening exercises, are also utilized to help restore muscular balance and increase healthy posture.

Our team will pay particularly close attention to both your posture and overall movements. Verbal instructions and a hands-on approach will be used to improve both of these things if needed. By working on this, you will begin to both see and feel proper alignment and will subconsciously practice better posture. These both will allow you to release tension and go about your day more easily.

Our trained staff will help you learn more about CTD and the causes of your symptoms. We are more than willing to provide information on how to combat any potential symptom while at work via rest and relaxation. This may include a specific set of stretches to be performed while at work. If needed, our team can visit you at work to observe your day-to-day and create a tailored routine to not only provide you with less daily strain but also to lower your chance of injury. These changes are both inexpensive and impactful, meaning that you can be on your way to living a more productive life.

Ultimately, our goal here at Hicksville Physical Therapy is to help our clients understand CTD to the extent that they can be on the lookout for potential factor that may be causing, or aggravating, symptoms. In turn, our clients can avoid these issues in the future once physical therapy has been completed. Even after therapy has ended, our team will continue to be a resource to our patients.

Hicksville Physical Therapy provides a wide variety of physical therapy services in Hicksville, New York and the surrounding areas.


While this is quite rare for CTD, specific incidents can arise that may require surgery. Unless there is a structural problem in a muscle or soft tissue, such as a nerve that has been pinched or an overly inflamed tendon, surgery is often not suggested.

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