Five Common Management Approaches

No matter what you call them, cumulative trauma disorders, repetitive motion injuries or musculoskeletal disorders (MSDs), softtissue injuries continue to be a major cause of loss in today’s workplace. In 1713, Ramazzini (trans. 1964) made one of the first published mentions of these types of injuries as “diseases of those who do fine work.” In 1917, Hamilton (1943) described a disorder called “dead fingers” affecting stone cutters using air hammers to cut and shape limestone, one of the first published recognitions of the effects of vibration on soft tissue. MSDs have continued to affect workers over time. In the mid-1980s, safety professionals and employers realized that MSDs (a common term used in the U.S. for such injuries) were an increasing issue and began implementing controls. It is interesting to note that the terminology for MSDs is not universal. Boocock, Collier, McNair, et al. (2009), reviewed literature from 15 countries and found that the terminology used to describe MSD conditions in upper extremities lacked international consensus, which can add challenges when managing these disorders across global organizations. Fortunately, the risk factors that cause MSDs, primarily awkward posture, high force, and long duration and/or high frequency (Figure 1, p. 36), are well known, and a substantial body of credible epidemiological research provides evidence of these associations (NIOSH, 1997a; b). Although the limits for each of these risk factors vary by joint structure (e.g., shoulder, wrist, back), increasing combinations of these factors are tied to the increased risk of developing an MSD (NIOSH, 1997a; b). This evidence-based cause-and-effect association provides a reliable basis for effective MSD management. In recent benchmarking studies, employers indicated that MSDs account for 24% to 75% of their recordable injuries (Humantech, 2011). Further investigation reveals that the strategies used to manage these injuries range widely from reactive to proactive, and are based on various approaches, including changing personal wellness, fitness and employee work behaviors, and changing the workplace to better fit employee capabilities. IN BRIEF •Strategies used to manage musculoskeletal injuries range widely from reactive to proactive, and are based on various approaches, including changing personal wellness, fitness and employee work behaviors, and changing the workplace to better fit employee capabilities. •This article summarizes five commonly used approaches by examining the pros and cons for each, and the investment needed and value returned of each. Their effectiveness and application in industry are reviewed as well.