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Musculoskeletal disorder prevention is about more than lifting technique and posture. Research shows that physical
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Why Your Manual Handling Program Is Only Managing Half the Risk
Musculoskeletal disorder prevention is about more than lifting technique and posture. Research shows that physical and psychosocial hazards can combine to increase MSD risk — making workload, job design, support and worker involvement critical parts of an effective prevention strategy.
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A Broader View of MSD Prevention
Musculoskeletal disorders (MSDs) remain one of the largest health and safety problems in Australian workplaces — the leading cause of workers’ compensation claims, lost time and long-term disability. Yet according to a widely cited paper by Wendy Macdonald and Jodi Oakman of La Trobe University, most workplace prevention programs are built on an outdated assumption: that MSD risk comes almost entirely from the physical demands of work.
The evidence tells a different story.
It's not just lifting and posture
There is now strong scientific consensus that MSD risk is driven by two categories of hazard acting together: physical hazards (heavy lifting, repetitive actions, awkward postures) and psychosocial hazards (high workloads and time pressure, low job control, night shifts, low supervisor support and poor recognition). Critically, these effects are often additive or interactive — force that presents low risk when exerted occasionally can present high risk when combined with time pressure and unsupportive supervision.
The size of the psychosocial contribution is striking. Reviews cited by Macdonald and Oakman attribute between 14 and 63 per cent of low-back injuries, and up to 84 per cent of upper-limb injuries, to psychosocial factors. In one rigorous prospective study of manufacturing workers, psychosocial hazards showed stronger and more consistent associations with neck, shoulder and upper-limb disorders than physical hazards did.
So why do workplace programs miss this?
Macdonald and Oakman identify several barriers that keep workplace practice behind the evidence:
- A persistent belief that physical injuries must have purely physical causes, so psychosocial risk management is seen as relevant only to mental health, not MSDs.
- Regulations and codes of practice — including Australia’s Hazardous Manual Tasks Code of Practice — that focus overwhelmingly on physical hazards, with minimal guidance on assessing or controlling psychosocial risk.
- Risk assessment tools that score subsets of physical hazards yet present their outputs as overall ‘MSD risk’ indicators.
- Continued reliance on ‘safe lifting technique’ training, despite strong evidence it does not reduce MSD risk on its own.
What effective MSD prevention looks like:
The authors argue for a more holistic, systems-based approach:
Assess the Whole Risk
Assess risk from all relevant hazards together — physical and psychosocial — rather than in isolation, because it’s the combined effect that determines risk.
Optimise the Demands
Aim to optimise rather than simply minimise demands. Eliminating movement isn’t the goal — sedentary work carries its own well-established health risks, and both very high and very low workloads are hazardous.
Involve Your Workers
Involve workers directly in risk assessment and control. They hold the best information about the day-to-day realities of their tasks.
Engage Your Managers
Engage line managers and supervisors, not just safety personnel. Managers shape workloads, schedules and support — many of the hazards that matter most sit within their control.
The takeaway for employers
If your MSD prevention strategy starts and ends with manual handling assessments and lifting technique training, you’re likely managing only part of your actual risk. The organisations that get ahead of musculoskeletal injury are the ones that look at job design, workload, scheduling and workplace culture alongside the physical demands of work — and that bring workers and line managers into the process.
Talk to our team
Are you managing the full picture of MSD risk?
Manual handling is only one part of the equation. Employ Health can help you identify the physical, psychosocial and organisational factors contributing to musculoskeletal risk across your workforce — and turn those insights into practical controls.
Get in touch to find out how Employ Health can support your workforce.
Frequently Asked Questions
What are the main risk factors for workplace musculoskeletal disorders?
Work-related musculoskeletal disorders can be influenced by both physical and psychosocial hazards. Physical risks include repetitive movements, force, awkward or sustained postures and vibration, while psychosocial factors can include high job demands, time pressure, low job control and inadequate support. Safe Work Australia also recognises that psychosocial hazards can contribute to physical harm, including musculoskeletal injuries.
Is manual handling training enough to prevent musculoskeletal injuries?
No. Training may form part of a broader risk-management approach, but lifting technique training alone has not been shown to effectively reduce injury risk from hazardous manual tasks. Employers should first identify the hazards and implement controls that reduce the underlying exposure.
For workers already experiencing musculoskeletal pain, tools such as the Örebro Musculoskeletal Pain Questionnaire can help identify factors associated with persistent pain and delayed recovery.
Can psychosocial hazards contribute to musculoskeletal disorders?
Yes. Psychosocial hazards can contribute to both psychological and physical harm. Factors such as excessive workloads, poor support, low job control and fatigue may interact with physical demands and increase the likelihood of musculoskeletal problems.
How can employers reduce MSD risk in the workplace?
Effective prevention starts by identifying the hazards associated with how work is actually performed and then eliminating or minimising those risks. This can include redesigning tasks, changing equipment or workloads, improving work organisation and involving workers in identifying practical controls.
Citation:
Macdonald, W., & Oakman, J. (2015). Requirements for more effective prevention of work-related musculoskeletal disorders. BMC Musculoskeletal Disorders, 16, 293. https://doi.org/10.1186/s12891-015-0750-8
This article is published open access under a Creative Commons Attribution 4.0 licence (CC BY 4.0), so you can legally link to it and share the full text with attribution. Free full text/PDF: https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-015-0750-8
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