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.

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 Feed The Dog (Video)

The danger of your first episode of Low Back Pain

Did you know that one of the biggest risk factors for low back pain is prior low back pain? It sounds obvious, but this has huge implications for you. It means that preventing a first episode of low back pain decreases your chance of having future episodes. Therefore, you are less likely to have chronic low back problems in your future.

Each of you is in one of these categories:
Group 1. No prior low back pain
Group 2. Prior low back pain

Here is my advice for both groups.

Group 1. Prevent an initial back injury and a first episode of low back pain through good posture, body mechanics/ergonomics, lifting correctly, avoiding bending/twisting and regular exercise. This is urgent for you because if you hurt your back once, you will very likely hurt it again. So prevent it now, before it is too late.

Group 2. See a Physical Therapist if you have frequent episodes of low back pain. Prevent future episodes through good posture, body mechanics/ergonomics, lifting correctly, avoiding bending/twisting and regular exercise. It is harder for you to prevent future back pain than group 1 because you have already injured your spine in the past. But Physical Therapy treatment can be very effective to teach you how to manage and prevent symptoms.



Ref: McKenzie Institute International. Part A. Mechanical Diagnosis and Therapy of the Lumbar Spine.

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.

Top 7 reasons why sitting causes back pain

1. Most people sit with slouched posture, which puts your low back in a rounded or flexed position for hours each day. Our backs were not made to stay in one position all the time. This can cause future problems in the spine such as arthrits, herniated disks, and sciatica.

2. People who sit at work typically sit for too long without changing positions. If your job involves sitting all day, standing up, stretching or walking around briefly every 30-60 minutes will help.

3. Very few people sit with lumbar support, which helps to align the low back. Good posture starts with the pelvis. Tilt your pelvis forward so that less of your buttocks are supported on the chair. That way the bottom of your pelvis is supporting your trunk and you increase the arch in your low back. Once you have that position, use a lumbar roll/pillow to maintain it.

4. A slumped low back leads to a rounded mid back with shoulders rounded forward and the neck to be excessively forward. This can lead to progressive neck problems and even shoulder pain (especially with lifting overhead).

5. Aside from sitting at work, we tend to have a sedentary lifestyle, with many leisure activities done also in the sitting position. With present technology, we can do almost everything from the convenience of our homes. While it is convenient to buy clothes and even stamps at home, it is taking a toll on our backs. Having a sedentary lifestyle leads to obesity, which carries multiple health risks.

6. We do very few activities with our spines extended backward, which is an important position to achieve regularly for optimal back health. If you do not regularly lean backward (increasing the arch in your low back), then start doing so several times daily. It can be done sitting or standing. Another way to arch backward is to lie on your tummy and prop up on your forearms.

7. Slumped sitting posture puts the back muscles (and other back tissues) in a lengthened or stretched position while also causing the muscles and tissues on the front of the hip, abdomen and chest to be in a shortened position. This imbalance can cause further posture problems, weakness and instability with greater risk for back pain and injury.

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!

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.

How to make a bed.M2TS

SAFETY 101

"Although there are many sources of unexpected or unplanned things that can happen, there are three main categories:

1. You do something unexpectedly that gets you hurt.
2. Someone else does something unexpectedly that gets you hurt.
3. The equipment, tools or machinery you're working with does something unexpectedly that gets you hurt.

However, statistics show that only about 4 or 5% of all injuries at work, at home or on the highway occur because of equipment or component malfunction, weather or road conditions, faulty brakes, etc." (1)


As this quote demonstrates, incidents/accidents are usually caused by people. AKA Operator error. So a little personal initiative on the front end can ensure that you succeed in PAIN PREVENTION! Have you ever done something unsafe and as you did it, you thought it was not the best idea? You briefly thought of the worst case scenario but did the task anyway. The next time that happens, listen to your instincts and choose the SAFE option.

Just live by this motto for safety: Is it worth the risk?



(1). SAFESTART. Unit 1. Introduction & Overview. 1999: SAFESTART. Canada, p. 13.