Written by the Phoenix Rehab physiotherapy and hand therapy teams. Clinically reviewed by Louise Yow, Principal Physiotherapist & Director, AHPC A1300363H; hand, wrist and elbow sections by Nigel Chua, Principal Hand Occupational Therapist & Director, AHPC A1300362Z. Last reviewed 6 October 2026.
The injuries we see most from construction and the trades are lower back pain, shoulder pain from overhead work, and hand injuries: cuts, crushes and fractures. Lifting and carrying cause most of the back pain. Hand tools, blades and machinery cause most of the hand injuries, and falls from height cause the fractures.
The work is physical in specific ways. An aircon technician drills into a ceiling with both arms overhead. A tiler kneels on a bathroom floor for a whole day. A carpenter swings a hammer thousands of times a week. Someone carries cement bags up from the lorry, one after another.
Then there are the single moments. A blade slips. A sheet of metal edge catches the palm. A finger gets caught between a pipe and a beam. A ladder shifts. A review of the research found lower back, knee and shoulder symptoms common among construction workers.1
The slow injuries, the back and the shoulder and the knees, are load problems we can measure. The sudden hand injuries usually need a surgeon first. After the repair, getting the hand to grip, pinch and feel again is the work of our hand therapy team.
The tasks, and what they load
| Task | What it loads | What it most often irritates |
|---|---|---|
| Drilling and fitting overhead (ceilings, aircon, lighting) | Shoulders held up, neck tipped back | Rotator cuff, neck |
| Lifting and carrying (cement, tiles, rebar, pipes) | Lower back, discs | Back strain, slipped disc |
| Kneeling and squatting (tiling, flooring, plumbing) | Kneecaps, the cartilage inside the knee | Kneecap bursitis, meniscus tears, knee arthritis |
| Hammering and gripping tools | Outer elbow, the heel of the hand | Tennis elbow, the blood vessel in the palm |
| Power tools (drills, grinders, breakers) | Nerves and blood vessels of the hand | Hand-arm vibration syndrome, carpal tunnel |
| Blades, sheet metal and glass | Fingers and palm | Cut tendons and nerves |
| Machinery and heavy materials | Hands and feet | Crush injuries, fractures |
| Ladders and scaffolds | Wrists, spine, heels, ankles in a fall | Wrist, spine, heel and ankle fractures |
| Uneven site ground | Ankles | Ankle sprain |
Every construction injury, by body part
Start from where it hurts. Each linked row goes to the page that covers that injury in full.
| Where | Injury | How construction work usually causes it |
|---|---|---|
| Hand and finger | Hand crush injury | A hand caught in machinery or between materials |
| Hand and finger | Cut tendon on the palm side (flexor tendon laceration) | A blade or a sheet-metal edge across the palm or finger |
| Hand and finger | Cut tendon on the back of the hand (extensor tendon laceration) | A blade across the back of the hand or finger |
| Hand and finger | Cut finger nerve (digital nerve laceration) | A blade cut along the side of a finger |
| Hand and finger | Finger fracture | A hammer strike or a dropped load |
| Hand and finger | Hand-arm vibration syndrome | Years of drills, grinders and breakers |
| Hand and finger | Hypothenar hammer syndrome | Using the heel of the hand as a hammer |
| Wrist | Carpal tunnel syndrome | Vibrating tools and a hard grip |
| Wrist | Wrist fracture (distal radius) | A fall from a ladder or scaffold onto the hand |
| Wrist | Scaphoid fracture | A fall onto an outstretched hand |
| Elbow | Outer elbow pain (tennis elbow) | Hammering and gripping tools all day |
| Shoulder | Rotator cuff tendon pain | Overhead drilling and ceiling work |
| Shoulder | Rotator cuff tear | Overhead work and lifting, on a cuff already worn with age |
| Neck | Postural neck pain | The neck tipped back to work on a ceiling |
| Spine | Spinal compression fracture | A fall from height landing on the feet or the buttocks |
| Lower back | Lower back strain | Lifting and carrying materials |
| Lower back | Slipped disc (lumbar disc herniation) | Lifting with a twist |
| Knee | Kneecap bursitis (prepatellar bursitis) | Kneeling all day, for tilers and floor layers |
| Knee | Meniscus tear | Squatting and kneeling, and twisting up out of a squat |
| Knee | Knee arthritis flare | Years of kneeling and squatting |
| Ankle | Ankle fracture | A fall from height |
| Ankle | Heel bone fracture (calcaneus fracture) | A fall from height landing on the heels |
| Ankle | Ankle sprain | Uneven ground on site |
| Foot | Foot crush injury | A dropped load |
Not on the list, or not sure which row is yours? That is what the first visit is for.
The injuries we see most in construction and the trades
Lower back pain from lifting
What it feels like. A catch across the low back as you lift, or a back that tightens up overnight after a heavy day. Bending to put on your boots hurts the next morning. Sometimes the pain runs into a buttock or down a leg.
What is usually going on. Most of it is a strain of the muscles and joints of the lower back, from a load that was heavier, further from the body or more twisted than the back was ready for. Pain that runs below the knee with numbness can be a disc pressing on a nerve.
What we measure. Back movement in each direction, how far you can bend before pain, trunk endurance holds in seconds, hip range, nerve tests in the legs, and a lift from floor to waist at a weight close to what your job asks.
This week. Keep moving. Walking helps most backs settle. Carry loads close to the body, and turn with your feet, not your back. Split loads where you can: two trips with a half bag. Pain relief and anti-inflammatory medication are a decision for your doctor or pharmacist. More on lower back pain.
Shoulder pain from overhead work
What it feels like. An ache on the outside of the upper arm when you reach up, worse with a drill held overhead, and often worse at night lying on that side.
What is usually going on. The rotator cuff holds the ball of the shoulder steady while the arm is up. Hours of holding a tool overhead tire and irritate those tendons. In workers over about 40, a lift or a fall can tear a cuff that was already worn.
What we measure. Shoulder range in degrees, rotation strength against the other side, how long you can hold the arm overhead before pain, and how the shoulder blade moves.
This week. Bring the work closer: a higher platform so the hands work at or below head height. Alternate overhead tasks with work at waist height. Sudden weakness lifting the arm after a fall or a heavy lift needs a doctor. More on the rotator cuff.
Cut tendons and nerves in the hand
What it feels like. A cut on the palm side of a finger, after which the finger will not bend on its own. Or a cut along the side of a finger, after which half the fingertip feels numb. A cut on the back of the hand can leave a finger that will not straighten.
What is usually going on. A blade or a sheet-metal edge has cut through a tendon or a finger nerve. These need a hand surgeon to repair. After the repair, the tendon must glide without pulling apart, and the hand has to relearn grip and feeling. That is the job of the Flexor Tendon Repair Recovery Program, the Digital Nerve Repair Recovery Program and extensor tendon hand therapy.
What we measure. Finger range in degrees at each joint, tendon glide, swelling, scar, sensation in each fingertip, and later grip and pinch strength in kilograms against the other hand. We make the protective splint and adjust it as the repair heals.
This week. A cut that leaves a finger numb, or unable to bend or straighten, goes to the emergency department now. After surgery, follow the splint and exercise plan to the letter, and do not grip or lift with that hand until your surgeon and therapist clear it.
Crush injuries and finger fractures
What it feels like. A finger or hand caught between a load and a hard surface, with swelling, bruising and sometimes a bent finger or a split nail.
What is usually going on. A crush can break the finger bones, damage the nail bed, and bruise the tendons and nerves at the same time. A doctor decides how the fracture is held. Swelling in a crushed hand is heavy and stays a long time, and swollen fingers stiffen.
What we measure. Swelling with a tape measure at each finger, range at each joint, sensation, and grip once the bone allows it. See the Finger and Metacarpal Fracture Recovery Program.
This week. Keep the hand above the level of the heart. Move the fingers that are free to move, as your doctor allows. A crushed finger that turns pale or cold goes to the emergency department now.
Numb, white fingers from power tools
What it feels like. Tingling or numbness in the fingers after a day on the breaker or the grinder. In some workers, fingers turn white in cold air or a cold aircon room, then red as they warm up. Fine tasks like picking up screws or doing up buttons get clumsy.
What is usually going on. Years of vibration can damage the small nerves and blood vessels in the fingers (hand-arm vibration syndrome). A hard grip on a vibrating tool also raises the pressure on the nerve at the wrist (carpal tunnel syndrome). The two can look alike, and a doctor sorts out which it is.
What we measure. Sensation in each fingertip, pinch and grip strength, dexterity tasks timed in seconds, and the muscle bulk at the base of the thumb.
This week. Fingers that turn white need a doctor. Keep the hands warm and dry, take breaks from vibrating tools, and use the lightest grip that still controls the tool safely.
Knees from kneeling
What it feels like. A soft, swollen lump over the front of the kneecap (bursitis), or pain inside the knee when you squat and twist up from the floor, sometimes with catching or locking.
What is usually going on. Kneeling presses the small fluid sac over the kneecap against the floor all day. Deep squatting and twisting up out of a squat strain the cartilage inside the knee (meniscus). After years of both, a knee with arthritis flares more easily.
What we measure. Knee range in degrees, swelling, single-leg strength against the other side, and how long you can kneel and squat before pain.
This week. Wear knee pads every time you kneel. Get up from the floor by kneeling up on one knee rather than twisting. A hot, red, swollen kneecap, with or without a fever, needs a doctor the same day.
Back to full duty on tests, not dates
The end of your MC is a date on a form. Full duty on a site has its own physical requirements. Before full duty, we look for these:
- Lifting and carrying. The weight your job asks for, lifted from floor to waist and carried the distance your site needs, without symptoms that day or the next morning.
- Overhead work. Arms held overhead with a tool for the length of a typical task, and shoulder rotation strength within 10% of the other side.
- Ladders. Climbing up and down a ladder with three points of contact, and balance on one leg on each side.
- Kneeling and squatting. Kneeling and getting up for the length of a typical task without pain or swelling the next day.
- Hands. Grip and pinch within 10 to 15% of the other hand, the feeling to handle small parts safely, and tolerance of the tools you use.
In Singapore, a work injury claim under the Work Injury Compensation Act is handled by your employer and their insurer, and a therapist can write a functional report on what you can and cannot yet do for your doctor to review. Pain is the first thing to leave. Strength is the last to train and recover.
Is this normal?
Usually expected: tired, aching muscles after a heavy day, in both arms or across the back, that ease with movement and are gone after a night’s sleep.
What our patients say
Google reviews from our clinics in Singapore.
Worth getting checked: pain at one spot that is there at the start of the next day, pain that stops you doing part of your job, tingling or numbness in the hand, fingers that turn white, a swollen kneecap, or a hand that is still swollen and stiff two weeks after an injury.
When to see a doctor first
- Call 995 for a fall from height, a head injury with loss of consciousness, heavy bleeding, a crush to the chest or trunk, a severed finger or fingertip, or neck or back pain with numbness or weakness in the arms or legs. Do not move someone with a suspected spine injury. Wrap a severed part in damp gauze, seal it in a plastic bag, and keep the bag cold on ice without the part touching the ice.
- Go to the emergency department now for a cut after which a finger is numb or will not bend or straighten on its own, a crushed finger or hand that is pale or cold, a small puncture from a paint gun, grease gun or hydraulic line even if it looks minor, a limb that looks out of shape, heel pain after landing from height, or back pain with numbness between the legs or new problems passing urine or stool.
- See a doctor the same day for a wrist that is painful or swollen after a fall onto the hand, pain at the base of the thumb after a fall, sudden weakness lifting the arm after a fall or a heavy lift, or a hot, red, swollen knee, hand or finger.
- See a doctor soon for fingers that turn white with cold or vibration, numbness in the fingers that stays all day, weakness or thinning of the hand muscles, or leg pain below the knee with numbness or weakness.
Questions people ask
What are the most common injuries in construction work?
The most common are lower back pain from lifting and carrying, shoulder pain from overhead work such as drilling into ceilings, and hand injuries from blades, tools and machinery. Kneeling causes kneecap bursitis and meniscus tears in tilers and floor layers, and falls from height cause wrist, spine, heel and ankle fractures.
What should I do after a cut to my finger at work?
A cut after which a finger is numb, or will not bend or straighten on its own, needs the emergency department now. It can mean a cut tendon or nerve, which a hand surgeon repairs. After the repair, hand therapy protects the repair with a splint and works on movement, feeling and grip.
What is hand-arm vibration syndrome?
Hand-arm vibration syndrome is damage to the small nerves and blood vessels of the fingers from years of using vibrating tools such as breakers and grinders. The fingers can tingle, go numb or get clumsy, and in some workers they turn white in the cold and red as they warm. Fingers that turn white need a doctor.
Can a therapist help with a work injury claim in Singapore?
In Singapore, a work injury claim under the Work Injury Compensation Act is handled by the employer and their insurer. A physiotherapist or hand therapist can write a functional report on what the injured worker can and cannot yet do, for their doctor to review.
Where are you with this right now?
1. It is settling on its own
If it eases week by week while you change how you lift or how long you work overhead, you are on the right road. Keep the changes once it settles. You do not need us for this, and we would rather say so.
2. It has stopped improving
It settles over the weekend and comes back by Tuesday. You have started asking a colleague to do the overhead fittings, carrying half loads without saying why, or gripping tools with the other hand. That pattern is usually a strength and load problem, and rest alone rarely changes it. It is worth measuring. If it has been months, the Stalled Recovery Review runs over three weeks with the same therapist.
3. You have had surgery, or you have a date
A tendon repair, a nerve repair, a finger or wrist fracture fixation, a rotator cuff repair or a disc operation each has a shape, with protected weeks before you grip, lift or climb. See hand therapy after surgery, physiotherapy after surgery and the recovery programs. All of it runs on the four stages of the Phoenix Recovery Protocol: Calm & Protect, Move & Mobilize, Rebuild & Strengthen, and Return & Perform.
Next step
Find out which stage you are in
Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. One Assessment and Treatment is a single 45-minute appointment at $230, nett, no GST. Your therapist finds what is actually limiting you, treats it in the same appointment, and you leave with your current stage and a written plan.
Prefer to phone? Each of our five clinics has its own number on the clinics page. No referral needed to book.
Related reading
Sources
- Umer W, Antwi-Afari MF, Li H, Szeto GPY, Wong AYL. The prevalence of musculoskeletal symptoms in the construction industry: a systematic review and meta-analysis. Int Arch Occup Environ Health. 2018;91(2):125-144.
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