Musculoskeletal Stress Markers Research Articles

Battered and abused: Analysis of trauma at Grasshopper Pueblo (AD 1275–1400)

Increasing violence and inter-group conflict in the American Southwest is prevalent into the 13th and 14th centuries AD. In the northern Mogollon region during this time period, the site of Grasshopper Pueblo experienced a shift in social organization as population movements occurred in response to regional stressors. The skeletal remains of 187 adult individuals from the site are analyzed for nonlethal and lethal trauma, musculoskeletal stress markers, and pathology as indicators of changing social dynamics. Nonlethal, healed trauma is present in all adult age groups and both sexes. Approximately one-third (n=63) of the population has healed cranial depression fractures. Females and males are fairly equal in the proportion of cranial injuries incurred; however more females are injured overall when post-cranial injuries are added. Musculoskeletal stress markers do not differ substantially among age groups or between sexes. Heavy musculature development is also similar for groups with and without cranial depression fractures. The results of this study suggest that interpersonal violence was ubiquitous within the pueblo and may have escalated as the community grew in size. Immigrants from other parts of the Southwest may have sought refuge at Grasshopper only to find that the community was experiencing its own social stress.

Comment on the Analysis of Two Skeletons from Terqa, Syria

ABSTRACTRecently, a report on two human skeletons from an Early Bronze Age tomb excavated at Tell Ashara, Syria has been published in International Journal of Osteoarchaeology. One individual was identified as a warrior following these criteria: (i) size and robustness of bones, (ii) cut marks on the humerus, (iii) reduction of the ulnar styloid process, both interpreted as healed weapon‐related trauma, (iv) well‐developed muscle insertions, and (v) degenerative joint disease. Actually, none of these five criteria support the conclusion because of the following reasons: (i) not necessarily all tall and robust men become warriors, (ii) the post mortem origin of cut marks on the humerus is more likely than sharp force trauma, (iii) there are several possible causes of the unusual ulnar styloid shape other than weapon‐related trauma, (iv) the interpretation of musculoskeletal stress markers and (v) degenerative joint disease lacked control for age, sex and body size. Copyright © 2012 John Wiley & Sons, Ltd.

The relationship between musculoskeletal stress markers and biomechanical properties of the humeral diaphysis

Musculoskeletal stress markers (MSM) at entheses and bone biomechanical properties are used in activity reconstructions. The effect of physical activity on bone biomechanical properties is well established but the relative role of physical activity on MSM is less well known. In this article, it is hypothesized that the same causal mechanisms should affect MSM development as those responsible for bone biomechanical properties. Further, there should be a correlation between MSMs and bone cross-sectional properties as both are considered to reflect physical activity. This was tested using three skeletal samples: early 20th century Finnish (Helsinki) and two medieval English (Blackgate and York) populations. Torsional/average bending rigidity (J) for four cross-sectional locations at 80, 65, 50, and 35% of humeral length from the distal end was calculated and pectoralis major, teres major, and deltoid were scored for MSM. Correlations between MSM and size-standardized J were significant for many comparisons, although they were stronger in males than in females, especially on the right side. In ANOVAs, sample was found to be a significant influence on the right side in both sexes. Using an aggregated MSM score, covariance between J and high MSM scores was again stronger in males. Covariance between J and MSM was found both at cross-sectional locations under muscle insertions and at more distant locations, demonstrating both direct and general effects of muscular loadings applied to diaphyses. Thus, the two types of skeletal markers appear to be related to similar underlying mechanical factors, but effects may also be sex- and sample-specific.

Modeling skeletal traits and functions of the upper body: Comparing archaeological and anthropological material

The aim of this study is to look at upper body functional modifications caused by mechanical loading. We look at 4th lumbar vertebra as well as fibrous humeral musculoskeletal stress markers (MSMs). This study uses information provided by magnetic resonance images of living individuals from the University of Oulu Hospital data banks (N=91), archaeological skeletons from Sweden (N=54) and England (N=61), and autopsied skeletal collection of early 20th century Finns in Natural History Museum, University of Helsinki (N=48). The lumbar vertebrae and MSM are subjected to mechanical loading caused by the upper body weight and loads lifted and/or carried. We hypothesized that the vertebral size reflect body size, habitual mechanical loading and the overall skeletal robusticity as mechanical competence to withstand mechanical loading standardized to body size, which has decreased over millennia. For Helsinki material occupation, age and sex is known and the material was used in Niinimäki (2011). In the study by Niinimäki (2011) MSM were found to be affected by the intensity of muscular action as well as body size and age. This study is reviewed here in light of re-analysis of the data to follow the current anatomical understanding of the entheses as well as viewing MSMs as a part of upper body functional complex. Only fibrous entheses were included in the re-analysis. Furthermore, due to small number of females where activity intensity could be assessed, females were dropped from the re-analysis.Our findings reveal that the size and shape of the 4th lumbar vertebra has changed significantly from medieval times through post-medieval to modern day affecting the biomechanical characteristics of the lumbar vertebrae, possibly making spine fractures increasingly common. MSM are affected by the skeletal robusticity and activity level, although age bias is significant after biological maturity, where results remained the same after the re-analysis. The close relationship between biomechanics and therefore skeletal modeling is clearly revealed by the extent to which the level of habitual mechanical loading reflects in our skeletal anatomy.

Sex differences in musculoskeletal stress markers: Problems with activity pattern reconstructions

AbstractThis study examined six musculoskeletal stress marker (MSM) scores that showed reverse sex differences in the previously published research. MSM scores often differ by sex within a population. Most often females have lower MSM scores than do males; however, reverse sex differences do occur. If reverse sex differences are culturally specific, then these MSM scores are more likely caused by activity patterns than biology. Yet, if the same MSM scores show reverse trends in multiple populations, then perhaps these reversals may be the result of biological sex differences, such as hormonal differences and body size, or methodological reasons, such as MSM location. In the current study, deltoideus, pronator quadratus and trapezius MSM scores were significantly more pronounced in males in the California Amerind population examined. Most MSM scores examined significantly correlated with body size and age. With articular size and age controls, only the pronator quadratus and trapezius continued to display significant sex differences. Males had greater MSM pronator quadratus and trapezius scores than did females. The lack of sex differences in four out of six MSM scores may relate to the confounding factor of body size. Thus, it is suggested that some reverse sex differences in the published literature may not relate to activity patterns whereas other MSM sites show more promise. Copyright © 2010 John Wiley & Sons, Ltd.

The usefulness and methodological validity of the study of musculoskeletal stress markers for the reconstruction of past human activities and life-styles

The usefulness and methodological validity of the study of musculoskeletal stress markers for the reconstruction of past human activities and life-styles

Comment on “Musculoskeletal stress marker (MSM) differences in the modern American upper limb and pectoral girdle in relation to activity level and body mass index (BMI)” by K. Godde and R. Wilson Taylor

Comment on “Musculoskeletal stress marker (MSM) differences in the modern American upper limb and pectoral girdle in relation to activity level and body mass index (BMI)” by K. Godde and R. Wilson Taylor

Assessment of Musculoskeletal Stress Marker Development in the Hand

ABSTRACTThe analysis of musculoskeletal stress marker (MSM) development is a commonly employed tool in osteological surveys and is used to infer patterns of occupational activity and societal organisation in archaeological populations. Although the majority of research into upper limb MSMs has focused on the bones of the arm, the bones of the hand have been conspicuous by their absence. This is likely to be due to methodological issues surrounding the study of hand bones and a presumed lack of variation in MSM development in this area. To date, there have been no systematic studies investigating the presence and variation in MSM morphology for the muscles of the human hand. To address this issue, a presence/absence scoring system was developed for twelve sites of muscle origin and insertion in the metacarpals and phalanges, which was used to determine bilateral asymmetry in the hands of 31 individuals from the Naval Hospital Cemetery site in Greenwich, London. Analysis found observable variation in MSM development between and within the hands, which could be used to determine patterns of asymmetry within the sample. Comparisons with MSM scores from the humeri of these individuals indicate a differentiation in MSM development and asymmetry between these anatomical regions. Levels of asymmetry in the hands and humeri were generally low, with only the dorsal interossei displaying statistically significant asymmetry. Subsequent upper limb MSM research will benefit from the inclusion of data from the hands. These results do not support the continued use of the humerus as a proxy for MSM expression across the upper limb as a whole and suggest that important information regarding behavioural asymmetry in the hands is being lost because of the continual exclusion of this anatomical unit from MSM research. Copyright © 2011 John Wiley & Sons, Ltd.

Osteoarthritis and activity—an analysis of the relationship between eburnation, Musculoskeletal Stress Markers (MSM) and age in two Neolithic hunter–gatherer populations from Gotland, Sweden

AbstractThe occurrence of osteoarthritis (OA) as an indicator of physical activity was explored in two Middle Neolithic samples from Gotland (c. 3400–2300 BC) in the Baltic Sea: Ajvide (n = 46) and Västerbjers (n = 32). The difficulty in diagnosing OA is recognised and only eburnation was used as a definite criterion for OA. The relationship between eburnation lesions and Musculoskeletal Stress Markers (MSM) was investigated particularly in relation to age, but also with reference to patterns of sex, body side and site. Results show that increasing prevalence of eburnation as well as increased MSM scores was highly correlated with age. In the combined sample, females exhibited higher frequencies of eburnation, while total MSM mean scores were higher in males. Significantly higher MSM mean scores were also found in those individuals with eburnation lesions. Västerbjers exhibited higher frequencies of eburnation as well as higher mean MSM scores, which in part may be explained by the difference in age distribution at the two sites. However, the differences in both eburnation and MSM patterns between the sexes, and between age groups as well as between the two sites indicate that other factors also have to be considered. These may include genetic predisposition and possibly activity, although, a direct link (other than age) between eburnation and MSM was difficult to discern. Copyright © 2009 John Wiley & Sons, Ltd.

Musculoskeletal stress marker (MSM) differences in the modern American upper limb and pectoral girdle in relation to activity level and body mass index (BMI)

Obesity is a widespread condition affecting modern Americans. The prevalence of obesity has led to questions of how it can affect the skeleton, and if so can it be identified in unknown skeletal material. This study attempts to decipher the effects of activity level and body mass in modern Americans by employing musculoskeletal stress markers (MSM) to estimate osseous responses to workload and body weight. A total sample of 108 skeletons of known activity level and body mass index (BMI) was observed for MSM in the upper extremity (excluding hands). The entheses selected included arm muscles used during the sit-to-stand transition, which is common in most persons, regardless of activity level and BMI. Using the three categories: normal, active, and obese, logistic regression was calculated on MSM to ascertain which markers were the best indicators of these three categories. Numerous muscles of the upper limb were significant predictors of activity level and body mass, although they did not perform much better than chance. MSM may be used as predictors of activity level and/or BMI in forensic contexts; however, they should be used in conjunction with other indications of workload and/or BMI.

Paleoepidemiology of pre-Columbian and Colonial Panamá Viejo: a preliminary study

Panama Viejo, a coastal site in the Panamanian Pacific, was occupied from ca. AD 850 to 1200 and from the arrival of the Europeans in AD 1519 to 1671. This paper describes the bone anomalies observed and recorded in the pre- and post-contact skeletal series from the site. The bone anomaly frequencies were calculated, taking their observability into account. A number of changes were found between the two periods, concerning MSM (Musculoskeletal Stress Markers), DJD (Degenerative Joint Disease), porotic hyperostosis and trauma, as well as changes that are classified as ‘cultural’. However, these differences were significant only in the case of porotic hyperostosis and the ‘cultural’ anomalies. Further investigations using an enlarged series should clarify the impact of European contact in this region.

Shape and size of the body vs. musculoskeletal stress markers

The objective of this paper is to assess the relationship between the degree of development of muscle attachment sites (musculoskeletal stress markers - MSM1) and the length and circumference measurements of long bones and the body build expressed with the reconstructed values of body height (BH) and body mass (BM). The bone material (102 male and 99 female skeletons) used in the study was collected in the medieval burial ground in Cedynia, Poland. The authors analyzed 10 musculoskeletal stress markers located on the scapula (2), humerus (2), radius (2), femur (2) and tibia (2). The frequency and the degree of expression of muscle attachment size was carried out using the scale prepared by Myszka (2007). The scale encompassed three degrees of expression of muscle attachment size. Only changes of robusticity type (nonpathological changes) were taken into account. The assessment of body build of individuals was carried out according to the method proposed by Vancata & Charvátová (2001). Body height was reconstructed from the length of the humerus and femur using eight equations. Body mass was reconstructed from the measurements of the breadth of the proximal and distal sections of the femur and tibia (mechanical method) using twenty one equations. The equations were developed for different reference populations. The same equations were used for men and women. The correlation between the MSM and the length and circumference measurements of the bones was analyzed using the principal components analysis and the Gamma correlation coefficient. The strength of the correlation between the reconstructed body build traits (BH, BM) and the moderate degree of musculoskeletal stress markers expression was studied based on the principal components method and the Pearson correlation coefficient. A linear correlation was found between musculoskeletal stress markers and the circumference measurements and the reconstructed body mass, but no relationship with body height and the length measurements of long bones was revealed. From previous research it is evident that the relationship between the MSM and metric skeletal traits does not occur in every population. Divergent findings necessitate further corroboration of results on diverse skeletal material.

Between‐group Differences in the Patterning of Musculo‐skeletal Stress Markers: Avoiding Confounding Factors by Focusing on Qualitative Aspects of Physical Activity

ABSTRACTThis paper presents a method for studying between‐group differences in physical activity patterns through the analysis of musculo‐skeletal stress markers (MSM). The specific aim was to develop a method that could overcome the problems related to confounding variables such as body size by shifting the analytical focus from the comparison of differences in intensity to the comparison of differences in kinds of activity. Instead of testing whether there are differences in the measures of central tendency of MSM scores between two groups, we proposed looking for differences in MSM covariation patterns. Formally, this is achieved through the statistical comparison of group‐specific MSM intercorrelation matrices. The null hypothesis is that the matrices are equal, and the statistical significance of the test statistic is obtained with a permutation test. In this way, the problem of confounding variables such as body size is mostly avoided because the procedure is based on the comparison of group‐specific sets of correlation coefficients which are scale‐free. The method was employed in a case study to investigate the differences in activity patterns between men and women from the Early Bronze Age population buried at the necropolis in Mokrin, Serbia. The null hypothesis of no difference between the male and female MSM correlation matrices was rejected (p = 0.0135). After the statistical significance of the difference was established, further investigation of male and female activity patterns was undertaken by means of principal component analysis (PCA) with varimax rotation. PCA results suggest that covariation between MSMs is stronger in the male sample. Success in demonstrating differences in activity patterns between sexes implies that the proposed method can be used to test for differences in physical activity between groups of individuals defined by criteria other than sex. Copyright © 2011 John Wiley & Sons, Ltd.

The Coimbra Workshop in Musculoskeletal Stress Markers (MSM): an annotated review

The Workshop in Musculoskeletal Stress Markers (MSM): limitations and achievements in the reconstruction of past activity patterns, was held at the University of Coimbra, in Portugal (2 nd-3 rd July 2009). The chief goal of the organizing committee was to provide a productive environment where researchers could discuss the methodologies and terminology employed for the study of MSM as well as assessing how well these enthesopathies serve as markers of occupational stress. The Workshop was organized in three major sessions, each one introduced by a keynote lecture: (1) Methodological issues; (2) MSM studies of archaeological samples and Identified Skeletal Collections; and (3) The multifactorial etiology of enthesopathies. The meeting was concluded with a Plenary Session where two annotators discussed the presentations; this was followed by a general discussion and the formation of three working groups focused on the topics of Methods, Terminology, and Occupations. Details of the Workshop and the presentations presented are available for download at) was created to facilitate communications about individual experiences and to share knowledge among researchers in this field. We hope that this Workshop will help to standardize methodologies and terminology and promote the creation of a more integrated scientific approach to future studies of MSM.

Enthesopathies as occupational stress markers: Evidence from the upper limb

Enthesopathies--that is, "musculo-skeletal stress markers"--are frequently used to reconstruct past lifestyles and activity patterns. Relatively little attention has been paid in physical anthropology to methodological gaps implicit in this approach: almost all methods previously employed neglect current medical insights into enthesopathies and the distinction between healthy and pathological aspects has been arbitrary. This study presents a new visual method of studying fibrocartilaginous enthesopathies of the upper limb (modified from Villotte: Bull Mém Soc Anthropol Paris n.s. 18 (2006) 65-85), and application of this method to 367 males who died between the 18th and 20th centuries, from four European identified skeletal collections: the Christ Church Spitalfields Collection, the identified skeletal collection of the anthropological museum of the University of Coimbra, and the Sassari and Bologna collections of the museum of Anthropology, University of Bologna. The analysis, using generalized estimating equations to model repeated binary outcome variables, has established a strong link between enthesopathies and physical activity: men with occupations involving heavy manual tasks have significantly (P-value < 0.001) more lesions of the upper limbs than nonmanual and light manual workers. Probability of the presence of an enthesopathy also increases with age and is higher for the right side compared with the left. Our study failed to distinguish significant differences between the collections when adjusted for the other effects. It appears that enthesopathies can be used to reconstruct past lifestyles of populations if physical anthropologists: 1) pay attention to the choice of entheses in their studies and 2) use appropriate methods.

Enthesopathy formation in the humerus: Data from known age‐at‐death and known occupation skeletal collections

Enthesopathies, in the guise of musculoskeletal skeletal stress markers (MSM), have been widely used to reconstruct activity levels in human skeletal populations. In general, studies have focused on their presence in the upper limb, which is used in the majority of daily activities. The aim of this study was to use some of the attachment sites on the humerus to explore the relationship between enthesopathy formation, activity, and the ageing process. The skeletal sample used in this study comprised male adult skeletons with known age-at-death and known occupations from the late-19th and early-20th century cemeteries in Portugal. The enthesopathies were recorded as either present or absent. Statistical analysis using Fishers exact tests and logistic regression was undertaken to determine whether associations could be found between specific activities or socioeconomic status (manual or nonmanual workers), and age and enthesopathy presence. Left and right sides were analyzed separately. Fisher's exact tests were used to determine the relationship between activity and enthesopathy, and they demonstrated no association between activity and enthesopathies (P > 0.01). The results of the logistic regression established that age was the single most significant factor in enthesopathy formation (P > 0.05). This study found that, in these samples, age-at-death, and therefore age-related degeneration rather than degeneration caused by activities, was the primary cause of enthesopathy formation. Considering the difficulties of reliably ageing adult human skeletal remains, this is a major issue for studies of activity using enthesopathies.

Pottery production and markers of occupational stress: Musculoskeletal stress markers and osteoarthritis in two Pacific Island skeletal samples

Pottery production and markers of occupational stress: Musculoskeletal stress markers and osteoarthritis in two Pacific Island skeletal samples

Upper limb musculoskeletal stress markers among middle Holocene foragers of Siberia's Cis‐Baikal region

This evaluation of musculoskeletal stress markers (MSMs) in the Cis-Baikal focuses on upper limb activity reconstruction among the region's middle Holocene foragers, particularly as it pertains to adaptation and cultural change. The five cemetery populations investigated represent two discrete groups separated by an 800-1,000 year hiatus: the Early Neolithic (8000-7000/6800 cal. BP) Kitoi culture and the Late Neolithic/Bronze Age (6000/5800-4000 cal. BP) Isakovo-Serovo-Glaskovo (ISG) cultural complex. Twenty-four upper limb MSMs are investigated not only to gain a better understanding of activity throughout the middle Holocene, but also to independently assess the relative distinctiveness of Kitoi and ISG adaptive regimes. Results reveal higher heterogeneity in overall activity levels among Early Neolithic populations-with Kitoi males exhibiting more pronounced upper limb MSMs than both contemporary females and ISG males-but relative constancy during the Late Neolithic/Bronze Age, regardless of sex or possible status. On the other hand, activity patterns seem to have varied more during the latter period, with the supinator being ranked high among the ISG, but not the Kitoi, and forearm flexors and extensors being ranked generally low only among ISG females. Upper limb rank patterning does not distinguish Early Neolithic males, suggesting that their higher MSM scores reflect differences in the degree (intensity and/or duration), rather than the type, of activity employed. Finally, for both Kitoi and ISG peoples, activity patterns-especially the consistently high-ranked costoclavicular ligament and deltoid and pectoralis major muscles-appear to be consistent with watercraft use.

Patterns of physical activity and material culture on Gotland, Sweden, during the Middle Neolithic

AbstractLinking MSM (Musculoskeletal Stress Markers) to specific activities is difficult. This problem is explored by combining and comparing patterns of MSM and material culture. Sex‐ and age‐related patterns for MSM and grave goods distributions are analysed and compared from five Pitted Ware (c. 3400–2300 BC) sites on Gotland, Sweden. Possible links between MSM patterns, burial objects, faunal remains and subsistence are explored for a better understanding of some of the irregularities surrounding the Pitted Ware culture hunter‐gatherer complex on Gotland. Fifty‐two muscle and ligament attachments on seven skeletal elements were scored on adult skeletal remains (n = 126) from the five Middle Neolithic Pitted Ware sites at Ajvide, Västerbjers, Visby, Ire and Fridtorp. Noteworthy differences were observed in MSM mean scores between the sexes as well as significantly increased scores with increased age. Distributions for ten selected grave goods categories were also examined for the adult individuals as well as for 50 subadult individuals. The grave goods frequencies showed the opposite pattern from that of MSM: young individuals had higher frequencies of the selected grave goods than the old, and females generally more than males. Burial find distributions also differ at the five sites, as well as faunal refuse proportions, while isotopic data indicate homogeneous subsistence all over the island. Circumstances surrounding the faunal remains in graves and surrounding cultural layers indicate site‐specific utilisation, but also ritual handling of animals. An image of common identity on the island and membership of the local community is visible in the material culture. In addition, individual differences are apparent through MSM patterns and grave goods, but not in direct correlation to activities implied by the artefacts in the grave. Copyright © 2008 John Wiley &amp; Sons, Ltd.

Muscle markers revisited: Activity pattern reconstruction with controls in a central California Amerind population

Anthropologists frequently use musculoskeletal stress markers to reconstruct past activity patterns. Yet, researchers have called into question the reliability of muscle marker measurements in part because body size and age affect muscle marker scores. In this study, the author examined an aggregate upper limb muscle marker to determine if after controlling for the effects of body size and age, one could reconstruct activity patterns of a prehistoric Amerind population. Analyses were made of a sample of 102 (43 males, 59 females) prehistoric central California Amerinds. Muscle markers were measured using two-point observer rating scales; body size was measured by humeral articular surfaces; age and sex were determined previously through standard procedures. Using sex separated rankings and partial correlations, disaggregated muscle markers were examined for correlations with age and size to determine if specific muscle markers may be useful in pinpointing to activity patterns. Aggregate upper limb muscle marker correlated with: age, r = 0.44; humeral size, r = 0.44; and sex, r = 0.43; Ps < 0.001. Older individuals had greater muscle markers, as did larger individuals, and males. Rankings seemed to be confounded by the effect size had on the muscle markers. However, based on partial correlations controlling for size and age, the differences that remained between males and females could be used to reconstruct male activities of throwing in hunting and interpersonal aggression acts.