Transcript Slide 1

81 Metcalfe Street
Suite 801,
Ottawa, Ontario,
K1P 6K7
Tel: 613-564-9000
W. Mark deGruchy B.S., D.C.
Brent E. Burton B.A.Hon., D.C.
Framing Your
Body Mechanics
Outline
1. Introduction to Posture
2. What Factors Affect
Posture?
a) Forward Head Posture
b)Office Posture
c) Lifting/Carrying Posture
d)Sleeping Posture
3. Building a Good Base of
Support
4. Chiropractic Correction
Introduction to Body Mechanics
What is posture?
• The position of the body in space.
Why is Posture so Important?
• It is the first step to either good or
poor health, e.g. more difficulty
with deep breathing when
slouching.
• Improved body self-awareness.
• Decreased risk of injury during
activities.
• Decreased risk of chronic
diseases such as osteoarthritis,
low back pain, neck pain,
headaches, etc.
“As a twig is bent
the tree inclines” Virgil
Structure vs. Function?
Postural
Example:
Poor Sitting Posture
Mechanical
(function)
Structural
Example:
Upper-Cross Syndrome1
(Tight & Weak muscles)
Example:
Osteoarthritis2
Factors Affecting Posture:
Forward Head Posture
• Very common in office workers, students, whiplash
injuries/accidents
• Direct relationship to computer monitor usage.
• Average weight of head (approx 8-12 lbs).
• Every inch forward places further strain on muscles,
ligaments, and joints.
Factors Affecting Posture:
Forward Head Posture
• Prolonged contraction of muscles used to support
head in forward position  Chronic Shortening and
Tightening and Pain2
• Dysfunctional muscles at back of head, front of
neck, top of shoulders and front of chest can lead to
headaches, numbness and tingling into arms.
Factors Affecting Posture:
Forward Head Posture
• Easy exercise: Brügger’s postural break .
• Balances muscles so that poor work posture
does not become permanent.
• Hold for 8-15 seconds, 1x/every hour sitting.
4
Factors Affecting Posture:
Office Posture
• Slouched posture straightens
spinal curves and puts uneven
wear on discs (especially low
back).
• Prolonged sitting leads to
strain of muscles, ligaments,
and joints.
• Incorrect mouse, phone and
keyboard positioning leads to
strain of neck, shoulder, elbow
and wrist, e.g. carpal tunnel
syndrome.
Repetitive Strain Injuries:
Stages of Pain
5
Early:
• The body aches .
• Feel tired at work, but symptoms
disappear during time away from work.
• The injury does not interfere with the
ability to work.
• The injury will heal completely if dealt
with properly at this early stage.
Intermediate:
• The injured area aches and feels weak
soon after the start of work, until well
after work has ended.
• The injury will completely heal if dealt
with properly.
Advanced:
• The injured area aches and feels weak,
even at rest.
• Sleep is affected.
• Even light duties are very difficult.
How to Correct Office Posture
• Adjust seat so that hips, knees and
ankles are at roughly 90°(knees at level
of seat, you may need a footrest).
• Allow 2-3 fingers space behind knees.
• Rest back against backrest.
• Constantly change positions.
• Sit close to work.
• Reduce time seated to 75% of workday.
Try to alternate sitting, standing and
walking every 30 minutes.6
• Adjust lumbar support so that it is in
small of back.
• Keep chin, shoulders and low back
aligned (don’t slump).
How to Correct Office Posture
• Armrest Height – Should be at elbow height with relaxed
shoulders and elbows at 90 º.
• Place keyboard and mouse within comfortable reach at
same level as armrests.
• Wrists should not be extended or flexed and relaxed
(don’t lift baby finger or thumb).
• Monitor should be 40-79cm away from face.
• Monitor should be positioned so head is neutral when
reading the top row of text onscreen (may be lower if
you wear bi-focals).
• Hold phone with hands, not shoulder. Switch hands.
Factors Affecting Posture:
Lifting/Carrying Posture
• Lifting and twisting together place enormous
strain on spine.
• Lift with knees and hips, then turn with feet.
• Hold loads close to body.
• Reduce loads whenever possible. (Adolescents
should keep loads below 15% of body weight)7.
• Distribute weight towards bottom of bag.
• Alternate shoulders/arms if carrying a purse,
carry-on bag, satchel.
Factors Affecting Posture:
Sleeping Posture
• Comfortable sleep is very important since we should
be spending about 1/3 of our time sleeping.
• Many people have neck pain from sleeping facedown. Chronic strain on muscle and joints of neck.
• Many people snore/breath poorly sleeping on their
back. Side-lying appears best for snorers/sleep
apnea.
Factors Affecting Posture:
Mattresses and Pillows
•
•
•
•
Research lacking on
mattresses and pillows.8
Now accepted that firmer
support is not necessarily
better. 9
Recommendation is
usually a medium-firm
mattress as it reduces the
likelihood of low-back
pain.9
However: Sleep quality of
each mattress appears to
be based on the individuals
needs.10
Factors Affecting Posture:
Mattresses and Pillows
General principles when buying a
mattress or pillow:
1. Ensure that contours of spine
are supported separately.
2. Ensure there are no points of
excess pressure/discomfort.
3. Ensure you spend at least 15
minutes lying on the mattress
you intend to buy.
4. Ensure there is a return policy
incase you don’t like the
mattress.
Building a Good Base of Support
1. Average steps/day = 8,000-10,000.
2. Eyes will always try to be level with
gravity.
3. Problems in ankles, knees, hips,
back? Start by looking at your feet!
4. There are 52 bones and 66 joints in
your feet!
5. If you have problems with any of the
following, have a qualified doctor
look at your feet/posture:
a)
b)
c)
d)
e)
Pain in feet, knees, hips, low back
Excessive shoe wear
Low or high arches
Knock-knees or bow-legged
Arthritis or diabetes
Building a Good Base of
Support: Shoes
10,11
• Find out whether you are neutral, a
pronator (flat-footed) or supinator
(rigid arch). Buy shoes accordingly.
• Shoes should be comfortable when
you try them on. Don’t break them in!
• Make sure shoes are wide enough in
toe box and there is 1/2” between end
and longest toe.
• Make sure your heels don’t slip.
• If you wear an orthotic, try a neutral
shoe, with your orthotic in it (take out
the insole).
• Try not to wear high-heels constantly.
• Try on shoes at end of day.
Building a Good Base of
Support: Shoes
Testing Running Shoes When Buying
1. The Shelf Test:
2. Pinch Grip Test:
3. Fold Test:
4. Dish-Rag Test:
Building a Good Base of Support:
Orthotics
• Orthotics can be used to treat a variety of health concerns. E.g.
diabetic foot, flat feet, etc.
• Main functions of custom orthotics:
–
–
–
–
–
Correct poor foot mechanics.
Stabilize and support foot during gait.
Shock absorption/comfort.
Protect joints and muscles from over-use.
Provide feedback to your nervous system about where your foot is in
space.
– Correct Posture.
– Prevent Injuries E.g. ankle sprains, foot fractures during sports.
• Can be made for specific shoes: Running, skating, skiing, dress,
sandals, etc.
Note: Not everyone requires custom orthotics (even if you have foot
problems). Speak to a qualified doctor!
Chiropractic Correction
• Purpose of chiropractic treatment is to not only rid
patients of pain, but to reduce/correct
postural/mechanical stresses and strains.
• Evidence shows chiropractic treatment is also useful
for increasing range of motion12,13, and increasing
postural symmetry14.
• Chiropractors use a variety of techniques, exercises,
physical therapies, and devices to restore normal
muscle, joint and nerve function.
• Focus on functioning of entire body, not just area of
complaint.
References
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14.
Janda, V. 1988. Muscles and cervicogenic pain syndromes. Physical Therapy of the Cervical
and Thoracic Spine. Churchill Livingstone. London. pp.153-166.
Harrison DD, Jones EW, Janik TJ, Harrison DE. 2002. Evaluation of Flexural Stresses in the
Vertebral body Cortex and Trabecular Bone in Three Cervical Configurations with an Elliptical
Shell Model. J Manipulative Physiol Ther. 25(6): 391-401.
Moore, M. 2004. Upper cross syndrome and its relationship to cervicogenic headache. JMPT.
27(6):414-420.
Liebenson, C. 1999. Advice for the clinician: the brugger relief position. Journal of Bodywork
and movement therapies.3(3):147-149.
Workers Compensation Board - Alberta. 1999. Office Ergonomics: Remembering the Basics.
Juul-Kristensen, B. and C. Jensen. 2005. Self-reported workplace related ergonomic
conditions as prognostic factors for musculoskeletal symptoms: the “BIT” follow up study on
office workers. Occup. Environ. Med. 62: 188-194.
Chansirinukor, W. 2001. Effects of backpacks on students: Measurement of cervical and
shoulder posture. Australian Journal of Physiotherapy. 47:110-116.
Buckle, P. and A. Fernandes. 1998. Mattress evaluation – assessment of contact pressure,
comfort and discomfort. Applied Ergonomics. 29(1):35-39.
Kovacs et al. 2003. Effect of firmness of mattress on chronic non-specific low-back pain:
randomised, double-blind, controlled, multicentre trial. Lancet. 362:1599-15604.
American Academy of Orthopaedic Surgeons. 2000. If the shoe fits, wear it.
http://orthoinfo.aaos.org/fact/thr_report.cfm?thread_id=104&topcategory=foot.
Asplund, C. and D. Brown. 2005. The Running Shoe Prescription. Physician and Sports
Medicine. 33(1).
Martinez-Segura et al. 2006. Immediate effects on neck pain and active range of motion after a
single cervical high-velocity low-amplitude manipulation in subjects presenting with mechanical
neck pain: a randomized controlled trial. JMPT. 29(7): 511-517.
Cassedy et al. 1992 . The effect of manipulation on pain and range of motion in the cervical
spine: a pilot study.
JMPT. Oct;15(8):495-500
Childs et al. 2004. Immediate improvements in side-to-side weight bearing and iliac crest
symmetry after manipulation in patients with low back pain. JMPT. 27(5):306-313.