Work involving above-shoulder movements is a common requirement across many industries, from construction and painting to warehouse operations and even athletic activities. However, such tasks are often linked to an increased risk of shoulder injuries, which can lead to long-term complications if not managed properly.
Recent research published in the International Archives of Occupational and Environmental Health by Waersted et al. highlights the association between shoulder disorders and repetitive tasks that require reaching above shoulder height (90 degrees). The study concludes that there is moderate evidence linking such work to shoulder injuries.
This raises a crucial question for workplaces: Does limiting arm elevation below 90 degrees ensure safety, or are there additional factors at play?
Beyond the Surface: Contextualising the Data
Research findings provide valuable insights, but they often focus on isolated factors. In real-world scenarios, shoulder injuries arise from a combination of occupational and non-occupational factors, which must be considered when creating workplace safety protocols.
We spoke with Dr Brett Shannon, an Occupational and Environmental Physician Registrar, to better understand how these findings can be applied to practical workplace settings.
“In occupational medicine, we don’t just look at workplace factors. We evaluate a range of contributors, including age, BMI, and the presence of metabolic conditions like diabetes, which are equally significant,” Dr Shannon explained.
Key Takeaway: Workplace risk factors such as awkward postures and overhead tasks must be evaluated alongside personal health factors to develop effective prevention strategies.
Understanding the Evidence
The AMA Guides to the Evaluation of Disease and Injury Causation (2nd Edition) provide a framework for assessing how various factors contribute to shoulder injuries. Dr Shannon highlighted that while the research by Waersted et al. strengthens the evidence for the impact of awkward postures, the role of non-occupational factors should not be overlooked.
“For example, a worker over 40 years old, with a higher BMI, performing overhead tasks regularly, is at a significantly increased risk of developing shoulder problems due to the compounding effect of these factors,” Dr Shannon explained.
Incorporating both occupational and personal health factors into workplace health assessments can help employers make informed decisions to prevent shoulder injuries.
Work or Non-Work: Determining Responsibility
When workplace injury claims arise, the challenge often lies in determining whether the injury is predominantly work-related. Work-related shoulder injuries can result from a mix of occupational tasks and individual predispositions.
What Happens to the Shoulder?
The shoulder’s tendons are placed under significant stress during activities requiring lifting, rotation, or repetitive movements—common in professions like carpentry, painting, or warehouse operations.
Age also plays a role, with rotator cuff tears being most prevalent among individuals over 40. Certain athletes, including swimmers and tennis players, are also prone to these injuries due to repetitive overhead motions.
The Growing Concern: Rising Shoulder Injury Claims
Why the Increase?
Several factors contribute to this trend, including:
- An ageing workforce
- Increasing physical demands in certain industries
- Delayed reporting or treatment of symptoms
Actionable Steps for Employers
To address the risks of above-shoulder work, employers can implement the following strategies:
1. Regular Fitness Assessments:
Evaluate worker fitness at the time of hiring and periodically throughout their employment.
2. Early Symptom Management:
Encourage employees to report symptoms early. Implement telemedicine solutions for timely diagnosis and treatment.
3. Adjust Task Design:
Modify job roles to limit lifting above shoulder height or introduce mechanical aids where possible.
4. Partner with Medical Advisors:
Collaborate with occupational health specialists like Phoenix Occupational Medicine to create tailored health programs.
Final Thoughts: Prioritising Worker Health and Safety
Working above shoulder height is an unavoidable reality in many industries, but with the right measures, its risks can be managed effectively. By addressing both workplace and personal health factors, employers can reduce the rate of work-related shoulder injuries and create safer working environments.
For expert advice on occupational health strategies, contact Phoenix Occupational Medicine today.
References
1. Wærsted, M., Koch, M. & Veiersted, K.B. Work above shoulder level and shoulder complaints: a systematic review. Int Arch Occup Environ Health 93, 925–954 (2020). https://doi.org/10.1007/s00420-020-01551-4 https://link.springer.com/article/10.1007/s00420-020-01551-4
2. AMA Guides to the Evaluation of Disease and Injury Causation (2nd Edition)
3. Safe Work Australia, Australian Workers’ Compensation Statistics -https://www.safeworkaustralia.gov.au/system/files/documents/2001/australian-workers-compensation-statistics-2017-18_1.pdf
