Musculoskeletal injuries are the most common form of workplace-based claims. The fact that they are also the least understood, means that current health and safety approaches and campaigns may even be contributing to the prevalence of these injuries.

That doesn’t mean overuse problems do not occur. Here’s an example. A month ago I saw a man who had developed pain in both arms within three weeks of commencing a new job. The job was unusually and very demanding on the arms, requiring repeated forceful twisting over the course of the day with little opportunity for breaks. By the end of the fifth week the chap was struggling to continue, and didn’t. He was subsequently diagnosed with carpal tunnel and there are reasonable grounds to suggest this came from his job.

However, when people attribute their long-term back problem to 15 kg of lifting once an hour at work or to standing and walking around all day, it’s time to recognise the misperception that work activity can be harmful.

A 2006 article, “Underuse as a cause for musculoskeletal injuries: is it time that we started reframing our message?” states that, “too little activity may in fact be the primary cause of a large percentage of musculoskeletal injuries.”

This 14 year study of 961 people over 50 found that those who exercised had a “substantial and significant” reduction in musculoskeletal pain, despite differences in gender, body mass and strength. The article referred to several other studies which found that higher levels of physical activity were associated with less pain and disability and a higher health related to quality of life.

The article suggests that the epidemic of physical inactivity plaguing developed countries is resulting in people believing that physical activity can be harmful.

In actual fact, the researchers noted that a life time of physical activity actually seems to protect people from musculoskeletal pain and injury. They noted that literature for treatment of upper and lower limb injuries consistently supported mobilisation over rest. They reinstated that there was real potential harm in resting.

Musculoskeletal problems often occurred when there was a period of activity after a period of rest. This means that the term ‘overuse’ is not technically accurate because the injuries are usually caused by underuse, followed by unaccustomed activity. The study makes the point that because muscle exercises are proven to be the most beneficial in treatment for musculoskeletal injuries, we should recognise the role of activity as helpful, not harmful.

This is not to say that injuries don’t occur through work, but that inappropriate restriction of activity at work can be harmful rather than beneficial. The implications for workplace injuries are clear: employees and employers need to discuss exercise and activity programs so that people understand the role of activity in returning to work.

Another problem that occurs from the ‘activity is harmful’ attitude is disbelief when a person develops a problem shortly after commencing a job. This might be a new employee, or a previously injured worker taking on a new role who has developed another problem. Is it real?

Employee, employer, treating practitioner and community misunderstandings about these issues are rife. The more they can be discussed and articulated, the more we are likely to see reason apply in such cases. All figures in the return to work process must discuss, understand and articulate the facts so that we can confidently and positively promote health and wellbeing in the workplace.