Preventing Devastating Repetitive Stress Injuries in the Workplace

By: Kristen Cederlind, OTR/L, Contributor

In a world where there is an unprecedented labor shortage and more employees seem to be going than coming, it is crucial to keep the employees you do have. But, more than just retaining these employees, you need to keep them healthy, productive and injury-free. You can accomplish that by enhancing your workplace safety programs.

It’s not surprising that repetitive stress injuries (RSIs) are the fastest growing category of workplace injuries. Caused by repetitive movement and overuse, RSIs can result in debilitating pain and loss of function in performing even simple tasks.

RSIs usually develop gradually, but their impact can be long-lasting. Early signs may include muscle fatigue and soreness, episodes of numbness or tingling, or joint stiffness. Unaddressed, symptoms will progress to where pain and inflammation cause severe impairment. RSIs most commonly occur in the upper extremity joints—hands, wrists, elbows and shoulders. However, they can also affect the neck, back and lower extremity joints. These injuries can be devasting and, at worst, can negatively impact work productivity and even basic daily activities at home.

Knowing Where Workers are Vulnerable

Job tasks particularly vulnerable to RSIs include assembly line work, data entry or other computer use, warehouse/store inventory stocking, lab-type work, operating heavy machinery or power tools, and driving. Management of RSIs often includes anti-inflammatory drugs, physical therapy, ergonomic interventions and sometimes even surgery.

RSIs are part of the broader category of musculoskeletal injuries, which represent upwards of 30% of all workers’ compensation claims and cost employers $20 billion annually in direct costs, including benefits and legal costs. One reason these types of injuries are so costly is they take a long time to heal. Indirect costs are estimated to be four-five times that of direct costs, i.e., recruiting and training replacement workers; accident investigation; loss of productivity associated with absenteeism; and reduced employee morale. And that is just the impact on the employer. The long-term effects on the injured worker are distressing, with the loss of function, chronic pain, loss of wages, etc.—all of which can lead to depression and anxiety.

Let’s take a closer look at programs that can help prevent these catastrophic injuries from happening in the first place:

Functional Job Descriptions (FJD): A functional job analysis is the process of evaluating and objectively measuring the critical physical demands of a job. The analysis involves interviewing the workers who perform the job and supervisors who understand the job, and then observing and assessing aspects of the work and worksite to identify a job’s essential functions and critical physical demands. Data and measurements, such as weight, force, distance and repetitions, are collected and compiled into a document that is validated by the workers who perform the job.

The primary purpose of the FJD is to document and confirm the minimum physical requirements necessary to perform the job safely. Yet, in the process, it can often uncover potential ergonomic issues and risks that might eventually contribute to worker injury if not addressed. These risks can be filtered to ergonomics or safety teams for further assessment and elimination. The FJD can serve as the foundation for many workplace safety initiatives.

Ergonomics Assessments: An effective ergonomics assessment will help identify risks associated with RSIs. Risk factors, such as force/duration, repetition, awkward and/or sustained postures, or contact stress, are often contributing causes for RSIs. Whether the assessment was prompted due to a risk identified during job analysis or because of an injury that occurred, the most important part of the ergonomic assessment is the resulting action plan. Solutions may range from simple to complex. When possible, the goal is to mitigate the risk entirely, though that may not always be possible (at least initially). In any case, implementing measures, such as workstation adjustments or work process changes; job or task rotation; routine microbreaks to help counteract awkward or sustained postures or repetitive motion; or protective equipment (such as gloves or enlarged grip tools), can reduce the severity of the risk factor and improve safe task performance.

Onsite Physical Therapy Clinics: Onsite PT programs can provide immense value in identifying injury risks in the worker population and address work-related musculoskeletal symptoms—before they become injuries that impact people’s economic livelihoods. Onsite physical therapists provide job coaching that reiterates best practices for safe body positioning and movement and can consult on helpful workstation modifications. Workers can visit the onsite physical therapist to address minor aches and pains that can turn into those devastating injuries, if not dealt with early. In most cases, a combination of interventions—including OSHA first aid, employee education, ergonomic evaluation and job coaching—can lead to complete resolution of the worker’s discomfort. This proactive early intervention and support for the worker can change the trajectory of their future by mitigating the issue. An onsite physical therapist can also become a valued partner in ergonomics teams and safety programs by approaching ergonomics recommendations from a biomechanical and behavioral perspective.

Work Wellness and Fitness Programs: Providing workers with targeted education and resources to promote healthy movement and activity can positively impact their physical and mental well-being. Educating workers on the importance of movement, such as taking short micro-movement breaks throughout the day to offset sustained or awkward postures or engaging them in dynamic warm-up routines to prepare their bodies for work, can serve to promote blood circulation which, in turn, can help reduce risk for injury. Total employee wellness encompasses many aspects, including physical, spiritual, social, financial, occupational, emotional, intellectual and environmental health.

In the event an injury has occurred, several measures can be taken to help the worker restore physical readiness and prevent reinjury.

Work Conditioning: When there is a performance gap between the worker’s physical abilities after rehabilitation and the physical requirements of the job, a worker may benefit from work conditioning. Work conditioning is an intensive therapy program geared toward building the worker’s physical strength and functional abilities in relation to their documented job requirements.

Functional Testing and Return-to-Work Programs: Following treatment for injury, workers may need additional support to safely transition back to work. These programs may include return-to-work planning, fit-for-duty testing and/or Functional Capacity Evaluations (FCE). A team approach, with collaboration and open communication among the worker, supervisor and care provider(s), to modify work or set expectations for transitional work duties can be helpful. An FCE, performed by a PT or OT, is a comprehensive functional test designed to objectively evaluate the safe maximum functional abilities of a worker across a broad range of tasks. It is used to describe worker abilities and generate recommendations for return to work and is often used to assist in workers’ compensation cases, transitional duty or return to work placement, and disability determination cases.

Identifying, understanding and reducing work or worksite risks is truly the best approach to prevent repetitive stress injuries in the workplace. Implementing workplace safety programs that facilitate risk identification and reduction can go a long way in keeping workers safe and injury-free.

Occupational Therapist Kristen Cederlind currently serves as the Director of Clinical Services for WorkWell Prevention and Care.

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