Preventing Soft-tissue Injuries

• By Robert Pater
• Sep 01, 2022

These are times where the heartbeat of the world’s economy seems to be uncontrollably fibrillating. And with this come psychosocial stressors that can disrupt the pulse of many. 

This cascades into safety. Not just mentally, but physically as well. Yet, it’s easy for many leaders to default towards trying to do what they’ve been doing, a “stay-the-course” mindset, especially when it comes to preventing continually plaguing soft-tissue injuries (i.e. strains-sprains/musculo-skeletal disorders/cumulative trauma disorders, etc.). 

Here, a too-common “keep on keeping on” leadership mindset tends towards engineering out physical contributing forces to these injuries. While doing this is part of a strong approach, narrowly fixating only or mostly on physical factors hasn’t moved the needle. You know the strategies: emphasizing redesign and repositioning, tool replacement, load minimization, automating tasks, software task analysis, enhanced personal protective equipment (such as skeletal assists), exercises for work hardening, etc.  

I appreciate why leaders default to this. After all, most soft-tissue injuries seem caused by concrete physical actions (well, or in some cases, by inactivity.) It’s understandably easier to do something that impacts what you can readily see. And investing in physical equipment is so tangible. Plus, physical interventions are readily monitorable.  

But what’s “easier” to see and affect doesn’t necessarily equate to being maximally effective. Just look at the disturbingly constant history of safety statistics (Liberty Mutual’s yearly Workplace Safety Index, which charts costs of disabling/lost-time injuries or the Bureau of Labor Statistics, which monitors numbers of incidents). Soft-tissue injuries continue to reign as the undisputed king of costs and numbers of incidents, over as many years as you’d care to review (consistently followed by slips, trips and falls—which can be related). 

Recently, there seems to be heightened emphasis on soft-tissue injury prevention—perhaps in part driven by concerns of leaders in the supply chain sector, where strains and sprains dominate and worker retention and performance have become increasingly problematic. Redoubling attention to preventing these injuries is good—as long as leaders don’t fall into the rut of doing the same old things, expecting different results. 

Case in point: There has been a raft of research, most recently published by European Agency for Safety and Health at Work (EU-OSHA), that point to the importance of assessing and redirecting psychosocial contributors in soft-tissue injuries. “Musculoskeletal Disorders: Association With Psychosocial Risk Factors At Work” overviewed 53 published studies on the firm links between soft-tissue injuries and psychosocial risk factors. 

In essence, this EU-OSHA report found: 

• There’s no doubt that stress and other psychosocial influences (mental, emotional and social stresses) contribute to the incidence and severity of soft-tissue injuries although, at this time, the exact relationship is difficult to pin down. But lack of clear cause-and-effect chain doesn’t mean this relationship doesn’t actually exist.  
• Stress and physical strains/sprains can be like chicken-and-egg. “Importantly, the negative association between psychosocial factors and MSDs can work both ways. Such factors can materially contribute to the causation of MSDs, but having an MSD can exacerbate or accentuate the perception of some psychosocial factors.” 

This can have significant application to improving return to work. With worker shortages being a significant concern in many sectors, this can potentially resuscitate lost employees to re-enter the workforce. 

• Workers’ perception of social support can be critical to reducing/preventing soft-tissue injuries; on the other hand, the lack of social support (isolation or not believing the company or immediate supervisor is actually concerned for their subordinates' well-being) can contribute to these injuries, even if indirectly. 
• These findings applied across a range of countries and industries, not isolated to just one type of task, age range, gender or sector. 
• When leadership is effective, psychosocial factors can also have positive impacts on safety.  
• A balanced prevention approach is needed, not just one focusing solely on reducing EITHER physical contributors OR mental/social stressors but strategies that are balanced, combining both. 

What Can Leaders Do? 

• Stress can be defined as, “the feeling of being out of control.” To reduce psychosocial stress, support workers to take control of themselves and their own safety to the highest degree possible, not just with talk but by offering tangible mental and physical methods for asserting self-control.  

Mental methods include developing a mindset of personal control, improving self-monitoring, techniques for better directing attention, understanding how to apply physical “laws” of motion to manual materials handling, personal preparation/mental rehearsal, time-efficient warmups, heightening cumulative thinking and much more.  

Physical methods include significantly improving balance, leverage, better applying strength, strategic bracing, redirecting physical forces away from vulnerable-to-soft-tissue-damage body areas, releasing cumulative tension and more. 

• Provide mechanisms to elevate social support, especially among dispersed or remote workers. Such as enhancing team communications and informal peer-to-peer support. (We’ve seen the impressive long-term effects of training peer safety trainers, coaches and reinforcement agents). 
• Transfer practical safety methods to at-home activities, hobbies or sports, as well as work tasks. This helps reduce buildup of cumulative trauma, fosters positive habit formation and encourages an overall safer mindset. 
• Encourage workers to make small changes that make noticeable improvements. 
• Be sure to include managers and those not performing highly physical tasks when transferring techniques and strategies. Everyone who moves their body at all can be prone to soft-tissue injuries, and saturating organizational inclusion significantly strengthens safety culture. 
• Raise energy by tapping into the power of discovery, asking more and dictating less of how to “work safer.” Leaders might consider becoming more receptive to a range of individually-appropriate work methods (that are all acceptable) rather than proclaiming the “one right way” to do a task. 

These can be challenging times for many. However, we’ve long known from our practice that weaving together potent mental and physical methods are essential for attaining significant and sustaining reductions in soft-tissue safety (as in reports of up to 85 percent reduction in companies with physically demanding tasks). 

A balanced approach is essential, especially now. By positively harnessing psychosocial forces—along, of course, with greatly improving physical/task ones—numerous companies have made impressive improvements in soft-tissue safety. 

This article originally appeared in the September 1, 2022 issue of Occupational Health & Safety.