Lifting to avoid back pain
Back injury is the number one cause of days off work in the UK, and so injury prevention and rapid return to work of injured workers is a major focus of industries throughout the world. The burden of low back pain is huge, both financially for companies, and emotionally for workers. Reducing injury at work is crucial, for both employee and employer.
Many companies try and counterract this by paying for employees to take manual lifting courses, teaching us to “bend through the knees and hip, not the back.” Unfortunately, this conventional method of lifting isn’t always possible, or appropriate. Objects have to be lifted from the floor, from parts bins, from above- any number of possibilities, and so this conventional lift won’t help avoid injury in these situations.
The thought process behind a conventional lift is that it reduces physiological load (the amount of stress put on your joints and muscles) and is more energy efficient, however the validity of this depends on a number of different factors, such as the size, weight, and density of the object, coupled with where we are moving it from and to, over which terrain, and how many times we have to repeat the lift. Squatting repeatedly throughout the day is physically tiring, and we know that many workers end up stooping to lift objects as they tire throughout the day.
If there is no one perfect lift, how do we help avoid injury?
- Remove the stressors that are causing or aggravating the injury
- Enhance the activities that build healthy supportive tissues
Injuries don’t often occur as the result of one major event- often because minor injuries accumulate over time, amounting to pain and problems when eventually the structures are no longer able to cope with what is being asked of them. It is therefore more important to address the cumulative causes of the injury in order to prevent reoccurrence.
You may think that injuries are more common in those with physical jobs, however injuries are just as prevalent in those who have sedentary jobs. Gagnon (2003) studied “expert lifters” and concluded that their personal body movements, as well as their individual lifting strategies, were key to their avoidance of injury- in fact some evidence exists to suggest that our personal spine movements (how we naturally move our backs) can influence whether or not we will become injured.
Olympic weightlifters often provide the best example of lifting technique, as they have recognised the importance of avoiding lumbar flexion (bending from the lower back) to prevent injury. We therefore need to stop emphasising the importance of stooping or squatting to lift, and instead work on placing the load closer to the body to help reduce forces on our joints, and avoiding full flexion of our lumbar spines when lifting. This avoidance of full flexion is really the key element in lifting.
So what other lifting techniques could be used?
Here’s two alternatives for the conventional technique and when they could be used.
When to use: Great for picking up light objects out of deep bins/containers or picking up small objects off the floor
1- Place one hand on a stable surface next to the object to be lifted- this is to help stabilise your upper body during the lift.
2- Keeping your back straight, lean forward, allowing the leg opposite the stabilising hand to swing out straight behind you as you lean down. This will act as a counterbalance to the weight of your body.
3- Prepare for the lift: Look forward, and begin to push down on the stable surface with your hand as you lower your leg to the floor. Focus on keeping your spine straight.
Tips: Good for people with knee problems.
When to use: Good for heavy objects with uneven weight distribution (such as sacks of food)
1- Put one foot next to the object, keep your spine straight, push your buttocks out and lower yourself down to the floor, keeping one knee bent up, one knee on the floor.
2- Position the object close to the knee on the ground.
3- Slide the object from the ground on to the mid-thigh of the knee on the ground.
4- Keeping your spine straight, lift the object on to the opposite thigh.
5- Palms upwards, put both forearms under the object and hug it into your chest.
6- Prepare for the lift: Extend your legs with your back straight, pushing your buttocks out, keeping the load held close to your body.
Tips: This is a good lift for people who may not have great arm strength.
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