Back Care Tips

Information on when injury is most likely to occur can significantly influence what we do. One of the most vulnerable times is in the early morning hours withing 30 minutes of waking. This is because the discs in the spine are well hydrated with water, which causes extreme stiffness, which can lead to injury if too much of a load is placed on the disc. Reilly (1984) showed that 54% of the loss of disc height (water content) occurs in the first 30 minutes after rising. Once this loss occurs, the spine is more flexible and less apt to injury with heavy loading. Other vulnerable times are after prolonged sitting or stooping in extreme end ranges. Both of these activites can compromise protective joint stiffness, in this instance, and lead to laxity in the joints which can cause injury with repetitive or heavy loading. SOURCE: Dr. Craig Liebenson, Dynamic Chiropractic, Apr. 17, 2000.


1. SITTING

• Don't slump, this puts undue stress on your back by overstretching muscles and ligaments. Even in a chair with good lumbar support, the natural tendency is to slump forward as the back muscles fatigue. It is essential to maintain the curve in the low back either by using a rolled up towel or a lumbar support placed at the beltline. Sit with your pelvis against the back rest and with feet flat on the floor in a chair with arm rests.
• Avoid sitting for prolonged periods. Take frequent breaks to stand up and stretch backwards a few times to reverse the curve in the low back.
• The ideal office chair will have an adjustable height, adjustable armrests, and an adjustable seat pad and seat back. The height should be such that your knees are level with or just slightly below the level of your hips. This will help take the pressure off your lower back. The lower border of the seat back should fall just above the belt line. The arm rests should be set so that you can comfortably rest your forearms on them while keeping your elbows bent to 90 degrees.

2. STANDING

• Try to keep the normal curves in your back at all times. High heels may cause the low back to arch excessively. Wear comfortable shoes with good arch supports.
• Shift positions frequently and rest one foot on a low stool or shelf.
• Keep your work close to you and at a comfortable height.

3. SLEEPING

• Sleep on a mattress that is comfortable and does not sag. The natural curves in your back and neck should be supported.
• When lying on your back, use a flat pillow to support your neck and one or two pillows under the knees help to support the low back. When lying on your side, place one pillow between your knees.
• When arising, roll onto your side and push up with your arms.

4. COMPUTER WORK STATION

• Your keyboard should sit directly in front of you
• the screen should be centered if you use the computer for word processing functions. For data entry, the screen may be slightly off to one side provided the documents you will be working from are centered.
• the top of the screen should be at eye level so that your neck is maintained in a neutral posture.
• place small towel rolls under your wrists to keep them in a neutral position ie. not bent forward or backward.
• use chair guidelines as above

5. EXERCISE

• Maintenance of trunk flexibility and strength are imperative for a healthy spine. Gentle back exercises should be performed daily and should be included in your normal exercise routine.
• It is necessary that the abdominals, as well as the back, muscles be strong so that the front and back of the spine is stabilized. The lower abdominals are especially important because they form a muscular brace when properly activated and strengthened.
• The large muscles of hip and thigh; gluteals, quadriceps and hamstrings, need to be strong so that during lifting they can be depended upon to do the work, thereby protecting the spinal joints and back muscles from injury.
• Improved flexibility can be achieved through daily stretching. It is important that flexibility of the spine, shoulder girdle and pelvic girdle be optimum so that the normal curves of the spine are maintained during all activities.
• If you have back pain, you should be instructed in the appropriate exercises for your condition.

6. BODY MECHANICS/LIFTING

• Bending and lifting should be avoided during the acute stage of an injury.
• Avoid heavy lifting 30 minutes after waking up or after sitting or stooping in full flexion for prolonged periods.
• Avoid "end range" movements with your back while lifting.
• Rotate jobs to vary loads and take frequent breaks.
• When lifting, bend your knees and keep your back straight as if you have a broomstick attached to your spine.
• Keep the lower abdominals activated and "braced" during the lift, don't hold your breath.
• Keep the object as close to you as possible and maintain a balanced position throughout the lift.
• Keep your body squared to the object at all times, avoid twisting the spine.

7. ACUTE INJURIES

• Discontinue the aggravating activity. Soreness, twinges and spasms are warning signs.
• ICE, ICE, ICE. As soon as possible, use crushed ice in a plastic bag, frozen peas or a frozen gel pack for 15 to 20 minutes at a time. Then let the skin temperature return to normal. You may do this as often as necessary during the acute stage ie. usually the first 24 to 48 hours.
• Find a position of comfort. Either: a) lie on your back with feet and lower legs elevated on pillows, b) on your stomach with one or more pillows under your hips, c) on your side with a pillow between your knees. Use ice on your back while resting in a comfortable position.
• Avoid lifting and forward bending activities
• Progress to gentle stretching exercises