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Why This Article is Important

When we talk about injuries that occur in the office, it seems that we always seem to the focus on injuries or discomfort that occur in the upper extremities. I’m sure that you have heard of injuries like carpal tunnel syndrome, neck pain, frozen shoulder syndrome, in the office before. Of course are all injuries occur in the upper body! In fact, in my experience I rarely come across major concerns in their lower extremities whenever I complete office ergonomic assessments. Just because lower extremity office injuries or discomfort are less reported than their upper extremity counterparts doesn’t mean we shouldn’t be looking at them with our keen ergo eyes. And, that’s the focus of today’s post – lower extremity ergonomic risks. 

In some of our past articles, like this one, we have looked into the cause of musculoskeletal injuries, or MSIs (Note: this is an umbrella term for any type of soft tissue sprain or strain injury).  There is now tons of support that MSIs are caused not only by physical risk factors (usually work-related and includes posture, force, repetitive actions, or time spent working for instance), but also from non-physical risk factors. These additional risks include individual and psychosocial risk factors… more on this later.

Disclaimer: just because something may be considered to be a risk factor, it is actually the person’s threshold or capacity that determines if it actually will result in injury.

Work-related physical factors: These are the stereotypical risk factors that most associate with ergonomics. They can include average number of working hours/day, working days/week and overtime working hours/week as well as years of working experience. Also included was the frequency of performing various physical activities during the working day (such as bending, twisting, climbing stairs, sitting, standing, lifting, working with computers, working in uncomfortable postures), and the frequency rest breaks. It can also include the self rated of tiredness at the end of their working day, the ergonomics of their workstation, and the environmental conditions (such as temperature, noise level, light intensity), etc. To say the least, there are many physical risk factors. physical risk factors

Individual risk factors: We all know that everyone is different, take a look at the picture below to put this all in perspective (actually these people all kind of look the same on second thought…). Individual risk factors include any personal risk factors. More specifically, they can include the person’s gender, age, height, body weight, hand/leg dominance, chronic diseases, and other personal habits (smoking, sleep, alcohol/caffeine intake, amount/quality of sleep, leisure activities).individual differences

Psychosocial risk factors: Various psychosocial factors play significant roles in the development of MSI symptoms with office workers. Isn’t this just surprising… but at the same time, kind of makes sense? Examples of risks includes the mental demands, responsibility required, repetitive work, work related decision latitude, frequency of work related problems, lack of personnel in the workplace, relationships with colleagues, level of support from supervisors, frequency of feeling stress, anxiety, fear of job loss, job dissatisfaction, and work pressure. Check out our past work on psychosocial risk factors and the development of lower back pain for more detailed information!

Let’s take a closer look at mental stress and how it may result in injury or discomfort. Mental stress can increase muscle activity and thereby the force applied to any physical activity, like typing on a keyboard. This increased exertion (or force) can compound the physical load to the body and this is what increases discomfort symptoms.  psychosocial 2

What You Can Implement Today

Let’s make this into usable information for you. And, trust me, there is a lot of usable information here! To do so, let’s take a keen look at this situation with our ergo eyes (I know, we are kind of corny!). We want to know what the relationship is between office worker’s self-reported MSI/discomfort in their lower extremities (ankle/foot, knee, and hip) AND between any individual, work-related physical and psychosocial factors.

Here’s one key finding: When someone reports that there is a really high stress level, specifically with mental demands and work repetitiveness, there is a really high tendency that there is an association with hip discomfort symptoms.

Need more key findings? So do we. Take a look at the factors listed below, these factors are very likely/significantly related to lower extremity MSI/discomfort complaints:

  • Chronic diseases 
  • Quality of sleep
  • Average number of working hours/day 
  • Low satisfaction with the size of office space and the condition of air circulation in the office
  • Mental demands/stress
  • Work repetitiveness
  • Frequency of feeling frustrated in the previous 4 weeks

It’s incredibly interesting to think that there are more than just the typical ‘physical’ risk factors that are related to the development of pain and/or discomfort in the office. Are you in charge of your company’s health and safety or wellness programs? If so, you can get a big BANG for your buck by integrating interventions and awareness campaigns aimed at the above factors.

The last piece of advice… Do not overlook the value of a comprehensive and thorough root cause analysis of a workstation! Because, a worker’s perception of their workstation as being ‘poor ergonomically’ has been found to be associated with an increased prevalence of pain in the neck and upper extremities! Wow! Many of the above factors, may be able to be addressed by ensuring that someone’s workstation optimally fits them. Need some advice with this? We offer Ergonomic Consultations, where we virtually assess your workstation, and Ergonomic Coaching, where we can chat in a more informal setting to discuss any concerns and offer advice to you!


Janwantanakul, P., Pensri, P., Jiamjarasransi, Sinsongsook, T. (2009). Biopsychosocial factors are associated with high prevalence of self-reported musculoskeletal symptoms in the lower extremities among office workers. Archives of Medical Research. 40, 216-222.


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