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Lower limb disorders

As an employer, you must protect your workers from the risks of developing lower limb disorders (LLDs) at work.

Lower limb disorders can affect the hip, thigh, knee, calf, ankle or foot. They include joint and soft tissue problems and can be caused or made worse by work. They may be either due to an acute injury or develop gradually over a period of time.

Protect your workers

You may not be able to prevent all cases of LLDs, but there are things you can do to help prevent symptoms or stop them getting worse, whether they are caused or made worse by work activities.

You must:

  • assess[79] tasks which may involve a risk of lower limb disorders
  • put controls in place to protect your workers from the causes of LLDs at work

Consult and involve your workers[80] and make sure they know how to report any injuries or symptoms.

A number of lower limb disorders are caused by overuse of joints and muscles. The best way to reduce risk is to design the work to avoid this, for example by:

  • changing working methods
  • providing mechanical aids
  • rotating workers between jobs to lessen the time spent carrying out 'risky' tasks
  • providing regular breaks
  • providing seating, where possible
  • providing, for example, knee pads or anti-fatigue matting
  • providing information and training about the risks

Causes of lower limb disorders at work

These disorders are more common in tasks at work that involve, for example:

  • repetitive kneeling and/or squatting
  • climbing stairs or ladders
  • heavy manual handling[81]
  • prolonged standing

Symptoms

Symptoms include aches and pains, reduced range of movement, tenderness, stiffness, weakness, cramp and swelling.

If an employee has any of these symptoms, they may suggest overuse or an underlying condition.

Work-related conditions

Several conditions can be caused or made worse by work, such as:

Osteoarthritis

Osteoarthritis is a degenerative condition that affects the joints, for example, hips and knees. Farmers have a higher risk of suffering from hip osteoarthritis. Floor layers and cleaners have a higher risk of developing knee osteoarthritis.

Knee bursitis

Knee bursitis is caused by repetitive kneeling. It causes tenderness and swelling, and a reduction in knee movement.

Knee meniscal (cartilage) lesions/tear damage

If the knee is bent or twisted while bearing a load, the force may cause meniscal damage. Overuse, for example repetitive squatting or kneeling, is also associated with damage. This damage can lead to osteoarthritis.

Stress fracture

Stress fractures are caused by repeated micro-injuries to bone. They are more common in the armed forces and in athletes, particularly long-distance runners.

Varicose veins

Varicose veins are dilated veins of the leg. Workers may complain of heaviness and pain, legs swelling, night-time calf cramps and restless legs. They are associated with prolonged standing and heavy lifting.

Link URLs in this page

  1. MSDshttps://www.hse.gov.uk/MSd/msds.htm
  2. Back painhttps://www.hse.gov.uk/MSd/backpain/index.htm
  3. Upper limb disordershttps://www.hse.gov.uk/MSd/uld/index.htm
  4. Lower limb disorders https://www.hse.gov.uk/MSd/lld/index.htm
  5. Display screen equipment (DSE)https://www.hse.gov.uk/MSd/dse/index.htm
  6. Manual handling at workhttps://www.hse.gov.uk/MSd/manual-handling/index.htm
  7. Overview - MSD toolkithttps://www.hse.gov.uk/MSd/toolkit.htm
  8. Overview - MAC toolhttps://www.hse.gov.uk/MSd/mac/index.htm
  9. Introduction to MAChttps://www.hse.gov.uk/MSd/mac/introduction.htm
  10. Developmenthttps://www.hse.gov.uk/MSd/mac/development.htm
  11. Score sheethttps://www.hse.gov.uk/MSd/mac/scoresheet.htm
  12. Overview - Liftinghttps://www.hse.gov.uk/MSd/mac/liftintro.htm
  13. Lifting from pallet videohttps://www.hse.gov.uk/MSd/mac/liftvid1.htm
  14. Lifting creels of wire videohttps://www.hse.gov.uk/MSd/mac/liftvid2.htm
  15. Lifting control measureshttps://www.hse.gov.uk/MSd/mac/guidance01a.htm
  16. Overview - Carryinghttps://www.hse.gov.uk/MSd/mac/carryintro.htm
  17. Carrying from conveyor videohttps://www.hse.gov.uk/MSd/mac/carryvid1.htm
  18. Carrying task in pastry factory videohttps://www.hse.gov.uk/MSd/mac/carryvid2.htm
  19. Carrying control measureshttps://www.hse.gov.uk/MSd/mac/guidance02a.htm
  20. Overview - Team handlinghttps://www.hse.gov.uk/MSd/mac/teamintro.htm
  21. Team handling pallet videohttps://www.hse.gov.uk/MSd/mac/teamvid1.htm
  22. Team handling container videohttps://www.hse.gov.uk/MSd/mac/teamvid2.htm
  23. Team handling control measureshttps://www.hse.gov.uk/MSd/mac/guidance03a.htm
  24. Psychosocial risk factorshttps://www.hse.gov.uk/MSd/mac/psychosocial.htm
  25. Individual differenceshttps://www.hse.gov.uk/MSd/mac/individuals.htm
  26. MAC assessment tipshttps://www.hse.gov.uk/MSd/mac/tips.htm
  27. MAC FAQhttps://www.hse.gov.uk/MSd/mac/faq.htm
  28. Overview - V-MAChttps://www.hse.gov.uk/MSd/mac/vmac/index.htm
  29. Advantages and limitationshttps://www.hse.gov.uk/MSd/mac/vmac/1-advantages-limitations.htm
  30. What you need to knowhttps://www.hse.gov.uk/MSd/mac/vmac/2-what-you-need-to-know-before.htm
  31. How to use the V-MAChttps://www.hse.gov.uk/MSd/mac/vmac/3-how-to-use.htm
  32. Which jobs and workers to assesshttps://www.hse.gov.uk/MSd/mac/vmac/4-which-jobs-workers-to-assess.htm
  33. Entering datahttps://www.hse.gov.uk/MSd/mac/vmac/5-entering-data.htm
  34. What does the V-MAC tell you?https://www.hse.gov.uk/MSd/mac/vmac/6-what-does-vmac-tell-you.htm
  35. Values in the summary tablehttps://www.hse.gov.uk/MSd/mac/vmac/7-summary-tables.htm
  36. Recording and usinghttps://www.hse.gov.uk/MSd/mac/vmac/8-recording-and-using.htm
  37. Worked exampleshttps://www.hse.gov.uk/MSd/mac/vmac/9-worked-examples.htm
  38. V-MAC FAQshttps://www.hse.gov.uk/MSd/mac/vmac/10-faqs.htm
  39. Overview - ART toolhttps://www.hse.gov.uk/MSd/uld/art/index.htm
  40. What is the ART toolhttps://www.hse.gov.uk/MSd/uld/art/whatis.htm
  41. Overview - Learning to use the ART toolhttps://www.hse.gov.uk/MSd/uld/art/learning.htm
  42. Preparationhttps://www.hse.gov.uk/MSd/uld/art/preparation.htm
  43. Risk factorshttps://www.hse.gov.uk/MSd/uld/art/riskfactors.htm
  44. Observationhttps://www.hse.gov.uk/MSd/uld/art/observation.htm
  45. Overview - Making an assessmenthttps://www.hse.gov.uk/MSd/uld/art/assessment.htm
  46. Task descriptionshttps://www.hse.gov.uk/MSd/uld/art/task.htm
  47. Overview - Assessment guidehttps://www.hse.gov.uk/MSd/uld/art/assessguide.htm
  48. A. Frequency and repetition of movementshttps://www.hse.gov.uk/MSd/uld/art/freqrep.htm
  49. B. Forcehttps://www.hse.gov.uk/MSd/uld/art/forceassessment.htm
  50. C. Awkward postureshttps://www.hse.gov.uk/MSd/uld/art/awkpostures.htm
  51. D. Additional factorshttps://www.hse.gov.uk/MSd/uld/art/addfactors.htm
  52. Score sheethttps://www.hse.gov.uk/MSd/uld/art/score.htm
  53. A walkthroughhttps://www.hse.gov.uk/MSd/uld/art/walkthrough.htm
  54. Overview - Try it outhttps://www.hse.gov.uk/MSd/uld/art/try.htm
  55. Book bindinghttps://www.hse.gov.uk/MSd/uld/art/bookbinding.htm
  56. Jogging sheetshttps://www.hse.gov.uk/MSd/uld/art/jogging.htm
  57. Collating papershttps://www.hse.gov.uk/MSd/uld/art/papers.htm
  58. Whisky carton assemblyhttps://www.hse.gov.uk/MSd/uld/art/cartonassembly.htm
  59. Croissant curlinghttps://www.hse.gov.uk/MSd/uld/art/croissant.htm
  60. Overview - Analysis and actionshttps://www.hse.gov.uk/MSd/uld/art/analysis.htm
  61. What the scores meanhttps://www.hse.gov.uk/MSd/uld/art/scoresmean.htm
  62. Analysing task rotationhttps://www.hse.gov.uk/MSd/uld/art/rotation.htm
  63. Overview - Taking actionhttps://www.hse.gov.uk/MSd/uld/art/action.htm
  64. Repetitionhttps://www.hse.gov.uk/MSd/uld/art/repetition.htm
  65. Forcehttps://www.hse.gov.uk/MSd/uld/art/force.htm
  66. Posturehttps://www.hse.gov.uk/MSd/uld/art/posture.htm
  67. Durationhttps://www.hse.gov.uk/MSd/uld/art/duration.htm
  68. Physical environmenthttps://www.hse.gov.uk/MSd/uld/art/environment.htm
  69. Psychosocial issueshttps://www.hse.gov.uk/MSd/uld/art/psychosocial.htm
  70. Art Tool Resourceshttps://www.hse.gov.uk/MSd/uld/art/resources.htm
  71. Frequently asked questionshttps://www.hse.gov.uk/MSd/uld/art/faq.htm
  72. Overview - RAPP toolhttps://www.hse.gov.uk/MSd/pushpull/index.htm
  73. Push/pull riskshttps://www.hse.gov.uk/MSd/pushpull/risks.htm
  74. Push/pull risk assessmenthttps://www.hse.gov.uk/MSd/pushpull/assessment.htm
  75. The lawhttps://www.hse.gov.uk/MSd/legislation.htm
  76. Health monitoringhttps://www.hse.gov.uk/MSd/health-monitoring.htm
  77. Workershttps://www.hse.gov.uk/MSd/workers-msds.htm
  78. Resourceshttps://www.hse.gov.uk/MSd/resources.htm
  79. assesshttps://www.hse.gov.uk/simple-health-safety/risk/index.htm
  80. Consult and involve your workershttp://www.hse.gov.uk/involvement/
  81. heavy manual handlinghttps://www.hse.gov.uk/MSd/manual-handling/index.htm
  82. osteoarthritishttps://www.nhs.uk/conditions/osteoarthritis/
  83. bursitishttps://www.nhs.uk/conditions/bursitis/
  84. varicose veinshttps://www.nhs.uk/conditions/varicose-veins/
  85. Manual handling at work: A brief guidehttps://www.hse.gov.uk/pubns/indg143.htm
  86. Managing upper limb disorders in the workplacehttps://www.hse.gov.uk/pubns/indg171.htm
  87. Manual handling assessment charts (the MAC tool) https://www.hse.gov.uk/pubns/indg383.htm
  88. Risk assessment of pushing and pulling (RAPP) tool https://www.hse.gov.uk/pubns/indg478.htm
  89. Assessment of repetitive tasks of the upper limbs (the ART tool)https://www.hse.gov.uk/pubns/indg438.htm
  90. Display screen equipment (DSE)https://www.hse.gov.uk/MSd/dse/index.htm
  91. Manual handling at workhttps://www.hse.gov.uk/MSd/manual-handling/index.htm

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Updated 2021-06-30