1. Lower Back Strains and Sprains Back Pain Strain/Sprain Prevention M.C. Nachtigal, ARNP, ND JHU/PBC Employee Health & Wellness Center

2. Lower Back Strains and Sprains Background Information 70 – 80% of all people have back pain at some time in their life. It is the most frequent cause of activity limitation in people younger than 45 years old. 10% of chronic back pain sufferers account for 80% of the cost for LBP patients.

3. Lower Back Strains and Sprains Three Year Injury History In PBC Lifting Bending Twisting Overexertion Reaching Pushing / Pulling Coaching tips for handling PBC product and equipment: 1.Bend knees and use legs when lifting and lowering product 2.Do not bend at the waist when lifting and lowering 3.Mental effort to eliminate / minimize overexertion situations 4.Mental effort to eliminate / minimize over-reaching situations 5.Understand the risk of twisting and awkward postures 6.Understand the added risk of overexerting and twisting and being in an awkward position all at the same time. Reinforce during Training, Behavior Observations, and MBWA’s… 51% of all = STRAINS Employee Behavior… Employee Injury…

4. Lower Back Strains and Sprains Cause of Injury 1. All injuries have the same root cause: The load placed on that body part is more than the body part can handle. 2. There are two choices to prevent injury: Decrease the load on that body part. Increase load-bearing capacity.

5. Lower Back Strains and Sprains Anatomy of the spine Spinal Nerves-Motor and Sensory –C1-C8: Neck, Shoulders, Arms –T1-T12: Chest, Upper, Abdominals –L1-L5: Legs and Feet –Sacral: Leg and Feet

6. Lower Back Strains and Sprains Relationship Between Abdominal Muscles And Lower Back You don’t have to be an anatomy expert to realize that when it comes to back pain, weak abdominal muscles are often the culprit. –Abdominal strength is the glue that keeps your back strong. Your back’s strongest ally is its abdominal muscles. Abdominal muscles support the back, and without the assistance of back and stomach muscles, your spine would collapse. Strong abdominal muscles are critical to general health, good fitness, and a strong, pain-free back. That’s why people with low-back pain invariably sport abdominal muscles that are much weaker than their lower-back muscles.

7. Lower Back Strains and Sprains Common Causes of Low Back Pain (Other than illness or trauma) Poor posture Improper bending/lifting Improper sitting Excess weight and weak abdominal muscles. Infrequent exercise

8. Lower Back Strains and Sprains Standing Posture Standing –Stand tall -- head up, shoulders back, pelvis forward. –– Keep one foot forward, knees slightly bent. –– If you must stand in the same position for a prolonged period, shift your weight frequently, if possible by alternatively resting your feet on a stool or large book.

9. Lower Back Strains and Sprains Sitting Posture Many people lean forward and eliminate normal lumbar curvature while sitting. Use a lumbar support pillow and put back against seat to maintain normal back curvature.

10. Lower Back Strains and Sprains Sleeping Posture Sleeping rests the back -- when you are lying down your back doesn’t have to support your body weight. – Lack of sleep can rob every part of your body, including your back, of energy and stamina. – Your bed mattress should be firm but not uncomfortable. --Put a pillow under or between knees, or under belly to maintain back curvature.

11. Lower Back Strains and Sprains Back Math & Numbers Lesson Upper torso weighs 100 lbs. for the average person Improper lifting technique adds a stress factor to the lower back of 10 times the actual weight

12. Lower Back Strains and Sprains Good vs. Bad Technique Strong Weak More StrainLess Strain

13. Lower Back Strains and Sprains The 5 L’s of Lifting L1, Load –Always test the weight of the load –before lifting. If to heavy, get help. L2, Lungs –Just prior to lifting the load, inhale, –and as you lift, breath out through pursed lips. L3, Lever –Keep the load close to you body, –thereby reducing the lever effect. L4, Legs –Always use your legs and not your back while lifting. L5, Lordosis –Maintain the hollow (S curve) in your back throughout the lift.

14. Lower Back Strains and Sprains Stretching For Health & Safety Stretching Guidelines Do each stretch 3 times Don’t bounce - it causes muscles to tighten If you feel pain you may be stretching too far Hold each stretch 12-15 seconds Take it slow, breath normally Stretch a few times during the day Stretching before work minimizes chances of injury significantly…some studies say as much as 40%. The following Stretches will help you warm up at the beginning of the day, and keep you flexible all day long! Shoulder Stretch Standing Side Stretch Triceps Stretch Low Back Stretch Quad Stretch

15. Lower Back Strains and Sprains

16. Back Injury Self Care Guidelines ● Use ice initially x 15 minutes every 2-3 hours. Then alternate or try heat ● Avoid bed rest for more than two days. ● Take OTC NSAIDS like naproxen, ibuprofen, or aspirin with food regularly for first three days according to manufacturers directions ● Move as much as possible-stay active and continue usual activities. Avoid sedentary activities. Walk. ● If you are working, continue to work. ● If off work, return sooner rather than later to avoid

17. Lower Back Strains and Sprains Injury Care If pain persists or you have any of these warning signs, see a medical provider immediately. –Pain running down your legs. –Loss of bowel or bladder control. –Fever, chills, or signs of infection. –Any concerning symptom.