cross
  • About us
  • Blog
  • NEWSLETTER
    • Request a demo

    Awkward postures

    Awkward postures are work positions in which one or more anatomical regions are moved from a natural, comfortable position to one that generates hyperextension, hyperflexion, or hyperrotation of the joints, or which are maintained statically for prolonged periods, resulting in overload of muscles, tendons, ligaments, and joint structures. These include both extreme postures (flexed or twisted torso, arms above the shoulders, flexed or extended neck, deviated wrists, working on one’s knees or in a squatting position) and postures maintained without variation (standing or sitting for hours without the possibility of changing positions). They are one of the main ergonomic risk factors and a frequent cause of musculoskeletal disorders of the back, neck, shoulders, and limbs. Several pathologies associated with awkward and sustained postures are listed in the schedule of occupational diseases in Royal Decree 1299/2006. Law 31/1995 requires risk assessment and adaptation of work to the individual, and the INSST includes postural load assessment methods such as OWAS (NTP 452) and REBA (NTP 601), along with design and organization criteria to reduce exposure.

    In short

    Work positions that remove one or more anatomical regions from their natural comfort position (hyperflexion, hyperextension, rotation, raised arms, kneeling or squatting) or that are maintained statically for prolonged periods, overloading muscles, tendons, and joints. These cause musculoskeletal disorders of the back, neck, shoulders, and limbs, several of which are included in the list of occupational diseases in Royal Decree 1299/2006. They are assessed using methods such as OWAS (NTP 452), REBA (NTP 601), or RULA and are prevented through workstation design, equipment and aids, organization, job rotation, training, and health surveillance.

    Content
    1. Types of awkward postures and their effects
    2. Postural load assessment
    3. Preventive measures
    4. Organizational application: how to prevent awkward postures
    5. Limits and common mistakes
    6. Practical example
    7. Regulatory and reference framework
    8. Related concepts
    9. On the blog
    10. References

    A–Z dictionary →

    Types of awkward postures and their effects

    Awkward postures can be classified by the affected region and by their dynamic or static nature. In the trunk, pronounced flexion, lateral bending, and rotation, especially when combined with lifting, overload the lumbar spine. In the neck, sustained flexion or extension (working with poorly positioned screens, precision tasks, overhead work) causes neck pain. In the shoulders, working with the arms raised above shoulder level or away from the body is associated with rotator cuff tendinitis. In the lower extremities, prolonged kneeling, squatting, or standing can lead to knee problems, circulatory issues, and fatigue. Static postures, even if not extreme, reduce blood flow to the contracted muscles and accelerate fatigue.

    The health effects include progressively developing musculoskeletal disorders: lower back pain, neck pain, shoulder tendinitis, epicondylitis, knee bursitis, and symptoms of fatigue and pain that reduce work capacity. The list of occupational diseases includes, in its group 2, several illnesses caused by awkward postures and repetitive movements, such as knee bursitis in jobs requiring prolonged weight-bearing, shoulder tendinitis in jobs with arms raised, and meniscus tears in jobs performed in a kneeling or crouching position.

    The sectors with the greatest exposure include construction, agriculture, manufacturing, cleaning, healthcare and caregiving (moving people), hospitality, retail, repair shops, and office work with poorly configured screens. The combination of awkward postures with force, repetitive movements, vibrations, or prolonged periods of use multiplies the risk.

    Postural load assessment

    • Identification. Observation of tasks, analysis of the frequency and duration of postures, complaints from people and health surveillance data.
    • OWAS method . Classifies back, arm and leg postures and the load handled into action categories according to the percentage of time in each posture (NTP 452).
    • REBA method . Evaluates whole body posture, load, grip type and muscle activity and assigns a risk and action level (NTP 601).
    • RULA method . Focused on the upper limbs, neck and trunk in sedentary or precision tasks.
    • Technical standards. UNE-EN 1005-4 and ISO 11226 establish criteria for evaluating postures and movements in relation to machines and static postures.
    • Duration and organization. Analysis of the actual time spent in each position, the possibilities for alternation, and the pauses.
    • Registration and review. Documentation of the evaluation and updating in response to changes in tasks, equipment, or detected damage.

    Preventive measures

    • Workstation design. Working heights appropriate to the type of task, frequently used items within reach, adjustable tables and benches, seats with support and the possibility of alternating between sitting and standing.
    • Equipment and aids. Platforms and scaffolding for working at the correct height, mechanical aids and tools that prevent working with arms raised or wrists bent, knee pads and supports when kneeling is unavoidable.
    • Organization. Rotation between tasks with different postural demands, recovery breaks, reduction of the duration of sustained postures and appropriate work pace.
    • Working methods. Procedures that reduce extreme postures, task planning, and arrangement of materials and tools.
    • Training. Postural techniques, use of aids and equipment, importance of alternation and early detection of symptoms.
    • Health surveillance. Specific health surveillance protocols for awkward postures and adaptation of the workstation based on the results.
    • Especially sensitive people. Adaptation for pregnant workers, people with pre-existing conditions and older people.

    Organizational application: how to prevent awkward postures

    1. Identify tasks with extreme or sustained postures through observation, consultation with staff, and data on injuries and complaints.
    2. Evaluate postural load using a recognized method (OWAS, REBA or RULA depending on the task), recording the frequency and duration of each posture.
    3. Prioritize design measures: working heights, reaches, adjustable furniture, platforms and mechanical aids that eliminate extreme postures.
    4. Redesign the organization: rotation between tasks with different postural demands, recovery breaks and alternation between sitting and standing.
    5. Define work methods and material arrangement that reduce awkward postures, and train people and managers.
    6. Apply specific health surveillance protocols and adapt jobs to particularly sensitive individuals.
    7. Re-evaluate after measures are taken and in response to changes, and monitor indicators of musculoskeletal disorders and absenteeism.

    Preventive management software allows you to record postural assessments by job and task, plan design and organization measures, link the results with health surveillance and reported injuries, and maintain traceability of the reviews.

    Limits and common mistakes

    1. Evaluate only extreme postures and forget about sustained and static postures.
    2. Applying an evaluation method without considering the actual duration of exposure or the combination with strength and repeatability.
    3. Limiting prevention to training in postural hygiene without modifying the design of the workstation.
    4. Maintaining inadequate working heights and reaches due to a lack of furniture or adjustable platforms.
    5. Failure to apply health surveillance protocols or to report associated occupational diseases.
    6. Do not re-evaluate after changes in task, equipment, or work pace.

    The evaluation and design criteria are detailed in the INSST technical notes and in the cited technical standards; this sheet is for informational purposes.

    Practical example

    Situation: an industrial vehicle maintenance workshop with 40 mechanics registers recurrent lower back pain and shoulder tendinitis, associated with work under vehicles and with arms raised.

    • Assessment. The prevention service applies the REBA method to the main tasks: operations under the vehicle without a pit or lift and work on engines from the ground obtain high risk levels due to trunk flexion, raised arms and sustained postures.
    • Technical measures. An additional column lift is installed, adjustable platforms and tool carts are incorporated at working height, and extension tools are acquired to avoid working with arms above shoulder height.
    • Organization. Tasks are planned to alternate operations with different postural demands, short breaks are introduced in the most demanding jobs, and staff are trained in the use of aids and postural techniques.
    • Follow-up. The health surveillance protocol for awkward postures is applied and, after re-evaluation, REBA levels decrease to medium and low ranges; cases of lower back pain and tendinitis are reduced in the following year.

    Regulatory and reference framework

    The UNE-EN 1005-4 and ISO 11226 standards establish the technical criteria for evaluating postures, and the specific health surveillance protocols of the Ministry of Health cover awkward postures.

    Related concepts

    On the blog

    References

    1. Official State Gazette. Law 31/1995, of November 8, on Occupational Risk Prevention. 1995, current consolidated text. Official source
    2. Official State Gazette. Royal Decree 39/1997, of January 17, approving the Regulation of Prevention Services. 1997, current consolidated text. Official source
    3. Official State Gazette. Royal Decree 1299/2006, of November 10, approving the schedule of occupational diseases in the Social Security system and establishing criteria for their notification and registration. 2006, current consolidated text. Official source
    4. Official State Gazette. Royal Decree 486/1997, of April 14, establishing the minimum health and safety requirements in the workplace. 1997, current consolidated text. Official source
    5. National Institute for Occupational Safety and Health. NTP 452: Evaluation of working conditions: postural load. 1998. Official source
    6. National Institute for Occupational Safety and Health. NTP 601: Evaluation of working conditions: postural load. REBA (Rapid Entire Body Assessment) method. 2001. Official source
    7. National Institute for Occupational Safety and Health. Ergonomic risks: musculoskeletal disorders. Thematic portal. Official source

    Editorial information

    Publication date: August 30, 2026 .

    Editorial Manager: Sabentis Editorial Team .

    Editorial review by Pablo Rodríguez LinkedIn

    Executive Vice President of the ORP International Foundation and Chief Financial Officer of Sabentis.

    Request a Demo

    Discover all that Sabentis can do for your organization.

    Try Sabentis

    request a demo
    stars 5
    GetApp Software Advice Capterra