Sprains, strains, and tears are the most common workplace injuries in the United States, and the leading cause is overexertion: lifting, pushing, pulling, or carrying something beyond what the body can handle. Over the 2023–2024 period, overexertion and related bodily reactions caused nearly 950,000 injuries serious enough to require time away from work, job restrictions, or a transfer to different duties. These injuries cost employers more than any other category, with overexertion alone responsible for roughly $12.5 billion in direct costs per year.
Overexertion: The Top Cause of Injury
Overexertion happens when you push your body past its physical limits during work tasks. That includes lifting a heavy box, pulling a loaded cart, bending repeatedly, or holding an awkward posture for too long. The result is usually a sprain, strain, or tear in the muscles, tendons, or ligaments, most often in the back. Historically, sprains and strains have accounted for about 43 percent of all private-industry injuries that required recovery time beyond the day of the incident.
These injuries don’t typically come from a single dramatic moment. Many develop gradually through repetitive motions or sustained physical effort that wears down tissue over weeks or months. A warehouse worker who loads trucks all day, a nurse who repositions patients, or an office worker who types for hours with poor ergonomics can all end up with the same category of injury. The median recovery time for overexertion injuries is 14 days away from work, though severe cases involving herniated discs or torn rotator cuffs can mean months of limited activity.
Other Leading Causes
After overexertion, contact incidents are the second most common cause. These include being struck by a falling object, bumping into equipment, or getting a hand caught in machinery. Contact incidents accounted for roughly 860,000 serious cases over the 2023–2024 period. Being struck by an object or piece of equipment alone costs employers about $5.5 billion per year.
Falls, slips, and trips round out the top three. Falls on the same level (think wet floors, cluttered walkways, or uneven surfaces) cost $10 billion annually in direct expenses, making them the second most expensive injury category despite sometimes being dismissed as minor. Falls to a lower level, such as off a ladder, scaffold, or loading dock, add another $5.7 billion. Workers who miss time for a fall-related injury are typically out for a median of 13 days.
Exposure to harmful substances is less common but often more severe. About 224,000 cases were reported in 2023–2024, and 87.6 percent of those required at least one day completely away from work, a higher proportion than any other injury category.
How Risk Varies by Industry
Your likelihood of getting hurt depends heavily on where you work. Two industries stand out for very different reasons: construction and healthcare.
Construction
Construction laborers face injury rates far above the national average across nearly every category. In 2020, their rate of falls, slips, and trips was 52.5 cases per 10,000 full-time workers, compared to 22.9 for all workers. Their rate of being struck by objects was 45.5 per 10,000, roughly four times the national average of 11.2. Overexertion from lifting or lowering alone hit construction laborers at more than double the rate of all workers (18.5 versus 8.4 per 10,000).
Fall protection violations are consistently the number one citation issued by federal safety inspectors, followed by hazard communication failures and ladder safety violations. These aren’t abstract regulatory concerns. They reflect the specific scenarios that send construction workers to the emergency room.
Healthcare
Healthcare might not seem like a physically dangerous field, but hospitals have some of the highest rates of musculoskeletal injuries in any industry. Sprains and strains account for 54 percent of hospital injuries requiring days away from work. Nearly half of all hospital worker injuries (48 percent) are caused by overexertion or bodily reaction, often during patient handling: lifting, repositioning, or transferring patients who may be unable to move themselves.
About a third of hospital injuries resulting in missed work involve direct interaction with a patient, and 72 percent of those patient-related injuries are musculoskeletal. Violence from patients is also included in this category, making bedside care one of the more physically demanding and risky workplace environments.
The Full Cost of These Injuries
Liberty Mutual’s Workplace Safety Index, which tracks the most disabling injuries by direct cost, paints a clear picture of where the financial burden falls. The top five categories and their annual price tags:
- Overexertion involving outside sources: $12.49 billion
- Falls on the same level: $9.99 billion
- Falls to a lower level: $5.68 billion
- Struck by object or equipment: $5.55 billion
- Other exertions or bodily reactions: $3.68 billion
These figures cover only direct costs like medical bills and wage replacement. They don’t include lost productivity, retraining, or the long-term impact of chronic pain that keeps workers from returning to full capacity. Together, just these five categories account for more than $37 billion a year.
What Actually Prevents These Injuries
Since overexertion is the dominant cause, the most effective prevention targets how physical tasks are performed. In warehouse and manufacturing settings, that means mechanical lift assists, team lifting policies, and job rotation so the same muscles aren’t taxed for an entire shift. In healthcare, patient handling equipment like ceiling-mounted lifts and slide boards has been shown to significantly reduce the back injuries that plague nurses and aides.
For falls, the solutions are often simple but easy to neglect: keeping walkways clear, cleaning spills immediately, wearing appropriate footwear, and using fall protection equipment at any height in construction. For contact injuries, proper guarding on machinery, hard hats, and awareness of overhead work reduce the most common strike-by scenarios.
Across all industries, the total number of recorded workplace injuries has been declining. In 2024, employers reported 2.5 million injury and illness cases in private industry, down 3.1 percent from 2023, with an overall incidence rate of 2.3 cases per 100 full-time workers. That’s real progress, but the pattern of which injuries dominate has remained remarkably consistent for decades. Overexertion and falls continue to lead, which means the physical demands of work, not exotic hazards, remain the biggest threat to most workers’ safety.