Back Safety and Safe Lifting

Back safety Learning goals: Understand anatomy and balance (how your back works) Learn safe body mechanics (lifting, standing, sitting, lying) Get your back in shape (exercises for strength, flexibility) A. Understand anatomy and balance (how your back works) 1. Your back is strong enough to support the weight of your head and body 2. Your back is flexible enough to allow you to walk, sit, move 3. The secret to its suppleness and strength is in its balance of curves 4. Knowing how the back works can help you avoid any strain or injury B. Learn safe body mechanics (lifting, standing, sitting, lying) 1. We are constantly using our backs to hold ourselves upright, sit, bend, we use our backs even when we are lying down 2. Poor posture can cause back problems 3. The back is most vulnerable to injury during any lifting C. Get your back in shape (exercises for strength, flexibility) 1. We often do “back-breaking” activities without any proper preparation D. Exercise can 1. Prepare muscles for work (cold muscles are prone to injury) 3. Keep bones and muscles strong, supple and aligned 4. Ease back pain 5. Rehabilitate injured backs

Back safety Definitions Manual handling: force exerted to lift, lower, push, pull, carry or otherwise move, hold or restrain something Manual handling injury: sprains, strains or fractures to muscles, tendons, ligaments and joints

Common causes of back injury/pain Traumatic injury (auto, industrial or sports accident) A. Traumatic injury (auto, industrial or sports accident) B. Poor posture and alignment 1. Any posture that compromises the natural curve of the spine puts strain on the supporting back muscles and weakens them 2. Without proper support, the vertebrae are forced to carry weight they are not meant to carry: premature spinal degeneration 3. Also makes movement difficult and awkward, increasing the chances of injury Poor posture and alignment: makes movement difficult and awkward

Common causes of back injury/pain Overexertion: failure to ease off activity or change position C. Overexertion 1. Failure to ease off strenuous activities 2. Failure to change position for long periods of time 3. Ignore the twinges. 4. Strain or muscle discomfort is a warning sign! D. Cumulative strain 1. Excess body weight, repetitive movements, working in awkward positions, age (wear and tear) 2. Happens over time, not all at once Cumulative strain: excess body weight, repetitive movements, working in awkward positions, age (wear and tear)

Common causes of back injury/pain Emotional stress and muscle tension Emotional stress and muscle tension 1. Stress causes the muscles to contract 2. Contracted muscles stop circulation of blood and oxygen: atrophy

Back anatomy Spine Made of 24 moveable bones (vertebrae) “stacked” in three flexible curves Supports head and trunk, protects spinal cord, provides flexibility to bend/rotate Spine 1. Primary component of your back 2. Supports head and trunk, protects spinal cord, provides flexibility to bend/rotate 3. Made of 24 moveable bones (vertebrae) “stacked” in three flexible curves a. Cervical vertebrae 1. Support head and neck 2. Smaller and more flexible than other vertebrae b. Thoracic vertebrae: support ribs forming chest cavity c. Lumbar vertebrae (lower back) 1. Largest and carries most of body’s weight (“workhorse” of the spine) 2. Area most prone to injury d. Sacrum: five fused vertebrae e. Coccyx: tailbone Most of body weight falls on lumbar region, making it prone to injury

Back anatomy Discs Flexible spacers between the vertebrae allow smooth movement Act as spinal “shock absorbers” Compress and release, like springs “Slipped” disc occurs when jelly-like center squeezes out of the disc Discs 1. Each vertebrae is separated from its neighbor by a cartilage cushion 2. Discs allow smooth movement; act as hydraulic “shock absorbers” 3. Compress and release, like springs 4. Disc anatomy a. Dense outer ring of criss-crossed fiber, like a radial tire b. Interior is soft and squishy, like thick jelly 1. 1/3 rd of height of spine is made up of discs 2. when lying down, they soak up nutrients and water from blood, making average person taller in the morning (up to 2 inches) 5. Disc injuries a. “Slipped” disc 1. Occurs when outer ring wears out like worn tire tread 2. Jelly-like center squeezes out and presses on a nerve (severe pain) b. Disc degeneration 1. Disc loses moisture, narrows 2. Bones grind together, irritating nerves (nerve damage)

“Slipped disk” jelly-like center squeezes out and presses on a nerve

Back anatomy Spinal Cord Central nervous system (with brain) Pair of spinal nerves exit below each vertebrae Cervical nerves go to the arms; lumbar area to the legs Spinal Cord 1. With brain forms the central nervous system 2. Pair of spinal nerves exit below each vertebrae 3. Cervical nerves go to the arms: pinched nerve in neck 4. Nerves in lumbar area go to the legs: sciatic nerve from tailbone down legs

Back anatomy Muscles Spinal (back) muscles: stabilize spine- not made for lifting Buttock and thigh muscles: strong and durable Stomach muscles: also used in lifting 1. Spinal (back) muscles a. Stabilize the spine: very strong because they support body b. But they are not made for lifting! 2. Buttock and thigh muscles: strongest in body and very durable 3. Stomach muscles a. Used in lifting b. When stomach muscles weaken, back muscles tighten (increasing chance of injury)

Muscles Dynamic muscle work: Static muscle work Involves muscle contraction and movement Blood flushes out lactic acid which causes muscle fatigue (can work for lengthy periods) Lifting and stacking boxes an example Static muscle work Muscles hold the body without movement Sustained contraction halts blood flow to muscles: lactic acid builds up, causes fatigue Bending over workbench, sitting at computer are examples 4. Dynamic muscle work a. Involves muscle contraction and movement b. Blood flushes out lactic acid which causes muscle fatigue (can work for lengthy periods) c. Lifting and stacking boxes an example 5. Static muscle work a. Muscles hold the body without movement b. Sustained contraction halts blood flow to muscles: lactic acid builds up, causes fatigue c. Bending over workbench, sitting at computer are examples

Spinal balance Posture is important. Spine is aligned in three “S” shaped curves Balanced to keep weight evenly distributed on spine Proper balance places least amount of stress on spine Vertebrae pushed out of line causes pain, invites injury A. Spinal balance 1. Spine is aligned in three “S” shaped curves 2. Column of curves is balanced to keep weight evenly distributed 3. In proper balance, the spine and all its structures are under the least amount of stress and muscles are at their strongest 4. Spine is out of balance when it loses its three natural curves 5. Good posture is important: simplest way to help keep back healthy and pain-free B. Laying down 1. Lay on side with knees slightly bent toward chest 2. Lay on back with a pillow beneath knees Posture is important.

Posture Standing “Stack” ears, shoulders, hips, knees and ankles in a straight line Tuck in chin Shoulders back and down Suck in gut: a pot belly can act as a load and pull spine out of balance a. Standing 1. “Stack” ears, shoulders, hips, knees and ankles in a straight line 2. Tuck in chin 3. Shoulders back and down 4. Suck in gut: pot belly can act as a load and pull spine out of balance 5. Elevate one foot to reduce stress in lower back

Posture If standing for long periods, elevate one foot to reduce stress in lower back

Posture Sitting Sit with ankles, knees, thighs and elbows at right angles Keep head balanced over shoulders Keep shoulders relaxed (not hunched) Sit back in chair for support b. Sitting 1. Sit with ankles, knees, thighs and elbows at right angles 2. Keep head balanced over shoulders 3. Keep shoulders relaxed (not hunched) 4. Sit back in chair for support

Safe body mechanics Body mechanics: The relationship between your posture and your movement Good body mechanics avoids putting undue strain on your back

Safe body mechanics Principles of levers: A weight, a short distance from the fulcrum requires less effort to move than the same weight a farther distance from the fulcrum 1. A weight, a short distance from the fulcrum requires less effort to move than the same weight a farther distance from the fulcrum

Principles of levers The worst lifting situation occurs when the body is used like a lever and extended over the load If the load is further away, there will be a greater strain on the person doing the lifting

Principles of levers The further the load, the greater the strain on the person doing the handling If the load is further away, the greater the strain on the person doing the lifting

Principles of levers The lower back becomes a fulcrum supporting the weight of the body plus the load The worst lifting situation occurs when the body is used like a lever and extended over the load If you bend at your waist and extend your upper body to lift an object, the lower back becomes a fulcrum supporting the weight of the body plus the load. this situation is called “overload”

Techniques for safe lifting Get a firm footing: keep feet shoulder width apart, toes out, distribute weight evenly on soles of both feet a. Keep feet shoulder width apart, toes out b. This adds stability and reduces stress on muscles c. Distribute weight evenly on soles of both feet This stance adds stability and reduces stress on muscles

Techniques for safe lifting Bend your knees: not your waist a. Bending at the waist puts tremendous pressure on the vertebrae b. The legs serve as a shock absorber for the body c. When the knees are bent, the weight comes first into the thighs and hips instead of the spine When the knees are bent, the weight come first onto the thighs and hips, not the spine

Techniques for safe lifting Bending at the waist puts tremendous pressure on the vertebrae

Techniques for safe lifting You can also lower your body down on one knee and glide the object up into your body to get a good grip before pushing your body upward.

Techniques for safe lifting

Techniques for safe lifting Tighten stomach muscles: they support spine when lifting, reducing force of the load Get a good grip: use both hands “Hug” the load: hold it as close as possible to your body; the closer it is to your spine, the less force it exerts on your back 3. Tighten stomach muscles a. They support the spine when lifting, reducing force of the load b. Keep center of gravity in the abdominal cavity 4. Get a good grip: lifting with one hand throws you off balance 4. “Hug” the load a. Hold it as close as possible to your body b. The closer it is to your spine, the less force it exerts on your back

Techniques for safe lifting Lift with your legs Gradually straighten to a standing position Lift steadily and smoothly without jerking a. Gradually straighten to a standing position b. Lift steadily and smoothly without jerking

Carrying Keep back straight: to help shift weight onto the legs

Techniques for safe lifting Avoid twisting Twisting can overload the spine and cause injury to the feet, knees and torso. Your feet knees and torso should always be in the same direction

Techniques for safe lifting Pivot with your feet, not your back.

Techniques for safe lifting Use the same technique to set down the load.

Lifting awkward loads Reaching into a bin or car trunk: Stand with feet shoulder distance apart Slightly bend knees and squat, bending at hip joints, not waist Slide the load as close to your body as possible Raise yourself with leg and hip muscles If possible, rest knees against edge for support

Hard to reach loads Do not reach above the shoulders: use a stepstool or ladder Test the weight before removing from shelf Slide it toward you and hug it close to your body Lifting above your shoulders is hard on your arms and back. If possible, reduce the amount of weight being lifted by removing some of the contents of the box or container. Try using a step stool or ladder to get closer to the target area, instead of lifting above your shoulders. If possible, place the item on a lower shelf.

Hard to reach loads Place item on lower shelf Don’t reach above shoulders Place item on lower shelf

Two person loads (Team lifting) - Both persons should be about the same height. - One person should charge of the lift, so that you are working together not against each other. - Lift together, walk in step and lower the load together.

Two-person long load Shoulder on the same side Keep load level Walk in step

Loading truck or shelf Put the load on the edge and push it into place.

Awkward location Don’t force your body to conform to the workspace Use the golfer’s lift to pick up light, small loads when you can’t bend your knees or get close to the object. Swing one leg straight out behind you. Keep your back straight while your body leans forward. To help support your body, place one hand on your knee or on a nearby solid object.

Awkward loads Instead of lifting, push a load Push, don’t pull!

Repetitive lifting If you must lift many items: Design workspace so items to lift are in your safe lift zone

Repetitive lifting Use mechanical assistance or get help!

Safe lifting Don’t: Lift anything that exceeds 1/3 - 1/2 your body weight Lift from the floor if possible Twist and lift Lift with one hand (unbalanced) Lift loads across or over obstacles Lift while reaching or stretching Lift from an uncomfortable posture Fight to recover a dropped object

Exercise Benefits: Muscle strength helps maintain natural curves Keeps back strong and supple Warm muscles increase ease of movement Benefits of back exercises 1. Healthy backs require strong supporting muscles a. Muscle strength helps maintain natural curves b. Keeps backs strong and supple 2. Greater flexibility a. Joint flexibility lets you move freely and easily b. Warm muscles increase ease of movement

Exercise More energy: increased blood and oxygen flow flushes out lactic acid Cool down exercises decrease potential stiffness 3. More energy: increases blood and oxygen flow, flushes out wastes like lactic acid 4. Balanced workout: some muscles get overworked while others “sleep in” 5. Cool down stretches decrease potential stiffness

Exercise “dos” Change your posture/position often Stretch frequently throughout the day Keep body flexible (not rigid or fixed) Warm up before any strenuous work or lifting Move slowly and gently Stop if there is any discomfort

Exercise Wall slides to strengthen back, hip, and leg muscles Stand with your back against a wall and feet shoulder-width apart. Slide down into a crouch with knees bent to about 90 degrees. Count to five and slide back up the wall. Repeat 5 times.

Exercise Leg raises to strengthen back and hip muscles. Lie on your stomach. Tighten the muscles in one leg and raise it from the floor. Hold your leg up for a count of 10 and return it to the floor. Do the same with the other leg. Repeat five times with each leg.

Exercise Leg raises to strengthen stomach and hip muscles Lie on your back with your arms at your sides. Lift one leg off the floor. Hold your leg up for a count of 10 and return it to the floor. Do the same with the other leg. Repeat five times with each leg. If that is too difficult, keep one knee bent and the foot flat on the ground while raising the leg.

Exercise Partial sit-up to strengthen stomach muscles Lie on your back with knees bent and feet flat on floor. Slowly raise your head and shoulders off the floor and reach with both hands toward your knees. Count to 10. Repeat five times.

Exercise Back leg swing to strengthen hip and back muscles Stand behind a chair with your hands on the back of the chair. Lift one leg back and up while keeping the knee straight. Return slowly. Raise other leg and return. Repeat five times with each leg.

Exercise Stretch Stand with your feet slightly apart. Place your hands in the small of your back. Keep your knees straight. Bend backwards at the waist as far as possible and hold the position for one or two seconds. Give participants the Back Exercise handout and explain it contains exercises to warm up, relieve pain, and exercises for people who sit a lot.