Everett Chiropractic Center Blog

April 13, 2011

Low Back Pain: An Once Of Prevention…

Why It Really Matters - Having Fun!!

(This started as a request for a flyer. Here I will expand on the flyer with more detail and links to other posts where additional context and recommendations will help you in deciding how you can best use the information.) [I will put my additions in brackets – the rest is on the flyer – in case you are interested in picking up a flyer for your work.]

HOW TO BEND & LIFT SAFELY

To bend and lift properly requires movement plus correct alignment (biomechanics). The three keys are Neutral Spine, Hip Crease, and The Knee Rule. [Understanding the need to tense up before lifting, depending on how heavy, how to do that and what to avoid, is also important. Tied to how to breath, this will – like proper body mechanics – insure a safe and strong lift. Tensing is the first of what our patients learn when they begin to transition from the relief stage of care to something that resembles rehabilitation – elementary breathing instruction is usually also necessary and helpful. The importance of breathing will become an increasingly popular subject in the media in coming years. Meanwhile it’s an inherent aspect of traditional movement systems such as Yoga and Tai Chi if you would rather get the benefits now.]

NEUTRAL SPINE: Keeping the spine in a line while maintaining the normal front to back curves in the neck and lower back. Hold a stick behind your back: one hand behind your neck; the other hand behind your lower back. Make sure the stick is touching your head, your mid back and your tailbone. Lengthen your spine along that stick while keeping your chin down. This is the all-important line we talk about in Tai Chi all the time. Violating the Neutral Spine rule means bending forward at the lower back and rounding out that little bit of curve you should have there. Do you do that all day while sitting? Notice.

THE KNEE RULE: When there is weight on the knee and you bend it, it must stay over the front of the foot: a plumb line down from your knee cap should fall right where the toes attach to the feet. Break this rule and the risk of knee injury skyrockets. (Think getting into and out of your car, walking up and down stairs and getting up and down off the ground.) Notice whether you are breaking The Knee Rule, and why it’s hard to not break it. [Maintaining Neutral Spine while not breaking the Knee Rule is a great way to train your “core” muscles as well as reflexes; not maintaining Neutral Spine while breaking the Knee Rule over the course of many years leads to many people telling the following story to their doctor of choice: “All I did was….”]

Notice how faithfully Tai Chi Master Ian Cameron adheres to the Knee Rule while applying self defense techniques.

HIP CREASE: This refers to pulling the hips back and down when you bend and lift. This is the motion that allows you to maintain Neutral Spine while not breaking The Knee Rule. Learn the Hip Crease by practicing Tai chi walking, the Box Squat or by practicing the Modified Chinese Wall Squat. Some refer to “snapping” the hips as you lift to describe the experience of contracting the butt muscles and using the hip hinge as the main lever performing the lift. It is important to train this awareness and the muscle. Learn the Dead Lift motion. Practice makes permanent so learn correctly: technique is everything!

[I put a link to my Biznik profile so you could see a clip of the Tai Chi Hand Form. It demonstrates Tai Chi walking during the form. Tai Chi walking can be an exercise/drill of profound benefit, easy to learn, easy enough to do, and a way to train all kinds of skills, stretch the hip flexors and the ankles, as well as practice Neutral Spine. I haven’t yet found a decent example on YouTube or I would put the link here.]

[Many of the terms used in this post are capitialized. You can Google them. You can YouTube it. You might find outstanding examples and explanations; you might not. Be careful who you listen to. I did Tai Chi wrong for 8 years before finding a teacher who could teach me correctly.]

The #1 thing (aside from awareness) that will stop you from being able to bend and lift properly is tight hamstring muscles: they prevent you from maintaining your lumbar curve while doing the Hip Crease. Stretch the Hamstrings passively and actively. Learn the Good Morning exercise (eccentric stretching.) In order to not break The Knee Rule you need flexible ankles, stretch them with Tai chi walking or by other means.

[Basic mobility is a prerequisite to proper movement. That means joints that move well and muscles that are of adequate length. Get adjusted. Stretch. Hip flexors are usually next in importance, followed by external hip rotators. Tai Chi walking will stretch the Hip Flexors, the Tibetan, and Thai (my labels) Sitting Postures will stretch the Hip External Rotators – these turn the leg/foot out when contracted and tend to have you walk like a duck when overly tight.]

Are You At High Risk For Developing Lower Back Pain?

1. Have you had it before? Yes? Then you will have it again. (#1 predictor)
2. Are you weak? (Failing the 2 min. low back muscle endurance test is #2)
3. Is your quality of movement dysfunctional, limited or asymmetrical (#3)

[There wasn’t room on the flyer but here, of course, is where I would suggest that being out of adjust is a risk factor also. Exercising while you are out of adjustment aint good – risk of injury goes up; benefits go down (there is one exception). Exercising while you are in pain aint good – there is a long list of reasons. Get relief first. Get checked by your Chiropractic doctor, and get adjusted. Then work on the elements of bending and lifting.]

[You know the answer to #1 above. If you want the answer to #2 and #3 find someone who can do the screening test for weakness and the screening test for quality of movement. I can.]

[Ask someone where you work about evaluating your bending and lifting technique: someone there is probably suppose to teach you. If not, have your employer call me – I will teach them so they can teach you. Hint: them being able to check a box that says you have watched a video may not be enough. And having another “safety meeting” after yet another person at your work has injured their back may not be enough to keep you from hurting yours.]

Here is a photo from the recent Snohomish County Business Journal. The gentleman bending over is an Emergency Room doctor. The article is from the Cover Story about the new $460 Million dollar medical facility in Everett.

Dr. Brown demonstrates unsafe bending

The same poor techniques shows up on page 30 of the current issue of Yoga Journal. There a woman is bending over taking cakes out of an oven. To be fair, anyone with a fairly healthy lower back, near normal body weight, who is only lifting themselves (not carrying weight), can get away with breaking the Neutral Spine rule now and then. In fact it’s reasonable to bend forward at the lumbar spine to stretch the posterior muscles, etc. of that area – carefully (and again a reasonably healthy spine and no weight). The problem is thoughtless bending over and lifting. The problem is doing it all the time. The problem is that most people don’t have that healthy of a lower spine. (I use the Yoga Journal example because in the middle of an otherwise fabulous source of all kinds of great advice and information, there can be examples of gaps; I use the ER doctor example for the same reason.)

Dennis Dilday, D.C. (425) 348-5207 DDilday239@aol.com www.doctordilday.com

Advertisements

12 Comments »

  1. […] keys to safe bending and lifting are the Neutral Spine, Knee Rule, and Hip Crease (described in detail in this post). Here I will describe how these critical concepts and principles of safe biomechanics are trained […]

    Pingback by Beginning Tai Chi Style for Safe Bending & Lifting « Everett Chiropractic Center Blog — May 18, 2011 @ 11:44 am

  2. […] She consistently got down using the same right knee to support her on the way down. She broke the Knee Rule every time she went down. It was her right knee that showed up as needing work in the […]

    Pingback by Leading Indicators: Workplace Injury Prevention « Everett Chiropractic Center Blog — June 2, 2011 @ 2:30 pm

  3. […] This is the post where that subject is covered… […]

    Pingback by How To Bend & Lift Safely « Everett Chiropractic Center Blog — June 17, 2011 @ 4:59 pm

  4. […] Activator Method Chiropractic Care Chiropractic/Back Pain Related Chinese wall squats (video clips) Bending & Lifting Chinese wall squats Neutral Spine Hip Crease/Modified Chinese Wall Squat – risk for Low Back Pain […]

    Pingback by Index of Chiropractic, Tai Chi and other Wellness Posts « Everett Chiropractic Center Blog — August 13, 2011 @ 8:43 pm

  5. […] the hip with the weight on it is pulled back (in order not to break the knee rule). I have talked elsewhere about why that is important in relation to walking and bending and lifting, […]

    Pingback by The Tai Chi Back Stance & Functional Rehabilitation Exercise « Everett Chiropractic Center Blog — September 9, 2011 @ 6:14 pm

  6. […] tai chi is the same, and not all tai chi teachers are the same. My first teacher didn’t teach The Knee Rule. He was having surgery on his knees about the time my current teacher corrected me. I have had no […]

    Pingback by MAYO CLINIC RESEARCH URGES CORPORATIONS TO DO TAI CHI « Everett Chiropractic Center Blog — September 19, 2011 @ 9:38 pm

  7. […] mention the #1 treatment for back pain. See all of my workplace wellness posts on this blog. Search “bending & lifting” on this Blog. Get adjusted by a good chiropractor on a regular basis. Do tai chi or yoga daily. Eat […]

    Pingback by #1 Treatment for Back Pain « Everett Chiropractic Center Blog — December 15, 2011 @ 5:19 pm

  8. […] last and knee damage and pain are in their future. The 340 pound new patient didn’t break the knee rule, but his legs, hips and back were so weak that he had to push himself up with his hands on his […]

    Pingback by This Week It Was Knees « Everett Chiropractic Center Blog — September 21, 2012 @ 4:31 pm

  9. Terry O’Brien of Back Trouble UK says “While 80 percent of the population are likely to experience low back pain at some stage in their life, there is a worrying trend in the amount of back pain experienced by teenagers. Irritable bowel syndrome sufferers can also experience symptoms of indigestion, passing excess wind, nausea, and exhaustion. Heavy lifting is one of the most common causes of muscle strain or sprain of back muscles.

    Comment by ปวดหลัง — September 23, 2014 @ 6:36 pm

  10. […] Wherever I go, when I see Posters promoting safe bending and lifting, or just safety, I look closely at them to see what is included and what is left out. So far I have noticed two things: first, in the text, the most import things are not even mentioned; and second, the images almost alway demonstrate how not to bend and lift. The posters are not all bad: they often have great information on them – good facts, reasonable recommendations, and nice graphics. But they have failed to produce a population that can safety bend over and pick something up. Everywhere you look you see people doing it poorly and I have commented on that here regularly for, now, five years. (You could search ‘back injury prevention’ or ‘bending & lifting’ for some of the Posts I have written on the subject, but start with How To Bend & Lift.) […]

    Pingback by May Is Posture Month: Saving The Best For Last | Everett Chiropractic Center Blog — May 16, 2016 @ 10:16 am

  11. […] Wherever I go, when I see Posters promoting safe bending and lifting, or just safety, I look closely at them to see what is included and what is left out. So far I have noticed two things: first, in the text, the most import things are not even mentioned; and second, the images almost alway demonstrate how not to bend and lift. The posters are not all bad: they often have great information on them – good facts, reasonable recommendations, and nice graphics. But they have failed to produce a population that can safety bend over and pick something up. Everywhere you look you see people doing it poorly and I have commented on that here regularly for, now, five years. (You could search ‘back injury prevention’ or ‘bending & lifting’ for some of the Posts I have written on the subject, but start with How To Bend & Lift.) […]

    Pingback by May Is Posture Month: Saving The Best For Last | Everett Chiropractic Center Blog — May 16, 2016 @ 10:16 am

  12. drama method program

    Comment by Donette Panepinto — July 23, 2016 @ 4:58 am


RSS feed for comments on this post. TrackBack URI

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Create a free website or blog at WordPress.com.

%d bloggers like this: