© 2016 Elsevier B.V. Aim Cake decorating involves several hand intensive steps with high grip force during the application of icing. The purpose of this laboratory study was to evaluate forearm muscle activity, discomfort, productivity, and usability of an alternative tool for cake decorating compared to decorating with the traditional piping bag. Methods Participants (n = 17) performed 2 h of cake decorating tasks using the two tools. Subjective hand and arm fatigue, usability, upper extremity posture, and muscle activity from three forearm muscles were assessed for each tool. Outcome measures were evaluated using the Wilcoxon Signed Rank test and the paired t-test. Results Less fatigue was reported in the dominant hand (p = 0.001), forearm (p = 0.003) and shoulder (p = 0.02) for the alternative tool when compared to the piping bag. Average median (APDF 50%) and peak (APDF 90%) muscle activity was significantly less for the alternative tool across all three forearm muscles. The alternative tool significantly reduced grip force, an important risk factor for distal upper extremity pain and disorders. Participants rated usability of the alternative tool superior for refill and comfort but the traditional method was rated better for accuracy, stability, positioning and control. Conclusions The alternative tool was associated with less dominant arm fatigue, muscle activity, and grip force when compared with the piping bag. However, the alternative tool did not receive the best overall usability rating due to problems with accuracy and overflow, especially with smaller decorating tips. Recommendations were made for addressing these problems with the alternative tool.