Maintain a Healthy Spine Using Good Body Mechanics

Good Body Mechanics
Most people are aware that when they bend or lift something, they should bend their knees. While it is important to bend your knees, attention must also be paid to the position of your spine. In order to avoid injury, either at the moment of lifting something or, more likely, as a result of poor body mechanics over time, care must be taken to maintain the previously described "neutral spine." Again, a neutral spine means that the three normal curves-at the neck, middle and lower back-are maintained. When viewed from the outside, the back looks straight with a hollow in the low back.

To practice maintaining this neutral spine with forward bending, take a cane, dowel rod, or something comparable.

1.) Place the stick down your spine. The top end must stay in contact with the back of your head. The bottom end rests against your sacrum/tailbone region. You'll notice a small arch in your low back.

2.) Holding the stick against your back as described, first "bow" at your hips, like a waiter or butler bows. (Figure 3a) Be sure to maintain the stick's contact at the head and tailbone. Practice a few "straight back" bows forward.

Figure 3a

3.) To add in the important knee bending, bow first, and then squat as if you are going to sit down. (Figure 3b) Don't bring your knees forward as if to kneel. Your knees should not go out past your toes. Your buttocks should be sticking out behind you.

Figure 3b

With practice and awareness, the bowing and squatting become one motion and feel more natural. Practicing proper bending with the neutral spine maintained can help protect your back and really make a difference in back pain during activities of daily living.

Now that you have a handle on bending, let's move onto some tips for lifting.

1.) Test the weight of the load first and get help if it is heavy or bulky.

2.) Get close to the load

3.) Move the feet apart, one foot ahead of the other, toes pointed outward.

4.) Perform the waiter's bow plus squat. (Picture the stick staying in contact with your head and tailbone!) (Figure 4)

Figure 4: Top: Incorrect lifting technique
Bottom: Proper lifting technique

5.) Pick up the load and bring it in close to you.

6.) Lift by using your legs and buttocks to push up to straight.

7.) If turning, don't twist. Turn your feet by taking small steps.

8.) If carrying is necessary, keep the stomach muscles tight and maintain a neutral spine.

9.) To lower the load, again perform the "waiter's bow" plus squat, sticking the buttocks out behind you as you go down.

Other hints:

- It is easiest to load and unload things at waist height.

- Lifting is easiest from knuckles to shoulder range.

- With overhead reaching, use a stool or chair to bring yourself up to the level of the object; again, get as close as possible.

- Regarding pushing or pulling, PUSH! Don't pull. The same body mechanics hold for pushing as bending and lifting neutral spine.

Regular Exercise
The final key to a healthy spine is regular exercise. Research has demonstrated that people who exercise regularly are less likely to suffer from back injuries and pain. They also show quicker recovery if injuries do occur than people who are less physically fit. Exercise can be divided into 3 basic groups, all of which are important to a healthy back:

1.) Strengthening

2.) Stretching

3.) Aerobic activities

Strengthening
The abdominals and back muscles are targeted because they help to support and stabilize the spine. They also help maintain good postural alignment. Strong hip and leg muscles help to facilitate proper body mechanics with bending and lifting.

Stretching
The soft tissues around the spine and in the legs need adequate flexibility to allow normal movement and to help prevent abnormal forces on the joints. With regard to the back, the goal is for balanced flexibility in both directions. Stretching also helps to prevent or address soft tissue injury and muscle soreness, and promotes relaxation.

(Specific exercises for an individual would be based on a thorough physical therapy evaluation assessing the strength, flexibility, posture, daily activities, pain pattern and abilities of the person.)

Aerobic Activities
Aerobic exercise helps to promote heart and lung function and overall conditioning. Aerobic activities are those that use several large muscle groups and increase your breathing and heart rate. Examples of activities include walking, biking, swimming, and dancing. For maximum benefit, the goal is to work up to 20-30 minutes at least 3-4 times per week. In addition to helping decrease spinal pain, aerobic exercise burns calories and helps with weight loss. It can also help increase energy, improve mood, allow better sleep, and help to decrease blood pressure and sugar levels. Before beginning any aerobic program, you should check with your doctor.

In addition, to a regular home or gym exercise program, individuals wishing to maintain a healthy spine need to do smaller scale exercises throughout the day. These might be postural correction/strengthening exercises or stretches of the neck or back. Again, specific exercises would be individualized according to the specific problem. For example, people who sit at a desk all day for work tend to lose the small arch in their low back. In order to balance out this tendency for a rounded forward spine, the person might be instructed to "reverse the curve" of their spine by standing and bending backwards several times during the day (Figure 5).

People who do a lot of sitting work tend to fall into a "forward head" posture. These people might be instructed to draw their chins in and elongate the back of their necks several times per day to help decrease muscle and joint strain, to correct posture, and to help increase postural muscle endurance. Pay attention to the different positions you find yourself in during the day. If you find yourself out of neutral alignment, correct the neck or back alignment as described previously, even doing it repeatedly to help strengthen the postural muscles. (For example, lifting the breastbone and pulling the shoulder blades down in back several times per day helps strengthen the "anchors" at the tips of the shoulder blades to keep you upright.)

In conclusion, the key concept for maintaining a healthy spine is to strive for balanced stresses to the joints with dynamic neutral alignment during activities of daily living. Postural awareness, use of good body mechanics, and regular exercise can help you manage, alleviate, and prevent neck and back pain everyday.