This site is available to everybody and you are welcome to keep on reading. The information is, however, primarily aimed at health professionals in the network of Nordic Netcare.

The website is updated on the first day of each month in cooperation with leading researchers within working environment and prevention of discomfort in the musculoskeletal system.

Neck/shoulder pain decreased when scapula trained:

Often heavy resistance could be painful for an already sore muscles. A new study tested whether, training of the surrounding muscles, can minimize neck / shoulder pain

In forskningsnyheden from July 1, 2012 we wrote about exercises that selectively activated muscles around the shoulder blade. The exercises enabled lower trapezius and serratus anterior, while activation of the upper trapezius was limited as much as possible. The exercises are intended to improve stability and coordination of the shoulder blade. Now the exercises used in a study among office workers.

Almost 100 office workers were included in the study. Half were randomly drawn to participate in weekly strength training for the muscles around the shoulder blade and the other half constituted the control group. To participate, you would at study entry, have a pain intensity in the neck / shoulder region of at least 3 on a scale of 0-9. Strength training was 3 x 20 minutes every week for 10 weeks.

Main Results
Neck / shoulder pain decreased significantly in the training group compared with the control group. The improvement was equal to 2 points on a 0-9 scale. Improvements of this magnitude is considered clinically relevant. Muscle strength was also greater in the training group and they improved their pain threshold.

This type of resistance training may be particularly useful in patient groups with problems with coordination of the shoulder blade. Patients with severe pain in the upper trapezius, which would limit opportunities for heavy resistance of the upper trapezius, could also benefit from this type of strength training.

To learn more, read the following scientific article:

Andersen CH, Andersen LL, Zebis MK, Sjøgaard G. Effect of Scapular Function Training on Chronic Pain in the Neck/Shoulder Region: A Randomized Controlled Trial. J Occup Rehabil. 2013 Jul 6. [Epub ahead of print]

Bungee training:

Uploaded 1. dec. 2012

Bungee training - both against muscle pain and headache
Training with rubber bands is simple, cheap and effective. A Danish research has now shown that strength training with elastic bands can have a number of positive effects on health lifeboats on muscle pain and headache.

Main Results
A large number of people suffer from each day of headache and / or muscle pain, which in many cases can restrict people to work or perform other daily activities.

There has in recent years been researched using physical exercise to protect against pain in the neck and shoulders. Training with weights and rubber bands has shown clear positive effects in the treatment of muscle pain in the neck and shoulders.

One recent study showed even a positive effect of just a 2-minute workouts per day. The very recent studies have now shown that even short-term headaches can be alleviated by elastic exercise.

In practice, this means that it makes sense to offer elastic exercise to:

        - Relieve muscle pain in the neck and shoulders
        - Reduce headache

Earnings Basis
The studies underlying the above knowledge, offered elastic training to individuals with computer work on average more than 150 days with neck and shoulder pain within the past year. Participants in the study had all frequent neck and shoulder pain with a pain intensity of greater than 5 on average (on a scale of 0-10). In return, they were free of chronic diseases and other typical musculoskeletal disorders such. impingement syndrome, previous disc herniation, whiplash, or fibromyalgia.

The results are therefore limited to people with computer work and for people with frequent, high intensity neck and shoulder pain. We can not know if it can help people with another type of work, lower pain intensity or training should have a preventive effect.

Elastic Training involved one exercise - skulderabduktion (lateral raise) - was performed to exhaustion. The study evaluated the effect after 10 weeks of elastic workout. The effect on headache was seen that people got headaches less often. The training showed no effect on the duration and intensity of the headache.

There was generally high level of participation in the training (more than 3 times per week), suggesting that elastic exercise is an easily usable form of exercise.

High-intense strength/fitness improves balance among people with high physical work demands:

Uploaded 06.09.2012

Over 100 cleaners were offered high-intense coordination training three times a week during working hours. The result was increased bugmuskelstyrke, improved balance and fewer chronic neck pain among the participants.

The cleaners perform a number of tasks which require their physical capacity - muscle strength, coordination and agility. Yet, evidence suggests a number of studies that the work does not have a training effect. By contrast, many cleaners sore muscles - especially in the back and neck. Consequently, a number of researchers to investigate whether physical exercise with both a strength and a coordination element could increase the cleaning assistants strength and balance and reduce muscle pain.

The training sessions are lasted 20 minutes and consisted of a short heating cycle followed by a training program to six different coordination exercises with 2-4 progression levels. The exercises should be performed with maximum intensity in 2 x 25 seconds, which corresponded to an intensity of 60-80% of participants maximum muscle strength. Examples of exercises was "plank with leg / arm / diagnoalløft", "sideways plank" "pelvic lift with leg lift" and exercises with training tool body blades. Participants were invited to train at the highest difficulty level according to their level of coordination.

Main results
Although cleaners already had high work demands, it was possible to build up their physical capacity. Cleaning assistants improved their coordination measured with a balance test and improved also their bugmuskelstyrke. In addition, neck pain decreased in the cleaners often was plagued by neck pain.

Effect on the back and shoulder muscle strength could not be proved like effect on back pain could not be proved. The survey was conducted among a large group of employees, of which only some had pain and among which training participation was only moderate. It can therefore be assumed that a similar exercise among people with frequent pain and a high level of participation will provide even better results than the studio.

To learn more, read the following scientific article:

Jørgensen MB, Ektor-Andersen J, Sjøgaard G, Holtermann A, Søgaard K A randomised controlled trial among cleaners--effects on strength, balance and kinesiophobia. BMC Public Health. 2011 Oct 10;11:776

Jørgensen MB, Faber A, Hansen JV, Holtermann A, Søgaard K.: Effects on musculoskeletal pain, work ability and sickness absence in a 1-year randomised controlled trial among cleaners. BMC Public Health. 2011 Nov 1;11:840.

Strength against neck / shoulder pain - What is best: one long training session or many frequent training sessions per week?:

Uploaded 1. August 2012

A workplace study of office workers with neck / shoulder pain examined how one hour of training / week during working best utilized. Participants were offered training either 1 x 60 min / week, 3 x 20 min / week or 9 x 7 min / week. All three training offers reduced neck / shoulder pain and there is thus great flexibility in how training can be offered in workplaces.

Main Results
Strength training can reduce neck / shoulder pain in office workers, which by now has been documented several times. But the effect of exercise depends, as we know of it training frequency and training intensity. When training offered during working hours, there are many factors that influence whether you participate in the training. This makes the implementation of training in working particularly important if workplace training must have an effect.

A new workplace study has investigated how 1 hour of exercise time best utilized to achieve effect on neck / shoulder pain. Three regimens were tested: 1 x 60 minutes / week, 3 x 20 minutes / week and 9 x 7 min / week. Over 100 participants in each of the various exercise regimens were randomly selected and tested against a control group.

There was a high degree of participation in all three training regimes. Also, there was reduction in the neck / shoulder-pains in all three training regimens, compared to the control group.

The study course for 20 weeks, and that could be seen small differences between the groups, which may not be shown statistically. For example, to give 3 x 20 minutes / week the largest effect on pain. 3 x 20 min / week and 9 x 7 min / week had the highest level of regular attendance. But despite lower regular attendance gave 1 x 60 min / week the best progress in training, ie weekly greatest increase in weight training. 9 x 7 min / week gave the largest outflow of participants.

One hour weekly strength training is effective in reducing neck / shoulder pain. Although there are small differences in both the power and the use of different training regimes, all regimes be effective actions in office workplaces with high prevalence of neck / shoulder pain. This study therefore suggests that there can certainly take into account the organizational routines at work when the weekly training during working hours should be planned.

To learn more, read the following scientific article:

Andersen CH, Andersen LL, Gram B, Pedersen MT, Mortensen OS, Zebis MK, Sjøgaard G Influence of frequency and duration of strength training for effective management of neck and shoulder pain: a randomised controlled trial. Br J Sports Med 2012, June 29, Epub ahead of print

Exercises to achieve selective activation of the muscles around the shoulder blade:

Uploaded 1. July 2012

A study of the activation of the muscles around the shoulder blade during training have contributed to the specification of training exercises for shoulders. Exercises with particularly high activation of the serratus anterior is recommended for people with neck problems or risk for shoulder impingement.

Main Results
Pain in the neck and shoulders is often associated with decreased mobility and strength. Furthermore often seen a deterioration of coordination of the muscles around the shoulder blade. For example, is often over-activation of the upper portion of the trapezius while an impaired coordination between lower trapezius and the serratus anterior muscle. Therefore, a therapeutic regimen benefit from involving specific training of the lower trapezius and serratus anterior.

A brand new study examined muscle activation around the shoulder blade under a variety of shoulder exercises. The study used surface electromyography (surface EMG) to measure the activation of the upper and lower trapezius and serratus anterior. In particular, two drills were found to be effective in selectively activating the lower trapezius and serratus anterior muscle at the same time having a relatively low activation of the upper trapezius. It was about two exercises described here in detail:

Sit up straight on the edge of a bench with straight arms and rest your palms on the bench edge with your fingers pointing forward. Place your feet on the floor in front of. Now lift the rear end off the bench and dip down just in front of the bench by a movement of the shoulder joint. Repeat the movement up and down. Increase the severity and intensity of the exercise by placing the dumbbells on your thighs.

Push-up plus
Decreasing push-up position (plank) with arms outstretched, hands on the floor and either feet or knees on the floor. Tighten abdominal muscles so the trunk is stable. Now push your body off the floor by protrahere shoulder blade (turning it outwards and forwards). Repeat the movement up and down. The severity and intensity can be increased by either choosing a more difficult starting position (eg. From knees to feet) or by placing the weight plates on the upper back.

The study was conducted on 17 healthy women. In conclusion takes authors therefore subject to that muscle activation in the study may not reflect muscle activation among patients with different genes. There must therefore be assessed by the practitioner's shoulder problems before the exercises used.

To learn more, read the following scientific article:

Andersen CH, Zebis MK, Saervoll C, Sundstrup E, Jakobsen MD, Sjøgaard G, Andersen LL Scapular Muscle Activity from Selected Strengthening Exercises Performed at Low and High Intensities. J Strength Cond Res 2011, nov 9, Epub ahead of print.


Uploaded June 1, 2012

Treatment with training in the workplace can reduce the intensity and the impact of low back pain

A review of training treatment in the workplace against low back pain has concluded that gradually are so many good studies that we have good evidence that exercise therapy can reduce the severity of low back pain.

Main Results
In clinical practice exercise therapy widely used as a method to treat low back pain. There has also been made a great deal of research in this area and more and more studies dealing with training in the workplace. Some studies have, however, little research quality, and there have been results that both pointing in one and the other direction. It has therefore been necessary to make a systematic review of the literature.

A systematic review is a survey that collects information from all existing literature of high quality within a given area and draw an overall conclusion on that basis. In principle, it would be good to always justify its actions in a systematic review. However, it may be inappropriate to have to wait a good initiative, as it can take a long time before results will be made up. But now there is good evidence for some types of work efforts with training.

There has recently been made a review which examined the effect of exercise therapy to reduce the incidence, intensity and consequences of low back pain. The study included 15 studies in the review.

It was concluded that there was enough good studies to confirm that exercise therapy can reduce the intensity of low back pain. Furthermore, exercise therapy reduce the negative impact of low back pain (eg. Reduction in activity).

Because of the lack of high quality studies could not conclude a preventive effect of training on new instances of low back pain. There is therefore a need for more high-quality studies that examine training potentially preventive effect on low back pain.

To learn more, read the following scientific article:

Bell & Burnett; Exercise for Primary, Secondary and Tertiary Prevention of Low Back Pain in the Workplace: A Systematic Review; J Occup Rehabil, 2009; 19:8-24.

Muscular pain and non-muscular symptoms:

Uploaded May 1, 2012

pain in the muscles tends to decline along with other symptoms which are not related to the muscles
Individuals with muscle pain in many parts of the body also typically have other symptoms not related to muscular pain to do. It shows a new Norwegian study among more some 3,000 people.

Main Results
When we treat people with muscle pain, we typically after local treatment of the area affected. But most of the normal population have muscle pain more than a place. In addition, there is a large correlation with other disease symptoms than muscular pain.

A new Norwegian study has counted how many body sites people in the normal population have hurt. There was asked to 10 different regions of the body. On average, each person hurt more than 2 points. Women had an average of evil 3 places and men 2 places. It is normal that women report more pain than men.

In addition to muscle pain, other symptoms counted. It was about arrhythmia, chest pain, breathing difficulties, heartburn, abdominal discomfort, diarrhea, constipation, eczema, fatigue, dizziness, anxiety, depression and sleep problems.

It was found that on average, the women had four of these symptoms and 3 men of these symptoms. There was a clear correlation between the number of body regions with muscle pain and the number of other symptoms. Dizziness, difficulty breathing and chest pain were the three symptoms that hung most to the number of body regions which were recorded muscle pain.

The results can be interpreted in several ways:

        1) maybe people with muscle pain more likely to get for example, depression or difficulty sleeping
        2) maybe there exists an underlying cause of both types of symptoms, regardless of diagnosis

In practice this may mean that we must be aware of to prevent people with pain have other health problems as a result of pain. But it can also mean that we in the treatment and prevention must go for a comprehensive approach that not only hits a possibly. muscle pain in the neck, but perhaps examine whether there may be underlying causes of the symptoms.

Finally, the survey shows that it is quite normal to have pain several places on / in the body.

To learn more, read the following scientific article:

Tschudi-Madsen et al; BMC Musculoskeletal Disorders 2011,12; 285.

Pain and Balance:

Uploaded April 1, 2012

Pain in the neck and back linked with balance
People who have pain in the neck or lower back have poorer balance than people who do not feel sorry. It has previously been shown in patients with severe pain, whiplash or diagnosed musculoskeletal diseases. Now a Danish research has shown that also workers - which is usually classified as healthy people - can have a link between pain and sense of balance.

Main Results
In certain types of jobs there are several who experience muscle pain than in other types of jobs. Especially people with physically demanding work experience frequent muscle pain than those with eg office work. Besides muscle pain itself may be of importance for example the quality of life, the impairments caused by the pain greatly affect one's ability to perform its work and enjoy his leisure time.

People with severe pain usually ends up having to leave of absence from work. In those cases is often a clear impairment of the person, which can potentially be the cause of sick leave. But it has so far not been investigated to what extent people who continue to carry out their work, have decreased function associated with pain.

A new survey of 194 cleaners showed that individuals who had neck pain had a significantly poorer balance. Also, individuals with both neck pain and low back had poorer balance than the cleaners who did not have pain.

In practice, it shows that the pain and the balance is connected. It has therefore been proposed to use balance training to prevent that the pain is compounded. We know not yet what comes first; pain or poor balance.

Earnings Basis
The study underlying the above knowledge, measured balance ability among 194 cleaners at Danish workplaces. There is no previous evaluation of the balance sheet compared to the pain of such a large group.
The balance was measured on a surface which registered gravity displacement during normal standing position with eyes open and closed. In addition, the participants' ability to balance on one leg for 30 seconds on a test. It actually turned out that the simple 30-second test also could measure the deterioration in the balance among people with pain.
30-second test is performed on one leg (stand leg) with opposing big toe leaning against standbenets medial malleolus and both arms crossed in front of chest. The eyes are kept open and the focus on a black dot placed at eye level about two meters in front of the participant. The participant gets three chances to complete. If one has held the position for 30 seconds in a row, the exercise is completed.

Pain was measured by questionnaire in which participants indicated how many days they had had trouble, pain or discomfort in the body part the last 12 months. People who had had pain in less than 8 days before the last 12 months were classified as "people without pain" and people with pain in more than 30 days the last 12 months were classified as "people with pain."

To learn more, read the following scientific article:

Jørgensen MB et al. 2011; Neck pain and postural balance among workers with high postural demands – a cross-sectional study. BMC Musculoskeletal Disorders, 12:176.