The only way to prevent something is to know what caused it, understand what caused it and then systematically eliminate those causes.

This is a foundational lesson because it is so vitally important that you understand what causes MSDs. This is where we see safety leaders get mixed up, and then spend precious resources trying to fix a problem they don’t fully understand.

Keep this in the back of your mind as you learn about the causes of MSDs: your prevention strategy is to eliminate these causes. Your goal is to identify MSD causes in your workplace and put control measures in place to lower, and hopefully eliminate, these causative risk factors.

The Cause of MSDs

The work environment is a complex set of systems and the human body is a complex set of systems. MSDs happen at the intersection of these systems, and so it won’t surprise you that there are many causative risk factors that can lead to the formation of MSDs.

We break these risk factors down into two categories in order to simplify the issues at hand:

1. Ergonomic Risk Factors (risk factors related to the work environment)
2. Individual Risk Factors (risk factors related to the individual themselves)

When workplace athletes are exposed to these risk factors over the course of time, it puts a tremendous amount of stress and strain on their soft tissues. An MSD is formed when this “wear and tear” outruns the workplace athlete’s normal soft tissue recovery process.

Reactive Ergonomics

A reactive ergonomics philosophy allows workplace athletes to be exposed to ergonomic risk factors.

The three primary ergonomic risk factors are:

• High task repetition: Many work tasks and cycles are repetitive in nature, and are frequently controlled by hourly or daily production targets and work processes. High task repetition, when combined with other risks factors such high force and/or awkward postures, can contribute to the formation of MSD. A job is considered highly repetitive if the cycle time is 30 seconds or less.
• Excessive Force: Many work tasks require high force loads on the human body. Muscle effort increases in response to high force requirements, increasing associated fatigue which can lead to MSD.
• Awkward Postures: Awkward postures place excessive force on joints and overload the muscles and tendons around the effected joint. Joints of the body are most efficient when they operate closest to the mid-range motion of the joint. Risk of MSD is increased when joints are worked outside of this mid-range repetitively or for sustained periods of time without adequate recovery time.

Other ergonomic risk factors include:

• Vibration
• Contact stress
• Cold temperatures

Reactive Healthcare

A reactive healthcare philosophy allows workplace athletes to be exposed to individual risk factors and only provides help after an injury occurs.

The primary individual risk factors are:

• Poor work practices: Workplace athletes who use poor work practices, body mechanics and lifting techniques are introducing unnecessary risk factors that can contribute to MSDs. These poor practices create unnecessary stress on their bodies that increases fatigue and decreases their body’s ability to properly recover.
• Poor self-care habits: MSDs develop when fatigue outruns the workplace athlete’s recovery system, causing a musculoskeletal imbalance. Workers who do not properly warm-up for work or get adequate rest and recovery after work put themselves at a higher risk of developing an MSD.
• Poor health habits: Workers who smoke, drink excessively, are obese, or exhibit numerous other poor health habits are putting themselves at risk for not only musculoskeletal disorders, but also for other chronic diseases that will shorten their life and health span.

Ed’s MSD Story

Behind every number at the end of the injury column is a story.

This is Ed’s story.

Before founding Ergonomics Plus, Mark Middlesworth worked at an outpatient rehab facility. And in 1989, that’s where he met Ed.

Unfortunately, Ed had been on quite a journey over a 10-year period leading up to the time they met.

He sustained an initial lower back strain from manual lifting at work which limited his function, requiring medical evaluation and treatment because he couldn’t continue to perform his job. The treatment consisted of pain medication and time off work. He returned to work without rehab or any of the causative risk factors being addressed.

Over the course of the next 10 years, Ed sustained multiple recurring lower back injury incidents. Each time, he would be treated the same way with meds, rest, and case management designed to get him back to work as soon as possible. So, after each episode he returned to work without rehab and consequently developed progressively diminished strength and functional capacity. At the end of this 10 year period, he sustained another injury to his lower back while lifting at work. This time, it was the last straw – one of the discs in his lumbar spine had finally herniated and rendered him incapable of even walking out of the facility. He was transported by ambulance to the local hospital, stabilized, evaluated by the company physician and then referred to a neurosurgical specialist.

The neurosurgeon recommended surgery. After surgery, Ed’s pain worsened and it was (after 6-8 weeks) finally determined that he had developed a serious infection in his back. Four months later, Ed was referred to rehabilitation and work hardening where he met Mark for the first time.

According to Mark, “There was not much we could do for him at that point. We gave it a shot, but in the end he just couldn’t tolerate a rehab program at that point. He ended up on social security disability.”

What was the cause of Ed’s journey that resulted in multiple injuries, painful surgery, and a disability?

Reactive ergonomics: The company Ed worked for had a reactive ergonomics philosophy. Ergonomic risk factors were left unchecked and Ed was exposed to these risk factors over a long period of time.

Reactive healthcare: The company Ed worked for also had a reactive healthcare philosophy. HR was all about aggressive case management as the primary method to contain costs. They only got Ed help after he was already injured, but by then it was too late. Also, Ed would also be the first to tell you that his poor health habits and work practices were part of the problem. He was a smoker and considered his time at work to be his “fitness routine”, and so he thought he didn’t need anything on top of that for maintaining strength and conditioning or to maintain musculoskeletal balance and core strength. Therefore, he developed imbalances over time that ultimately led to significant core weakness and musculoskeletal dysfunction that led to recurring strain injury to his lower back.

The bottom line is that a reactive philosophy only leaves you with one outcome:more MSD stories like Ed. 

This can be prevented. After seeing too many people like Ed go through the rehab clinic, Mark decided to be in the prevention business, founding Ergonomics Plus and going on his own journey to discovering a world class process to prevent MSDs.

That leads us to Lesson 3 – How to Prevent Musculoskeletal Disorders (MSDs) where we’ll explore the key to MSD prevention and outline a simple prevention philosophy we’ve used with great success for over 25 years. Here’s a hint: prevention is proactive.