PREVENTING
MUSCULOSKELETAL
INJURIES
Facilitator’s Guide
®
What’s Inside
1
Facilitator’s Guidelines
1-a
1-b
1-c
1-d
1-e
2
Overview
Getting Started
Presentation Guidelines
Lesson Plan
Frequently Asked Questions
Introduction
A successful ergonomics program can prevent musculoskeletal disorders.
3
What is Ergonomics?
Learn about the focus of ergonomics, what are musculoskeletal disorders
and what you can do to reduce your risks.
5
How the Body Functions
What are ligaments, muscles and tendons?
6
Upper Extremity MSDs
Causes and contributing factors of upper extremity MSDs.
7
Main Contributing Factors
Learn about the three main contributing factors: high force, excessive
repetitive movements and posture.
9
Signs and Symptoms
Early detection and recognition of MSDs.
10
Categorizing MSDs
The three categories of MSDs: tendon, nerve and neurovascular disorders.
12
Posture
The best posture puts the least amount of stress on the body.
14
Preventive Measures
Using the right tool for the job.
15
Problems & Solutions
Can you identify the problems and recommend solutions in these scenarios?
17
Summary
Review what you’ve learned.
19
Ergonomics Quiz
Test your knowledge of Ergonomics.
© 2004 Summit Training Source Inc.® All rights reserved. No part of this book may be reproduced in any form or by any
means without written permission from Summit Training Source® Inc. If you wish to purchase additional copies please call
our office at 1-800-842-0466.
Overview
Although the daily demands made on an employees’ body may seem
harmless, over time they can develop into significant injuries. This is
why it is so important to implement ergonomic principles on the job
site. Ergonomics is the study of the relationship between people, their
tasks, their equipment and their work environment. The objective is to
fit the job and tools to the worker, not the worker to the job and tools.
When the physical requirements of the job exceed the capacities of the
individual, Musculoskeletal Disorders can occur. Millions of workers
suffer from disorders caused by seemingly harmless risk factors found
in the work environment. An ergonomically correct workstation, using
proper posture and following best safety practices contributes to a safe
and healthy work environment.
Program Objective
This guide explains ergonomic risk factors and identifies the potential hazards
associated with developing Musculoskeletal Disorders. In it you will find:
• What are Musculoskeletal Disorders, or MSDs.
• Factors that cause MSDs.
• Measures that you can take to prevent their occurance.
© Summit Training Source, Inc.
1-a
Getting Started
Training Materials Collect all of the necessary materials
and supplies before training begins.
Here are some suggested materials
and supplies.
• A training location that is free of
distractions, has good lighting
and a comfortable temperature.
• Desks and chairs arranged so
that everyone will be able to see
the viewing screen, the facilitator
and each other.
• The video, a VCR and a TV with a
remote. Make sure the video
is rewound.
Preparation A successful presentation requires
preparation and planning. Give
yourself several days before the
training session to get organized.
• Locate and schedule the training
site as soon as possible.
• Notify trainees of the training
date and time, the training
schedule and proper dress.
• Obtain all necessary equipment
and supplies.
• Make sure you know how to
operate the TV, VCR and other
equipment. Check to ensure that
it is working properly. Replace
or repair any damaged equipment.
• Review all training materials,
including the Facilitator’s Guide,
handouts and any other
reference materials.
1-b
• An employee handbook and
pen / pencil for each trainee.
Each handbook includes a quiz
at the back, which can be used
to test comprehension and
document training.
• Other supplies and equipment
you may need - blackboard, chalk,
paper, handouts, transparencies,
overhead projector, markers,
notepads, etc.
• Additional information, such as a
copy of the regulation or other
reference tools.
• Prepare your presentation,
including a lesson plan or outline
of the training. Include the
training goals and objectives.
Some presentation guidelines
are included on the next page.
A sample lesson plan has been
included on page 1-d of this
Facilitator’s Guide.
• A day or so before conducting
the training session, you may
want to have participants take
the quiz as a pre-test. The results
of this test can help you to
determine weak areas to focus
on during the training session.
• Preview the videotape. Note any
key points you want to expand
upon in your training.
© Summit Training Source, Inc.
Presentation Guidelines
How you present the training course can have a great impact on
learning. By following these simple presentation guidelines and
keeping your objectives in mind, you can effectively and efficiently get
the most out of your training session.
Organize Training In today’s busy work climate, it can
Time Efficiently be difficult to find the time needed
for training. So, it is important to
be organized and well-prepared
when you do schedule training
sessions. Whether you use Summit’s
suggested Lesson Plan or not, it is
Stress the Purpose Training needs to be goal-oriented.
and Goals of Training State the purpose of training in a
clear, specific manner - whether it’s
to reduce injuries, increase production,
Capture Their Training needs to be interesting
Attention and compelling to hold trainees’
attention. To help motivate learners,
give them specific evidence that
their effort makes a difference and
provide feedback on their progress.
Also, remember that the first
Make New Learning For some adults, past experiences
Experiences Pleasant with education were unpleasant and
not helpful. Adults learn best when
they feel comfortable. By making
the learning environment open and
friendly, you can help adults to
Ask If There are When most adults learn new
any Questions information that conflicts with what
they already know, they are less
likely to integrate those new ideas.
It is very important to make sure
participants fully understand the
© Summit Training Source, Inc.
important to have a lesson plan
prepared that you can implement
comfortably. This ensures that time
spent in training is productive and
beneficial for everyone.
improve quality, improve working
conditions, etc. Review the goals and
objectives of the training so trainees
know what is expected of them.
experience with a new subject
usually forms a lasting impression
on the learner. By making that
experience a positive one, you can
help ensure your audience retains
the information learned.
feel secure in their new learning
experience. Offer support and feedback
as often as possible, and be ready to
provide extra attention to those who
may require it.
training and do not have any
unresolved questions. Provide for a
question and answer period so
participants can resolve those
questions and/or answer questions
throughout the training session.
1-c
Lesson Plan
As a qualified trainer, your job is to effectively communicate a great
deal of information in a well-organized manner. By preparing a lesson
plan, you can ensure that each minute of the training session is
productive. Summit has provided a suggested lesson plan for your use.
1. Introduce the Topic Research proves that audience
and Purpose retention is higher when programs
of Training are given a brief introduction before
viewing them. Prepare an introduction
that explains the reasons for training
and what will be taught.
2. Show the Video: "Preventing MSDs"
3. Discussion and To help relate the training to your
Demonstration site, you may wish to incorporate your
own discussion topics and exercises.
Key issues you might consider include:
• Musculoskeletal Disorders, what
causes them and possible risk factors
on your job site.
• Carpal Tunnel Syndrome.
• The science of ergonomics and
how it relates to employees on
your job site.
4. Use Handbooks to The handbooks increase comprehenReinforce Training sion and reinforce the information
learned in the video program by
explaining the main points and
expanding on the original material.
For increased employee information
5. Questions and Provide for a Q&A session to answer
Answers any questions. It may be necessary to
review some of the material when
1-d
• The benefits of ergonomically
organizing work areas.
retention, go over one section at a
time and stop to answer questions.
The quiz at the back of the
Facilitator’s Guide is provided to
document employee training. Answers
to the quiz are in bold type.
providing answers. The employee
handbook, equipment manuals and
other reference tools may be helpful.
© Summit Training Source, Inc.
Frequently Asked Questions
Why should I be
concerned about
developing a
Musculoskeletal
Disorder, or MSD?
At work employees may expose
themselves to many risk factors
which contribute to MSDs. Though
a task may seem harmless and does
not evoke immediate pain, over
time when preformed repeatedly
and combined with other stress
factors, permanent injury can result.
Carpal Tunnel Syndrome is an example
of a common MSD. This disorder does
not develop in a short period
of time, but only after repeated
exposure and strain. That is why it is
important for employees to recognize
the risks associated with MSDs in
their work environment.
How can the science
of ergonomics help
me to work safely?
Ergonomics is the study of the
relationship between people, their
tasks, their tools and their work
environment.
Employers study
ergonomics to fit the job and tools
to the worker. When the workers
adjust themselves beyond their
physical capacity to the requirements
of the job, they run the risk of developing a Musculoskeletal Disorder.
Ergonomically organizing your work
area can help you avoid risk factors
leading to MSDs.
How will I know if I’m
at risk for developing
an MSD?
Analyze the physical requirements of
your job and look for risk factors
associated with MSDs. Don’t wait
until you develop symptoms of an
MSD. Consider the risk factors that
may be present in your job function.
Are you working with excessive
repetition, static or awkward posture,
compression or force to complete the
required tasks? Check your posture
when sitting and standing, as well as
how your work area is organized. Most
importantly, notify your supervisor if
you have any concerns about developing
an MSD.
© Summit Training Source, Inc.
1-e
Introduction
A safe and healthy work environment is a top priority for industry
today. The fastest growing types of injuries and illnesses over the past
decade have been musculoskeletal disorders (MSDs). Over 1.8 million
workers suffer disabling injuries from MSDs each year.
The information in this training
program, “ERGONOMICS : Preventing
Musculoskeletal
Disorders,”
is
designed to educate you on:
• What are Upper Extremity MSDs
• The Factors That Cause Them
• Measures You Can Take to
Prevent Their Occurrence.
Ergonomics is the study of body
mechanics as related to job tasks. You
make thousands of body movements
every day. Most of them are so
routine you may not even be aware
of them.
Through an increased awareness
of how your body functions, an
under-standing of the causes of
musculoskeletal disorders and a
respect for the potential hazards, you
can help prevent injury to yourself.
2
A successful ergonomics program
requires a team effort of management, supervisors and you. Use the
information you learn to:
• Make Decisions Concerning
Your Body Mechanics
• Recognize Early Symptoms
of MSDs
• Effectively Communicate
Suggestions to Your Supervisor
Concerning Your Job Function
The goal is to eliminate musculoskeletal disorders from occurring in
your facility.
If you have questions, ask your
supervisor.
What is Ergonomics?
Ergonomics is the study of the relationship between people and the
work they perform.
There are many complex factors and variables involved in the science of
ergonomics research and design. They include:
Human Factors
Work Stations
Equipment
& Tools
Job Tasks
Environmental
Conditions
Anatomy, physiology, environmental
conditions, production requirements
and other factors are incorporated in
ergonomics decision making to put
the least amount of stress on the body.
What are Musculoskeletal
Disorders?
MSDs are injuries to the musculoskeletal and nervous systems caused by
excessive repetition, high force and
awkward positions.
Broken down to basics, it means . . .
fitting the job to the person, NOT
the person to the job.
3
What is Ergonomics?
(continued)
What can you do to reduce your exposure to the risk of MSDs?
By understanding how the body works and the causes of MSD symptoms,
you can:
• Effectively make decisions concerning your posture and body mechanics,
both on and off the job.
• Determine proper selection and use of tools and equipment.
• Effectively communicate suggestions to your supervisor concerning your job
requirements from an ergonomics standpoint.
4
© Summit Training Source, Inc.
How the Body Functions
A successful ergonomics program requires a respect for the potential
hazard and a team effort by management, supervisors and employees.
The upper extremities of the human body contain three major joints: wrist,
elbow and shoulder. Movement and strength at the three major joints are
provided by ligaments, muscles and tendons.
LIGAMENTS are strong fibers that
connect one bone to another to form
a joint. Their function is to bind the
bones and limit their range of motion.
MUSCLES create movement
contracting and expanding.
by
TENDONS are ropelike material that
is smooth, white and shiny. Tendons
connect muscles to bones. They do
not stretch or contract like muscles,
but simply transfer muscle movement
to the bone.
© Summit Training Source, Inc.
5
Upper Extremity MSDs
Unlike acute injuries, which are caused by a single incident such as
a fall that results in a broken wrist, MSDs are a culmination of a
number of incidents over an extended period of time.
Rotator Cuff
Tendonitis
Thoracic
Outlet
Syndrome
Medial
Epicondylitis
Tendonitis
Stenosing
Tenosynovitis
Trigger Finger
MSDs are injuries to the musculoskeletal and nervous systems.
The three main causes of MSDs are:
• High Force
• Excessive Repetitive Motions
• Awkward Posture or
Body Mechanics.
Another contributing factor is poor
physical condition of the body.
Being overweight causes additional
fatigue to the body with each
6
Carpal Tunnel
Syndrome
Vibration
Syndrome
movement. The body has tremendous
recuperative powers, given proper
time to rest. Insufficient recovery
time for the muscles, nerves, tendons
and other parts can cause swelling
and tears.
Environmental conditions such as
exposure to vibration or cold
temperatures also place additional
stress on the body.
© Summit Training Source, Inc.
Main Contributing Factors
Using a particleboard shelf as an example of the effects of varying
amounts of force, let’s look at the three main contributing factors
of MSDs.
High Force
Most of us are familiar with the
effects of differing amounts of
weight (or force) on a board. There
is a weight, or level of force, at
one end of the scale that will cause
no damage.
There is an amount of weight, or
level of force, at the other end of the
scale that will break the board in half.
In between is a gray area where the
force does not cause immediate damage
but can build up over time, under
varying conditions, and eventually
bend or damage the board.
© Summit Training Source, Inc.
7
Main Contributing Factors
(continued)
Excessive Repetitive Movements
Tasks requiring high repetitive
motions require more muscle effort
and provide less recovery time.
Forces that are not strong enough
to cause fatigue and damage in a
single incident will, over time and
with excessive repetition, damage
the body.
Thinking of the board again, the
more the board is bent up and
down, the quicker it will weaken
and become damaged.
Posture
Using the board again, identical force
can be applied to the supporting
ends with no damage while the
same force applied to the middle can
easily deform the board. The same is
true for the body. Some postures and
body mechanics will wear out the
body quicker than others.
Though there are a number of scientific sounding MSDs, they all result from
a mismatch between the force applied, the frequency of the application and
the posture in which it was performed. The greater the number of contributing
factors involved, the greater the risk of developing MSDs. Consequently, the
more factors eliminated, the less risk for MSDs.
8
© Summit Training Source, Inc.
Signs and Symptoms
Be sure to inform your supervisor of any early signs or symptoms of
MSDs early to promote a safe and productive work environment.
If high force, excessive repetitive
movements and poor posture
persist in a daily work routine, you
may experience one or more of
the following signs or symptoms
which could indicate an MSD and
must be reported immediately.
• Pain in wrists, shoulders, forearms or knees
• Fingers or toes turning white
• Back or neck pain
• Stiffness
• Painful joints
• Painful tingling or numbness in hands or feet
• Shooting or stabbing pains in arms or legs
• Swelling or inflammation
• Burning sensation
© Summit Training Source, Inc.
9
Categorizing MSDs
MSDs can be categorized into three groups: tendon disorders, nerve
disorders and neurovascular disorders.
Tendon Disorders
Nerve Disorders
Tendon disorders can occur at or
near the joints where the tendon
rubs on nearby ligaments or joints.
Nerve disorders occur when repeated
or sustained activities expose the
nerves to external pressure from hard,
sharp edges or internal pressure from
nearby bones, ligaments or tendons.
Symptoms include a dull aching
sensation over the tendon, discomfort with specific movements and
tenderness to the touch. Rarely is
there noticeable redness or warmth
to the touch.
10
Symptoms include pain, numbness and
tingling sensations. These symptoms
may occur hours after the activity was
last performed and even during sleep.
© Summit Training Source, Inc.
Neurovascular Disorders
Neurovascular disorders involve the
nerves and nearby blood vessels. The
nerves and blood vessels become
compressed beneath the bones
and tendons. The nearby tendons,
ligaments and bones are deprived
of oxygen and nutrients.
Symptoms include numbness in the
fingers and hands. The arm may feel
as if it is going to sleep. The pulse at
the wrist may become weakened.
© Summit Training Source, Inc.
11
Posture
The best posture is one that places the least amount of stress on the
body. This is also referred to as the neutral zone.
The postures that place the least amount of stress on the body are:
• Arms below shoulder level
• Elbows close to the body without the forearms rotated inward or outward
OK
Forearms in
neutral position
12
AVOID
Forearms rotated
outward
Forearms rotated
inward
© Summit Training Source, Inc.
• Hands and wrists as natural extensions of the forearms. Avoid
repetitive actions that put the hands in extreme positions.
OK
Radial
Neutral
OK
Neutral
© Summit Training Source, Inc.
AVOID
Ulnar
AVOID
Extension
Flexion
13
Preventive Measures
The best way to reduce your risk of MSDs is to eliminate as many
contributing factors as possible. An example of how this can be
accomplished is with the decisions you make concerning the selection
of tools you use.
Excessive Repetitive Motions
versus
Awkward Posture or Body Mechanics
versus
High Force
versus
14
© Summit Training Source, Inc.
Problems & Solutions
Using the information you have learned, identify the problems and
provide what steps could be taken to reduce the risks of MSDs in the
following examples:
1
PROBLEM:
Flexion of the wrist.
Tool selection.
Position of area of activity in relationship
to the worker.
SOLUTION:
Reposition worker. Reposition the part
being worked on to prevent awkward
posture. Use a vertical grip screwdriver.
2
PROBLEM:
Awkward posture.
Area of forward activity.
Height of work station.
SOLUTION:
Reposition area of focused activity closer
to the worker. Adjust the height of the
work station. Seat the worker.
3
PROBLEM:
Person has to bend over and reach over
the side of the box.
SOLUTION:
Raise or tilt the box. Provide access by
cutting the side of the box. Train the
worker to bend at the knees.
© Summit Training Source, Inc.
15
Problems & Solutions
4
(continued)
Which power screwdriver would be the proper choice for this example?
A.
√
5
B.
PROBLEM:
Person has to raise arm above shoulder
level to load bottle in box.
SOLUTION:
Raise the worker and the box. Lower the
conveyor filled with bottles.
16
© Summit Training Source, Inc.
Summary
Fill in each blank with the word that best completes the sentence.
Unlike acute injuries that are caused by a single incident, Musculoskeletal
disorders are a culmination of incidents 1.____________________
a period
OVER
of time. The three main contributing causes of MSDs are excessive
2.____________________
movement, high
REPETITIVE
3.____________________
and awkward
FORCE
4.____________________
or body mechanics.
POSTURE
Additional contributing factors include poor 5.____________________
PHYSICAL
condition of the body, 6.____________________
ENVIRONMENTAL conditions and insufficient
7.____________________
time
for the body.
RECOVERY
The best posture for the body is one that puts the least amount of
8.____________________
on it. That would be arms 9.____________________
BELOW
STRESS
shoulder level, elbows close to the side of the body with no
10.____________________
or 11.____________________
rotation of the
INWARD
OUTWARD
forearms, and the wrists and hands as natural 12.____________________
EXTENSIONS
of the forearms.
Symptoms of tendon disorders include discomfort with
13.____________________
movements, tenderness to the
SPECIFIC
14.____________________
and a dull aching sensation over the specific
TOUCH
15.____________________.
TENDON
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17
Summary
(continued)
Nerve disorders are caused when repeated activities expose the
16.____________________
to external pressure of hard, sharp
NERVES
17.____________________
or internal pressure from
EDGES
18.____________________,
tendons or ligaments.
BONES
Respect the potential hazards of MSDs by knowing the
19.____________________
and recognizing the symptoms. Be aware
CAUSES
of your posture at all times. Communicate any effective solutions
with your supervisor. A successful ergonomics program requires a
team effort from 20.____________________.
EVERYONE
18
© Summit Training Source, Inc.
Ergonomics Quiz
Your Name
Date
1. Musculoskeletal disorders usually occur within one week if they
are going to happen.
a. True
b. False
2. Proper posture and correct body mechanics play a significant role
in the reduction of risk to MSDs.
a. True
b. False
3. Poor physical condition of the body is a contributing factor
to MSDs.
a. True
b. False
4. Excessive repetition or high force with the arms above shoulder
level is a cause of thoracic outlet syndrome.
a. True
b. False
5. A proper posture can be achieved whether standing or sitting.
a. True
b. False
6. A successful ergonomic program requires a team effort on
everyone’s part.
a. True
b. False
7. Which of the following puts the least amount of stress
on the wrist?
A.
© Summit Training Source, Inc.
√
B.
C.
19
Ergonomics Quiz
(continued)
8. The three main contributing factors of MSDs are repetitive
motions, age and gender.
a. True
b. False
9. The following is an example of good body mechanics.
a. True
b. False
10. MSDs primarily affect workers over the age of 35.
a. True
b. False
11. Pain, numbness and tingling sensations in the hands are
symptoms of carpal tunnel syndrome.
a. True
b. False
12. The shaded areas in the diagram represent low stress positions
for the hands and wrists.
a. True
b. False
13. Awkward static posture can cause just as much stress on the body
as excessive repetition.
a. True
b. False
14. Tendons connect bone to bone and limit their range of motion.
a. True
b. False
15. A successful ergonomics program is the sole responsibility
of management.
a. True
b. False
20
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®
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Grand Rapids, MI 49546
800-842-0466
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