SEPTEMBER 17, 2025 – Musculoskeletal injuries represent a significant challenge for military readiness, accounting for roughly 95% of all military injuries and serving as the leading cause of medical visits, limited duty, and medical discharges across the armed forces.
To combat this pervasive threat to force readiness, the Defense Health Agency-Public Health ergonomics program within the Occupational Health Sciences directorate at Aberdeen Proving Ground, Maryland, takes a comprehensive approach that recognizes optimal human performance as critical to mission success.
“The program recognizes that ergonomic design is both a force protection and force-multiplication strategy,” said Steven Chervak, a DHA-PH ergonomist. “We aim to enhance warfighter performance, health, and safety by integrating ergonomic and human factors principles into military systems, equipment, and operations to reduce injury risk and optimize human-system performance.”
The primary goals of the ergonomics and human factors field are to reduce human error, increase productivity and efficiency, enhance safety, and reduce exposure to work-related musculoskeletal disorder risk factors, said John Pentikis, DHA-PH Ergonomics Branch manager.
Three-pronged approach to injury prevention
The DHA-PH ergonomics team accomplishes its mission through three primary focus areas: design reviews, worksite assessments, and training and education initiatives.
Design reviews, frequently conducted through the health hazard assessment process, aim to incorporate ergonomic principles into the acquisition process to ensure purchased or developed equipment is designed for optimal human performance prior to fielding.
“This proactive approach allows the team to identify and address potential injury risks before equipment reaches service members,” said Chervak.
Worksite assessments use job hazard analysis and biomechanical assessment techniques to optimize performance by improving human-machine interaction. These assessments focus on reducing ergonomic risk factors such as excessive force generation, repetitive motions, and exposure to vibration while optimizing posture for various military tasks, said Chervak.
“We assess a wide variety of work environments, including military hospitals and clinics, clinical care and laboratory settings, laundry and dining services, and industrial environments from cable assembly to paint booths and vehicle maintenance,” said Pentikis. “We also assess musculoskeletal -specific tasks such as weapons loading, litter carrying, parachute rigging, and load carriage.”
The training and education component involves multiple audiences, from teaching occupational health and safety personnel to perform worksite assessments to instructing service members on proper lifting and material handling techniques, said Chervak. The program also provides equipment-specific and site-specific training while educating leadership on ergonomic principles.
“For example, the ergonomics program recently developed specific ergonomic trainings in the areas of dining services, vehicle mechanics, emergency medical technicians, laboratories, and health care environments at the request of customers,” said Chervak.
The ergonomics team continually assesses ergonomics concerns as new equipment is developed.
“There are always new patient care environments, equipment, and circumstances to be assessed for safe patient handling and mobility, and the majority of work environments across the military place workers and military members at some level of musculoskeletal disorder risk,” said Kelsey McCoskey, a DHA-PH ergonomist. “Each time a depot mission changes, and a new system or equipment is being built or refurbished, the ergonomic risk factors change. Helping the local safety and occupational health personnel to continuously identify, prioritize, and remediate these work-related musculoskeletal risks is part of our mission.”
Real-world impact on military operations
Recent ergonomics evaluations have highlighted the direct impact our program can have on service members’ lethality, readiness, and equipment development, said Chervak.
“Studies have established a link between exposure to high levels of whole-body vibration and slowed reaction times,” said Chervak. “In combat scenarios, this delay can be the difference between life and death, especially when rapidly exiting a vehicle and returning fire. However, until now, the levels of whole-body vibration experienced by service members operating in military vehicles during realistic training and operational environments remained largely unknown.”
To address this critical knowledge gap, Chervak and McCoskey collaborated with the National Guard Bureau’s Office of the Joint Surgeon to pilot whole-body vibration exposure data collection on opposing force military vehicles during a recent Operation Northern Strike training exercise. This effort provides crucial data towards characterizing the whole-body vibration exposure soldiers face on missions, said Chervak.
“Additionally, it offers invaluable insights for optimizing future data gathering, allowing us to focus on targeted vehicle types, smaller exercises, and leveraging schoolhouse opportunities to develop a robust soldier vibration exposure algorithm,” said Chervak. “Ultimately, these evaluations aim to inform the development of vehicle designs and operational strategies that minimize vibration exposure, thereby enhancing service member lethality, protecting readiness, and optimizing mission success.
The team has also done whole-body vibration exposure studies with rotary wing aircrews.
“A recent evaluation of whole-body vibration exposure among a select group of rotary wing aircrew by the ergonomics group has led to further investigations by the program managers, structural engineers, and manufacturers of the aircraft to determine methodologies for reducing vibration exposures within the aircraft,” said Chervak.
The ergonomics team is also at the forefront of emerging technology assessment, particularly in evaluating exoskeletons for military applications, said Kevin Purcell, DHA-PH ergonomist. Currently, the ergonomics program is collaborating with endoscopy surgeons at Walter Reed National Military Medical Center in Bethesda, Maryland, to determine whether exoskeleton technology can reduce lower back and shoulder muscle fatigue during medical procedures.
“Exoskeletons hold promise for improving ergonomics and reducing the risk of injuries in workplaces with physically demanding tasks,” said Purcell. “However, they need to be implemented in the proper settings that carefully consider both the potential benefits and drawbacks, focusing on user-centered design, proper fitting, and thorough assessment in real-world work environments to maximize their effectiveness and minimize potential risks.”
The Walter Reed project uses Surface-Electromyography, or sEMG, to measure muscle activity during simulated endoscopy tasks performed with and without exoskeletons, said Purcell. This process captures muscle activation signals noninvasively through electrodes placed on the skin over target muscles and provides objective data on the technology’s effectiveness in reducing muscle activity.
Customer-driven investigations
The ergonomics team determines focus areas through both systematic processes and direct customer requests. Design reviews are coordinated through the HHA process, where the team receives assignments to review specific equipment for ergonomic risk factors including material handling requirements, force requirements, and vibration exposure.
“Work environment, job hazard analysis evaluations, training, and education initiatives are usually customer driven,” said Chervak. “We are either contacted by a unit directly or through a safety and occupational health professional who is responsible for the unit.”
Service members and units can request assistance through the ergonomics website by completing DHA Form 435 [right click to download], or by contacting the team directly. The team works to route requests through appropriate channels to begin direct collaboration with requesting units.
Targeting work-related musculoskeletal disorders
The ergonomics program specifically targets work-related musculoskeletal disorders which include various types of overuse injuries resulting from repetitive stress or excessive use without adequate recovery time, said Chervak. In military settings, these injuries often blur traditional workplace injury definitions.
“Overuse injuries are a part of work-related musculoskeletal disorders because they result from repetitive stress or excessive use without adequate recovery time,” said Chervak.
Examples of some disorders commonly linked to ergonomic risk factors are musculoskeletal injury to tendons, ligaments, muscles, and joints; degenerative disc disease; herniated discs; pinched nerves; and carpal tunnel syndrome, said Chervak. Specific examples of military-related overuse injuries include rotator cuff injuries prevalent among parachute riggers, and back injuries from lifting mortar shells.
Data-driven approach to prevention
To identify emerging trends and prioritize interventions, the ergonomics team collaborates closely with the DHA-PH’s Injury Prevention Branch, which is part of the Clinical Public Health and Epidemiology directorate, also located at Aberdeen Proving Ground, said Chervak. The Injury Prevention Branch tracks injury trends and uses the Force Risk Reduction management and analysis tool which is managed by the U.S. Army Combat Readiness Center at Fort Rucker, Alabama, to recognize patterns and emerging issues across military installations.
FR2 is available to individuals in the SOH community and human resources community with a government-issued CAC and a .mil email address.
Accessing ergonomic support
Multiple pathways of assistance are available for service members experiencing ergonomic concerns. The primary recommendation is to contact local safety officers, industrial hygienists, or occupational health specialists, who serve as the first line of defense for addressing ergonomic issues, said Chervak.
“If your local team cannot resolve the issue internally or needs additional expertise, they will escalate the matter to our specialized team for advanced assessment and solutions,” said Chervak. “You can also contact us directly if you prefer or if the situation requires immediate attention. We’ll work collaboratively with you and your local SOH team.”
The ergonomics program also develops strategic partnerships with installation SOH personnel. In some cases, an ergonomics team member will virtually attend regularly scheduled SOH meetings, said Lauren Costanzi, DHA-PH ergonomist.
One example of the benefits of this type of collaboration is an effort related to the assembly of a fabric military battery pouch. The SOH office had identified the task as being physically difficult to perform and causing hand and wrist injuries, said Costanzi. The pouch is sewn inside out, which requires it to be flipped right side out prior to shipment. This task requires high-hand forces due to the inflexibility of the stiff fabric. DHA-PH ergonomists measured the forces required to manipulate the battery pouch by using a force gauge to push the corners of the pouch into position. The gauge recorded the peak push force as 42 pounds.
“Ergonomists investigated the use of a home-grade steamer to soften the battery pouch fabric,” said Costanzi. “Softening the fabric reduced the push/pull forces required to manipulate the fabric from inside out to right-side out. Subsequent manipulation of the pouch to turn it right side out resulted in maximum pulling force of 10 pounds, which represents a 67% decrease in the amount of force needed to manipulate the battery pouch.”
Strategic partnerships and standards development
Beyond direct service delivery, the DHA-PH ergonomics program maintains strategic partnerships with professional organizations and standards committees to influence policies affecting military operations, said Chervak. The team actively collaborates with the U.S. Department of Veterans Affairs Veterans Health Agency Safe Patient Handling and Mobility and ergonomics programs, the Maryland National Guard, and participates in safe patient handling organizations, human vibration exposure technical advisory groups, and exoskeleton standards committees.
“These partnerships ensure the military can shape standards rather than simply comply with them, preventing increased procurement costs while protecting service member health through proactive engagement in policy development,” said Chervak.
The program also provides digital support to U.S. Army and Department of Defense end users through educational materials, fact sheets, policy guidance, professional publications, and regular updates to military ergonomics guidance documents.
Story by Douglas Holl
Defense Health Agency