Are Your Workers Begging for Knee Injury Prevention?

Prepatellar bursitis, a painful swelling of the fluid sack over the kneecap, is a common work-related injury, especially among those who spend prolonged periods kneeling, squatting, crouching, or working on hands and knees.

Often known as miner’s knee—or the old “housemaid’s knee”—general symptoms of these knee injuries include pain, swelling, warmth in the knee joint, and difficulty bending the knee.

Prevention

Here are some suggestions from a NIOSH study of workplace knee injuries that you can use to reduce the risk of knee injuries among your workers.

Workspace redesign. Twisting the knee joint while it is bent increases the risk of injury. Observe your workers. If they’re twisting the knee joint while it’s bent to do a job, is there a way to redesign the workspace or layout to eliminate this risk factor?

Possible changes include:

• Raising the work off the floor
• Designing the space so that employees can work from a seated position instead of a kneeling one
• Positioning materials that workers must grasp and move above the knees so that the worker won’t need to bend the knee to retrieve or lift the item

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Relieving the pressure. Workers who kneel or squat for extended periods place a lot of pressure on their knee joints. It is important to relieve that pressure by moving the knee joint through its full range of motion—bending, stretching, and flexing the knee and leg—at regular intervals. This activity helps the knee’s shock absorbing tissues to better absorb synovial fluid, improving lubrication of the joint and reducing the risk of injury.

Shock absorption. Use of well-designed knee pads is another pressure relieving strategy. Like other PPE, knee pads work best when the worker can choose from a selection of pads to find the most comfortable pair with the best fit. Floor mats can also be used to provide cushioning for some jobs.

Cleanliness. Dirty clothing and knee pads can result in skin infections for workers who spend a lot of time on their knees. And skin infections directly over the kneecap can cause infections of the bursa or cartilage in the knee. Remind these workers to keep work clothes and PPE clean.

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Strengthening leg muscles. Workers in the NIOSH study were taught exercises that strengthened and stretched leg muscles, and they were instructed to perform these exercises at home.

Maintaining a healthy weight. Excess body weight is also a risk factor for knee injuries. Workers who maintain a healthy weight are less likely to injure their knees. A general wellness program aimed at weight control, exercise, and conditioning can help reduce the risk of knee injuries on the job.

Training. Make sure workers at risk of knee injuries understand the hazards, recognize symptoms of injury, and can identify preventive measures to avoid injury. Teach knee exercises in training as well.

Treatment. Employees with knee injury symptoms should see a doctor promptly for treatment. If swelling is persistent or significant, the doctor might drain fluid from the kneecap. Chronic swelling that does not respond to treatment might require the surgical removal of the bursa and subsequent weeks of rest and rehabilitation. This procedure usually results in motion being restored to the knee. However, return to work will often require temporary alternate duty assignments that do not involve prolonged kneeling, squatting, or working on hands and knees.

Tomorrow, we’ll set our sights higher and focus on preventing shoulder injuries.

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