by Thomas B. Gilliam Ph.D.

Over the years, I have posted many papers on the importance of a healthy muscle mass to help deter injury and certain lifestyle diseases. The research continues to be published supporting the importance of maintaining a healthy muscle mass especially since the worker is working at a much older age. The loss of muscular strength with age contributes to an increase in slips and falls and MSK injuries. I continue to analyze the IPCS strength testing data and the results have not changed. The worker continues to lose strength each year, especially in the shoulder and thigh regions for both genders and across age groups. Most industries today that have physically demanding jobs report that the shoulder is now their number one injury and most costly. A contributing factor to the increase in shoulder injuries is the loss of strength.

Chart 1

In addition to studying the loss of absolute strength in the worker, I was able to use 9-years of the Cleveland Clinic test results to validate and generate the Physical Strength Risk Assessment (PSRA™) to measure the risk of the worker for injury and certain lifestyle diseases. The PSRA™ is based on over 23,000 muscular evaluations which were tracked for both workers’ comp costs and employee health costs.

Using the PSRA™ data from the Cleveland Clinic and applying the results to all strength tests (145,942 tests¹) completed from 2018 through 2022, Chart 1 shows how those PSRA™ test results fall into the High Risk (Red), High-Moderate Risk, Low-Moderate Risk, and Low Risk (Green) categories for injury and certain lifestyle diseases. According to Chart 1, 33.4% of the workers fell into the High-Risk Category as opposed to 19.1% in the Low-Risk Category. It should be noted that in 2018 about 25% of the workers fell into the High Risk category and about 24% fell into the Low Risk Category. Further Chart 2 shows that between 2018 and 2022, the percentage of workers falling into the High Risk Category increased from 25% to about 40% which is a 60% increase. Likewise, the percentage of workers found in the Low Risk Category in 2018 decreased from about 24% to about 15% or 38% decrease in 2022.

Chart 2


What does this mean for Industry?

Using the Cleveland Clinic PSRA™ data, the worker that falls into the High Risk Category cost the company 42% more in employee health costs (Chart 3). This means if your company had 1,000 employees in physically demanding jobs in 2018, 250 of the workers fell into the High Risk Category compared to 400 in 2022 which would result in a significant increase in employee health costs both direct and indirect.

Chart 3

Is there a solution?

What is happening to worker in terms of loss of strength can be reversed, but it will take time. Muscle can get stronger no matter the age of the worker. Unfortunately, this situation is falling on the shoulders of industry because a variety of community programs over the last 50 years have failed to reverse this situation. Programs can be set up at work that would allow the worker to at least stop losing strength and start gaining strength. Incentives through benefit plans are critical for these kinds of programs to succeed.


Dr. Gilliam is a leader in the scientific community and the Founder and President of Industrial Physical Capability Services (IPCS), the industry leader in employee physical capability assessments. He has presented at many scientific meetings on the PCETM procedure and has been a keynote speaker at numerous medical conferences nationwide. He has written countless scientific papers, published by leading scientific journals and scholarly publications. Notably, he is the co-author of the book Move It. Lose It. Live Healthy. The Simple Truth About Achieving & Maintaining a Healthy Body Weight.