Muscle injury in repetitive motion disorders.

Documentation of causality between repetitive motions and musculoskeletal disorders calls for detailed understanding of the exposure variables and the corresponding physiologic responses in the biologic tissues. Quantification of the kinetics in some jobs characterized by repetitive motions is summarized with the physiologic responses in the muscles. Muscle activity pattern was studied in different shoulder muscles or muscle parts, and in elbow and wrist flexor muscles. Activity pattern was dependent on the kinetics of the work requirements. This holds true for the compound electromyographic signal and for single motor units. Low threshold motor units have been identified that are recruited continuously, the so called Cinderella fibers. The physiologic consequences of prolonged muscle fiber activity are reviewed, revealing mechanisms for the development of necrotic changes in the muscle, which support the likelihood of work relatedness for musculoskeletal disorders.