Monday, February 27, 2012

Posture and spine care – How to get rid of backache


January 11, 2009 in Orthopedic Health

Pain may be due to lifting a heavy object incorrectly, over-exercising, sitting for long periods of time, or carrying a heavy backpack on one shoulder. By using proper lifting techniques, maintaining the appropriate body weight and tone, keeping the back and body muscles strong, and keeping good posture, many back injuries and episodes of low back pain could be avoided.
“My back hurts” is a common complaint for people of all ages.
At least 80% of the industrial population, 60% of general population, and 45% of college students expenence musculoskeletal back pain at some point in their lives. Back pain is the fifth most common health problem for which people visit the doctor. The cost to employers each year, due to low back pain problems alone, is in the order of several billion dollars.
The “ounce of prevention is worth a pound of cure” philosophy holds when it comes to low back pain. The appropriate time to take care of low back problems is before they occur. \our lifestyle may play a big part in the care or abuse of your back.
Pain may be due to lifting a heavy object incorrectly, over-exercising, sitting for long periods of time, or carrying a heavy backpack on one shoulder. By using proper lifting techniques, maintaining the appropriate body weight and tone, keeping the back and body muscles strong, and keeping good posture, many back injuries and episodes of low back pain could be avoided.
ANATOMY OF THE SPINE
The spinal column is made up of 33 bones, vertebrae, held together by tough 
spinebands of tissue called ligaments. Small cartilage discs help absorb shock and minimize friction between the vertebrae. The spinal column protects the spinal cord as it extends from the brain and branches into nerves connecting to various parts of the body. The nerves pass through openings between the vertebrae.
Spinal Cord is divided into five parts:
  • Cervical
  • Thoracic
  • Lumbar
  • Sacrum
  • Coccyx
The Spine has three natural curves :
  • Cervical spine : lordosis (with the spine arched backwards).
  • Thoracic spine: kyphosis (with the spine slightly flexed forwards).
  • Lumbar spine : lordosis.
These curves allow for the centre of gravity to be placed over ones feet. Disruption of one of these curves place an undue strain upon the other curves.
1. Cervical (C-1 to C-7) – Seven vertebrae in the neck support and move the heat.
2. Thoracic (T-1 to T-12) – Twelve vertebrae in the chest/upper back area support the shoulders and upper body.
3. Lumbar (L-l to L-5) – Five vertebrae in the low back support most of the body weight so they are the larges and strongest of all vertebrae.
4. Sacrum: Triangular structure of the five attached vertebrae. They form the base of the vertebral column.
5. Coccyx (tailbone): Four fused vertebrae.
FACTS ABOUT BACK PAIN – Most low back pain is caused by accident or injury. It is estimated that in 97% of low back pain, the source of pain is unknown.
However, it is believed that back problems often result from an imbalance between tissues (muscles, ligaments and tendons) surrounding the spine or incorrect spine alignment (posture). In ideal posture, the spinal column should form a gentle, sloping V shape. When the spine’s natural curves are too extreme or flattened for a long period of time, muscles, tendons and ligaments are forced to adapt by tightening or weakening.
Also, obesity may contribute to back pain by causing the lower back curve to arch too much. Maintaining a healthy weight may relieve some symptoms.
Back pain problems so prevalent that it seems everyone has experienced one or both at least one time in their life. Is there any way to avoid them? Once they start, are you doomed to have pain forever? Much of the answer is up to you. Research suggests that many spine problems are preventable because they result from poor posture and body mechanics, which subject the spine to abnormal stresses. Abnormal stress over time can lead to structural changes in the spine, including degeneration of disks and joints, lengthening or shortening of the supportive ligaments and muscles, and wear and tear of cartilage. All of these structural changes can lead to pain.
VARIOUS MEANS TO CONTROL BACKACHE
However, there are many things that you can do each day to minimize current spine pain and prevent future episodes from occurring. (Think of your body, especially the spine, as a machine that needs regular care and maintenance to keep it functioning properly and efficiently. For example, does your car work properly when the alignment is off?). The Key factors to taking care of your back and neck centre around three concepts.
1. Learning and practising good posture.2. Using good body mechanics during the day.
3. Regular exercise.
Now let us explore each one of them in detail.
POSTURE
The basis for good posture is maintaining a “neutral spine”. A neutral spine retains three natural curves.
1. Small hollow at the base of the neck.
2. A small roundness at the middle back.
3. A small hollow in the low back.
A neutral spine is neither rounded forward nor arched back too much. Maintaining a neutral spine is a dynamic process as your transition from one position to another.
Many people spend portions of their day sitting or performing tasks that require bending forward or lifting. Think about your lifestyle, the posture you assume, and the activities you perform each day. Let’s look in detail at proper alignment in standing, sitting, sleeping and lifting posture.
AN IDEAL STANDING POSTURE
1. Feet should be shoulder width apart, thigh muscles elongated without locking the knees back.
2. Maintain a small hollow in your low back, but avoid the tendency for too much arch/leaning back, especially with prolonged standing. The “tail” should remain slightly tucked down.
3. Lift the breastbone. As you do this, the shoulder blades will move down in back. This should create a good distance from your hip bone to rib cage.
4. Make your chin level. The highest point of your body should be the top back region of your head. Relax your jaw and neck muscles. With the mouth closed, rest your tongue on the roof of your mouth.
AN IDEAL SITTING POSTURE
postures2
1. Feet should be resting on the floor with knees and hips bent 90 degrees.
2. Maintain an arch in the low back. If you are unsure how much arch is “good”, go from a slouched position up to the extreme end range of erect posture. Now back off 10-15%. This is the neutral position for your low back. A “lumbar roll” is recommended to support the low back with prolonged sitting. It is a foam roll, approximately 4-5 inches in diameter, 12 inches long. To place it, scoot your hips back so that you are touching the back of the chair. “Bow” forward and place the roll in the natural arch of your low back.
3. Lift your breastbone. Picture a string tied to the 2nd or 3rd top button on a shirt pulling straight up to the ceiling. This again created a good distance from your ribcage to your hipbones. Your shoulder blades should be down in back. Think of the bottom tips of your shoulder blades as “anchors’, helping you to maintain this upright posture.
4. Make your chin level. If it helps, picture a book on your head. The highest point of your body should be the top back region of your head.
While it is okay to assume other positions for short periods of time, most of your sitting time should be spent as described to allow for the least stress on your spine. It is also strongly recommended to take frequent breaks from sitting and change your position, at least hourly if you have spine problems.
AN IDEAL SLEEPING POSTURE
1. In sleeping posture, the spine will be the most comfortable when a neutral spine is maintained. A sagging mattress or the use of more than one pillow will interfere with the neutral spine position.
2. The best sleeping positions for someone with neck or back pain is either lying on the side or on the back. When lying on the side, pillow between knees helps the spine neutral. People who lie on their side without a pillow between the knees sometimes draw one knee up high and in front. This asymmetry can result in pain over time.
3. Whether lying on the back or sides, rolls can be added to support the natural curves of the spine in the neck or low back.
GOOD BODY MECHANICS
Body mechanics is defined as maintaining proper position during movement. Constant or repeated small stresses over a long period of time can cause faulty body mechanics and can lead to injury.
Most people are aware that when they bend or lift something, they should bend their knees. While it is important to bend your knees, attention must also be paid to the position of your spine. In order to avoid injury, either at the moment of lifting something or, more likely, as a result of poor body mechanics over time, care must be taken to maintain the previously described “neutral spine”. Again, a neutral spine means that the three normal curves-at the neck, middle and lower back are maintained. When viewed from the outside, the back looks straight with a hollow in the low back.
IDEAL LIFTING AND BENDING POSTURES
1. Test the weight of the load first and get help if it is heavy or bulky.
2. Get close to the load.
3. Move the feet apart, one foot ahead of the other, toes pointed outward.
4. Perform the waiter’s bow plus squat.
5. Pick up the load and bring it in close to you.
6. Lift by using your legs and buttocks to push up to straight.
7. While turning, do not twist. Turn your feet by taking small steps.
8. If carrying is necessary, keep the stomach tight and maintain a neutral spine.
9. To lower the load, again perform the “waiter’s bow” plus squat, sticking the buttocks out behind you as you go down.
o It is easiest to load and unload it.
o Lifting’ is easiest from knuckles to shoulder range.
o With overhead reaching, use a stool or chair to bring yourself up to the level of the object; again, get as close as possible.
o Regarding pushing or pulling, PUSH! Do not PULL. The same body mechanics hold for pushing as bending and lifting neutral spine.

REGULAR EXERCISE
The final key to a healthy spine is regular exercise. Research has demonstrated that people who exercise regularly are less likely to suffer from back injuries and pain. They also show quicker recovery if injuries do occur than people who are less physically fit. Exercise can be divided into 3 basic groups, all of which are important to a healthy back.
1. Strengthening : The abdominals and back muscles are targeted because they help to support and stabilise the spine. They also help maintain good postural alignment. Strong hip and leg muscles help to facilitate proper body mechanics with bending and lifting.
2. Stretching : The soft tissues around the spine and in the legs need adequate flexibility to allow normal movement and to help prevent abnormal forces on the joints. With regard to the back, the goal is for balanced flexibility in both directions. Stretching also helps to prevent or address soft tissue inquiry and muscle soreness, and promotes relaxation.
3. Aerobic activities : Aerobic exercise helps to promote heart and lung function and overall conditioning. Aerobic activities are those that use several large muscle groups and increase your breathing and heart rate. Examples of activities include walking, biking, swimming and dancing. For maximum benefit, the goal is to work up to 20-30 minutes at least 3-4 times per week.
In short, the key to good posture is awareness and perseverance. It is not easy to change poor postural habits, nor do the changes come quickly. However, if good posture is practiced, it becomes easier and you will find yourself preferring the “neutral alignment” to your previously poor position. In addition to feeling better, good posture also makes you look better. It is said that good posture can make you look 10 pounds lighter and 10 years younger! Give it a try. The benefits are will worth the effort.

1 comment:

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