title: Exploring musculoskeletal injuries in the podiatry profession: an international cross sectional study.
abstract: BACKGROUND
  Workplace injury is an international costly burden. Health care workers are an essential component to managing musculoskeletal disorders, however in doing this, they may increase their own susceptibility. While there is substantial evidence about work-related musculoskeletal disorders across the health workforce, understanding risk factors in specific occupational groups, such as podiatry, is limited. The primary aim of this study was to determine the prevalence and intensity of work related low back pain in podiatrists.
  
  
  METHODS
  This was an international cross-sectional survey targeting podiatrists in Australia, New Zealand and the United Kingdom. The survey had two components; general demographic variables and variables relating to general musculoskeletal pain in general or podiatry work-related musculoskeletal pain. Multivariable regression analyses were used to identify factors associated with musculoskeletal stiffness and pain and low back pain intensity. Thematic analysis was used to group comments podiatrists made about their musculoskeletal health.
  
  
  RESULTS
  There were 948 survey responses (5% of Australian, New Zealand and United Kingdom registered podiatrists). There were 719 (76%) podiatrists reporting musculoskeletal pain as a result of their work practices throughout their career. The majority of injuries reported were in the first five years of practice (n= 320, 45%). The body area reported as being the location of the most significant injury was the low back (203 of 705 responses, 29%). Being female (p< 0.001) and working in private practice (p= 0.003) was associated with musculoskeletal pain or stiffness in the past 12 months. There were no variables associated with pain or stiffness in the past four weeks. Being female was the only variable associated with higher pain (p= 0.018). There were four main themes to workplace musculoskeletal pain: 1. Organisational and procedural responses to injury, 2. Giving up work, taking time off, reducing hours, 3. Maintaining good musculoskeletal health and 4. Environmental change.
  
  
  CONCLUSIONS
  The postures that podiatrists hold while treating patients appear to impact on musculoskeletal pain and stiffness. Recently graduated and female podiatrists are at higher risk of injury. There is a need for the profession to consider how they move and take care of their own musculoskeletal health.
authors.affiliation: Department of Physiotherapy, Monash University, Frankston, VIC 3199 Australia.
authors.forename: Cylie M
authors.initials: CM
authors.lastname: Williams
authors.affiliation: University of Western Sydney, School of Science and Health, Penrith, NSW 1797 Australia.
authors.forename: Stefania
authors.initials: S
authors.lastname: Penkala
authors.affiliation: Monash University, Epidemiology and Preventative Medicine, Prahran, VIC 3181 Australia ; Institute for Work & Health, Toronto, ON Canada ; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Smith
authors.affiliation: Department of Physiotherapy, Monash University, Frankston, VIC 3199 Australia ; Monash Health, Allied Health Research Unit, Cheltenham, VIC 3192 Australia.
authors.forename: Terry
authors.initials: T
authors.lastname: Haines
authors.affiliation: Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, VIC 3199 Australia.
authors.forename: Kelly-Ann
authors.initials: KA
authors.lastname: Bowles
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology* / Q000209:etiology; D009520:New Zealand / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology*; D010348:Patient Care Team / Q000706:statistics & numerical data*; D011032:Podiatry / Q000458:organization & administration; D011331:Private Practice / Q000706:statistics & numerical data; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Back pain; Ergonomics; Health workforce; Musculoskeletal disorders