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Watch your back

March 24, 2016
by Judah Gutwein, LNHA
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Guest Blog

Any caregiver who works directly with patients in a healthcare setting will readily attest to the rigors and strain involved in the day-to-day help with the residents’ Activities of Daily Living (ADLs). It isn’t easy to provide comprehensive physical care without taxing the muscles of the body and the exoskeletal system, and without the proper caution it is easy to injure yourself.

The most common form of injury is to the upper and lower back—it’s the most frequent type of workers compensation claim. The fact is, most motions affect the spine or back muscles, and the back is not an extremely resilient part of the body. Once the back has been injured, it proves to be very difficult to heal and will never be as stable as it was prior to the injury. Therefore, the old adage that “an ounce of prevention is worth a pound of cure” aptly applies.

Body mechanics and emotional impacts

Proper body mechanics are absolutely essential in preventing injuries. The position of the back naturally conforms to an “S” curve. In clinical terms, this is known as the neutral position. In order to maintain good posture, it is important to keep a straight line from middle of the ears all the way down to the midline of the ankle.

But, the biomechanics and the physical body aren’t the only things affected by back pain and injuries. Lower back pain goes considerably beyond the physical and wreaks havoc on our emotional wellbeing. Chronic back pain impacts our moods and our relationships. It affects appetite and influences the ability to concentrate properly.

When we experience acute back pain, it’s almost as though everything else recedes into the background and we become consumed by the pain and anxiety to the point that simple day-to-day tasks become difficult.

People who are ill typically rely on those who are closest to them for help and comfort. However, in the case of back pain, this is often very difficult, since there is an inherent conflict between our need for help and our desire for independence. This type of conflict will invariably stress and tax our relationships and will also have a deleterious impact on our work productivity.

An ounce of prevention

A daily routine of mindfulness can help staff avoid back injuries. The following can serve as a guide for maintaining proper body posture and facilitating correct biomechanics with lifting, pushing, pulling and carrying.

  • Test the weight. Before you start exerting yourself with heavy lifting, test the load to see if you can lift it unassisted. Always remember: there is no shame in asking for help.
  • Keep your back erect. Always make sure your lower back is properly erect with your hips and keep your knees slightly bent. This helps distribute the load evenly and safely.
  • Be mindful of your platform. Make sure the surface you are standing on will support you and your load. Avoid slippery and narrow surfaces and remember that without the right platform to stand on, your proper posture will be an exercise in futility.
  • Bring the object close to your body. Do not keep your arms unnecessarily extended, since this will cause tremendous strain on your back. Instead, keep objects as close to you as possible.
  • Avoid body contortions. The more you twist and turn with your feet, the more you are creating an imbalance with your center of gravity and redistributing the weight and stress to your upper and lower back.
  • Tighten your muscles. Think about how you do your routine abdominal crunches and copy it. This exercise will prepare your lower back for the heavy lifting and will reduce strain.
  • Think before you lift. Don’t lift before you prepare yourself mentally. Create a plan in your mind and you’ll be surprised by how effective this will be in minimizing the ensuing tension and strain on the body.
  • Use the big muscles. Always try to distribute the bulk of the load to the larger muscle groups like the legs. This is preferable to straining your back.
  • Communication is crucial. If you are lifting as a collaborative effort with assistance from others, make sure you all agree on the plan and are in sync with each other. Some of the worst back injuries occur when team members are unclear about the lifting plan and move in different directions simultaneously.
  • Make sure the path is clear. This should be obvious, but it’s surprising how often obstacles block the intended path. Survey the transfer path beforehand and make sure there are no objects along the path that could be a stumbling risk. Rugs, boxes, chairs and even paper on the floor can be a recipe for disaster.
  • Pushing is always better than pulling. The human body, with its strong leg muscles and forward gait, is much better at pushing forward than pulling backwards.

In the final analysis, if you cannot stay safe and healthy of body and spirit, you will be of little value to the folks who rely on your care. Stay healthy to stay relevant.

Judah Gutwein is director of corporate marketing at Regency Post-acute, Rehab and Nursing Centers, Hazlet, N.J. He can be reached at