WORK-RELATED

MUSCULOSKELETAL
DISORDERS AND ERGONOMICS

DR. PRIYANKA RISHI (PT)

ASSOCIATE PROFESSOR
SGT UNIVERSITY
MY CAMPUS
MUSCULOSKELETAL SYSTEM
The musculoskeletal system (locomotor
system) is a human body system that
provides our body with movement, stability,
shape, and support.

It is subdivided into two broad systems: 

•Muscular system, which includes all types

of muscles in the body. Skeletal muscles, in
particular, are the ones that act on the body
joints to produce movements. Besides
muscles, the muscular system contains the
tendons which attach the muscles to the
bones.

•Skeletal system, whose main component is

the bone. Bones articulate with each other
and form the joints, providing our bodies
with a hard-core, yet mobile, skeleton.
 MUSCULOSKELETAL DISORDER

Musculoskeletal Disorders or MSDs are

injuries and disorders that affect the
human body’s movement or
musculoskeletal system (i.e. muscles,
tendons, ligaments, nerves, discs, blood
vessels, etc.).

It is not an acute injury, rather a chronic

disease which develops over time.
MDS is related to manual tasks
It has been recognized as a source of
significant pain, disability and disadvantage
for the injured person and a substantial
burden on modern societies.
Statistics suggest that more than 30% of all
occupational injuries are musculoskeletal
injuries associated with manual tasks (Straker
et. al. 2004).
 MUSCULOSKELETAL DISORDER
 The World Health Organization (WHO), recognizing the impact of ‘work-
related’ musculoskeletal diseases, has characterized WMSD s as
multifactorial, indicating that a number of risk factors contribute to and
exacerbate these maladies (Sauter et al., 1993).
 The presence of these risk factors produced increases in the occurrence of
these injuries, thus making WMSD s an international health concern. These
types of injuries of the soft tissues are referred to by many names, including
WMSD s, repetitive strain injuries (RSI), repetitive motion injuries (RMI),
and cumulative trauma disorders (CTDs) (McCauley Bush, 2011).
COMMON MUSCULOSKELETAL
DISORDER
SOME AMAZING FACTS
 The average person working at a keyboard can perform 50,000 to 200,000
keystrokes a day

 Overexertion & falls are the most common cause of workplace injury.
 An average of 125,000 back injuries due to improper lifting each year.
 Muscles overuse results in tiny tears in the muscles and scarring; these contribute
to inflammation and muscle stiffness
MUSCULOSKELETAL DISORDER
 Other common names for MSDs are “repetitive motion injury”, “repetitive stress
injury”, “overuse injury” and many more.
 The problem with using that kind of terminology is that it implicates a singular cause
for damage to the musculoskeletal system – repetition and stress. This is limiting
because more and more research is pointing to multiple causative risk factors leading
to MSDs.
 When a worker is exposed to MSD risk factors, they begin to fatigue. When
fatigue outruns their body’s recovery system, they develop a musculoskeletal
imbalance. Over time, as fatigue continues to outrun recovery and the
musculoskeletal imbalance persists, a musculoskeletal disorder develops.
 These risk factors can be broken up into two categories:
1. work-related (Ergonomic) risk factors
2. Individual-related risk factors.
 WHY ERGONOMICS?
 To reduce the risk of
•Accidents
•Injury
• Ill health due to poor ergonomics
 Reduce Sickness absence / Costs
 Increase Performance / Output
Everyone in any organization is at risk and it is not just “heavy” or “physical” jobs that
cause injury So our aim should be
FEEL BETTER , WORK SMARTER
ERGONOMICS
 DEFINITION
 Ergonomics is the science and the
art of fitting the job and the
workplace to workers’ needs.
 It is the study of work.
 It is a way to make jobs/tasks fit
the employees better.
 It is a way to make work easier.
The International Ergonomics Association
defines ergonomics-

“Ergonomics (or human factors) is the scientific discipline

concerned with the understanding of interactions among humans
and other elements of a system, and the profession that applies
theory, principles, data and methods to design in order to optimize
human well-being and overall system performance.”
Its potential results:

greater productivity,
heightened morale, and reduced
compensation for work-induced injuries.
 ERGONOMICS - OBJECTIVES
 To improve the relationship between people , equipment ,
workplace, and the environment.
 Increase work efficiency and productivity.
 Promote safety and comfort at work station.
 To reduce physical work loads.
 To minimize the risk of injury , illness , accidents and errors
without compromising productivity.
 The study of ergonomics enables a person to know how to
provide safety for a worker and his environment.
 Realize how to eliminate or reduce injuries
 Know how to stretch and warm up
 Improve quality of life
 BENEFITS OF ERGONOMIC
PROGRAM
 Reduce worker discomfort.
 Improve & increase general health
awareness.
 Improve morale

 Reduce fatigue related costs

 Decrease errors and product defects

 Decrease time required to perform

tasks
 Financial savings. (cost saving
associated with injury)
FACTORS AFFECTING ERGONOMICS

 Workstation design- desk, chairs, space, layout.

 Work posture- sitting, standing, reaching, lifting.

 Work organization- pace, breaks, variety.

 Tools, equipments and furniture design- body size,

height, gender, promoting neutral postures, exposure to
acceptable lighting, noise and temperature.
 Manual material handlings- lifting, pulling, pushing,
carrying and holding material.
 Work environment- ventilation, noise, temp. humidity,
lighting and vision.
FACTORS AFFECTING ERGONOMICS

This are differences in size, shape,

strength and ability of individual
workers. This differences call for
different designs in equipment ,
furniture, Workstations and
routines.
1. The Human Factor
• People are different
 Biological :everyone has their limitations
 Shapes and sizes  Tall and short
 Congenital defects, vision, hearing
 Emotional & physical stress  Educational level
 Physical restrictions
 Behavioral: People have predictable reaction
 Attitude  Lifestyles
 Job satisfaction or employer relationships
 Time pressures (stress) ( No time for stretching, breaks, lunch)
 Work culture  Interaction with co-workers
 Personal problems
 Lifestyle influences
 Obesity
 Lack of physical fitness
 Age and gender
 Leisure/hobbies/sports
 Smoking
 Medical/psychological factors
 Previous injuries & illness
 Stress
2. Environmental Factors
 Heat- Effects blood circulation & causes cramps, burns/rashes and general
discomfort
 Cold - Effects the body’s blood circulation, causes hypothermia, loss of flexibility,
distraction.
 Lighting- Poorly lighted areas contribute to trip and fall hazards and poor
coordination .
- Under and over lighted areas can cause- Headaches, muscle strains, fatigue and eye
strain.
ERGONOMIC PRINCIPLES:
1. Work activities should permit worker to adopt several different healthy and safe
postures.

2. Muscle forces should be done by the largest appropriate muscle groups available.

3. Work activities should be performed with joints at about mid-point of their ROM
(esp. head , trunk , UE)
 10 MAIN PRINCIPLES OF ERGONOMICS

 Principle-1: Work in Neutral Postures

Our spinal
A. Maintain the "S-curve" of the spine column is
Our posture provides a good starting point shaped more
for evaluating the tasks that you do. The best or less like
positions in which to work are those that an "S."
keep the body "in neutral."
 It is important to maintain the natural S-curve of the back,
whether sitting or standing. The most important part of this
"S" is in the lower back, which means that it is good to keep
a slight "sway back," When standing, putting one foot up on
a footrest helps to keep the spinal column in proper
alignment.
 Principles of Ergonomics Working for long
periods with your back in a “C- curve” can
place strain on your back.
 Good lumbar support is often helpful to
maintain the proper curve in the small of
your back.
 The “Inverted V-curve” creates an even greater
strain on your back. Even without lifting a load,
bending over like this creates a great deal of
pressure on the spine. One common improvement
is to use a lifter or tilter. Or there may be other
ways of making improvements depending upon
the situation
 Principle-1: Work in Neutral Postures
B. Keep the neck aligned
- The neck bones are part of the spinal column and thus are subject to the same
requirements of maintaining the S-curve. Prolonged twisted and bent postures of the
neck can be as stressful as its equivalent for the lower back.

-The best way to make changes is usually to adjust equipment so that your neck is in its
neutral posture.
 The neutral posture for your arms is to
keep you elbows at your sides and your
shoulders relaxed. This is pretty
obvious once you think about it, but we
don’t always do it. 
 Principle-1: Work in Neutral Postures
C. Keep elbows at sides
Here’s an example of changing a workstation to get the arms
in neutral. In the illustration at the left, the product is too
high, and the employee is hunching her shoulders and
winging out her elbows. In the right-hand illustration, the
product has been reoriented and the shoulders and elbows
drop to their relaxed position.

Here’s an example of changing a workstation to get the arms

in neutral. In the illustration at the left, the product is too
high, and the employee is hunching her shoulders and
winging out her elbows. In the right-hand illustration, the
product has been reoriented and the shoulders and elbows
drop to their relaxed position.
 Principle-1: Work in Neutral Postures
D. Keep wrists in neutral
A slightly more accurate approach is to keep your
hands more or less like they would be when you
hold the steering wheel of your car at the 10 and 2
o’clock position — slightly in and slightly forward.
 Principle-2: Reduce Excessive Force
Excessive force on your joints can create a potential for fatigue and injury.
In practical terms, the action item is for you to identify specific instances
of excessive force and think of ways to make improvements.
 For example, pulling a heavy cart might create
excessive force for your back. To make
improvements it might help to make sure the
floor is in good repair, that the wheels on the
cart are sufficiently large, and that there are
good grips on the cart. Or a power tugger
might be needed.
 Principle-3: Keep Everything in Easy Reach

This principle deals with keeping things within easy reach. In many ways, this
principle is redundant with posture, but it helps to evaluate a task from this specific
perspective.  
 Principle-4: Work at Proper Heights

Working at the right height is also a way to make things easier 

 Principle-5: Reduce Excessive Motions

 The next principle to think about is the number of motions you make
throughout a day, whether with your fingers, your wrists, your arms, or your
back.
 One of the simplest ways to reduce manual repetitions is to use power tools
whenever possible.
 Principle-6: Minimize Fatigue and Static Load 

 Holding the same position for a period of time is known as static load. It
creates fatigue and discomfort and can interfere with work.
 Principle-7: Minimize Pressure Points
 Another thing to watch out for is excessive pressure points, sometimes
called "contact stress."
 Leaning your forearms against the hard edge of a work table creates a
pressure point. Rounding out the edge and padding it usually helps.
 A good example of this is squeezing hard onto a tool, like a pair of pliers.
Adding a cushioned grip and contouring the handles to fit your hand
makes this problem better
 Principle-8: Provide Clearance
 Work areas need to be set up so that you have sufficient room for your head,
your knees, and your feet. You obviously don’t want to have to bump into
things all the time, or have to work in contorted postures, or reach because
there is no space for your knees or feet.
 Equipment should be built and tasks should be set up so that nothing blocks
your view.
 Principle-9: Move, Exercise, and Stretch
To be healthy the human body needs to be exercised
and stretched.
 Depending upon the type of work you do,
different exercises on the job can be helpful. If
you have a physically demanding job, you may
find it helpful to stretch and warm up before any
strenuous activity. If you have a sedentary job,
you may want to take a quick "energy break"
every so often to do a few stretches.
If you sit for long periods, you need to shift postures: Adjust the seat up and down
throughout the day. Move, stretch, and change positions often.
 Principle-10: Maintain a Comfortable Environment
 This principle is more or less a catch-all that can mean different things depending
upon the nature of the types of operations that you do.
 Lighting and Glare- One common problem is lighting. –
- In the computerized office, lighting has become a big issue, because the highly
polished computer screen reflects every stray bit of light around. But many other types
of tasks can be affected by poor lighting, too. Concerns include glare, working in your
own shadow, and just plain insufficient light.
 JOB RISK FACTORS
 Working in awkward postures / positions
 Prolonged sitting and standing
 Bending, reaching, stretching
 Driving for extended periods of time
 Heavy lifting
 Illumination
 Awkward lifting
 Lifting in combination with twisting
 Pushing, pulling, carrying
 Accidents, slips, trips, falls
 Vibration & Noise
 Repetition
 Contact Stress
 Thermal Condition 
 Two classifications of ergonomic injuries
1. Cumulative Trauma Disorders (CTD’s) –
Cumulative Develops gradually

Trauma Damage from stress

Disorder Physical impairment,

Abnormal condition

 Injury to soft tissue caused by prolonged exposure to

multiple ergonomic risk factors.
 Typically develop in small body segments (i.e. fingers,
wrists, elbows, and neck)
Examples of CTD’s
 Tendon disorders:

- Inflammation of tendon and/or tendon sheathing caused by

repeated rubbing against ligaments, bone, etc.
- Lateral epicondylitis (tennis elbow)
 Nerve disorders:
- Compression of nerves from repeated or sustained exposure to
sharp edges, bones, ligaments, and/or tendons.
- Carpal tunnel syndrome
 Neurovascular disorders:
- Compression of blood vessels and/or nerves from repeated
exposure to vibration or cold temperatures
- Raynaud’s phenomenon (white finger syndrome)
 Types of Injuries
 Muscle pain
 Joint pain
 Swelling
 Numbness
 Restricted motion
 Repetitive stress injury
 Repetitive motion injury
 Cumulative trauma disorder
 Musculoskeletal disorder
2. Strains/Sprains – instantaneous (event driven)-
 Injury to connective tissue caused by single forceful event: lifting
heavy objects in awkward position.
 Common to large body segments (i.e. back, legs, and shoulders)
 Risk of injury increases with the presence of multiple risk factors 
 Body Parts Prone To Workplace Musculo –Skeletal Disorders-
 Back - Lower
 Neck and Upper Back
 Upper Extremities - Arms and Hands
 Lower Extremities - Legs and Feet 

 Signs and Symptoms

 Decreased ROM
 Decreased grip and/or pinch strength
 Swelling  Fatigue  Loss of function
 Numbness  Burning sensation  Tingling
 Pain  Cramping  Stiffness
ERGNONIMICS APPROCHES
 Body Mechanics
 Proper Lifting Techniques

 Exercise

 Stretching

 Improved postures 
 Benefits of Ergonomics

Quality of Work Safety

Risk of WSMDs Fatigue Errors

MAINTAIN NEUTRAL POSTURE

 Maintain erect position of back & neck w/ shoulders

relaxed
 Position equipment & work directly in front of and close
to your major tasks
 Keep upper arms close to the body, elbows 90-100
degrees
 Keep feet flat on floor, upper body weight resting on
“sits bones”
 Wrists as neutral as possible; safe zone for wrist
movement is 15 degrees in all directions
 USE CORRECT BODY MECHANICS
 Use the largest joints & muscles to do the job
 Use 2 hands to lift rather than one, even with light objects and tasks.
 Avoid lifting with the forearm in full pronation (palm down) or supination (palm
up)
 Slide or push & pull objects instead of lifting
 Keep reaching to a minimum
 Carry objects close to body at waist level
Incorrect & Correct Techniques
ADVANTAGES
 The  benefits  of applying ergonomic principles:
- Maximize productivity, efficiency and quality;
- Reduce MSD risk by eliminating or minimizing   ergonomic risk factors;
- Improve employee morale; and
- Cost savings associated with injury-related   absenteeism, treatment, new hire
training and   WCB claims.
 It can help you do work safely.
 It can make you more comfortable
 It can prevent injuries
 Reduce worker fatigue; and
 Improve worker morale. 
THANK YOU