By: George Matos, CAT(C), CSEP-CPT, RCRT, BA Kin

Musculoskeletal Injury Prevention Specialist

Occupational & Environmental Health & Safety – HSC Unit
Musculoskeletal Injury
 Definition: Injury or disorder of the muscles, tendons,
ligaments, joints, nerves, blood vessels or related soft
tissue
 Can be a sprain, strain, inflammation
 Referred to as an RSI
Musculoskeletal Injury
 Caused or aggravated by:
 Repetitive Motion
 Repetitive Exertion
 Mechanical Compression
 Sustained Positions
 Awkward Positions
 Limitations on Motion or Action

What are Typical MSK Risks

 Force
 Fixed Postures  Cold/Hot Temps
 Awkward Postures  Work Organization
 Gripping  Work Methods
 Repetition
 Vertebral Disc
The inter-vertebral discs lie
between the vertebral bodies,
separated from them by a thin
cartilaginous endplate and
consisting of two main regions,
the nucleus pulposus and an
outer, firm, collagenous
annulus fibrosus

The role of the inter-vertebral

discs is mechanical. They are
the joints of the spine,
enabling it to bend and twist in
all directions.
Stages of a • Perform daily as an
aid to help
prevent/reduce disc
Disc Injury injury
End Plate Injury
 Muscle Injury

 Muscles run in segments

 Some from shoulder blade to
base of skull
 These muscles may become
easily over loaded
 Median
Nerve
Squeezed in
Carpal
Tunnel
 “Tennis Elbow”
Lateral Epicondylitis
The Progression of MSK Injuries

 Stage 1 - Aches and Tiredness

 During work hours, but settle overnight

 Stage 2 – Discomfort Early in Work Shift

 Does not settle over night

 Stage 3 – Pain
 Persists at work, home, rest, and disturbs sleep
Body Mechanics
Spinal Curves
 Back can absorb 10x
more shock when
curves are neutral
 Cervical – ears over
shoulders
 Thoracic – limited by
rib attachments
 Lumbar – iliac crests
over pelvic rami
Neutralize Postures

 Cervical Spine
 Ears over shoulders
Neutralize Postures

 Lumbar Spine
 Shoulders above Hips
Neutralize Postures

 Wrists
 Flexion – 0º
 Extension – 0º
 Ulnar Deviation – 0º
 Radial Deviation – 0º
 Pronation/Supination - 0º
(for sustained work)
 Active Abdominals
 Helps support your
back
 Makes you stronger!
 Bring stomach IN
slightly & contract
like you are
TIGHT
SOFT coughing
 Remember to
breathe!
 Contract BEFORE
moving and HOLD
until finished
Power Position
Description
 Pelvis is ½ flexed,
or tilted
 Buttocks out
 Knees and hips
flexed
Results
 Keeps the curves
 Keeps the work in
the legs
 Applying Power Position
Rounded Back Straight Back

POOR POSTURE WHEN WORKING ON EQUIPMENT CAN

LEAD TO OVERUSE INJURIES. ALTHOUGH NOT ALWAYS
ATTAINABLE, TRYING TO ESTABLISH A NEUTRAL SPINE
WHEN POSSIBLE DOES REDUCE THE RISKS
Power Range
 Between elbow height
and shoulder height
 Neutral – elbows at 90º
 Close Work – 6” Above
 Heavy Work – 6” Below
 Adjust your body to level
of work, or adjust you
work to the proper level
Force - Lifting
 NIOSH recognizing the 51lbs
to 90% male workers 75%
female workers
 Frequency will lower this limit
 Get help when required
 Best to ensure a good grip
 Try to keep levels between hip
and chest level
 Break larger loads into
smaller, lighter loads.
Proper Use of Equipment
• Whenever
possible, reduce
the amount of
“hands-on” and
use the
mechanization of
the process.
Basic Principles to Lifting
 Size up the load  Get a good grip

 Plan the job  Keep the load close

 Base of support  Lift with legs

 Bend your knees  Pivot, don’t twist

Force – Lifting and Reaching
“LIFT WITH YOUR LEGS”
…THEN WHAT?
Lowering
 Keep the load close
 Keep your knees
and hips flexed
 Keep your head up
 Tighten your
abdominals
 Ensure a good grip
Partial Squat Lift

• The same can be done with your

elbow if having to crouch lower

• Use the opposite

arm and hand to
help support your
back
Golfer’s Lift
• Even with good
posture, there is still
Straight Leg Lift
a risk for injury
• Always attempt to
keep the load close to
the body
• Turning the
hips/knees out allows
you to get closer
while keeping them
bent
• Work the load to the
lip of the trunk
before fully lifting it
out
 CAN YOU DO IT
WITH BOTH HANDS?
• When performing tasks
that normally require one
hand at a time, teach your
yourself to be
ambidextrous
• Being able to work
equally with both hands
can reduce will reduce the
chances of overuse
injuries
Sustained and Awkward
Positions
SAFE MOVING HABITS
 PLAN before you move an object
 How heavy is the object?
 Do you need help (equipment and/or person)?
 PUSH before you PULL before you LIFT
 Perform all movements in a CONTROLLED
manner
 No jerky or rapid movements!
 FOCUS on the TASK and use proper
techniques EVERY TIME
 Moving Equipment

Perform controlled motions as items can be harder to move than

anticipated, this can cause jarring at the back and shoulder
High Risk Positions:
Moving Equipment
 Keep elbows in front
of chest wall
 Centre trunk with
task
 Weight shift load
once secured
 Keep shoulders
relaxed
 Release tension from
jaw and neck
High Risk Positions: Repeated
Spinal Flexion
“I Picked Up A Pen Up Off The
Floor And My Back Went Out!”
Restricted & Confined Spaces
Ready Mix Drivers/
Operators
Reaching - High Risk Positions
 Regular reaching over
shoulder can contribute to
spasms at the neck and
shoulder
 Try to avoid or remove
obstacles between yourself
and the object to be
reached
 When required to place
body in forward position,
this can increase load on
the spine
If possible…ask for help!
 Concrete Chute Safe Handling
• Use gloves to reduce pinching
• Keep the chutes close to the
body
• Adjust height of flip chute,
attaching and disassembling
of extension chutes at waist
level
• Always turn the body and the
chute by stepping with the
feet
• Lift, carry and lower the chute
with constant speed
• If carrying chute on shoulder,
do so on both sides, otherwise
neck and shoulder injuries
may arise
 Myths & Misconceptions
 Back belts are not considered personal protective
equipment
 The use of back belts has not been proven to
reduce the risk of lower-back injury from
repetitive lifting
 Back belts do not significantly improve lifting
capacity
 Back belts have not been shown to remind
workers to use proper lifting techniques
 Back belts have not been shown to cause workers to avoid
heavy lifting
 Back belts were not originally designed for workplace
injury prevention, but rather for medical rehabilitation
purposes, and later adapted to specific weight-training
applications
 Myths & Misconceptions
“Have you seen my job? I do more than enough exercise at work
all day long, why would I go to a gym or exercise on my own?”
Positioning in
Standing
 Work at elbow height
 Footrests
 Anti-fatigue matting
 Cushioned soles
 Stools or sit-lean
stools
 Adjustable Platform
for Shorter Workers
 Stretching/Conditioning
At Work-Rest-Play
 Make it functional and do-able
 Stretch muscles in the opposite direction that work
demanded of them
 Focus on muscle groups stressed performing work
tasks
Job Specific Stretches
 Stretches and Movement
 SAID principle used in conditioning exercises for
athletes and individuals competing in sports.
 We need to apply the similar principles when
preparing our body for work…this may sound far
fetched but in fact necessary for reducing the chance
of aches and pains and sustaining long injury-free
careers.
S - Specific
A - Adaptations
I - Imposed
D - Demands
 References
Clin Biomech (Bristol, Avon). 2006 Feb;21(2):122-7. Epub 2005 Oct 7.
The mechanical effect of a pelvic belt in patients with pregnancy-related pelvic pain.
Mens JM, Damen L, Snijders CJ, Stam HJ.
Source
Institute of Rehabilitation Medicine, Erasmus MC, University Medical Center, P.O. Box 1738, 3000 DR
Rotterdam, The Netherlands. [email protected]

J Clin Nurs. 2009 Jun;18(11):1523-32. doi: 10.1111/j.1365-2702.2008.02749.x.

Effectiveness of maternity support belts in reducing low back pain during pregnancy: a review.
Ho SS, Yu WW, Lao TT, Chow DH, Chung JW, Li Y.
Source
The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong.

Adapted from the chapter on back belts by Stuart McGill in: “Ultimate Back Fitness and Performance”, Wabuno
publishers, 2004, Canada.