Changing Crib Sheets Without Pain

There are a few baby-related tasks that can be near-impossible without straining your back, so here is what I do for changing crib sheets.

Photo: National Media Museum

1. Buy at least 3-4 crib sheets and 3-4 waterproof pads. I promise that the price of these is far less than a back injury.

2. Take the mattress out of the crib to change the sheets.

3. Layer your waterproof pads and crib sheets over each other so that when the top layer gets wet, you simply remove it and your clean, dry one is already there.

4. As soon as possible, remove the bumper pads. For safety reasons, they are not even recommended anymore. Changing the crib sheet is much easier when there are no bumper pads in the way.

5. Consider using a sheet saver. It is a sheet that actually attaches to the bars of the crib, so it is fairly easy to snap on or off (each sheet has at least 12-15 snaps). There are some safety concerns with this because it does not fit as tightly as a fitted sheet. To get it on or off, it still takes several minutes, and you have to be able to reach all four sides of the crib.

6. For crib sheet selection, buy the T-shirt material ones that stretch a little.

7. Change the sheets for a toddler bed the same way--by taking the mattress out first.

Back Pain Prevention: Avoid Twisting

Never twist your body when holding something. It is common for me to ask a patient with low back pain how he hurt his back and he responds that he was holding a heavy box and twisted his back. This is one common way to cause a disc in the low back (lumbar spine) to bulge or herniate, which is a very common diagnosis in PT clinics. The complication associated with disc problems is that if a lumbar disc bulges out of its normal position, it can compress the nerves in the spine, causing pain and other symptoms into the leg or legs. It is much easier to prevent a disc herniation than to treat one after it occurs!

            One common way for this to happen is while doing the laundry. Many people twist their bodies when putting clothes from the washer into the dryer. This is worsened because they are holding wet clothes while twisting their backs, causing more injury than if nothing were held. Instead, step over to the dryer, then squat to throw the clothes in. It takes a conscious effort every time, but just remember "step, squat, and toss." It only takes one wrong twist to cause low back pain which could last for months or years, so avoid twisting—every time!
         Here is a video showing what not to do. I posted it a year ago, but it's funny and worth another viewing.

Ergonomics Rap with Sustainable John - Lawrence Berkeley Lab

Click on the title to view this video about workplace ergonomics! Good reminders for those of you who sit at a desk all day.

Back Pain Prevention: Proper Lifting Techniques

Photo: New York Public Library

Never lift an object if you are in a forward bent position. The picture here shows a proper squat in order to reach down to the floor. Your spine is a perfectly stable system of bones (vertebrae) with discs in between each one. This system is designed to support your body weight and has the capacity to support much more weight (for example, carrying furniture) if the spine is maintained in its neutral position. (Note, it is not designed to support excessive body weight). The neutral position of the spine is when each vertebra is stacked on the one above it, which happens when you are demonstrating proper posture. You lose the stability and strength of the spine when you are twisted or bent, which removes the vertebrae from their properly stacked resting position. When this occurs, the muscles of your back have to be used in a way they were not made for. Why not use the stability of your spine when you lift instead of straining weak back muscles? 

Back muscles can be strengthened, but strong back muscles alone cannot prevent back injuries when your spine is in a compromised position, such as bent forward. Instead, it is best to lift when your back is straight and you use your legs to do the work. This involves squatting down but maintaining a straight back position. Our leg muscles are very strong and large and are made to do the work of lifting heavy objects, if we use our legs instead of our backs. If you are familiar with weight lifting, squatting is the exercise in which one can lift the most weight, compared to dead lifts, bench press, etc. This is because the thighs and buttocks have huge, powerful muscles, which are much less prone to injury. I rarely see patients for quadriceps (anterior thigh muscle) or gluteus maximus (buttocks muscle) strains whereas low back strains are very common in outpatient PT clinics.

What Your Toothbrush Tells You About Back Pain

Where do you store your toothbrush? Most of us store it right on the bathroom sink. Why do you store it there? Why don't you store it up on the top shelf or down in the bottom drawer? Your answer gives a simple example of BODY MECHANICS! You store your toothbrush within close reach to make life easier and more convenient. Why bend if you don't have to?

BODY MECHANICS is using your body to its advantage so that you don't have to work harder than necessary for whatever task you are doing. Here is another example. Ladies: why don't you carry your heavy purse by holding it with 1 or 2 fingers? You have naturally learned that the easiest way to carry a large handbag is strapped over your shoulder. 

We all practice good body mechanics with things like where we place our cups/plates/silverware in the kitchen, where we put our socks in our drawers and where we position our debit cards in our wallets. We want easy access to the objects that we use the most every day. So good body mechanics comes naturally...until we deal with our backs. We use our backs for things that our legs and arms should do, such as lifting and bending. Our leg muscles are massive and powerful and can do much heavier lifting than our back muscles. And our shoulder and arm muscles are very strong and able to lift, carry or hold significant amounts of weight.

So to prevent back pain, keep your back straight and use your legs more. Try squatting down using only your legs (maintaining a straight spine position) the next time you need to reach down toward the floor. Here is one easy way to demonstrate bad body mechanics: hold one arm straight out in front of you (with elbow straight) and place a dictionary or phone book in your hand. Time yourself to see how long you can keep it there.

Right Way To Unload Dryer, Short Video

Wrong Way To Unload Dryer, Short Video

The Best Way To Treat Low Back Pain

The answer is prophylaxis (prevention)! What other things are best treated with prophylaxis? Cold, flu, heart attack, diabetes type 2, blood clot, stroke, HIV, lung cancer, etc.  Prevention is the easiest and best way to approach low back pain, so whether you have pain or not, this applies to you!

What factors put you at risk for low back pain (LBP)?
1. Prior episode of low back pain.
2. Repetitive lifting (with incorrect body mechanics).
3. Repetitive vibration at work or leisure (example: truck driving).
4. Repetitive forward bending and twisting of the low back.
5. Repetitive poor posture.

What are the components of low back pain prevention?
1. Staying fit/exercising consistently.
2. Progressing your fitness program slowly and with caution.
3. Keeping your back flexible.
4. Maintaining good POSTURE!
5. Changing positions frequently.
6. Standing frequently between longer bouts of sitting.
7. Standing and bending backwards (5-10 reps, 1-2x/day). (Note, this exercise is contraindicated for some individuals, so please consult your physician).


Reference: McKenzie, Robin. Mechanical Diagnosis & Therapy: Lumbar Spine. 2009: The McKenzie Institute International, Part A, pages 126-127.

Right Way To Load Dishwasher FUNNY

Right Way To Brush Teeth, Funny Video

How to avoid BACK PAIN with reaching/bending

My patients with back pain typically fall into two categories: trauma vs non-trauma. Traumatic injuries can come from a major accident or an easy task done incorrectly (bending down to pick up shoes from the floor and then patient is unable to stand back up). Non-traumatic back pain frequently comes from repetitive poor postures and bad bending/reaching habits.

Based on my posts "How many times per day do you reach to the floor," the number is likely more than 30 times and may be even higher than 50 for those of you with small children. So how can you modify these RTF's (reach-to-floors) so as to decrease your risk for back pain, back spasm, back strain or worse?

First, check your back position each time you reach down to the ground or a low surface. You can squat (with your back straight) or use the golfer's grab (kick 1 leg back behind you). You can sit on a stool or chair. You can kneel. You can get on your hands and knees. You can sit on the floor. Be creative; there are many ways to reach down without straining your back. It simply takes the effort to think twice before you bend.

Next, modify where you place the objects that you use the most to be at an easy-to-reach height. For example, store your dish soap in a decorative container on the counter instead of under the sink. What objects do you have in your lower cabinets, cupboards, drawers and shelves? They should be the ones you use rarely. Anything you use multiple times/day should be easily accessible with minimal reaching required. This is especially true for those of you with back problems (which limit your ability to bend) and knee problems (which limit your ability to squat).

Finally, always give yourself the mechanical advantage. Use your big muscles to do the work they were made for (thigh, buttocks muscles). They are easily able to do the work of lifting so your back does not have to.

Right Way To Feed The Dog (Video)

Wrong Way To Feed The Dog (Video)

How many times per day do you reach to the floor? Part 2

15. Reach into bottom drawer of the refrigerator for an apple.

16. Reach down into lower kitchen cabinet for a tupperware to take leftovers to work.

17. Pick up your keys, which you dropped on the floor.

18. Throw your bags into the trunk of your car or your back seat.

19. Reach down to the floor of your car for the water bottle that fell.

20. Pick up your bag/briefcase out of the trunk or back seat.

21. Pick up the quarter you found on the sidewalk.

22. Place your bag/briefcase down on the floor while you take off your coat.

23. Pick up the paper from your desk that blew off.

24. Get a book out of the bottom drawer/shelf.

25. Reach down to get the water bottle you just bought from the vending machine.

26. Plug in the cord from your laptop into the outlet.

27. At lunch, pick up the napkin that fell off your table.

28. Tie your shoelaces.

RTF's (reach-to-floors) continue increasing, and it's only 2 pm!

To be continued.

How many times per day do you reach to the floor?

How many times per day do you reach down to the floor to pick up a light object? Consider how you do this reaching because it is quite frequent. And if you bend/twist your back every time, you are at high risk for back pain. So let's consider a typical weekday and count up the necessary RTF's (reach-to-floor's).

1. Pick up the pillow on the floor that fell off during the night.
2. Reach under the bathroom sink for a towel.
3. Reach under the bathroom sink for another roll of toilet paper.
4. Reach down to wash your toes.
5. Reach down to dry your toes.
6. Reach into bottom drawer of your dresser.
7. Pick up your shoes from the floor.
8. Tie your shoes.
9. Pick up your cell phone that dropped out of your pocket.
10. Reach under the bathroom sink for your after-shave or makeup.
11. Pick up your socks that you threw on the floor.
12. Pick up your briefcase or computer bag.
13. Pick up Snoopy's water bowl.
14. Replace Snoopy's water bowl.

As you can see, the RTF's add up, with 14 by 7AM! To be continued.

Right and wrong way to pick up toys

Charging your cell phone and laptop

Unless you follow my blog regularly and have begun to think like a PT, you probably have never thought about body mechanics while plugging in your electronic devices. But everything you do can and should be done with good body mechanics so as to PREVENT PAIN! So here are some tips for the next time you plug in your phone charger.

1. Squat instead of bending your back. (You guessed right!)

2. Hold onto the bed or desk, kick one leg back behind you and perform a golfer's grab.

3. Try charging your phone in the kitchen or bathroom, where the plugs are higher.

4. Keep the phone connection piece (what's it called?) up on a table or chair instead of on the floor.

5. Use a desktop charging device.

6. Try to avoid outlets that are hidden behind furniture.

7. Be careful not to twist your back if the outlet is hard to reach. You may need to get onto your hands and knees. 

So think twice the next time you have to plug anything into the wall, and check your body mechanics! A lifetime of good choices will make your future less painful!

Prevent recurrent daily PAIN

"It hurts every time I..." Fill in the blank. What activity causes you some pain or discomfort every time you do it? Here are some examples:

1. Feeding the dog.

2. Blow drying your hair.

3. Playing tennis.

4. Running.

5. Working in the yard.

6. Picking up your child.

7. Sitting in a certain chair.

8. Closing the trunk of your car.

You get the idea. So can you think of something you do that causes pain regularly?

Here are the steps to fix it. 

1. Name the activity and the area of pain.

2. Think about how you do that activity. What about that activity causes you pain?

3. Think of ways to modify the activity to make it easier for you. Are you using the right body mechanics? How is your posture? Is there a tool you could use? Could you simply use two hands instead of one? Are you using a small muscle to do something a large muscle could do easily? Could you take a few rest breaks? Is there a stretch that helps? Brainstorm ways to modify the activity.

4. Test out the modifications to see what works the best. 

5. Implement your new way of doing the activity. Modify it as needed. 

6. Do it consistently for best results!

Why live with pain if you don't have to? Catch your pain before it is too late! If you catch it early, you can prevent it from becoming an injury.

How to sit at a computer

The perfect SQUAT

In light of yesterday's video, "How to make a bed," let's talk about squatting. Can you squat down to the floor while keeping your back straight? If there were a 20-lb. box on the floor, could you pick it up by squatting the right way? Can you make your bed without bending your back? Just "lifting with your legs" is not enough for good body mechanics. It must be accompanied by a straight back position.

Unless you have hip or knee problems, you should be able to learn the skill of squatting. First, start with a small squat. Spread your feet apart. Squat halfway down (or less), checking your back position. It should be completely straight the whole time. If you find yourself bending your spine as you squat, then decrease how far you squat down. Practice the partial squat with perfect back position. Then you can increase the depth of the squat progressively. But only squat as low as you can maintain your straight back position. Be careful to limit your repetitions if you get any knee discomfort.

If you cannot squat because of various orthopedic or other medical problems, then you must learn how to do activities without bending your back. Here are some ideas:

1. Sit on a chair or stool when doing tasks such as unloading the dishwasher.
2. Use a "reacher" so that you can pick up light objects from the floor easily.
3. Have a stool or folding chair in every room of the house so they are accessible.
4. Avoid putting objects on the floor (clothes, shoes, bags, etc), knowing that you cannot easily pick them up.