Frank: “Doc, it hurts when I lift my arm toward the ceiling.”
Doctor: “So don’t lift your arm toward the ceiling.”
Frank: “You’re a genius, Doc! I’m cured!”

This parable is a classic example of the fallacy of dealing with proximate symptoms instead of delving deeper and looking for root causes to problems. I can’t tell you how many times I have seen companies take this shortcut with ergonomics.

Earth to management — this is not the best, or even the most cost-effective, attitude. What usually happens is that the symptoms go away temporarily, but then they reappear either as a more serious injury or among more and more workers because the problem was never solved. Instead, consider the many benefits of taking a systems approach.

The systems approach
The systems approach in ergonomics means you need to take a step back before employing your first idea. Look for potential impacts on the rest of the body before implementing proximate solutions.

The RULA1 is one of the most popular and validated analysis tools in the ergonomics field, and even though the acronym stands for RapidUpper LimbAssessment, it still includes consideration of the trunk and legs. The trunk and legs are important in understanding the overall risk involved in an upper limb activity. In my ergonomics training courses, attendees often question the necessity of a full-body evaluation for an upper body activity, but just a few examples usually shows them the wisdom of the systems approach.

Applying the systems approach
In one case, we looked at an inspection job in a biotech product assembly facility. The inspection required the worker to hold heavy preassembly materials up to shoulder level under a microscope to detect flaws. Workers complained of constant shoulder fatigue, and the company started to see a rise in repetitive strain injuries. Lowering the microscope would have required a torso bend to look through it, so that was not a good solution.

Instead, we took the systems approach. By applying concepts from Lean Six Sigma, we eliminated the inspection requirement completely, saving the company considerable money and processing time.

Without an industrial engineer who knew something about Lean Six Sigma, we would not have been able to develop this solution. The broader your team’s expertise, the more improvement ideas you can develop and the better the final solution will be.

You can also employ the systems approach to investigate how a job interacts with upstream and downstream activities. If you have an industrial engineer on the team, you can look into converting a line operation into a work cell or converting individual stations into team stations. These changes may not sound like ergonomic interventions, but they can radically reduce repetitive strain injuries by reducing repetitions and/or eliminating the need for bad postures.


1. McAtamney L, Corlett EN. (1993) RULA: A survey method for the investigation of workrelated upper limb disorders.Appl Ergon. 1993 Apr;24(2):91-9.