Musculoskeletal disorders (MSD) are pervasive. These injuries impact the bones, muscles, and joints, and can cause lifelong disabilities. They can also have an impact on a worker's ability to do the work they are assigned.

According to United States Bone and Joint Initiative research, half of adult Americans have reported at least one MSD. Over $800 billion is spent annually in the U.S. on healthcare for persons with musculoskeletal diagnoses, representing 5.7% of GDP. MSDs represent the largest category of workplaces injuries, according to the U.S. Bureau of Labor Statistics.

However, on the job injuries do not represent all of the risks inherent in MSDs. There are safety risks for co-workers and the public, and additional costs for lost days and decreased productivity.

It is also not surprising that companies choose to mitigate these risks with Fit-for-Work testing that looks specifically at a candidate's musculoskeletal health. As part of Fit-for-Work testing, the musculoskeletal exam focuses on screening potential employees and identifying potential risk factors that may contribute to an MSD or other general health conditions.

A comprehensive musculoskeletal examination will assess a candidate's ability to do a job and to do it safely. It is used to screen potential new employees and evaluate an injured worker's ability to return to a job.

Pre-screening Questionnaire

Generally, a musculoskeletal exam will start with information gathering from the patient to determine their overall health status. This could be in the form of an interview or a pre-screening questionnaire. It helps the examiner identify pre-existing conditions, previous surgeries or areas experiencing weakness or pain.

The Exam

The components of the exam will depend on the nature of the job and its physical requirements. However, the musculoskeletal exam focus on the muscles, bones and joints, and the connective tissues, such as ligaments and tendons, that hold them together.

These are a few of the specific capabilities that a comprehensive musculoskeletal exam might focus on:

• Posture
• Range of motion
• Reflexes
• Gait analysis
• Strength
• Back fitness
• Bending/stooping
• Reaching
• Squatting
• Manual dexterity
• Stability of joints and general flexibility

The Body at Work

A musculoskeletal fitness examination involves testing how the bones, muscles and joints work together and will generally focus on four key components: strength, endurance, power and flexibility.

Strength measures how much weight a muscle can move. An example of this type of testing might be assessing your ability to grip or grasp an object. This test is usually performed using a handgrip tool.

Endurance measures a muscle's ability to carry a lighter weight over a more extended period of time without weakening. Push-ups and curls are two methods used to test the endurance of your upper body and trunk.

Power is the ability of a muscle to produce force quickly. For example, a vertical jump is used to measure the muscular power of your legs.

Flexibility is the functional capacity of the joints to move through a full range of motion. It can be measured by several means including a sit and reach test or a chair stand.

Past and Current Impairment

In addition to testing for strength, endurance, power and flexibility, the examiner may assess the result of previous surgeries and look specifically for deformities or tenderness in muscles, bones and joints. They will also examine impairments in the use of legs, toes, arms, hands or fingers and specifically look at any possible paralysis or atrophy of the limbs that might interfere with a worker's ability to do a job. They may require additional lab tests if the results of the physical examination warrant.

The Examiner

Musculoskeletal examinations are usually conducted by trained health professionals such as physiotherapists, kinesiologist or medical doctors. They will start with a physical demands analysis of standardized job-specific duties. This allows the assessor to accurately gauge what requirements exist for a specific job and assess the applicant accordingly.

Fairness and Standardization

Government regulations ensure that Fit-for-Work Musculoskeletal Examinations, like any pre-or post-employment assessment, are applied fairly to all workers. This means that any testing that occurs follows an acceptable standardized scope of practice.

Like other parts of Fit-for-Work testing, musculoskeletal examinations help prevent the worker from doing a job that they are physically incapable of performing or incapable of doing safely. This protects everyone, including the worker, co-workers, the public and the company.