The strange case of the ice cream scooper’s arm
One of the ice cream scoopers at my favourite gelateria consulted me about her chronically painful right arm. She had the triad of tennis elbow, carpal tunnel syndrome and trigger thumb. Her misfortune became an extension of my interest in the medical problems of tennis players and musicians.
A quick search of PubMed produced one case report of a scooper who had fractured her second metacarpal, along with one study of ice cream scoopers by two American ergonomists. Sadly, there were no studies from New Zealand or Australia, despite their respective ranking of first and third in the world ice cream consumer league table (second is the USA). Clearly, ice cream scoopers’ arm is an under-researched Repetitive Strain Disorder worthy of further exploration!
In 2016-7, I conducted an opportunistic series of between two and three separate purchases at 14 ice cream and 16 gelato shops in four Australian states. I explained my interest in ice cream or gelato and observed and discussed the ergonomic set up of the counters, the type of scoops and the ways they were used. I was also able to obtain an occupational medical history from 52 (32 females, 20 males) of the scoopers who served me.
Only two of my informants, who worked for an international ice cream chain, had received a considered training on scooping ice cream. They were advised to put their right foot forward, keep their wrist locked and use the muscles in their upper arm and forearm to scrape from the centre of the circular ice cream container to its side. The only instruction given to the other scoopers was that the ice cream ball should be round and of a regular size and that the pan containing the ice cream should always look neat and attractive to the customers.
All but two of my informants had developed a sore arm, wrist and /or shoulder in their first two weeks on the job. With time, most of the scoopers got stronger and became pain free. Those who scooped ice cream as their permanent job usually looked like a professional tennis player with their scooping arm having a larger diameter than their non-scooping arm.
Ten of my informants had continued to suffer from a sore arm, especially after a busy weekend when they might serve more than 400 customers in a 10 to 12 hour working day. All of these ice cream scoopers were women and were physically less robust than their male counterparts. Their symptoms were exacerbated by carrying heavy ice cream canisters, reaching into poorly set up ice cream and gelato containers and by serving nut flavoured ice cream varieties eg pistachio, that have a high freezing point and can be rock hard.
The most commonly used scoops were hemispherical in shape, made of aluminium with a heat conducting fluid in their handle. This aims to facilitate the release of the ice cream by conducting heat from the ice cream server’s hand to the ball of the scoop. Their main advantage is that they are cheap and produce a neat rounded ball of ice cream or gelato. These scoops are not dishwasher safe and have been reported to explode if dipped in hot water.
I identified over 100 different makes of ice-cream scoops that can be purchased online. Most are a variation of the one already described. There are also a small number of scoops that have various spring mechanisms to facilitate the release of the ice cream ball. They require the use of the thumb to work the release mechanism. Scoopers with small hands and weak grips find them difficult and tiring to use. Their moving parts are also prone to sticking and jamming. They are adequate for the home but not for repetitive commercial use.
There are several new ingenious scoops developed by American ice cream aficionados with a parallel interest in ergonomics. They are designed to maximise the use of the larger, stronger muscles of the scooper’s arm. None of my informants were aware of them.
The size and composition of the scoop handle is also important. It should be large enough for power and comfort and made of a non-slip material. The commonly used aluminium scoop fails all these criteria.
Ice cream scooper’s arm is one of the large family of repetitive industrial musculoskeletal disorders. It consists of many related but separate underlying pathologies. It could be prevented or mitigated by attention to training, optimum freezing temperatures of different types of ice cream, the ergonomic set up of ice cream counters and the type of scoop that is used. Tennis players customize their racquets and chefs have their personal and much prized cutting knife. Ice cream scoopers use whatever their shop makes available. Ice cream scoopers come in all shapes, sizes and strengths and one type of scoop does not fit all of them. Ice cream shops should have a selection of scoops that scoopers could try. It would only take a little more awareness and effort to prevent the ice cream licker’s pleasure being the ice cream scoopers’ pain.
Max Kamien is an Emeritus Professor of General Practice and Senior Honorary Research Fellow at the University of Western Australia