This spring, Okanagan College and Total Physiotherapy in Houston, BC, collaborated on a research project studying preventative strategies for a very common tendinitis affecting tree planters. Tendinitis of the thumb, termed de Quervain’s tenosynovitis, is a frequent early season tree planting injury occurring on the shovel side. Total Physiotherapy has successfully treated de Quervain’s through a comprehensive injury prevention program which includes education, monitoring and support, and taping. The purpose of this research project was to assess if early intervention through preventative taping at the beginning of the planting season would help reduce the incidence and impact of this painful condition. This study was funded through the National Science and Engineering Research Council of Canada (NSERC).
In May 2017, data was collected at four participating Windfirm Resources Inc, and Summit Reforestation & Forest Management Ltd, field camps. Using well recognized clinical tests for de Quervain’s, 113 tree planters in total were tested prior to the start of the planting season and randomized into a Control group who received usual care, and a prophylactic Taping group who were instructed and supported in how to tape their wrist and thumb. Four planters were excluded from the study due to signs of existing tendinitis but received taping. The planters in the Taping group taped for three weeks and both groups were retested. One planter was excluded from the study due to noncompliance with taping, one planter dropped out due to a skin allergy, and six planters were no longer in camp or unavailable, leaving a final sample size of 101 participants.
On analysis, the Control and Taping groups were well matched with no statistical difference for age, gender, or years of planting experience. On reassessment the third week of the planting season, 11 planters in the Control group had developed tendinitis but only two planters in Taping group had signs of tendinitis. This difference was both statistically significant (p = 0.028) and practically important in reducing the incidence of this common work-related condition. There was no effect of gender in who developed tendinitis. The small sample of 13 planters who developed tendinitis limited statistical analysis but there were some important trends noted. Somewhat surprisingly, the incidence of tendinitis did not appear to increase with age, with only one individual above the age of 24, who developed tendinitis. Rookies and planters with one year experience were the prevalent group to develop de Quervain’s with the incidence decreasing dramatically after two years of planting experience. This finding likely suggests the benefits of experience and learning proper planting technique in minimizing injury.
In conclusion, the results of this study strongly supports the use of prophylactic taping in reducing the incidence of de Quervain’s in tree planters. This proactive evidence-based intervention could help prevent acute tendinitis, and the further development of chronic tendinitis and disability. The recommended industry practice guideline is that all planters should consider preventative taping during the first two or three shifts of the planting season. This recommendation would apply equally for male and female planters, and especially younger planters or those planters with less than three years of experience. Further research projects in the area of injury prevention are being considered by the authors and they can be contacted for questions or further information.
Contact: Darrell Skinner PT, Okanagan College, Kelowna, BC,
Mike McAlonan PT, Total Physiotherapy, Houston BC