BACK CARE BIOMECHANICS OF LIFTING -
As the load mass center of gravity is moved horizontally away from the body, a proportional increase in the compressive force on the low back is created ↓ Thus even light loads need to be handled close to the body
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When a load is lifted from the floor, additional stresses are exerted on the low back due to the body weight moment when stooping to pick the load up ↓
Thus heavy load should not be stored on the floor, but should be raised to about standing knuckle height (minimum 50cm) to avoid the necessity for stooping over & lifting -
Lifting loads asymmetrically (by one hand or at the side with the torso twisted) can impart complex & potentially hazardous stresses to the lumbar column ↓ Such acts should be avoided by instructions &
Workplace layouts, which permit the worker to address the load in the symmetric manner -
The dynamic forces imparted by rapid or jerking motions can multiply a load’s effect greatly ↓ Instructions to handle even moderate loads in smooth & deliberate manner is recommended -
The postures used to lift loads from the floor can exert a complex & relatively unknown effect on the stresses of the low back during lifting ↓ Specific instructions as to the safe postures to use will be complex reflecting such factors as leg
strengths, load & load size. Until such complexities are better researched, it is recommended that instructions as to lifting postures be avoided
Nandgaonkar Hemant (2004, 2005) Do Not Reproduce
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BACK CARE MINIMIZING BACK STRAINS -
When lifting = keep weight of the object close to your body
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Twisting, especially while lifting can be very harmful
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In sitting or standing maintain good posture
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Do not do anything that your muscles are not prepared to do
1. Stretch the muscles you are going to use 2. Do not lift anything too heavy 3. Do not lift too suddenly or when off balance 4. Bad posture puts increased stress on your back -
When an activity is done when the back is not in good posture ↓
The ligaments holding the vertebrae are held in their maximum stretched position ↓ In which they cannot hold the joints in proper alignment ↓ This makes the back muscles work very nard so that the back feels tired -
To lift something above shoulder height
1. Pause at waist level 2. Change grip 3. One foot behind → to give balance 4. Use legs to start moving the object above the waist level -
When reaching into container below the waist level
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Support your upper body weight with one arm while sliding the load towards the body
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Then bend your knees
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Push rather than pull,
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Use your legs to do the work
Nandgaonkar Hemant (2004, 2005) Do Not Reproduce
2 http://indianhandsontherapy.tripod.com/hemant/
BACK CARE -
If possible place objects to be lifted between your knee & waist level
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Plan ahead before beginning to lift
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B →balance
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A → alignment
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C →contract (abdomen & buttock)
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K → knees bend
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Stance should be wide
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Shoes should have good traction & low heels
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Reaching should be restricted to 16 lb
Nandgaonkar Hemant (2004, 2005) Do Not Reproduce
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BACK CARE PROPHYLACTIC & ERGONOMIC TIPS FOR PATIENTS WITH SPINE PAIN -
Exercise to maintain painless ROM & muscle tone
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Avoid improper sit-ups & back extension exercises
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When sitting
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Use a lumbar support &
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Recline the seat when possible
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Use armrests when possible
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Move around within the seat; also
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Get out of the seat occasionally
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Determine whether the flexed or extended lumbar position is better for you
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Usually straight or slightly flexed is better
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Use this position in walking, standing & lying
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When lying in the bed during severe pain, flex hips 90 degree
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Try sleeping on the floor on three blankets during severe pain
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Use a flat, firm bed otherwise
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Lift with legs & with object close to you while doing a Valsalva’s maneuver
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Develop truncal muscles with isometric abdominal & erector spinae exercises
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Be careful about opening & closing windows (especially postmenopausal women)
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Avoid sudden jerks or incremental loads when lifting or carrying
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Avoid heavy lifting & strenuous activity when back is symptomatic
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Swimming is generally an excellent exercise in both acute & chronic phases
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Avoid obesity
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Sit on the bed or use a high table for changing diapers
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Avoid pain causing activities
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When standing for a long period of time, elevate one foot on a footrest
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Make love in the side-lying position
Nandgaonkar Hemant (2004, 2005) Do Not Reproduce
4 http://indianhandsontherapy.tripod.com/hemant/
BACK CARE SEXUAL ERGONOMICS Don’t bend forward with knees straight ↓ This applies to both standing & lying positions Avoid excessive swayback (Lordosis) ↓ This may irritate disc, nerve root or facet joints Avoid lying prone or supine if flat with hips & knees extended ↓ This loads lumbar spine through the psoas & also produces Lordosis ↓ Thus the simple “missionary position” is potentially aggravating to the back pain sufferer, Top or bottom Flexed hips & knees tend to relax the psoas & the sciatic nerve, strengthen the lumbar spine, reduces the disc bulge, and decrease loads on the facet joints ↓ Thus the side lying position is fundamentally the best position for either partner with low back pain
Nandgaonkar Hemant (2004, 2005) Do Not Reproduce
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