A step-by-step approach to better work, aimed at reducing physical workload among scaffolders, is evaluated. The approach is based on a strong commitment of the management in the enterprise. Workers participated as direct as possible. Information on branch level of Arbouw showed the need for improvement. In a department of a middle sized enterprise, 50 scaffolders completed a checklist to identify the problems. These determined the user requirements for the redesign of the working methods. Redesign proposals of TNO were tested by the workers. Based on the test a steering group led by the management chose the improvements. Before implementation, the effect on musculoskeletal load was tested, and half a year after implementation the number of changes and the process were evaluated. The shoulder complaints and physical work load during horizontal and vertical transport were the major problems. The main improvements were mechanizing the transport, decreasing the loads and organizing the work in another way. Due to these changes the musculoskeletal load was significantly decreased, especially on the shoulder. Only 26% of the subjects responded to the evaluation on the number of improvements after half a year. These data indicated that for the major problems improvements were implemented, which reduced the physical workload and the perceived shoulder- and backpain. The process evaluation indicated that the approach was considered worthwhile, especially regarding the involvement of scaffolders themselves.