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Why Self-Care Is a Safety Issue: The Business Case for Expanding Training with Liz Kirk PhD

Why Self Care Is a Safety Issue The Business Case for Expanding Training



Do you or your team members engage in a computer-intensive role in the workplace? If so, we’re confident that you’ll greatly benefit from the expertise of Dr. Liz Kirk, founder of Beyond Ergo and one of Australia’s leading researchers and trainers in ergonomic and self-care competencies. In the newest episode of The Safety Guru, Liz expresses why self-care is a safety issue by sharing the negative effects taking place as a result of our increasingly sedentary and screen-intensive work style, including a higher risk of musculoskeletal injuries and disorders. Tune in as Liz shares her research into personal protective behaviors, such as postural mindfulness and developing habits of releasing muscle tension, to decrease musculoskeletal aches and pains at work.


Real leaders leave a legacy. They capture the hearts and minds of their teams. Their origin story puts the safety and well-being of their people first. Great companies ubiquitously have safe yet productive operations. For those companies, safety is an investment, not a cost, for the C-suite. It’s a real topic of daily focus. This is The Safety Guru with your host, Eric Michrowski, a globally recognized ops and safety guru, public speaker, and author. Are you ready to leave a safety legacy? Your legacy’s success story begins now.

Hi, and welcome to The Safety Guru. Today I’m very excited to have with me, Dr. Liz Kirk. She’s from Beyond Ergo. She won Dean’s Award for her research at the University of Queensland in reducing muscular computer-intensive pain. Beyond Ergo goes beyond ergonomics for a broad range of personal protective behaviors, particularly for computer-intensive roles. So, Liz, very excited to have you with me today. And you’re joining us from Western Australia. Beautiful spot. So, tell me a little bit about your background.

Thanks, Eric. And thanks for letting me join you today and for everybody to hear a little more about this new range of injury risks associated with computer-intensive work. So, my background originally has always been in training of some kind. Before I went back into corporate health, I was doing adventure-based experiential training programs for team building and leadership. And in those great days when we used to send everybody out into the wilderness and sell them and do problem-solving, things like that, which was much fun. But the Beyond Go programs that I deliver now were born out of my own experience of needing to get back into corporate health. And to do that, I joined a large corporation, actually in a contact center. And it was the first time I had to use computers for a really long period of time. And what I thought was going to be a very easy 9 to 5 sit-down job, turned out to be the most stressful job of my life. Very quickly, I developed back pain, shoulder pain, headaches, and sore eyes. And by the end of the day, all I wanted to do was go home, pour a large Scotch, sit in the cupboard, and talk to nobody.

So very quickly, I realized that I was the least likely person to be injured because I knew about this stuff. I knew about healthy exercise, injury prevention, the basics of workplace health and safety, and office ergonomics. And I had the disposable time and income to care for myself. But I still experienced that growing pain, the stress, and the accumulating medical bills, and I still ended up injured. So it was after that experience that I understood that it really doesn’t matter how much you know if you can’t convert that knowledge into practical work skills. And that’s what sent me back to do my PhD in these programs that now form the founding. The founding foundation of the Beyond Ergo programs. So, the things that I’d like to share with your listeners is that the largely unrecognized issue of pain and injury amongst knowledge workers, and how the stunning success of technology has created this great surge in health and injury risks. Why we need to now have a broader focus when we’re planning training, and why that training must go beyond an economic checklist to build the self-care competencies that people need when they’re involved in computer intensive work.

What’s changed in the business context where the dynamics need a much broader view?

Well, as I say, the stunning success of technology means that knowledge workers can now work from almost anywhere. And people still have this perception that computer work is easy. I mean, how could you get injured in an office? But sitting at computers all day is surprisingly mentally and physically demanding. Computers have also become integrated with every part of our lives, leisure, and in work. And that has removed those natural breaks from screens. And it’s reduced the recovery time from those poor postures and the small repetitive movements that contribute to overuse injuries. This, combined with our increasingly sedentary lives, means that, in general, we have a decline in physical conditioning, and that leads us to an increased risk of pain and injury and increased recovery times when we do get injured. In fact, Dr. David Marshall, who was the medical director at the Sports Medicine Children’s Healthcare Atlanta, said that their technology injuries have now surpassed sporting injuries in their clinic. And we know from the research that Gen-Z is now entering the workforce already injured, and primary school children are now showing signs of prehistoric postures, all because of their now current high screen use.

So, it’s a growing and concerning problem, and you can see it filter down through the generations. And I knew from my PhD research that over 86 % of knowledge workers report aches and pains, and over 11 % suffer from chronic pain. And just in Australia, and we’re not very big, just in Australia, chronic pain costs our economy $55 billion a year. And of that, $7 billion was simply lost in productivity. That’s before you’d add any other business expense to cover any other injury or illness in the workplace. So, for Australia, we only have 30 million people. That was a loss of $540 in lost productivity for every person in the Australian workforce. And sadly, that’s not all the bad news because when COVID forced everybody home into flexing work, those reports of doctor visits and allied health services increased significantly. And together with the other social isolation and depression, and loss of productivity that we’re now seeing filtering through in the research when COVID forced everybody home into flexy work. And I think one of the pieces is you’ve got people moving from the work environment, desktop to home using a laptop, probably not the most economical or economically sound work environment, which aggravated the circumstances. Is that a fair statement?

Absolutely, Eric. That’s absolutely right. So clearly, the whole world of work for computer-intensive work has changed drastically over the last 20 years. And now we have to question whether an economic checklist is adequate for staff trying to manage an increasingly complex array of work choices like hot desking, working remotely, sit-stand workstations, multiple screens, and mobile devices. And we’re now getting research on the new health risks associated with this increasingly sedentary behavior, including the increased risk of heart attack, type 2 diabetes, various cancers, and depression. And for businesses that where flexi work has created a situation where managers must still ensure safe work conditions, but they now actually have less control over the work environment and less oversight about how staff likes to work or how they choose to work. So, the jump into laptops was so essential during COVID. Still, it’s added that extra layer of risk of injury because we’ve all heard stories about people sitting on their beds to work, using ironing boards as tables, or getting leg pain because hard deck chairs were never meant to be designed for eight hours of sitting each day. We also know that we need to expand the economic recommendations that we’re sending home for flexi work because they do need to cover laptops.

And as an example, the economic recommendations state that laptops should not be used flat on the work surface for more than two hours a day. But I don’t think I’ve talked to anybody here in Australia, and I don’t know what it’s like there for you, but managers have not realized that. And they haven’t sent the equipment home or given the training to make sure that staff that are on flexi work can set up their workstation properly. And of course, using laptops flat on the work surface forces people into that turtle posture that now looks so natural because we see everybody doing it. But your head is now jutting forward to look more closely at the screen. Your neck is in compression, which leads to fatigue and headaches, poor concentration, increased muscle tension, and can even lead to injury of your vertebrae over time. That slouched posture, sorry, slouched posture, say that twice, actually compresses your abdomen and slows your circulation. And of course, the small keyboard increases your input errors. So ,it’s a really big issue often people are wondering whether that’s really how that’s affecting our flexi workers. And I like to give them an example of a lady that I worked with some years ago.

Her name was Jean, and she worked for a help line, a 1 in 300 help line for seven years, without any injury or health concerns to do with her computer work. But when she had the opportunity to go home to work, she just thought that was going to be great. So, Jean took that economic checklist and purchased the right office chair, a document stand, plugged in her mouse, and sat down to work. But after just six months from working from home, Jean was experiencing significant pain and mounting medical bills. Weekly physio and acupuncture appointments had replaced her yoga classes and her beach walks because her neck, shoulders, and back pain was so extreme. So, in just six months, Jen’s shoulder needed cortisone injections, and surgery was already planned. So that was just in six months of working from home because she hadn’t been given all the support and training that she needed to cope with this new range of skills and information she needed because the checklist couldn’t cover all the issues she faced. It couldn’t demonstrate how to adjust her furniture. It couldn’t check if the equipment was positioned correctly. And there was no one to check Jen’s work posture while she worked.

And that was, I have found, a major concern and a major cause of people building pain and ending up in injury. So, whenever I take a workstation assessment, I always quietly stand behind the person and take some photos while they work, so they can see their work posture. And when I showed Jean her posture, she was absolutely done found it, because she had no idea. She had been constantly leaning on her elbow to work. And we find that a lot. People are unaware. It feels so natural the way they’re sitting. They don’t realize how poor their posture really is. So, after I made the economic adjustments and we built Jean a very positive work behavior program, she could return to her yoga and start her early morning walks. But the real tragedy was that the damage to Jean’s shoulder was considerable, and she still needed surgery. And that’s certainly one of my frustrations, is that I’m not called in until people are already in extreme pain. By then, the damage is often already done, and it couldn’t be reversed. So, it’s one of the reasons we need to broaden this scope of training for knowledge workers, from the reactive wait until somebody’s in pain, to the more preventative style of building these self-care competencies.

Sure. And so we touched before on the importance of having a broader focus on going beyond just ergonomics. Tell me a little bit about those additional components being yond just the economic and desktop set up.

Yeah, sure. And what I’d like to do, too, when I do that, after I do that is show the business costs that are associated with not giving people the new self-care skills that they need. Because, of course, companies allocate significant time and money to their employee assistance programs and the return-to-work programs, all to cover these work-related injuries. But logically, it’s better to promote injury prevention. And, of course, being safety, the first step in any safety prevention program is to follow the hierarchy of controls. And in relation to computer-intensive work, that still means defining and implementing the tiers of elimination, substitution, engineering, administration, controls, and, of course, PPE. But PPE for knowledge workers is different. My research shows that this final tier for injury prevention should be PPBs. These are personal protective behaviors. So, these are the competencies that allow individuals to consistently identify and take early action to eliminate or at least manage the triggers that are personally causing them pain and then prevent that pain and stop it from progressing to an injury. So, these skills will enable staff to take greater personal control over their health and safety in computer-intensive work environments, no matter where they work.

So, the most efficient way to do that, of course, is by building training that extends to build these personal protective behaviors. So, it’s a more holistic range of knowledge that goes beyond the economic checklist to build transferable, actionable self-care health and safety skills. So, in the Beyond Ergo programs, we describe these holistic ranges of skills as the three pillars of personal protective behaviors. And the first, of course, is getting the ergonomics right. But it’s not just about going through a checklist. We also demonstrate how to refine those generic recommendations to match stature. And the example I love to give is that one of the most common mistakes I see is people having their screen set either too high or too low. And the economic recommendations say that the center of your screen should be 17 and a half degrees below eye level, but nobody actually knows what that means, and they don’t know how to judge it, so they don’t even bother to try. And I’d love people to try this as they’re listening to your podcast to check screen height. If you place your arm parallel to the work surface and point to your screen, you should be pointing to the center of your screen because your fingertips are now about 17 and a half degrees below eye level.

So, it’s so easy. And you’re not pointing to the center of your screen, you know you have to adjust your screen height. So, by using this action, you’re actually refining those generic economic recommendations to match your stature. And it doesn’t matter if you’re 6’8 or 4’0, it automatically works no matter where you are. And actions are also easy to remember. You don’t need any special equipment. And of course, you always have your body with you. So, it doesn’t matter where you are, you can adjust your workstation set up to match your structure properly and the tools that you’re using. So that’s the first pit here. The second pillar of personal protective behaviors is building a wider range of positive work behaviors. And that, of course, goes beyond eating a healthy snack and taking the stairs. And these include the obvious, like supporting mini and micro breaks, doing the stretches, and knowing how muscular carotid disorders start. But the biggest benefit I found in the work that I did is by coaching postural mindfulness. And we touched on that with Jean. She didn’t know she was sitting in an awkward posture. So, learning to feel when you’re working in poor postures, and developing habits of consistently releasing muscle tension and resetting posture back to relaxed and neutral is really important.

This behavior has proven to provide the greatest benefits and decrease aches and pains, and of course, those injuries that go along with it. Because if you can’t feel when you’re working an awkward posture, and you don’t recognize that there’s an eight star, then you can’t go ahead and fix it. Because if you can’t feel it, you can’t fix it. So that’s the second pillar is these broad ranges of positive work behaviors. And the third pillar is building the targeted physical conditioning we need to speed recovery and help prevent common aches and pains, especially of the neck, shoulders, and upper back. So, recommending aerobic classes and massage and yoga and going to the gym is, of course, great. But there are very specific dynamic stretches and strengthening exercises that knowledge workers need to habitually do if they’re going to avoid pain and injury. And as an example, the research shows four recommendations for recovering from and preventing neck, upper back, and shoulder pain. And these are, and of course, the first one is ergonomics, getting your ergonomics right. So, you’re setting everything up so you’re not sitting in awkward postures. The second is your stretches.

So designed to release that muscle tension and recover through periods of work. The third is aerobic exercises. And trials of aerobic exercises found it significantly reduced migraine frequency, pain intensity, and duration. But while the most dominant approach we talk about is getting the ergonomics right, the fourth strategy was targeting the strengthening of muscles of the neck and shoulder girdle. And that always worked consistently. So, in the podcast Download, there’s a link to an article that explains those and the four exercises that strengthen the neck and shoulder girdles. That’s probably a lot more valuable than me trying to describe them.

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And there’s really good visuals to help with those exercises in the show notes.

Yes, absolutely. The article has those as well. And of course, the big question I’m always asked when in relation to doing these extending training and whether it’s really of benefits to extend training is whether there’s a business case for increasing that investment in training, and why that’s important. Because it’s easy to see how individually and accumulatively, the risk for computer intensive work is obviously a concern. But the examples I have that show the cost benefits are really important. Actually, the calculator I use actually comes from OSHA. So, the American Occupational Safety and Health Administration have designed the Safety Pays calculator. And this calculator is designed to calculate the potential damage to a business’s profitability from various work-related injuries. So, to explain why it’s important to extend training and to this wider range of personal protective behaviors, I input into the calculator three common overuse injuries. And the figures will demonstrate the direct and in direct cost of those injuries to a company. So, I chose three. The first one is carpal tunnel syndrome. And the cost of that injury to the company was over $64,000 just for one case of carpal tunnel syndrome.

One case of an inflammation injury, so we’re thinking tendonitis or repetitive strain injury, was nearly $82,000. And one case of a strain, like upper back pain or shoulder pain, was calculated at $70,000. So, most managers I talk to find those figures very surprising. But the safety pay calculator actually goes beyond that because in that calculator, you can enter the percentage profit that you would make on each sale. And if there were any cause for concern, they need to try the calculator because the figures that come out of the amount of sales you have to make to cover the cost of those injuries are absolutely eye-watering. But my concern, of course, is more about thinking about the injured employee because while the cost of the business is high, the immediate financial burden for the injured person is much higher because they cover over 70 % of the associated costs of that injury. And a significant muscle, little disorder can reduce their earning capacity for the next 4 to 5 years. So that’s not only the pain and disability that affects their work and their private life, with stress and injury and pain, but also their earning capacity and their quality of life because it decreases their income now, but also how much they can save for retirement and their financial security in the future.

I love the example you shared earlier around the angle for the monitor because I think whenever you see the diagrams like you said, the 17 and a half degrees is really hard to conceptualize. Here’s a very easy tool for somebody to quickly particularly assess their workstation. I’m wondering if you could also share maybe some tips on the laptop side of the equation because you talked about how people have moved to laptops, and I know a lot of people have set up at home where their laptop connects to monitors and have external keyboards and mice, which then makes it look more like a desktop. But then you’ve also got the person who travels who can’t travel with a monitor as well.

That’s exactly right, Eric. And the whole reason we love laptops is that they’re so portable. So, by having a broader range of skills and doing the physical conditioning means that when you can’t set up your laptop on your little laptop stand or with an external keyboard and all the things that you need if you need to work with it flat, you also know that you’re going to start getting some discomfort, that it is awkward. So, then you have your strength-enhancing exercises, you have your dynamic stretches that release that tension. There is a great exercise that I love to do. And the research showed that this one exercise can reduce upper back and neck pain by 50 % when it’s done regularly. And it’s even more important now that we use laptops so much. It’s called the Roll Reset Relax. And what it does is that, as you know, when you work on any computers, but particularly laptops in this hunch turtle position, we build up a lot of tension in the neck and shoulders. And the only way to release that tension is by doing big movements and consciously relaxing. So, the Roll Reset Relax is designed to do that.

You do big shoulder rotations; you do big rotations forward and then big rotations backward. And then, you take a deep breath and consciously relax your arms into your lap and reset your posture back to a neutral position. So, you get the feel of your body being squared up to your monitor and your laptop keyboard. And you release that tension because those fine motor units switch on, and they can’t switch off again until you do those big movements. So often, when we’re working, they can be switched on for eight hours a day, but we don’t consciously relax them, which is a great cause of pain and discomfort. So, roll, reset, and relax. You do big shoulder rotations, take a deep breath and consciously relax, and reset your posture, leaning back in your chair, squaring yourself up to your monitor and your keyboard, and relaxing back into relaxed and Neutral. And as I say, the research showed us that by making that a habit, doing that throughout the day, anytime that you find yourself leaning to one side, or you’ve lent forward to read from the screen, or you’ve been sitting down for a while, just repeating that can reduce that upper back pain and neck pain by 50 %.

Excellent. So again, how do I organize my workstation, and then the exercise I really liked as well your other elements around a broader range of tools that look into posture and mindfulness, things of that nature. So, tell me a little bit about how companies can help address some of these risks. Obviously, flex work is still present, and the pandemic is mostly past, but people are still working in dispersed environments in many organizations, and even if they come back to the work environment, these risks are still present.

Oh, that’s right. And in fact, I think flexi work is going to be here to stay. It’s certainly one of the conditions that people are looking for, and that will adjust over time. But of course, these managers are really looking now to health, safety, and wellness programs to meet their workplace health and safety obligations, but also to provide that commercial edge of reversing the decline in productivity that a lot of us are seeing and acquiring and retaining new talent. So, decreasing the attrition rates and improving levels of labor costs, because we’re not seeing so much absenteeism and present teens and stress. So this is best done by expanding training and the expectations of the training that knowledge workers need to include this broader range of health and safety self-care competencies. So, as I say, I’ve dubbed it the personal protective behaviors, the PPBs. Individuals need to consistently identify and manage the new complex range of health and injury issues that are associated with computer-intensive work. And for businesses, that means enabling staff to take greater personal responsibility for their health and safety, no matter where they work. And in turn, that will improve their productivity and reduce the chance of work injury claims.

So as I say, remember, Jean there, that after seven years of being a dependable and valuable staff member, in just six months from working from home, she was in so much pain that the company was covering the significant direct and indirect costs of lost productivity, medical bills, return to work programs, overtime payments, and of course, the company had a reputation hit as well because people don’t want to work where they know they’re going to get injured or they’re not getting the support that they need for these. So, in terms of the programs that are out there, obviously, people should really look for this broader range, not just doing the checklist of hiring a seated massage or giving people discounts to go to the gym or go to yoga classes. But if they would like to see more of how the Beyond Ergo programs work, then, of course, there’s links in the program to my website. But there’s also a free webinar that’s coming up on the 19th of July, which is about the practical skills team leaders and managers can use to build resilience and stress management. And it’s all about frontline leaders being able to nurture their teams, before they need the big stress management conversation, that Are You Okay conversation, which can be very intimidating for team leaders and for their teams as well.

And it can feel quite intrusive. And, of course, I’m very happy for people to connect with me on LinkedIn. And I’d love to share ideas and information. I’d love to know how I can help people.

Absolutely. So, your website is It has many resources, including, as we’ll include in the show notes, the stretching exercise we talked about earlier, as well as the OSHA calculator. And if somebody wants to reach you, is that the best way to start the conversation?

Yes. LinkedIn is probably the best way to do it. Yeah, absolutely.

Excellent. Well, Liz, thank you very much for coming and sharing your wisdom about economics and going beyond just a standard checklist economic program. I think it’s something organizations definitely need to think about as we embrace flexible work environments. But even in an office environment, the environment still requires good economic environments and the right reinforcement for success.

Yeah, thank you, Eric, and thank you for letting me share these concerns and ideas about all things new with these computer-intensive work environments.

Absolutely. Thank you for joining us.

Thanks, Eric.

Thank you for listening to the Safety Guru on C-Suite Radio. Leave a legacy, distinguish yourself from the pack, and grow your success. Capture the hearts and minds of your teams. Elevate your safety. Like every successful athlete, top leaders continuously invest in their safety leadership with an expert coach to boost safety performance. Begin your journey at Come back in two weeks for the next episode with your host, Eric Michrowski. This podcast is powered by Propulo Consulting.

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Dr. Liz Kirk (PhD) won the Deans Award at the University of Queensland for her 2013 PhD research focused on defining and reducing levels of musculoskeletal pain and MSD among knowledge workers in the Australian Contact Centre industry. While the original research focused on using clients’ anthropometry to refine ergonomic recommendations to match stature, the Beyond Ergo talks and workshops now go beyond ergonomics to build a broad range of Personal Protective Behaviours (PPBs). These are the new WHS and wellness self-care competencies knowledge workers need to take greater personal responsibility for their health and safety in computer-intensive work environments, no matter where they work.
For more information:
Four ways to help minimize screen-related neck and shoulder pain:




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