Articles

Back to Basics: Physical Therapy Tips

by Lynda Blackwell, P. T.

By being aware of a few simple "Back Basics," you can save yourself potential pain and discomfort.

POSTURE

SITTING

Don't slump, this puts undue stress on your back by overstretching muscles and ligaments. Even in a chair with good lumbar support, the natural tendency is to slump forward as the back muscles fatigue. It is essential to maintain the curve in the low back either by using a rolled up towel or a lumbar support placed at the beltline. Sit with your pelvis against the back rest and with feet flat on the floor in a chair with armrests.

Avoid sitting for prolonged periods. Take frequent breaks to stand up and stretch backwards a few times to reverse the curve in the low back.

The ideal office chair will have adjustable height, armrests and seat pad and back. The height should be such that your knees are level with or just slightly below the level of your hips. This will help take the pressure off your lower back. The lower border of the seat back should fall just above the belt line. The arm rests should be set so that you can comfortably rest your forearms on them while keeping your elbows bent at 90 degrees.

STANDING

Try to keep the normal curves in your back at all times. High heels may cause the low back to arch excessively. Wear comfortable shoes with a good arch support.

Shift positions frequently and rest one foot on a low stool or shelf.

Keep your work close to you and at a comfortable height.

SLEEPING

Sleep on a mattress that is comfortable and does not sag. The natural curves in your back and neck should be supported.

When lying on your back, use a flat pillow to support your neck and one or two pillows under the knees to help support the low back. When lying on your side, place one pillow between your knees.

When getting out of bed, roll onto your side and push up with your arms.

COMPUTER WORK

Your keyboard should sit directly in front of you.

The screen should be centered if you use the computer for word processing functions. For data entry, the screen may be slightly off to one side, provided the documents you will be working from are centered.

The top of the screen should be at eye level so that your neck is maintained in a neutral posture.

Place small towel rolls under your wrists to keep them in a neutral position (i.e., not forward or backward).

Use chair guidelines as discussed.

EXERCISE

Maintenance of trunk flexibility and strength are imperative for a healthy spine. Gentle back exercises should be performed daily and should be included in your normal exercise routine.

It is necessary that the abdominals, as well as the back muscles be strong so that the front and back of the spine is stabilized. The lower abdominals are especially important because they form a muscular brace when properly activated and strengthened.

The large muscles of hip and thigh; gluteals, quadriceps and hamstrings, need to be strong so that during lifting they can be depended upon to do the work-thereby protecting the spinal joints and back muscles from injury.

Improved flexibility can be achieved through daily stretching. It is important that flexibility of the spine, shoulder girdle and pelvic girdle be optimum so that the normal curves of the spine are maintained during all activities.

If you have back pain, you should be instructed in the appropriate exercises for your condition.

BODY MECHANICS

Bending and lifting should be avoided during the acute stage of an injury.

When lifting, bend your knees and keep your back straight as if you have a broomstick attached to your spine.

Keep lower abdominals activated and "braced" during the lift- don't hold your breath.

Keep the object as close to you as possible and maintain a balanced position throughout the lift.

Keep your body squared to the object at all times-avoid twisting the spine.

ACUTE INJURIES

Discontinue the aggravating activity. Soreness, twinges and spasms are warning signs.

Ice, Ice, Ice! As soon as possible, use crushed ice in a plastic bag, frozen peas or a frozen gel pack for 15 to 20 minutes at a time-then let the skin temperature return to normal. You may do this as often as necessary during the acute stage (i.e., usually the first 24 to 48 hours).

Find a position of comfort. Either lie: (a) on your back with feet and lower legs elevated on pillows; (b) on your stomach with one or more pillows under your hips; or (c) on your side with a pillow between your knees. Use ice on your back while resting in a comfortable position.

Avoid lifting and forward bending activities, and slowly progress to gentle stretching exercises.