Body Mechanics

Using proper body mechanics can prevent back injury, help speed up recovery if you are already injured and prevent further injury after your back has healed. The following are some suggestions for activities that you may use with daily activities.

Body Mechanics Basics:

1. Test the load. Before you lift, check the weight and make sure you can lift it safely. If not, get help or use an assistive device.
2. Keep your back in its natural curve. Bend at the hips and/ or knees. With the low back erect, the forces are distributed safely.
3. Maintain a wide base of support. A solid and wide base will help reduce the possibility of slipping.
4. Hold objects as close to you as possible. This reduces stress on the back.
5. Do not twist when carrying. Move or change directions with the feet. This decreases the stress and load on the back.
6. Tighten stomach muscles when lifting. This helps the abdominal are to help in the lift and reduce strain on the low back.
7. Think before you lift. First think how you will lift the object. Plan the path and make sure it is clear.
8. Lift with the legs or the large muscles. Using the large muscle groups helps diminish the forces on the low back.
9. Maintain good communication if two or more people are involved. Good timing on a lift reduces the likelihood of jerky or sudden unexpected movements.
10. Move obstacles out of the way. Making sure the path is clear (clearing away toys, tools, loose rugs, etc.) decrease the risk of slipping or falling.
11. Push rather than pull. It is easier to utilize your weight advantage when pushing.
12. Eliminate repetitive lifting duties if possible. Place things or supplies that you constantly need or use at a better height initially to decrease lifting activities.

When getting out of car, first open the door completely, then swing the legs out to the side and pivoting on the buttocks so the entire body moves as a unit. Do not twist the low back. Place one hand on the seat and the other hand on the car frame. Scoot forward and place feet under the hips, lean forward, and push with one hand while pulling with the other hand, and use the leg muscles to come up to a standing position. To sit down, reverse the procedure.

When retrieving things from a low shelf, instead of bending over and twisting it is better to kneel down or squat in front of the shelf, pick up the objects holding them close to body, and then stand up using the strong leg muscles and keeping the back straight.

Many activities require standing for a long periods of time. First to avoid fatigue, try to break these duties up into smaller time periods. Second, place one foot on a step or ledge. Do not bend at the waist, instead bend at the knees and keep back straight. Third, use one hand to provide support. And lastly, try to do the activity at a comfortable height.

When doing activities that are above chest level always use a stable step stool so that these activities are at a better level. Another alternative is to use a long handled tool or brush.

These are several things to remember when performing work tasks. Stay close to the work area. Use the arms and leg muscles while keeping the back straight. Avoid twisting movements. Use body weight to help with the job.

Pulling:

Remember try to think of a way to push first. First test the load to see how easy it is to pull. Make sure the path is clear. Stand facing the object, placing the hands on the object. Place one leg behind the other. Bend the knees and keep the back straight. Tighten the abdominal muscles and slowly pull with the arms and legs. Once moving, continue to pull in a slow and steady manner. When ready to stop pulling, slowly ease up, and return to a standing position.

Carrying:

When carrying things like boxes or other items that can be held, hold the object close to the trunk. Do not twist.

If carrying things like suitcases or handbags, observe the following rules:

1. Try to carry equal weight in both arms.
2. Then picking up the bags, keep back straight and bend at the knees,
3. Do not twist wile varying the bags.
4. Lower bags by bending knees, not the back.

Pushing:

First, test the load to see how easy it is to push. Make sure the path is clear. Stand facing the object, placing the hands on objects.  Place one leg behind the other, Bend the knees and keep the back straight. Tighten the abdominal muscles and slowly push with the arms and legs. Once moving, continue to push in a slow and steady manner. When ready to stop pushing, slowly ease up, and return to a standing position.

Lifting Options Relating to Daily Tasks

Following are examples of different lifting situations which you may find yourself facing.

Basic squat lift: This lift is useful for something of moderate size and weight

Begin standing close to the object to be lifted. Squat down, keeping your back straight and then firmly grasp the container. Pick the container up and hold close to body as you tighten the stomach muscles. Next, stand up slowly and smoothly letting the large leg muscles do the work.

The half kneel lift:  This lift may be helpful with things that have be irregular shape or may tend to move as you lift. This lift can also be useful when lifting objects from a low shelf or table.

Stand close to the object to be lifted. Squat down onto one knee. Keep the back straight and pick up the object and slide up onto thigh and then cradle the object against body. Tighten stomach muscles and slowly stand, using the leg muscles.

The partial golf pickup: This is a good way to retrieve things out of a car trunk,

When lifting from a car trunk, prepare the object to be lifted by placing one leg on bumper, keeping back straight, and sliding package to the edge. Place both feet back on the ground. Place one hand on the receptacle that you are picking up the object from (car), Reach in with arm. Keep back straight and pivot at the hips while extending the opposite leg backwards. Grasp the object firmly, and slowly lift while straightening at the hips, pushing up with the other arm, and bringing the leg back down. Position the object close to body.

The full golf pickup: This lift should only be done with objects that weigh only a pound or less. If you currently have a back injury, a weak back, had prior back surgery, a tendency to have back pain, or are pregnant, this lift should be avoided.

Keeping the back straight, pivot at the hips, while extending one leg straight behind you as you reach down to pick up the object. As you pivot back up with the object, swing the straight leg back down.

The over head lift: This lift is used when lifting objects down from a high surface such as a shelf. If the object is higher than head level, use a step stool. Move up closer to shelf. Place one leg in front of the other. Shift weight slightly to the front leg. Reach up and firmly grasp object in both hands while keeping back straight. Slowly lift object off of shelf as you shift weight back onto both feet. Carefully lower object down to chest.

The 2 person lift: This is used when the object is either too heavy for one person or is too large, bulky, or cumbersome for one person. If the object cannot be entirely held close to you body, or there is any doubt, get help. Both people stand on either side of object as close as possible. Communicate between each other as to who will count for the lift and which direction you will go. The lift performed is the squat lift. Squat down, keeping the backs straight and firmly grasp the object. The lead person gives a 1-2-3 count and both people lift on the 3 count by tightening abdominal muscles and slowly straightening legs.

Reducing the load: When possible it may be better and easier to break up the lift into several smaller lifts, such s with a box of books.

Sleeping;

When you have back pain, sleeping can be very difficult. For this reason, how you sleep can have a great impact on your rest and recovery. Following are some things you may try which may help to give relief during your sleep.

1. Sleep on a firm and flat mattress.
2. If you have had a recent injury you may be advised to stay in bed and rest flat on your back. This should be limited to only 1 – 2 days. After that time you should try sitting occasionally and participate in short walks.
3. While sleeping on your back, it may help to place a pillow under your knees.
4. If sleeping on your back is too painful, try lying on your side with one of your knees up near your chest. Placing a pillow or spacer between the knees may also help.
5. While lying in bed, do not raise your arms over your head.
6. If your bed is too soft, it may help to place a piece of plywood between the mattress and springs. 5/8 or ¾ inch should work fine.

Many back pains are from improper body mechanics during daily activities. If you currently have back pain, there are several ways of getting in and out of bed to decrease the discomfort while you are healing.

To move from lying on back, bend knees up and roll to your side. Slide legs off edge of bed with knees bent. Push up with your arms, using the legs as a counter weight and sit up.  To move from sit to lying down, reverse the procedure. Begin sitting on bed. Lower yourself down to your side, using your arms to help guide and control the movement. Once you are lying on your side, you may slide the legs up onto bed. To roll on your back, keep knees bent and roll onto back.

Proper Sitting and Standing Posture

Improper posture can create many types of back pain. The spine has three natural curves, one in the neck, one in the mid back, and one in the low back. It is important to maintain these curves so the body stays “stacked up” properly. When an improper posture is maintained for extended periods of time the muscles can become weak and fatigued, resulting in burning or sharp pain, headaches, as well as muscle spasms. Some muscle groups become overstretched while other muscle groups become shortened. The ligaments (tough cord like tissue that provides stability for the spine) also can become irritated with improper posture, resulting in back aches and stiffness. This abnormal posture condition is called Postural Dysfunction.

Postural Dysfunction and its symptoms can generally be resolved with proper treatment. Therapeutic exercise is used to stretch the sort muscles and provide strengthening/endurance to the weak muscles. Posture re-education helps to provide instruction on proper posture and how to avoid further episodes of pain.

Other forms of treatment may be used along with exercise and education. These “modalities” such as moist heat, electrical stimulation, ultrasound, and deep tissue massage help to relieve the symptoms until the muscle imbalances can be corrected.

The basic Rules of posture are as follows:

1. The head should sit directly over the neck, chin tucked in slightly and not jutting forward; the ears should be over the shoulders.
2. The shoulders should be level and “squared” back, not slumped or rounded forward.
3. The mid back should be straight up and not slumped forward.
4. The hips should be in line with the shoulders and the ankles should be in line with the hips.
5. When sitting the hips and knees should be at 90 degree angles.
6. A lumber support can help maintain a natural curve in the low back.

You should try to attain this posture as often as possible during your day. At first your muscles will not have the endurance to keep your posture correct all day, but as you begin using your proper posture it will become easier and you will find your pain and spasm will begin to diminish.

Ergonomics

Ergonomics is the study of how to adapt the work place to the person. In other words the work environment should be adapted to YOU, not the other way around. This is important because when the work station fits your needs, fatigue and stress decrease and your comfort increases. In the long run you are more efficient and you decrease your risk of getting a repetitive trauma disorder. Repetitive disorders are things like carpal tunnel syndrome or “tennis elbow” (tendonitis).

Repetitive stress conditions occur when tendons, muscles, and nerves are placed under stresses and strains that at first seem very slight, but over time can eventually cause wear and tear to the soft tissues of our bodies. There are many different aspects of wear and tear and if one can decrease or eliminate any of these aspects, then the risk for this type of injury can also decrease.

Since it is your body, it is your responsibility to try to identify these risks and take an involved part in reducing the risks. Things to consider are items like how much force is involved in a job, how long are you subjected to that force (not just hours in a day but how much repetition), what kind of rest do you get, and how long you have to maintain static postures. These are also other items which relate to the environment, for instance, lighting, vibrations, temperatures, and so on. And finally, one should always consider your overall general health.

1. Is your computer or desk station set up so that you have a good posture, and that you are not always twisting in one direction over and over? If not, make sure the chair and desk station is set up correctly. Be sure there is proper lighting.
2. a) Hips and knees should be at 90 degrees, feet flat on floor/footrest.
3. b) Shoulders should be relaxed (not elevated) and elbows should be held at 90 degrees.
4. c) Monitor should be at eye level.
5. d) Keyboard should be positioned so wrists are not bent up or down or twisted.
6. e) A lumbar roll or support should be used to provide low back support.
7. f) If you do other types of desk work, tilt the work up instead of lowering head and neck.