No magic pills make musculoskeletal disorders (MSDs) disappear, yet risk, human resources and safety departments continue to buy into programs and systems that do not affectively aid in helping employees deemed the “walking wounded.” 

First, you need to find the lagging indicators found in weekly and monthly reports. Lagging indicators measure effectiveness and can alert you to system failures in your existing safety and health programs. The late safety consultant Dan Petersen noted safety statistics are almost always invalid but are a basic measurement of safety program success.  

Use leading indicators

Continuous improvement is driven by using leading indicators for change. They play a vital role in prevention of fatalities, injuries, illnesses, absenteeism and strengthening safety and employee health in the workplace. This becomes a clear competitive edge for employers. Demonstration of commitment to maintaining a socially responsible workplace that values workers improves their overall organization performance.

Yet many employers still struggle with going “upstream” to address employee health and well-being in the workplace.  

Ensuring profit retention

Human performance is a strategic factor in profit retention. The emerging ISO 45001 standard requires safety and operations professionals to work collectively to assess and discover risks and how to avoid them. This includes finding solutions to prevent losing workers to injuries which has a direct and negative impact on safe production and profitability.

Dr. Stephen Grennan, Founder of BHMI has stated:

“What don’t you understand about how your employees are showing up to work? These walking wounded employees are one repetitive motion away from making a claim and continuing the never-ending workers’ compensation cycle. By recognizing the early symptoms that a body is breaking down will prevent it from getting injured. It’s like a slow leak in a tire; if you don’t address it, you’ll end up with a flat tire. Practical results are no accident in addressing MSDs.”

The cost of MSDs

MSDs create discomforts, joint limitations, and hurt daily productivity and activities of your employees. Neglected MSDs is a leading cause to workplace injuries and workers’ compensation claims. According to OSHA (2018) $afety Pays Program, the typical direct cost of an upper-extremity MSD ranges from $28,666 to $33,258.  The typical direct cost of a low-back discomforts disorder ranges from $22,548 to $76,430. The National Health Institute Survey (NHIS) completed in 2012 noted back and neck discomforts affects nearly 1 in 3 adults every year with the average number of workdays lost per person at 11.4.

Research published in 2015 in the American Journal of Industrial Medicine has shown many employees hold the belief that MSDs are inevitable as part of the job and reported limited availability and accessibility of tested and effective tools that both reduce physical demand and do the job efficiently and effectively.  

Like the fictitious Dr. House would say, “Are you an idiot?” 

Don’t accept MSDs

Why don’t these alarming statistics justify the resources for improvement? The more the status quo resists change to handling MSDs, the more a single mode of delivery is applied indiscriminately to the situation. The causes of musculoskeletal discomforts are varied, solutions need not be. The body breaks down by design. Muscle tissue can be damaged with the wear and tear of daily activities. Jerking movements, falls, sprains, dislocations and direct blows to the muscle create trauma causing musculoskeletal discomforts. MSDs are also caused by postural strain, repetitive movements, overuse and prolonged immobilization.  

Typical treatments

Web MD website notes typical treatment includes different manual therapy, mobilization or medications such as nonsteroidal anti-inflammatories (NSAIDSs) to treat inflammation or discomforts. In severe cases, surgery may be required. Meanwhile, the walking wounded employee gets caught in the workers’ compensation trap of occupational doctors and physical therapists. Shoulder and back injuries along with general fatigue and discomfort are quietly stealing employee quality of life and productivity. 

Are there other solutions for the management team?

Are there leading indicators?

Is it possible to have a fail-proof system that addresses the common discomforts before they turn into an injury and lost-time case? 

Limits of ergonomics

Safety, risk and human resource professionals understand the importance of the OPDCA (Observe-Plan-Do-Check-Act) iterative management model used for continuous process improvements applied to changing the status quo. Successful improvement processes are owned by the organization, specifically the management team and front-line supervisors who implement, track, and decide for workplace improvements.

Ergonomics is a common tool used to reduce workplace injuries, and while justified and proven to help some employees with proper posture and lifting techniques, ergonomics does not address nor is it a solution for those individuals considered the walking wounded. 

It’s like putting a bad foot in a good boot. The good boot will not address what is causing a bad foot. These employees come to work with chronic discomforts and limitations in joint range of motion. Bottom line, ergonomics is not as effective for MSDs and companies continue to suffer from workplace injuries even with an ergonomic program. 

So, how does management alleviate the discomforts already existing with the employee?

Eliminating MSDs

While traditional workers’ compensation processes include getting an injured worker back on the job quickly and empathetically, some safety and risk managers are focused on getting rid of injuries/loss events entirely. Imagine eliminating the MSD risk that ties up capital?

Changing the status quo cycle includes using outside MSD advisors with a proven track record. Even though using outside MSD advisors are not a source of revenue, their integration into the OPDCA process becomes part of the profit-retention strategy for an organization. When awareness and intervention are provided by skilled, trained professionals working with front-line supervisors and employees, MSDs can be alleviated and often, resolved.   

Alleviate employee discomforts 

1) Find it

As part of the OPDCA process, the OSHA 300A and workers’ compensation Loss Run Report lists those with strains, sprains and back discomforts. Review this before and with your MSD advisor. Front-line supervisors know employees who are the “walking wounded” and don’t know where to turn. Most supervisors will know when their employees recognize their own range of motion and flexibility is affected, starting a chain reaction on other muscles in the body.  

2) Fix It

Embrace the vision of offering employees a choice between expedited MSD recovery and eliminating the need to recover, before employee discomforts escalate into a claim. While ergonomic assessments may be justified to help the employee fit better into the work processes demanded of them when sitting, standing, bending, reaching and stooping, use the MSD advisors who work directly on and with the employee.  

Dr. Stephen Grennan, D.C. chiropractic orthopedic pioneered an OPDCA system that provides employees with the science-based techniques to avoid, prevent, and reduce musculoskeletal strains and sprains. In a short 15 – 25 minutes initial voluntary consult in the employees work environment (minimizing time away from the job) BHMI has decreased employee discomfort, identified hazards for the work at hand and introduced risk reduction techniques to complement a company’s safety program. 

In addition, claims costs decreased at least 60 percent when used by various employers. His case studies show managers who embraced this proactive involvement reaped the benefits of higher employee morale and fewer trips to the occupational doctor resulting in an OSHA recordable. An added benefit, similar to the requirements of ISO 45001 is a better written and executed Job Hazard Analysis (JHA) as required by OSHA and regulatory compliance.

3) Check It

MSD advisors should provide monthly, quarterly and annual company-specific key performance metric report delivery. What gets measured gets done.

4) Sustain It

Dr. Grennan has a proven system for sustainability by training front-line supervisors on how and why discomforts and joint limitations are created in the work environment. Team members monitor employees for feedback feeling better and alleviating discomforts and improving range of motion. Performance reports can be shared with other managers and staff leading to workplace improvements and efficiencies. Key performance metrics reports and benefit from profit-retention, lower OSHA recordables, fewer workers’ compensation claims and improved efficiencies. A small investment of the MSD advisor reaps large benefits.  

Time to get proactive

What we know about MDSs and what we do about them continues to be a discrepancy. Yet, identifying early symptoms to avoid injuries is a step in the right direction. Human performance and safe production go hand-in-hand.  The OPDCA system offers employers a new rule book for addressing employee MSDs, reaping a gold mine of profit retention results by identifying and alleviating the early symptoms of employee discomforts.


  • Dan Peterson, Authentic Involvement, National Safety Council, 2001.
  • “Creating a Climate for Ergonomic Change in the Construction Industry”, American Journal of Industrial Medicine, July 6, 2015.
  • OSHA (2018) Estimated costs of occupational injuries and illnesses and estimated impact on a company’s profitability worksheet.
  • National Health Interview Survey (NHIS), Person Sample.
  • The impact of Musculoskeletal Disorders on Americans—Opportunity for Action Executive Summary, Bone and Joint Initiative USA,
  • Insurance Thought Leadership blog, Worker’s Comp: Tip of the Spear on Innovation.
  • Dr. Stephen Grennan, Preparing the Industrial Athlete for Work, EHS Today, October 10, 2000