Mechanical loading of the low back and shoulders during pushing and pulling activities
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Updated: Aug 29, 2026

Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
Marco J M Hoozemans1, P Paul F M Kuijer, Idsart Kingma
1Coronel Institute for Occupational and Envrionmental Health, AmCOGG Amsterdam Centre for Research into Health and Health Care, Academic Medical Centre/University of Amsterdam, PO box 22700, 1100 DE Amsterdam, The Netherlands.
Abstract:
The objective of this study was to quantify the mechanical load on the low back and shoulders during pushing and pulling in combination with three task constraints: the use of one or two hands, three cart weights, and two handle heights. The second objective was to explore the relation between the initial and sustained exerted forces and the mechanical load on the low back and shoulders. Detailed biomechanical models of the low back and shoulder joint were used to estimate mechanical loading. Using generalized estimating equations (GEE) the effects were quantified for exerted push/pull forces, net moments at the low back and shoulders, compressive and shear forces at the low back, and compressive forces at the glenohumeral joint. The results of this study appeared to be useful to estimate ergonomics consequences of interventions in the working constraints during pushing and pulling. Cart weight as well as handle height had a considerable effect on the mechanical load and it is recommended to maintain low cart weights and to push or pull at shoulder height. Initial and sustained exerted forces were not highly correlated with the mechanical load at the low back and shoulders within the studied range of the exerted forces.
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