Five Approaches to Managing Occupational Musculoskeletal Disorders

Walt Rostykus

Walt Rostykus

While working and benchmarking with a wide variety of companies, I hear a range of interpretations of what constitutes an “ergonomics program.”  Unfortunately, the term is being used to describe a mix of approaches (in addition to ergonomics) to managing musculoskeletal disorders (MSDs).

Several leading organizations are in the process of evaluating and changing their programs to simplify, improve focus and improve efficiencies in addressing and preventing MSDs. Currently, there are five general, but very different, approaches used to manage MSDs.  Companies use a few, some, or all of these to reduce losses resulting from these types of injuries.

1.     Change the Work and Workplace: This approach focuses on the design of new jobs, or changes to existing workstations, tools and equipment to better fit the population doing the work.  This is occupational ergonomics, which has been defined by the National Institute for Occupational Safety and Health (NIOSH) as “The science of fitting workplace conditions and job demands to the capabilities of the working population.  Ergonomics is an approach or solution to deal with a number of problems – among them are work-related musculoskeletal disorders.”

The most effective workplace changes are engineering controls, which are adjustments and changes in the physical workplace to ensure that the reaches, forces and distances are within the acceptable limits of the workforce.  This means designing the workplace to fit people, from the fifth-percentile female to the ninety-fifth-percentile male, to prevent exposure to MSD risk factors for most workers.  Engineering controls have been proven to be effective and efficient through research and benchmarking studies.

A secondary level of control is administrative controls, or changes to the administration of work, like job rotation, rest breaks and slowed pace.  Unfortunately, administrative controls do not reduce or eliminate the presence of MSD risk factors; they just reduce the exposure time.  They can also create additional work and challenges for managers and supervisors as they shift people between work task assignments.

Both of these types of controls are best supported by ergonomists, engineers, and professionals qualified in ergonomics.

2.     Change the Capability of the Person: This approach is based on trying to change the capabilities, fitness and stamina of the individual doing the work.  This is an element of fitness and wellness programs, and includes stretching, exercise and conditioning.  The focus is on changing the individual employee and is dependent upon the willingness and participation of people, as well as their existing physical condition.

Although some organizations mandate stretching before and during work, many find it a challenge to get people to participate in stretching and wellness programs.  In addition, company-mandated stretching programs have not been proven to be effective in preventing MSDs.

Unfortunately, employers have limited influence on the personal health and wellness of their employees, and have no control over pre-existing conditions.  This approach is typically supported by fitness trainers/specialists, physical therapists and occupational therapists.

3.     Change how the Person Performs the Task: This approach is based on getting people to behave differently in hopes of reducing exposure to MSD risk factors.  This is behavioral modification, and may include behavior-based safety programs, training and awareness campaigns, and use of body mechanics.  This requires people to change their perceptions of work and risk, and change how they perform work (consistently throughout the day, week and their careers).

Even when behaviors do change, they rarely have a significant impact on preventing exposure to MSD risk factors.  Managers have expressed their frustrations on “getting people to use safe working practices.”  This approach is typically supported by behavioral safety professionals/programs, training and fitness trainers.

4.     Fit the Person to the Task:  In this approach, the focus is on the individual employee (or candidate), measuring their physical abilities (strength, reach, range of motion), and matching their individual capabilities to the demands of work tasks.  This is accomplished by conducting a Functional Job Analysis and Pre-Work Screening to match the results to Functional Job Descriptions.

It requires an investment in performing tests on each employee and the time to match them to the physical demands of a task.  This practice was in favor in the 1960’s through the early 1980’s but appears to be waning.  It is our experience that 15 to 30 percent of U.S. companies still practice this approach. Companies in which manual material handling and field tasks are common typically have these programs in place.

Physical therapists can provide valid test methods to help match the capabilities of an individual to the physical requirements of a task.

5.     Fix the Person: When people experience an MSD or sprain/strain injury, they must be diagnosed and treated, and then managed in their return to work.  This is medical management, a reactive program to reduce the losses due to injuries that have already occurred.  The need for good medical management is totally dependent on the exposure to MSD risk factors in the workplace and the effectiveness of the ergonomics, fitness and job placement programs in place.  A medical management program is best supported by health care providers (nurses and doctors) qualified in occupational health.

So, how does your organization manage MSDs?

What approach or approaches do you use?

What has worked for you and what hasn’t?

What changes have you made to improve management of MSDs?

About Walt Rostykus

Walt Rostykus is a vice president with Humantech Inc., a consulting firm that combines the science of ergonomics with the company’s unique 30-Inch View® to deliver practical solutions that impact safety, quality, and productivity.

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1 Comment
  1. Randy Klug

    April 27, 2012

    In regard to item #3, changing how the person performs the task, I think the relationship between behavior and Item #1 often may be missed. In my experience, often how someone “behaves” in regard to performing their job, has more to do with the work and the workplace than the person. A behavioral observation of at risk posture may not involve choice on the part of the person, but rather points to a workplace barrier to taking the proper precaution. The observed behavior is the beginning of the problem solving process not the end.

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