I know this column is intended to be for cattle health, but I sometimes like to stray a bit for a good cause, which is the case here.
I recently had two encounters in one week dealing with shoulder health of humans.
First, a review was given by Ronald Ailsby at the 2009 Annual American Association of Bovine Practitioners annual meeting on “Your Livelihood, Your Neck, Shoulder and Arm.” Second, upon my return home, a dairy manager I work with was going in for shoulder surgery. He told me that he could not tolerate the pain any longer. It was no wonder — he had multiple bone spurs and a nearly completely severed tendon.
The resulting take-home messages I have are these:
Concern for shoulder health should not only apply to dairy veterinarians. A functional and pain-free shoulder is a valuable asset for veterinarians and dairy personnel alike. Anyone who performs rectal palpations on cattle on a regular basis is at risk. Odds of injury certainly increase with the amount of palpation, since some of the injuries stem from repetitive motion and fatigue. However, anyone can become victim to acute traumatic strains which can occur any time the animal makes an unexpected move. Good animal restraint is a must and can prevent many acute injuries.
Understand shoulder anatomy. The shoulder has a large range of motion controlled by muscles and tendons sitting on the mobile scapula bone. These muscles are controlled by a bundle of nerve roots coming from the neck region. Arm and shoulder dysfunction can occur as an injury to the nerves, muscles or tendons or as chronic repetitive injury to the rotator cuff or nerve bundle. Therefore, the history of the problem is important information to pass along to a physician during his physical exam to arrive at a correct diagnosis.
Do not ignore the symptoms. These include: limited range of motion, weakness, tenderness, pain, loss of sensation, loss of muscle tone and swelling. The pain can be in a specific area or generalized. The problem can come on over time or can be sudden. The earlier that the problem is looked into, the better. Keep in mind that not all problems can be fixed; damage can be permanent. Early detection and diagnosis are vital.
Recognize and eliminate problem causes. Correct shoulder and arm position during use is critical. A physician or physical therapist can demonstrate ways to best modify the position of the arm during the pelvic examination. From my experience, I fully utilize my entire upper body, as well as legs, when palpating. I use my passive hand to grip the tail, lock my palpating arm straight, then use my feet to push, and my passive hand and upper body to pull my palpating arm into the cow. I experience very little shoulder fatigue with this method, but it is likely height-specific as I am 5-feet, 6-inches tall.
Incorporate technology when possible. Based on personal experience, the use of ultrasound greatly lessens the amount of uterine positioning required and, therefore, shoulder movement needed to diagnose the pregnancy is also reduced. Serum-based pregnancy tests are on the market and appear to be competitively performing and priced. As with most technology, changes in management may be needed for full utilization. Your veterinarian can better advise you on the incorporation of these, and other ways to address shoulder problems on your dairy.
Meanwhile, take steps to protect a valuable asset on your dairy. Address shoulder-health problems at the onset and encourage your employees to do the same.
Angela M. Daniels is a veterinarian with Circle H Headquarters LLC, a dairy and swine veterinary practice, food safety laboratory and DHIA milk-testing and contract research organization in Dalhart, Texas.