1. Posture, Body Mechanics, and Back Pain
Elaine Tsay, SPT

2. Background Information
B.S. Kinesiology : University of Texas
Gymnastics : member and coach
Sports Coordinator for TASA

3. Background Information
Physical Therapy tech : Austin Regional Clinic
Doctor of Physical Therapy : Texas State University

4. Objectives Prevalence and causes of back pain
Proper posture and body mechanics
Basic exercises

5. How Common is Back Pain??

6. How Common is Back Pain??
50% of people that come in for physical therapy will present with low back pain
80% of people have experienced or will experience back pain in their lifetime

7. Shocking Fact
The money spent on visits to doctor’s offices, clinics, surgery, and prescription medication for low back pain in 2005 was $86 billion
$86 billion on low back pain
$90 billion on cancer
$100 billion on diabetes

8. What Causes Back Pain?

9. Most Common Causes of Back Pain
Muscles
Ligaments
Tendons
Nerves
Disc Herniation

10. Back Pain Facts Discs will degenerate over time
EVERYBODY will have degenerative discs with increasing age
DOES NOT indicate that you will have pain
Back pain is usually due to repeated stress
Exceptions include
Motor vehicle accidents (blunt force trauma)
Fractures due to fall
Nerve root impingement

11. Back Pain Myths
Myth : Imaging is helpful in managing back pain patients
Positive findings on x-rays and MRIs do not necessarily indicate causes of back pain
Increased risk of cancer with imaging

12. Asymptomatic Patients With Positive Imaging Results

13. What Does This All Mean?

14. Prevention
Proper posture and body mechanics can help prevent back pain from occurring
Prevention
Save money and time

15. Prevention Proper posture and body mechanics limit stress load on back
25% laying down
100% standing
140% sitting
150% leaning
forward
180% sitting and
leaning forward

16. Posture Proper posture can help prevent back pain
Can also prevent pain in the
Neck
Shoulder
Arms and wrists
Hip
Knees
Ankles and feet

17. Posture

18. Poor Standing Posture Head tilted forward Shoulders rotated forward
Hips sticking out in front
No curvature in low back

19. What Does Proper Standing Posture Look Like?

20. Proper Standing Posture
Ears in line with shoulders, head of the femur, and middle of the knee
GOOD!!

21. What About Sitting Posture?

22. Poor Sitting Posture

23. Proper Sitting Posture

24. Proper Sitting Posture
Knees bent ~ 90°
Knees should be slightly lower than hips
Back straight while maintaining curvature of low back
Elbows bent ~ 90°
Wrist and hands should be slightly lower than elbows

25. Proper Sitting Posture

26. Foot Rests

27. Ergonomic Chairs

28. Chair Cushions

29. Back Cushions

30. Back Support

31. Proper Lifting Body Mechanics

32. Base of Support Base of support is the distance in between your feet
Approximately hip width apart
Wider base of support means more stable

33. Staggered Stance
Stagger your stance (one foot slightly in front of the other) for an increased base of support

34. No Bending From the Back
POOR
GOOD – straight back

35. No Bending from Waist
POOR
GOOD – straight back

36. Close to Your Body

37. Proper Lifting Technique
Staggered stance for wide base of support
Make sure object is close to your body
Keep your back straight
USE YOUR LEGS!!

38. Proper Lifting Technique

39. Exercises

40. Core Exercises Abdominal drawing in (TA)
Quadruped (multifidus and erector spinae)

41. Abdominal Drawing In
TA’s are the deepest core muscle and help protect the back

42. Abdominal Drawing In Lay on back with knees bent and feet flat
Flatten back out
Without moving hips, legs, or holding breath, draw-in muscles and hold
Hold for 5 seconds
Repeat 10 times : 5 times a day

43. Abdominal Drawing In

44. Quadruped
Multifidus and eretor spinae are also core muscles that help protect the back

45. Quadruped Hands and knees Straight back and abdominal drawing in
Knees separated comfortably
Straight back and abdominal drawing in

46. Quadruped Progression
Assume quadruped position
Slowly lift one arm keeping the back and hips straight

47. Posture Exercises Chin tucks Scapular retractions Pelvic tilts
Bridging

48. Chin Tucks Laying down, sitting, or standing Eyes level
Hands under chin
Tuck chin slightly down and move head slightly upwards
DO NOT tuck chin into chest
Hold for 5-10 seconds and relax for 5-10 seconds
Repeat 10 times : 5 times a day

49. Chin Tucks

50. Scapular Retractions Laying, sitting, or standing Arms by your side
Can be done together with chin tucks
Arms by your side
Bring shoulder blades together and hold
Hold 5-10 seconds, relax for 5-10 seconds
Repeat 10 times : 5 times a day

51. Scapular Retractions

52. Pelvic Tilts Lay on back with knees bent and feet flat
Flatten out back without using legs (just from the pelvis)
Rock back and forth with the pelvis ONLY
10 repetitions : 5 times a day

53. Pelvic Tilts

54. Bridging Lay on back with knees bent and feet flat
Tighten glutes and lift hips off the surface
Keep glutes tight and bring hips back down to the surface and then relax
10 repetitions : 5 times a day

55. Bridging

56. Tips for Temporary Back Pain Relief
Ice or heat as needed
Take some ibuprofen
Laying on back : lay with pillows under knees or knees propped up (flat back)
Laying on side : pillows in between knees
Laying on stomach : pillows under abdomen and hips

57. Laying on Back

58. Laying on Side

59. Laying on Stomach

60. Questions??

61. Contact Information