Chapter 6 describes the evolution of human walking and the gait cycle. It then describes the basic mechanisms of back injury when loads are lifted and the factors affecting postural stability at work. The anatomy and biomechanics of manual handling are described. The NIOSH lifting equation for the evaluation of manual handling tasks is described in detail with worked examples. There is a discussion of trolleys and the basic biomechanics of pushing and pulling, with equations. The effectiveness of manual handling training is reviewed in detail, as is the evidence for the effectiveness of back belts as personal protective equipment. Evidence for the effectiveness and cost effectiveness of interventions to prevent manual handling injuries is reviewed. The NIOSH checklist for the evaluation of manual handling tasks is described and guidance for risk reduction summarized.