Aging, Fattening, Weakness – and COVID Blamed for Persistent MSDs

Nancy Grover

Sarasota, FL ( – Despite ergonomic advances, better safety efforts and automation to relieve some of the physical stress on workers, the frequency of musculoskeletal disorders has not decreased in recent years. There are several reasons, but the gist is that many people are in worse physical shape than they were 15 years ago.

“What’s happening to the worker in the last 15 years in terms of physical fitness, physical strength? It’s not good news,” said Tom Gilliam, president of Industrial Physical Capability Services, Inc. “If you have a company that has physically demanding jobs it’s harder to find someone who really has the capability to safely perform those essential functions of the job.”

Better education for existing workers as well as assuring employees hired can carry out the essential functions of the job can have an impact – even at a time when finding any workers may be challenging. During a recent webinar produced by Axiom Medical, speakers discussed the latest stats on MSDs and how employers can help change the narrative on frequency and cost.


Of the estimated 890,000 annual injuries involving days away from work, some 295,000 are musculoskeletal injuries. The number of MSDs had been decreasing but has been relatively static in the last two or three years.

Healthcare/social assistance workers sustain the majority of MSDs, followed by employees in the retail/trade, manufacturing and transportation/warehousing industries. However, workers in transportation/warehousing have by far the highest number of days away from work – 26, whereas as healthcare workers experience an average of eight.

Shoulder injuries are the most frequent and the most expensive of MSDs, with an average cost of $46,000. That’s followed by low back, knees and wrists.

“The shoulder is a very complicated joint. If you have surgery on your shoulder, it could take up to one year for full rehabilitation,” Gilliam said.

Repairing a rotator cuff requires the employee’s arm to be immobilized for several weeks, followed slowly with physical therapy. It can be quite a while before strength and range of motion return. “Before you know it six months has gone by,” Gilliam said. “That’s why shoulder is one of the worst in terms of median days away from work.”

In fact, the average shoulder injury incurs 28 days away from work, compared to 15 for wrists and seven for low back injuries.

“What astonishes me is the number of days away from work in 2019 totaled 70 million. That’s a lot of days, a lot of injuries,” Gilliam said. “When they lose a worker for a period of time, there’s a ton of indirect costs. When you factor that in, you’re looking at billions [of dollars] lost because of injuries, particularly MSDs – many of which can be prevented.”


“There are four or five very good reasons why musculoskeletal injuries are still around,” Gilliam said. “Industry doesn’t pay much attention to them. They are concerned, but don’t pay much attention.”

The primary reasons he cited for MSDs are

  • Aging workforce
  • Weaker muscles
  • Obesity
  • COVID-19 lockdown

“Workers are weaker than they were 15 years ago,” Gilliam said. “On average, the upper body strength – shoulder strength – today is 23 percent weaker than it was back in 2005.”

Organizations have incorporated such things and ergonomics into the workplace; however many still have items that weigh up to 100 pounds.

“Even though the job task analysis or job description says ‘you must do that with a two-man lift,’ my experience is there are a lot of workers who just want to get the work done and don’t wait for that second person to help out,” Gilliam said. “They go to make that lift and bingo, they pop a shoulder.”

Muscular strength tests also show that the average knee strength is 19 percent weaker than it was 15 years ago. “If you look at the age group 20 to 29, the gap between 2005 and 2019 is the greatest,” Gilliam said. “The percentage is 26 or 27 percent that younger worker you’re trying to hire is coming in worse condition that ever before. That’s another reason why they are so susceptible to injury.”

The lockdown during the pandemic has contributed to weakening muscles, as many workers have been unable to get regular exercise, and/or are eating unhealthily. People who had aimed for 10,000 steps a day may now do 1,000 steps – if that.

Aging is another major factor cited for MSDs – especially the costs. As people age, they typically get weaker and lose their strength. “That doesn’t have to happen,” Gilliam said. “You stay strong, you can stay strong throughout your entire lifespan. You might lose 5 percent of your strength from age 30 to age 65, 70 or 75, but you don’t have to lose 20 to 30 to 40 percent of your strength by virtue of just staying healthy, staying physically active and stimulating the muscles so they stay strong through weight lifting programs, things of that sort.”

Employers cannot mandate that their employees take part in various wellness activities but can help by educating them on the benefits of having strong muscles. “Research on healthy muscle mass [shows it] does help you manage certain critical lifestyle diseases, such as diabetes, hypertension and some cancers,” Gilliam said. “The healthier your muscle mass, the greater your survivability. Muscle is not just critical to injury prevention, but to your health.”

Hire Right

An effective intervention employers can take is to make hiring contingent on the person passing a physical capacity or functional capacity exam. Both are designed to determine if the applicant can physically do the essential functions of the job. However, the current business climate many prompt many employers to ignore such interventions.

“What I hear is that they are having a hard time hiring at all, and they hire knowing people are less healthy and potentially a higher risk for injury, in that first year, especially. They are going into it with that risk approach,” said Dara Wheeler, Chief Marketing Officer for Axiom Medical. “They are thinking ‘we know we are probably going to end up with claims, or people not able to perform the jobs we are asking them to perform.’ The alternative is not being able to hire at all.”

Companies don’t necessarily have to take an either/or approach, Gilliam said. They can make some adjustments for certain jobs to fill them and still prevent the most severe, costly injuries.

“When you set the standard, when you do a job task analysis and it says the physical demand of the job is ‘heavy,’ you can’t set the standard higher than that. But you have every right to say ‘OK, the job is ‘heavy’ but I’m going to lower it to a ‘medium heavy,’ or ‘medium,’ or even ‘light medium’ during this period of time while I’m having difficulty finding workers,’” Gilliam said. “So at least you’re doing some screening out, and you might be screening out instead of 10 percent of the workforce you’ll only be screening out 2 or 3 percent of the workforce, and it’s usually those 2 or 3 percent that are going to account for almost 80 percent of your injuries and costs.”

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