Rising Through the 4 Soft-Tissue Safety Cultures
Understanding where your organization stands in the safety culture spectrum can help prevent soft-tissue injuries and improve workplace safety.
- By Robert Pater
- Mar 14, 2025
Have you heard someone expound “there’s no such thing as Safety culture?” At least to some extent I partially agree.
Let me explain: Safety culture doesn’t exist on its own. Rather, Safety is a microcosm of a company’s overall culture; a complex compound of both the espoused as well as the unwritten and unspoken rules and ways “we actually do things around here.” The messages that we convey weigh heavily, and can either benefit or detract from Safety planning and performance.
You can see this in an issue that is an ongoing, pernicious problem for many organizations: soft-tissue injuries and sprains-and-strains. When any problem persists, it’s not by coincidence. Rather, there are underlying mindsets, forces, actions and inactions that contribute to any tenacious issue.
The Four Levels of Safety Culture
About two decades ago, I first wrote about seeing four levels of Safety Culture:
1. To, where Safety is “pushed” or applied onto others.
2. For, where Safety is led more benevolently but still predominantly driven by “experts” for others.
3. With, where there is leaders and workers partner.
4. By, where Safety is mostly internalized by people, and they increasingly believe in it and act for themselves.
(Note that there are actually more than just four clearly defined levels, and most companies fall between two of these.)
Soft-tissue Safety Culture
We can apply this to soft-tissue injuries and sprains-and-strains. From our global work over the past four decades, here are the characteristics of the 4 levels of “Soft-tissue Safety Culture”:
1. Forced (“To”). In this scenario, workers adopt an “out of sight, out of mind” approach and do as little as is required to stay out of trouble. A frequent default here is leaders assuming strains and sprains (S&S) are likely faked, not real, or occurring off-work. Out of frustration, leaders often resort to blaming workers for not paying attention, or for disregarding policies and procedures.
There can be pressure to not report these injuries (“suck it up,” “man up”, etc.). S&S are often disregarded as being inevitable. The company might provide only the minimal “required” prevention information. Posters and reminders generally emphasize strengthening “will power” with messaging such as “lift safe,” or “think before you act.” This culture’s focus is forced compliance.
2. Protective (“For”). Experts believe they know what’s best for workers, and tend to distrust employees to act for their own best Safety. So, they “benevolently” take the initiative to design out (often termed “idiot-proofing”) potential S&S exposures.
Messaging is simplistic but well-intentioned (“be careful!” “bend your knees,” “don’t twist,” “lift with your legs,” “keep your back straight”). The focus tends to be on only at-work exposures, with better “awareness” being encouraged. There can be a reliance on “carrot and stick” reinforcers (incentives and discipline.) Attendance at traditional “back schools” that emphasize imparting rudimentary physiology might be required for those who were injured.
Many such cultures attempt to incorporate pre-hire selection processes to somehow screen out those who might be S&S-prone. There’s an overriding emphasis on “quick fixes,” such as one-exposure education and equipment such as back belts, scissors lifts, and tool/weight suspensions.
3. Involved (“With”). Ergonomic redesign, adjustments and prospective equipment purchasing is done on another level, with strong input from those doing the work, including piloting new designs. Training is also stepped up towards better understanding and discovery vs. “just do as you’re told.” There’s greater attention fixed upon the specific tasks associated with higher risk of cumulative trauma (not just “heavy” loads.) Positive personal motivation is encouraged, rather than “do it for the company” or “to stay out of trouble.” These companies often use external or clipboard monitoring.
The culture initially considers psychosocial contributors in S&S and begins to encourage thinking cumulatively. Training is more hands-on, sometimes with “traditional”-but-limited methods. Off-work S&S risks begin to be considered. Overall, workers are seen as potential internal Safety agents, involved in training and in transmitting and reinforcing messaging.
4. Internalized (“By” workers for themselves). Here the default mindset moves towards personal control. People realize they’re their own ultimate Safety resource (“I make the biggest difference in my own life”). There’s greater talk and understanding that small repetitive motions and tasks can be an “invisible” contributor to S&S, and that, conversely, small positive decisions and actions can lead to greater Safety.
This culture tends to not rest on its laurels, assuming they aren’t perfect and must continue to hone their approaches. These companies see S&S connections to other injuries, such as slips/trips/falls, drops on foot, bodily reaction, and hand injuries. Understanding of S&S contributors and prevention dynamics is elevated, and this his level focuses on spreading protective principles that readily port to off-work activities, grounded in concrete practical applications. Energizing soft-tissue Safety is paramount, as is helping place workers in greater control of their own Safety.
Rising to the Next Level
If you find yourself mired on an S&S plateau, first identify your company’s level of “Soft-Tissue Safety Culture.” Then look towards incorporating elements of those on the “next step up” to move towards higher soft-tissue Safety. Better yet, this can in turn elevate your overall Safety culture and performance.
This article originally appeared in the February/March 2025 issue of Occupational Health & Safety.