Address Hand, Arm and Shoulder Injuries Through Proper Ergonomics

Relaxing your shoulders, elbows and wrists is one way of preventing injury from repetitive motions.. Photographer/Getty Images

In the world of increasing computer and device usage, people with jobs and lifestyles that involve repetitive use of devices seem to possess at least a basic understanding of the importance of good ergonomics. We know that repetitive motions can lead to injury.

But, the exact course to alleviating a nagging pain can be elusive. What should be our first line of defense if a pain arises? When should we seek additional support?

What can be done to prevent injuries altogether?

Hoang Tran is an occupational therapist, certified hand therapist, and certified functional capacity evaluator. She shares some of the insights she has gleaned from 15 years of working with clients who have suffered hand, arm and shoulder injuries.

What Is Ergonomics and Why Is It Important?

There’s a lot of talk about ergonomics and safety in the workplace. There are also a lot of products being sold that are ergonomically friendly, even for homes. Now, are you asking yourself “what is ergonomics exactly?”

To put it simply, ergonomics is the study of people and the environment in which they work. We study ergonomics so that we can create and ensure a safe environment to reduce possible injuries. There is an abundance of information about this topic because, for the most part, we all partake in some form of work. Of course, this can lead to injuring many parts of our bodies, making it difficult to return to work.

Not only is there traditional work (the paid kind), but there are all types of “work” that we do in our homes. How we function in our spaces requires sound ergonomics as well so that we can continue to do the things we need and want to do.

In the workplace, we need to recognize possible elements that affect our bodies, such as:

  • Work hours can last 8-12 hours
  • The workforce is getting older, WE are getting older
  • Prior medical conditions
  • Decrease physical fitness levels
  • Increased workload
  • Body types such as weight, stature, wrist size and shape

Other high-risk factors for injuries include:

  • Awkward or static (where you stay in one place for an extended period of time) positions
  • Highly repetitive movements
  • Strong, forceful pushing, pulling or gripping
  • Using equipment that produces vibration
  • Being in positions that put sustained forces on knees or wrist

Common areas of injury are:

Think about everything that you do from the time you wake up, go to work and go to sleep. You need your arms for everything you do. Your shoulders need to reach in space so that your hands can grab and manipulate objects. Your elbows bend and straighten to connect what your shoulder and hand are trying to do. For all that your arm does for you to function without pain, you need to make sure that you take care of it!

Some of the most common injuries to the arm, also known as upper extremity musculoskeletal disorders, are:

Actionable Advice For Preventing Upper Extremity Injury Through Ergonomics

How can we prevent some of these injuries?  It all depends on what you do for a living. There are so many different types of work and positions. But here are some helpful tips that you can apply at work (or at home for that matter) to reduce these types of injuries.

Stretch. If you work in an environment that requires you to be in one position like in an office at a desk, one of the most important things you need to do is stretch! Stop working for just five minutes and stretch your arms. No one at work is going to tell you to stop working and stretch, just like no one is going to tell you that you can’t stretch. It’s one of the most important things you can do to prevent injury. It allows you to relax your muscles and move your joints.

Stay relaxed. If you do find yourself sitting at a desk all day, it is important to keep your arms in a relaxed position rather than tensed. Keeping your arms tense can cause sore muscles, which over time can progress into pain and tendinitis type issues.

Take breaks. If you are working in a job that is highly repetitive, make sure you take breaks every 2-4 hours as allowed. Again, no one will blow a whistle and remind you. If you take those breaks, it will allow you to stretch out a little (pointed out in the first tip). Also helpful, if possible, is to switch to a different task to give those muscles a break. It changes it up and still allows you to be productive!

Ask for help if something is too heavy. One of the most common reasons injured patients provide for their accident is they were trying to do a task that was just too heavy for them, but they thought they could do it. The most severe types of injuries such as lacerations, amputations, and tears of ligaments or tendons occur in jobs that require much heavier types of work, like construction, assembly work and health care jobs. If this describes your line of work, do not hesitate to ask for help.

Don’t rush through your work. Another prevalent cause of injury is that people rush through their work. Rushing, combined with lifting something that is too heavy, creates the perfect storm for injury. Please remember to use proper technique when lifting; use the larger muscles of your legs instead of your arms, keeping the heavy load closer to your body so that it does not strain your shoulders, and pushing is easier than pulling on your arms.

Knowing and practicing good body mechanics doesn’t always prevent injuries. In arduous work positions, like a construction worker handling heavy equipment, I have seen many patients with lacerations or amputation type injuries due to a lack of experience with the equipment and rushing through their work.

Get the right gear. There are various types of personal protective equipment or gear that you can use to protect your hands during forceful gripping. Using tools with a wide grip can help prevent injuries. There are gloves that reduce vibration and gloves that can help grip better and protect from extreme temperatures. It's also smart to use plain workout gloves depending on the position to protect the palm of your hands but still allow you to feel and grip with your fingertips. 

Request an ergonomic assessment. If you are working and are having issues with your workstation, consult your supervisor about having an ergonomic assessment. Ergonomic assessments are not just for computer desks, they can be helpful if you are a health care provider or a person working in a manufacturing facility, to name a few. A qualified professional, such as an occupational therapist or physical therapist, should perform the assessment. The professional will take into account your specific job requirements and your unique ability to perform them.

Do more than adjust your workspace. A review of evidence suggests that simply adjusting your workplace may not be enough to prevent injury. As mentioned above, it is important the professional assessing your situation understands your tasks, looks for potential risk areas, and makes recommendations for modifications to reduce your potential for injury.

That being said, adjustments can still be part of the solution. Important factors to consider may include: seat depth, armrest height, computer ergonomics, and desk height. One of the workplace adjustments with the strongest evidence behind it is the use of arm supports.

Interventions with Little Evidence Supporting Them

Upper body injuries from repetitive motions have likely been a workplace concern ever since Ford rolled out the assembly line. So, over the years there have been many attempts at curbing the negative effects on workers and businesses’ bottom lines.

Research shows that workstation adjustments alone are not enough to curb injury. However, two popular supplemental interventions, biofeedback training and job stress management training, have shown to have very little impact on injury prevention. While both of these may have value outside of preventing upper body injuries, they are not recommended solely for this purpose. If your company tries to address your repetitive injury with either of these interventions, I would recommend sharing some of the studies listed below.

When Is It Time to Seek Medical Assistance?

If you have pain that is nagging and shows no signs of letting up, consult your doctor or occupational therapist. It’s better to go just a few times to get the help you need, then to wait until it is unbearable. If you wait, it takes much longer to get rid of chronic issues like tennis elbow or carpal tunnel syndrome. Don’t throw on a splint that you buy at the store either!  You might think it’s helping you now, but it can weaken your muscles, creating even more of an issue later. Getting a good home program that you can implement at home and at work can help you keep your arms and hands healthier, longer.


Conlon CF, Krause N, Rempel DM. A randomized controlled trial evaluating an alternative mouse and forearm support on upper body discomfort and musculoskeletal disorders among engineers. Occupational and Environmental Medicine 2008;65(5):311–8.

Faucett J, Garry M, Nadler D, Ettare D. A test of two training interventions to prevent work-related musculoskeletal disorders of the upper extremity. Applied Ergonomics. 2002;33(4):337–47.

Feuerstein M, Nicholas RA, Huang GD, Dimberg L, Ali D, Rogres H. Job stress management and ergonomic intervention for work-related upper extremity symptoms. Applied Ergonomics. 2004; 35(6):565–74.

Feuerstein M, Nicholas RA, Huang GD, Haufler AJ, Pransky G, Robertson M. Workstyle: Development of a measure of response to work in those with upper extremity pain. Journal of Occupational Rehabilitation. 2005;15(2):87-104.

Kennedy CA, Amick Iii B,C., Dennerlein JT, et al. Systematic review of the role of occupational health and safety interventions in the prevention of upper extremity musculoskeletal symptoms, signs, disorders, injuries, claims and lost time. Journal of Occupational Rehabilitation. 2010;20(2):127-62. 

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