Incidental Finding or Trauma? Using Biomechanics to Assess Workplace Claims
Workplace safety and efficiency are crucial to organizational success and worker satisfaction alike. Unclear or inconsistent procedures for the timely, methodical, and objective evaluation and resolution of workplace injury claims can impact employee morale, productivity, operating costs, and more. While many claims warrant minimal investigation, how you approach those incidents where the relationship between the incident and the injury is questionable can have a substantial impact on your business. Fortunately, biomechanics, the science of injury, can offer insight into these claims that doesn’t just ask what the injuries are, but how they happen in the first place. Biomedical and biomechanical engineers have spent decades investigating the effects of physical forces, torques, impacts, and accelerations on the human body and its various tissues. In addition to designing orthopaedic devices, reducing injury rates in sports, and evaluating vehicle safety systems, the engineers who specialize in this field are also trained to perform incidental injury analyses that look at both the incident AND the injury. This is done through an approach referred to as a biomechanical injury causation analysis.
The standard, well-established methodology used by these experts starts with the injuries diagnosed by the physician, and systematically evaluates the physics and forces of the incident to determine whether the fundamental injury process, known as an injury mechanism, occurred during the incident.
How is a biomechanical analysis different from a physician’s diagnosis?
The traditional role of the physician is to diagnose and treat patients, and offer medical perspectives on the potential impact an injury or condition may have on a patient’s outcomes. Many physicians’ opinions regarding injury causation rely heavily on subjective complaints of pain and patient-reported history, and may not involve any analysis of the forces or physics of the incident in question. Furthermore, medical doctors are not typically trained extensively on the mechanical properties of the human body or in the physical mechanisms leading to the injuries, they are trained to diagnose and treat.
As non-clinical experts, biomechanical engineers are not typically trained to treat or diagnose patients, but instead spend years studying the anatomy, physiology, and the fundamental physical processes behind trauma. This unique background allows the biomechanist to evaluate the objective facts of the incident, rather than subjective factors like pain and patient-reported history. Ultimately, the biomechanical expert is not there to in any way refute or dispute an MD’s diagnosis, but to determine whether a relationship exists between the diagnosis and the incident.
What types of incidents and injuries do biomechanical engineers typically analyze?
Biomechanical engineers have a wealth of experience in analyzing human motion, gait, human factors, environmental factors, tripping hazards, impact response, and more. Often biomechanical engineers are engaged to analyze slips, trips, and falls, falling object cases, motor vehicle collisions, pedestrian impacts, criminal matters, and product liability matters. All injuries have a mechanism and can be assessed though a biomechanical analysis. Biomechanical engineers are frequently employed to determine the forces and mechanisms that lead to fractures, soft tissue injuries, concussion and other traumatic brain injuries, catastrophic and paralyzing events, sports injuries, spinal fractures and disc injuries, rotator cuff and labral tears, cartilage injuries, meniscus tears, to name just a few.
What role does an injury mechanism play in helping me resolve my workplace injury claims?
With every diagnosed injury, there is a fundamental mechanical or physiological process by which that finding came into existence. Acute trauma requires forces to be applied to the body with the proper direction, as well as with sufficient magnitude, to overcome the strength of the tissue, causing it to fail. This concept is commonly referred to as an injury mechanism. But, trauma is not the only way that damage occurs to the tissues of the human body. All tissues in the human body are, to some extent, subject to wear, tear, degeneration, and the common effects of aging. When a question arises as to whether a diagnostic finding constitutes a traumatic injury due to a particular incident, or an incidental finding, the presence or absence of an acute injury mechanism is THE key factor that biomechanical engineers are trained to determine. Put simply, if an incident did not create the mechanism for an injury, the injury did not occur due to that particular incident.
Often, a question arises as to whether or not an incident could have aggravated or exacerbated a pre-existing condition. In cases when the forces of an incident are not applied in the proper manner to create a relevant injury mechanism, aggravation and/or exacerbation of a pre-existing condition is unlikely. This must, of course, be verified on a case-by-case basis. When a potential injury mechanism exists, and a relevant pre-existing condition is identified, biomechanical engineers are trained to evaluate the effects of the condition on the tissue’s mechanical properties, and to determine whether the forces of the incident exceeded that person’s unique personal tolerance.
Is biomechanics an accepted science?
Absolutely. Nearly every major university in the United States with an engineering program offers training in biomechanics, typically within the broader curriculum for biomedical engineering and in some cases mechanical engineering. Furthermore, biomechanical research is funded by the Department of Defense, the National Institutes of Health, the National Highway Traffic Safety Administration, the Occupational Safety and Health Administration, and countless other national and international institutions.
The human body is regularly and repeatedly subjected to a wide range of forces. Almost any movement beyond a sedentary state can result in short duration forces of multiple times an individual’s body weight. Events such as slowly climbing stairs, standing on one leg, or rising from a chair are capable of such forces. More dynamic events, such as running, jumping, or lifting weights, can increase short duration joint loads to as much as ten times body weight. Biomechanical experts are trained to evaluate the forces that the body experiences on a daily basis, and during potentially injurious events. When a workplace injury claim warrants investigation with respect to injury causation, a biomechanical engineer can offer a unique perspective into the mechanical forces of the incident and injury that goes beyond traditional opinions offered by the physician.
Dr. Sam Wordeman, Ph.D., is a Senior Biomechanist at ARCCA. To learn more about how Sam can help your next case, please visit his expert profile.