Transcript Cardinal Hill Healthcare System

Cardinal Hill Healthcare System
2014 AgrAbility National
Training Workshop
Back Pain
Lisa Harris, PT, MS, Cert MDT, HPCS, MSVSc
Cardinal Hill Healthcare System
Session Learning Objectives
1. The participant will understand basic spine
anatomy.
2. The participant will be able to determine common
causes of back pain.
3. The participant will be able to list three ways to
prevent back pain.
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Basic Anatomy
Vertebral body
Spinous process
Disc
Facet joints
Spinal canal
Nerves
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• Spine and Disc Mechanics
• Flexion/forward bending
– Increased space between vertebrae
– Disc moves toward the back
Extension/backward bending
Decreased space between vertebrae
Disc moves toward the front
Body Mechanics
 Body Mechanics: refers to the use of proper
body movements and postures with daily and
work activities in an effort to prevent injury
 Understanding proper body mechanics and
how they relate to your specific job tasks will
decrease your chances of having injuries as
well as decrease the risk of injuries to
patients/clients
Back Injuries
 Back injuries are the most
common work related
injury and seldom caused
by a single incident
 They occur over time
from repeated stress from
faulty positions and/or
movements
 ”the straw that broke the
camel’s back”
What Causes Back Injuries?
Almost all back disorders result from:
– Poor Posture
– Faulty Body Mechanics
– Stressful Living and Working Habits
– Loss of Flexibility
– General Decline of Physical Fitness
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Back Conditions
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Osteoarthritis/Degenerative Joint Disease
Degenerative Disc Disease
Abnormalities of the spine (kyphosis/scoliosis)
Stenosis (narrowing of the spinal canal)
Sciatica
Prevention: TIP 1
Tip Number 1:
Maintain normal spinal curves
Cervical – inward curve of neck
Thoracic – outward curve
Lumbar – inward curve of low back
Maintain Normal Curves
 Be aware of your posture during the day!
 When experiencing back or neck pain, check your
posture to see if you are maintaining the normal
curves in your spine.
 Change positions frequently to avoid long duration
stress or tension in the muscles, ligaments and
discs in your back
 Make an effort to change positions every 30
minutes if possible
Prevention : TIP 2
TIP Number 2:
Minimize bending and twisting
The disc stays healthy by moving the trunk.
It is like a sponge moving fluid in and out
as you move.
Movement is important, but some
movements should be avoided.
Body Mechanics
 Twisting while lifting is the
most common way to injure
your back.
 This person should turn his
body towards the object he
is lifting and pivot his feet
when he turns.
Improper Movements
 Forward bending
pushes the disc fluid to
the back of the disc (the
thinnest part).
 Repeated forward
bending causes disc
“micro” trauma until “the
straw that broke the
camel’s back.”
Disc Injury
These people are NOT maintaining normal
spinal curves!
Prevention
Backward bending pushes
fluid to the strongest part of
the disc.
Since it is not a very
common position, it is a
good stretch for the lower
back.
Prevention: TIP 3
Tip Number 3:
Plan for lifting and carrying
 test the weight of the object
 determine what you plan to do with the
object before lifting
 position your body facing the object and
close to it to use “power muscles” in your
legs and buttocks
 carry objects from the bottom if possible and with
elbows bent
Back vs Legs
Body Mechanics
 This is an example of
very poor body
mechanics.
 How should he change
what he is doing to
perform a better lift?
Body Mechanics
 This is the beginning of
a lift using perfect body
mechanics.
 What has the person
done to correct his
posture for this lift?
Body Mechanics
Prevention: TIP 4
TIP Number 4:
Use the “golfer’s pick up” for
light objects
 Face the object
 Body weight to one leg
 Use hand on un-weighted
side for support if needed
 Slightly bend weighted knee
 Keep back straight and
bend at hips letting the unweighted leg come off the
floor
Ligaments (cont.)
Prevention:
TIP 5
TIP Number 5:
Avoid excessive reaching up, down or all around
 Use a ladder or step stool to reach overhead
 Position equipment / materials between shoulders
and knees.
 Heaviest objects should be at waist height
 Lighter objects above and below
 Stagger your feet with a wide base for more
stability
 Avoid looking up for prolonged time periods
Body Mechanics
There are many other tasks
besides direct pt. care
activities or lifting activities
in which you should be
careful to maintain normal
spinal posture. This is a
good example.
Body Mechanics
This is a much better
position for this task.
Prevention: TIP 6
TIP Number 6:
Push don’t pull
 Pushing objects allows for use of “power” quads and gluts.
 Allows use of muscles to be used in mid range with elbows
bent rather than arms out straight.
 Avoids excessive strain on back as well as arms and
shoulders
 Decreases sprain/strain on joints and ligaments of the arms
Work Station
 Proper body mechanics
also applies to desk
jobs.
 This work setup is
horrible—he is twisted
in his seat, he has to
turn his head to see the
computer, and his hand/
elbow position is bad.
Work Station
 This is a much better
setup.
 Facing straight towards
the monitor with his
keyboard straight ahead
also.
 Knees, hips, and elbows
are all at right angles with
his wrists supported.
 Added lumbar support.
Prevention/ Wellness Opportunities
 Decreased flexibility makes you less tolerant of
some positions and more prone to injury.
 Establish a consistent stretching program.
 Exercise program of at least 20 – 30 min most
days/week—walking, lifting weights, stretching,
etc.
 The more physically fit we are, the less likely
we are to be injured.
Body Mechanics for Caregivers
 Proper body mechanics
is a must with patient
care transfers.
 This lift would put much
unnecessary stress on
the clinician’s back and
be very uncomfortable
to the patient.
Body Mechanics for Caregivers
 This is a much better
beginning position for the
clinician.
 The use of a gait belt
during the transfer will
make it easier and more
comfortable.
Body Mechanics for Caregivers
The powerful leg muscles are used throughout this lift
with less stress on the back.
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Mechanical Diagnosis and Treatment/McKenzie
Reliable assessment process
Developed by Robin McKenzie , 1950’s
Well researched
Mechanical source (position/movement is cause and cure)
Exercise based
Patient gains control of symptom management
Three steps: Assessment, treatment, prevention
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Thank you for your attention
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