The Best Injury Is the One That Never Happens: A Proactive Approach to Workplace MSK Health
Employers can identify musculoskeletal risks earlier by evaluating job tasks, tracking worker discomfort and providing job-specific movement training.
- By Luba Chernov
- Sep 24, 2026
Optimizing a task. Stripped to its most rudimentary definition, that is what ergonomics is. As a physical therapist, I have spent years looking at the way people move, how they sit, lift, reach, carry and sometimes contort themselves to get a job done. As an ER nurse, I have also been the worker doing the lifting, reaching and contorting. For workers in physically demanding jobs, however, that analysis and optimization can mean the difference between a career cut short by pain and injury and one with a long, healthy trajectory. The trick is being proactive and not reactive in matters of musculoskeletal injury prevention. The numbers support the need to get ahead of these injuries. During 2023-2024, BLS reported more than 568,000 cases involving sprains, strains and tears and another 248,000 cases involving the musculoskeletal structures of the back that required days away from work.
The first step is understanding workflow. Analyzing and assessing the task that will be performed hundreds of times a day, postures that will be sustained for hours and awkward movement patterns that will be required to get the job done. Many employers maintain a Functional Job Description (FJD) or similar document outlining the physical demands of a position. The question is whether it accurately reflects how the job is actually performed today or simply exists as an administrative requirement. As a staff nurse, my functional job description stated that I was to lift 20-50 lbs. but nowhere did it specify that this object was a human being who had no handles and would occasionally resist the maneuver. That distinction matters. Which is where a Physical Demand Analysis (PDA) comes in, a document which further breaks down the task into components taking into account forces, joint angles, time requirements, height variability and repetitions. These are not arbitrary measures. NIOSH identifies force, repetition and posture among the physical stresses associated with work-related musculoskeletal disorders, with risk influenced by the intensity, frequency and duration of exposure. Ideally, both documents are thorough and up to date. There is no shortage of high-tech methods of workflow analysis, from 3-D motion capture to wearable sensor suits. Involving a seasoned set of eyes is important from the start, a clinician that not only performs the analysis but ties the results to potential injuries, assists with ergonomic modifications and develop job specific movement programs for injury mitigation.
Track the Signals Before They Become Injuries
Another piece to staying ahead of worker incidents is tracking and trending injury data. Are workers reporting their injuries and is there regular monitoring and follow up when a problem occurs? When a worker sustains an injury what is the investigation like? Is there an in-person, non-punitive, conversation along with a recreation of the event? Where there is one injury there is a potential for others without a true understanding of the mechanism. The data should also be examined for patterns: Are complaints clustering around one task or body region? Are they occurring late in a shift, after overtime or among newer workers? Reports of discomfort and near misses may provide an opportunity to intervene before a more significant musculoskeletal injury occurs.
Build Capacity for the Work
Back to being proactive, while we have no control of anthropometric characteristics such as height or limb length, we can design a job specific strength and movement program tailored to the results of the PDA. A program done throughout the workday for a quick stretch to break up sustained postures as well as home exercises to develop strength in key areas. Conditioning should complement, not replace, efforts to eliminate or reduce unnecessary ergonomic hazards. A collective groan is often heard when you tell people to start doing squats at home. It ranks right up there with drinking the gallon of Golytely before a colonoscopy. Exercise can be a tough sell, but if the incentive of being pain-free at work is not enough of an uptick how about the promise of better overall function? This same set of exercises will help to feel better playing with your kids or grandkids, be more comfortable grocery shopping and walk for longer in the park. The PT in me will also tell you that strength training has a place across the working lifespan, but particularly for workers whose jobs require them to bend, lift and carry throughout the day.
Move Beyond the Body-Mechanics Handout
Body mechanics education has long been a component of workplace safety programs. We have all seen the figure in wide stance, holding a box close to their chest and bending at the knees. I wonder if that image has ever stopped an injury or lead a worker to reconsider their movement patterns? If it were only as simple as giving people a handout, Physical Therapy would go bust. As someone who has spent decades reeducating patients on faulty mechanics, it takes time and ongoing reinforcement to change postural habits and movement patterns. Observation, practice and feedback in the actual work environment can make that education more relevant than a one-time handout or annual training module.
A Four-Part Preventive Approach
- The preventative approach has 4 simple aspects:
- Workflow/task analysis injury data tracking and follow up
- Job-specific conditioning and movement breaks
- Ongoing postural and movement education
The goal is not simply to respond better once an injury occurs. It is to recognize risk earlier and create work that people can perform safely over the course of a career. Analyze the work before someone gets hurt. Listen when workers report discomfort. Use injury data to identify patterns. Reduce unnecessary physical demands where possible and prepare workers for the demands that remain. The best time to address a musculoskeletal injury is not when it appears on an incident report. It is before it happens. Healthy worker, healthy company, the upside of getting prevention right is reduced turnover, better morale and a workforce built for longevity.