posture correction by arthurwyndham


									Extending to A Healthier Spine

As we have evolved socially from agrarian based societies to our current technological status, the
demands placed on the human body have changed. In a society where much of a person's time
was spent in the upright position tending to their crops or live stock the pressures on the spine
were variable and in all planes of motion. In our current society whereby we have become more
sedentary in our daily pursuits, time spent sitting at computers, driving cars and trucks, and
running machinery, the human spine no longer enjoys the frequent changes of position and

The stresses are constant and generally prolonged in positions of flexion or forward bending.
Positions of flexion place stresses on all of the spinal structures, joints, discs, ligaments and as
time passes the body adapts to these stresses. These adaptations result in loss of joint mobility,
degenerative changes in the joints and changes in the normal structure and function of the
intervertebral discs.

A well-known physical therapist by the name of Robin McKenzie from New Zealand began
preaching the benefits of repeated extension of the lumbar spine in treating a variety of spinal
conditions based on the above notions. His belief was that by returning extension mobility to the
spine, the discs, joints, ligaments, muscles and other tissues would function in a more normal and
thereby a less painful way. Physical therapists familiar with the McKenzie approach to treatment
will often prescribe a regimen of home exercise that includes repeated passive extension of the
spine in both the prone lying and standing positions.

Though not appropriate for all causes of back pain, this is a successful back pain treatment and
prevention method for many people suffering from disc problems and other sources of lower back
pain. The extension exercises are especially effective when combined with other treatment and
exercise methods. Before engaging in these exercises you should be evaluated by a properly
trained physical therapist or other medical professional.

Illustrations of the basic mechanics affecting the intervertebral disc and the nucleus pulposus.

                                                                      Fig 3: The effects of
Fig 1: A disc in a neutral     Fig 2: The effects of forward
                                                                    backward bending on the
        position.                  bending on the disc

Progression of extension exercises in the lying position
                                                                  Fig 6: Full extension in lying
 Fig 4: Prone lying position       Fig 5: Prone on elbows

         Fig 7: Extension in Standing               Fig 8: Full Extension in Standing Position
Body Mechanics 101

Taking care of your back is a life long project. With the prevalence of back pain an alarming 60%
among U.S. adults, preventive measures are needed. The use of proper body mechanics is an
effective way to prevent further injury to your back. When incorporated into activities of daily
living, body mechanics help decrease the amount of stress on the spine. Education in body
mechanics is therefore, essential in preventing the occurence of back pain.

The goal of body mechanics is to learn how to move the body so as to prevent further injury to the
spine. Awareness of common mistakes and proper principles can only help to achieve this goal.
One such principle concerns posture.

Poor posture is one of the main causes of neck and back injuries. Forward head position and
rounded shoulders contribute to poor posture. Any desk or computer employee has probably
been guilty of poor posture at some point in their career and can attest to the fact that it's a hard
habit to break. Fortunately, there are a few simple exercises that can help.

The chin tuck or, cervical retraction, involves sitting or standing erect while gently pulling your
chin back to a comfortable position. Think of a turtle bringing his head back into his shell. This
exercise should be performed in sets of ten, starting with one set and working up to two or three
sets, several times daily.

Shoulder squeezes or, scapular retractions, can also help improve posture. Shoulder squeezes
involve bringing your elbows behind you while squeezing your shoulder blades together. This
exercise should be performed ten to twenty times while holding the squeeze for a count of five.
This motion increases mobility in your neck and back, making it easier to stand erect. Both of
these exercises should be performed pain free. If pain does occurr, try decreasing both the
number of sets and the frequency. If pain persists, stop the exercise and consult your physician.

Compliance towards the exercises required to maintain or improve posture will lead to proper
spine alignment. This in turn, will help decrease the intensity and frequency of painful flare-ups.
Slumped sitting or standing represents faulty body mechanics, and, although it is a common
mistake, it must be improved upon. If both the head and shoulders remain erect and balanced
throughout the day, regardless of the activity being performed, then the chance of future back
pain has lessened.

This has been just one of many examples of faulty body mechanics. Future articles will address
other key points of body mechanics while continuing to emphasize awareness of common
mistakes. It is through the understanding of the basic principles of body mechanics, that we can
strive to decrease back pain for ourselves and others. Why wait, start learning today!

What is good posture?
Posture is the position in which you hold your body upright against gravity while standing, sitting
or laying down. Good posture involves training the body to stand, walk, sit and lie in positions
where the least strain is placed on supporting muscles and ligaments.

Proper posture:
1. Keeps bones and joints in the correct alignment so that muscles are being used properly.

2. Helps decrease the abnormal wearing of joint surfaces.

3. Decreases the stress on the ligaments holding the joints of the spine together.

4. Prevents the spine from becoming fixed in abnormal positions.

5. Prevents fatigue because muscles are being used more efficiently, allowing the body to use
less energy.

6. Prevents backache and muscular pain.

7. Contributes to a good appearance.

Proper posture requirements:
1. Good muscle flexibility

2. Normal motion in the joints

3. Strong postural muscles

4. A balance of muscles on both sides of the spine

5. Awareness of your own posture, plus awareness of proper posture which leads to conscious

With much practice, the correct posture for standing, sitting, and lying down (as described below)
will gradually replace your old posture.

What is the correct way to stand?
1. Hold your head up straight with your chin in. Do not tilt your head forward, backward or

2. Make sure your earlobes are in line with the middle of your shoulders.

3. Stretch the top of your head toward the ceiling.

4. Keep your shoulders back, your knees straight and your back straight.

5. Tuck your stomach in. Do not tilt your pelvis forward.

6. The arches in your feet should be supported.

Posture for a Healthy Back: Sitting, Driving and Sleeping
What is the correct way to sit?
1. Sit up with your back straight and your shoulders back. Your buttocks should touch the back of
your chair.

2. All three normal back curves should be present while sitting. A small, rolled-up towel or a
lumbar roll can be used to help you maintain the normal curves in your back.

3. Here's how to find a good sitting position when you're not using a back support or lumbar roll:

        a. Sit at the end of your chair and slouch completely
        b. Draw yourself up and accentuate the curve of your back as far as possible.
        c. Hold for a few seconds
        d. Release the position slightly (about 10 degrees). This is a good sitting posture.

4. Distribute your body weight evenly on both hips.

5. Bend your knees at a right angle. Do not sit with your knees crossed. Keep your knees even
with or slightly higher than your hips.

6. Keep your feet flat on the floor.

7. Try to avoid sitting in the same position for more than 30 minutes.

8. At work, adjust your chair height and work station so you can sit up close to your work and tilt it
up at you. Rest your elbows and arms on your chair or desk, keeping your shoulders relaxed.

9. When sitting in a chair that rolls and pivots, don't twist at the waist while sitting. Instead, turn
your whole body.

10. When standing up from the sitting position, move to the front of the seat of your chair. Stand
up by straightening your legs. Avoid bending forward at your waist. Immediately stretch your back
by doing 10 standing backbends.

It is ok to assume other sitting positions for short periods of time, but most of your sitting time
should be spent as described above so there is minimal stress on your spine.

What is the correct way to sit while driving?
1. Use a back support (lumbar roll) at the curve of your back. Your knees should be at the same
level or higher than your hips. "

2. Move the seat close to the steering wheel to support the curve of your back. The seat should
be close enough to allow your knees to bend and your feet to reach the pedals.

What is the best position for sleeping and lying down?
The best lying or sleeping position may vary, depending on your symptoms. No matter what
position you lie in, the pillow should be under your head, but not your shoulders, and should be a
thickness that allows your head to be in a normal position. "

1. Try to sleep in a position which helps you maintain the curve in your back (such as on your
back with a pillow under your knees or a lumbar roll under your lower back; or on your side with
your knees slightly bent). Do not sleep on your side with your knees drawn up to your chest. You
may want to avoid sleeping on your stomach, especially on a saggy mattress, since this can
cause back strain and can be uncomfortable for your neck.

2. Select a firm mattress and box spring set that does not sag. If necessary, place a board under
your mattress. You can also place the mattress on the floor temporarily if necessary. If you've
always slept on a soft surface, it may be more painful to change to a hard surface. Try to do
what's most comfortable for you.
3. Try using a back support (lumbar support) at night to make you more comfortable. A rolled
sheet or towel tied around your waist may be helpful.

4. When standing up from the lying position, turn on your side, draw up both knees and swing
your legs on the side of the bed. Sit up by pushing yourself up with your hands. Avoid bending
forward at your waist.

Exercise for a Healthy Back: Strengthen and Stretch

These recommendations are for people currently not experiencing back pain.
Modifications are necessary if you have back pain. Do not continue to perform an exercise
which produces pain. Seek the advice of a physician or physical therapist.

Exercise is an important part of improving and maintaining normal, comfortable back function. It is
important to practice these exercises regularly so you can maintain your fitness level.

What are the different types of exercise? Exercise can be divided into three basic groups:

        1. Strengthening: repeated muscle contractions until the muscle becomes tired.

        2. Stretching or Flexibility: slow, sustained lengthening of the muscle.

        3. Aerobic: steady exercise using large muscle groups.

All exercises should be performed slowly and comfortably to avoid injury. When performing
strengthening and flexibility exercises, remember to breathe naturally and do NOT hold your
breath; exhale during exertion and inhale during relaxation.

A program of strengthening, stretching and aerobic exercises will improve your overall fitness
level. Research has shown that people who are physically fit are more resistant to back injuries
and pain, and recover quicker when they do have injuries than those who are less physically fit.

Strengthening Exercise
Strengthening exercises help increase muscle tone and improve the quality of muscles. Muscle
strength and endurance provide energy and a feeling of wellness to help you perform daily,
routine activities.

Adequate strength of abdominal and back muscles helps stabilize the spine, allows proper spinal
movement and makes it easier to maintain correct posture. Strong hip and leg muscles are
important to perform proper lifting techniques and body mechanics.

Stretching/Flexibility Exercise
Flexibility is the ability to move your arms and legs through their full range of motion. Stretching
will help improve your flexibility.

Adequate flexibility of tissues around the spine and pelvis allows full, normal spinal movement,
prevents abnormal force on the joints and decreases the possibility of injury. Stretching also
prepares muscles for activity; stretching should be done before and after each vigorous workout
to prevent muscle strain and soreness and to help avoid injuries.

When performing flexibility exercises, stretch as far as you can and hold the stretch for 10
seconds and then ease back. Each stretching exercise should be performed slowly, with no
sudden jerking or bouncing. Bouncing is more likely to injure or strain a muscle or joint

Aerobic Exercise
Aerobic exercise provides cardiovascular conditioning--it strengthens the heart and lungs and
improves the body's ability to use oxygen. Some other benefits of aerobic exercise includes
increased energy levels, improved mood, better sleep habits and decreased blood pressure.
Aerobic exercise also burns calories and improves your metabolism, helping with weight loss.
Some examples of aerobic exercise include:

        Cross-country skiing

In general, to achieve maximum benefits, you should gradually work up to an aerobic session
lasting 15 to 60 minutes, 3 or 4 times a week. Please check with your physician before starting
any aerobic program. Ask your physical therapists how to start an aerobic exercise program.

Your exercise routine should consist of a 5-minute warm-up ( including stretching exercises)
before the aerobic activity and 5 to 10 minutes of a cool down (stretching and slower activity) after
the activity.

Here are some precautions with aerobic exercise:
Jumping rope puts too much pressure on the discs and should be avoided. Running can be done
as long as it doesn't increase lower back pain. When walking or running, wear supportive, well-
cushioned shoes and walk or run on a level surface.

What should I know about pain during exercise?
Do not ignore pain--if you feel increased pain or pain spreading to the legs, do not continue the
activity. If you continue to perform the activity while you are in pain, you may cause unnecessary
stress or damage on your joints. Seek the advice of a physician or physical therapist. Fear of pain
can cause unnecessary inactivity. Learn to "read" your body and know when you need to stop an

Ergonomics: Risk Factor Checklist

Ergonomics for the Prevention of Musculoskeletal Disorders: Guidelines for Retail
Grocery Stores
Figure 1. - Checklist for Identifying Potential Ergonomics Risk Factors by Workplace

If the answer to any of the following questions is yes, the activity should be further reviewed.

Force in Lifting

        • Does the lift involve pinching to hold the object?
        • Is heavy lifting done with one hand?
        • Are very heavy items lifted without the assistance of a mechanical device?
        • Are heavy items lifted while bending over, reaching above shoulder height, or
        • Are most items lifted rather than slid over the scanner?

Force in Pushing, Pulling, Carrying

        • Are dollies, pallet jacks, or other carts difficult to get started?
        • Is there debris (e.g., broken pallets) or uneven surfaces (e.g., cracks in the
        floor) or dock plates that could catch the wheels while pushing?
       • Is pulling rather than pushing routinely used to move an object?
       • Are heavy objects carried manually for a long distance?

Force to Use Tools

       • Do tools require the use of a pinch grip or single finger to operate?
       • Are tools too large or too small for the employee's hands?
       • Repetitive Tasks Are multiple scans needed?
       • Is a quick wrist motion used while scanning?
       • Do repetitive motions last for several hours without a break (e.g., slicing deli
       meats, scanning groceries)?
       • Does the job require repeated finger force (e.g., kneading bread, squeezing
       frosting, using pricing gun)?

Awkward and Static Postures

       • Is the back bent or twisted while lifting or holding heavy items?
       • Are objects lifted out of or put into cramped spaces?
       • Do routine tasks involve leaning, bending forward, kneeling or squatting?
       • Do routine tasks involve working with the wrists in a bent or twisted position?
       • Are routine tasks done with the hands below the waist or above the shoulders?
       • Are routine tasks done behind (e.g., pushing items to bagging) or to the sides of
       the body?
       • Does the job require standing for most of the shift without anti-fatigue mats?
       • Do employees work with their arms or hands in the same position for long
       periods of time without changing positions or resting?

Contact Stress

       • Are there sharp or hard edges with which the worker may come into contact?
       • Do employees use their hands as a hammer (e.g., closing containers)?
       • Does the end of the tool/utensil (knife) handle press into the worker's palm?

   Simple Ways to Prevent the Onset of Low Back Pain
      Engage in regular fitness activity. If you are sedentary, you may want to check with your
       physician if you have any health problems or are over the age of forty. Also, you may
       want to consult with a physical therapist for injury-prevention education and with a
       personal trainer for instruction in proper use of the equipment at the gym.

      If you sit for long periods of time, interrupt your sitting regularly to get up and move
       around. If your work requires a lot of sitting, space out such activities as filing, faxing, or
       running short errands through the office periodically through the day.

      Consider taking a walk on your lunch break. · Be certain you have a good sitting position
       at work or in your car. Your knees should not be higher than your hips and make a habit
       of keeping your hips toward the back of the chair. This prevents slouching. Consider the
       use of a lumbar roll to keep a good sitting posture.

      If you have access to an ergonomist or an ergonomic evaluation at your work site, take
       advantage of any recommendations they may have.

      If you are gardening or performing any other activity that requires prolonged or repeated
       bending at the waist, straighten your back often and walk around. Intermittently perform a
       standing backward bending activity (place hands in the small of your back and bend
       backwards 5-10 times). This offsets the constant pressure in the back caused by bending
       forward and takes less than a minute to do every twenty to thirty minutes.
   When lifting an object from the ground:

           Get as close as possible to the object.

           Bend your knees while you maintain a hollow in your back, keeping your
            back erect as you squat.

           Straighten the knees, not the back, as you lift the object upward.

           Pivot your feet and do not twist the back as you move the object to
            another location.

           As you lower the object to the ground or other surface, get as close as
            you can to the surface onto which the object is to be placed.

           Bend your knees and squat as you lower the object, while maintaining
            the hollow in your back.

   After physical activity, avoid slouched postures immediately following the activity as your
    body cools down. Often, this is the time low back pain develops, not during the physical
    activity itself

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