Repetitive Trauma: a Lesser Known Work Injury

By: Matthew J. Healy

You’re on the job using your hands morning and afternoon, trying to ignore the tingling or numbness. The symptoms originally appeared months ago. They were mild and tolerable then. But with each workday, as you repeat the same motions, the symptoms increase slowly and steadily. Unexpectedly, as you’re performing your job, an intense pain develops in the wrist and up your arm. Is it just a momentary spasm or could it be carpal tunnel syndrome? If the pain persists it may be the latter, a painful, progressive condition caused by compression of an important nerve that runs through the wrist.

Carpal tunnel syndrome is one type of repetitive trauma. Repetitive trauma is an injury caused by a repeated motion. It is not limited to the hands and wrists. It may afflict the knees, elbows, neck, back, and any other moving body part. Although the body motion may appear simple, there is a distinct interaction of biomechanical factors at play, such as specific joint angles, clearances between tendons and bone, forces applied, and progressive friction over time.

Repetitive trauma is not limited to secretaries, court reporters, cashiers or those who type for a living. Actually, it is common in the construction trades: plumbing, electrical, carpentry, bricklaying, sprinkler fitting, operating and laboring. For example, while operating heavy equipment your knee or elbow may strike hard surfaces several hundred times a day. Shoveling material or using an air hammer all day may expose the back to slow but steady deterioration and ultimate breakdown.


To recover worker’s compensation for repetitive trauma, an employee must demonstrate that his or her condition was caused or aggravated by work. So long as the work activity is one contributing factor to the condition, other contributing factors such as the normal degenerative aging process or a non-work-related activity do not bar a claim.

In one case, an employee’s job required her to stand and walk 8 hours per day, a portion of which she carried 10-30 pound bundles of shirts. Because doctors opined that the repetitive carrying of the bundles and the inordinate amount of time spent on her feet caused her left heel spur and plantar fasciitis, and the arbitrator agreed that such job duties exposed her to a greater risk of injury than that of the general public, the employee was compensated for her loss. On the other hand, an employee who experienced sudden pain in his right foot, later to be diagnosed as a “fatigue fracture,” was denied compensation because the arbitrator found that walking on a concrete floor at work does not pose a unique risk of injury to the employee any greater than the general public.

In another case, a truck driver who suffered a ruptured disk in his lower back was compensated because it was found that the driver seat, cab and truck frame transmitted subtle but significant, repetitive shocks to his body while driving long hours over the road, and that his job exposed him to a greater risk of injury than the risk to the general public. On the other hand, if one injures his back while bending over at work to tie his shoes, it is not compensable because the act of bending over does not present a risk peculiar to or increased by the employment compared to the general public.


The typical compensation claim consists of a single, definable injury. A repetitive trauma claim is atypical because the injury is not obvious; rather, it is subtle, gradual, and manifests over a long period of time. A major problem is that workers who suffer from repetitive trauma often fail to provide timely verbal or written notice to their employer. Failing to do so can bar a compensation claim (consider that the Act requires employees to provide notice of the injury to their employer within 45 days from when they discover the injury). The indefinite nature of repetitive trauma combined with the finite nature of the notice requirement can create a pitfall for the worker.

For example, a laborer whose job requires an inordinate amount of crouching sees his doctor for consistent and increasing dull pain in his knees. The doctor tells him his condition is work-related repetitive trauma. But since the injury has yet to intensify, he returns to work, keeps quiet and continues on with his job. Then, about 6 months later, a severe pain develops in his knees. It is intense enough that he cannot continue working. He notifies his employer for the first time. The first question the employer asks is when did this injury occur? He responds that it has been gradual, that he and his doctor noticed it 6 months ago. This employee may have lost his rights to recover worker’s compensation benefits because he failed to give his employer notice of his condition within 45 days.

An employee can avoid this notice pitfall by telling his supervisor about the doctor’s diagnosis after the earliest medical treatment.


The Worker’s Compensation Act seeks to strike a fair balance between injured employee and employer rights: recognizing repetitive trauma (rather than requiring complete collapse) of a body part as a compensable injury was established to protect the worker, whereas, the 45 day notice requirement was established to protect the employer from old or non-work-related claims. Repetitive trauma cases present a challenge because the precise date the injury manifests itself is critical and yet open to wide interpretation. Any employee whose doctor tells him or her that he or she may have work-related repetitive trauma should seek prompt legal advice.

This general discussion of rights and responsibilities under the Act is not, and should not be considered a substitute for, individual legal advice. Please contact the lawyers of the Healy Scanlon Law Firm for legal assistance today.