2 Test your Spine Q True or False Very few people are affected by back painBack injuries cost employers an estimated $10 billion a yearThe back is a complex system of bones, discs, muscles and nervesThe spine is a straight column of rigid bonesThe safest way to lift an object is to stand close to it, bending your knees and letting your legs do the work.Regular exercise will keep your back limber and help prevent injury
3 Test your Spine Q True or False A lumbar support or rolled-up towel placed in the small of your back while sitting will relieve stress on your spineYour lower back is subject to greater mechanical stress than any other part of your bodyIf you're under 50, there is no need to worry about osteoporosisOnce you've injured your back you can never fully recoverTrueFalse
4 Why have Training?? Second most common injury in the state Second (only to the common cold) most frequent visit to the doctors officeStatistically, 8 out of 10 will suffer some sort of back pain throughout their lifeOne of the leading causes of disability and time lost from workDirect costs estimated at $24 billion, indirect costs reaching $35 billion with a total of nearly $60 billion to the employerLast bullet - Total costs are anywhere from $40-$60 billion a year depending on the data read.
5 State Statistics Back claims only... 3246 claims at a cost of about $12.5 million over the last four years so far.Claims have not fully developed yet and will surely increase.We should be concerned with the frequency.Frequency drop some between 1997 and 1998, but jumped to 1054 in 1999.Current track for 2000 is less than all the other years shown.FYI - The average cost per claim in 1997 and 1998 combined was $5280.
6 National StatisticsPercentage of claims compared Nationally in 1998 was 10% - all the other sectors were higher except for one, the mining industry.This is just a percentage of all claims - not a number comparison. However, it does show many of the other industries or exposures have a higher percentage of back injuries than us.Source: National Safety Council Injury Facts, Edition
7 5 Large Lumbar Vertebrae Anatomy of the Back7 Cervical Vertebrae12 Thoracic Vertebrae5 Large Lumbar VertebraeSacrumCoccyx or TailboneThe back has a natural “S” shapeThere are 7 cervical vertebrae making up the neck portion of the back.The next 12 vertebrae are known as the thoracic vertebrae. They are placed from the base of your neck to the upper portion of your lower back.The next 5 vertebra are called the lumbar vertebrae. They are the largest vertebrae in the back due to the fact they support the largest amount of weight - the entire upper body.Rounding out the back is the sacrum and coccyx or tail bone. These joints are considered immovable and do not contain a disc.
8 Lumbar Spine with Disc Details Spinal CordDiscVertebraSpinal NervesThe back (or Spinal Column) is composed of 24 moveable bones called vertebrae.The disc is a cushion-like pad that absorbs shock. These vertebrae and discs are supported by ligaments and muscles that keep the back properly aligned in three balanced curves.The facet joints are small hinge joints below and above each vertebra. Facet joints link the vertebrae and allow them to move.The foramen is an opening in the bone that allows the nerves to travel through and be protected by the bony structure.And the nerves are pathways that allow electrical currents to travel to and from the brain.
9 Top View of Healthy Disc NO, this is not what you think it is. This is a superior, or top, normal view of the vertebrae.
10 Normal Spine PositionNormal healthy spine position.
11 Deep Muscles of the Back Erector SpinaePosterior Serratus MusclesThe object of these next two slides is to show the complex muscle structure of the back only. [Discuss the many different angles at which the muscles attach to move our backs from one direction to another. Also, discuss the relative size of our small back muscles to that of our leg and gluteus muscles when it comes to lifting and how important it is to maintain proper technique when lifting. ]
12 Deep Muscles of the Back Serratus Anteriorand TransversusExternal Oblique
13 The Force is Against You *07/16/96The Force isAgainst You*2##
14 *The Forces InvolvedThe amount of force you place on your back in lifting may surprise you!Think of your back as a lever.With the fulcrumin the center, it onlytakes ten pounds ofpressure to lift a tenpound object.Discuss seesaw analogy.*3##
15 *The Forces InvolvedIf you shift the fulcrum to one side, it takes much more force to lift the same object. Your waist acts like the fulcrum in a lever system, on a 10:1 ratio.Lifting aten poundobject puts100 poundsof pressureon yourlower back.*4##
16 The Forces Involved When you add in the 105 pounds of the *The Forces InvolvedWhen you add in the105 pounds of theaverage human uppertorso, you see thatlifting a ten poundobject actually puts1,150 pounds ofpressure on thelower back.*5##
17 The Forces Involved If you were 25 pounds overweight, it would add *The Forces InvolvedIf you were 25 poundsoverweight, it would addan additional 250 poundsof pressure on your backevery time you bend over.Discuss shifting the fulcrum point by bending the knees.*6##
20 Back StrainDefinition: Strains are tears or stretches in the muscle fibers or the tendons that connect muscles to bones. Strains can range from relatively mild injuries, with some muscle fibers being torn, to large muscle tears with swelling and bleeding present.Symptoms/Signs:Pain, swelling, and tenderness in a muscle group or joint
21 Back SprainDefinition: A sprain occurs when a ligament -- the tissue that connects bones together -- is stretched or torn.Symptomsjoint pain or muscle painswellingdiscoloration of the skin, especially bruisingimpaired joint function
22 Bulging DiscA bulging disc appears to have moved or slipped out of place. Discs cant really move, but swelling or years of poor posture can leave them protruding from between the vertebrae. The vertebrae squeeze the bulging disc and cause pain
23 Herniated DiscA herniated disc is a rupture of the jelly-like substance from inside one of the fibrous discs that provide cushioning between the vertebrae of the spine. Herniation results in pressure on nearby nerves which can result in a variety of symptoms, depending on the location of the affected disc.
26 Common Causes of Back Injuries *Common Causes of Back InjuriesAnytime you find yourself doing one of these things, you should think:DANGER! My back is at risk!Try to avoid heavy lifting. . Especially repetitivelifting over a long periodof timeBe creative when it comes to repetitive lifting. [Use the chair lifting analogy learned by the ergonomist.]*7##
27 Common Causes of Back Injuries *Common Causes of Back InjuriesTwisting at thewaist whilelifting orholding a heavyload thisfrequently happenswhen using a shovel.Always pick up your feet and turn rather than twist.*8##
28 Common Causes of Back Injuries *Common Causes of Back InjuriesReaching and lifting . . .over your head, acrossa table, or out the backof a truck*9##
29 Common Causes of Back Injuries *Common Causes of Back InjuriesLifting or carryingobjects with awkwardor odd shapes*10##
30 Common Causes of Back Injuries *Common Causes of Back InjuriesWorking in awkward,uncomfortable positions . . .*11##
31 Common Causes of Back Injuries *07/16/96Common Causes of Back InjuriesSitting or standingtoo long in oneposition. . . sittingcan be very hardon the lower back*12##
32 Common Causes of Back Injuries Improper SittingIf you stand or sit with your head forward, your upper back rounded and your chest collapsed, your posture is less than optimal and can result in muscle strain throughout your bodyWhile standing or sitting, you should practice proper posture. Keep your head erect, your shoulders back but relaxed and your stomach in.
33 Common Causes of Back Injuries *07/16/96Common Causes of Back InjuriesIt is also possibleto injure yourback slipping ona wet floor or ice . . .*13##
35 Prevent Back Injuries Avoid lifting and bending whenever you can *Prevent Back Injuries07/16/96Avoid lifting and bending whenever you canPlace objects up off the floorRaise/lower shelvesUse carts and dolleysUse cranes, hoists, lift tables, and other lift-assist devices whenever you canTest the weight of an object before lifting by picking up a cornerGet help if its too heavy for you to lift it alone2nd point - Heavy objects should be between mid thigh and mid chest to avoid excessive stooping and reaching. Lighter objects should be stored on the floor or above mid chest.*14##
36 *Prevent Back Injuries07/16/96Use proper lift procedures Follow these steps when lifting . . .Take a balanced stance, feet shoulder-width apartSquat down to lift, get as close as you canGet a secure grip, hug the loadLift gradually using your legs, keep load close to you, keep back and neck straightOnce standing, change directions by pointing your feet and turn your whole body. Avoid twisting at your waistTo put load down, use these guidelines in reverse*15##
39 *07/16/96Things You Can DoMinimize problems with your back by doing stretches and exercises that tone the muscles in your back, hips and thighsNote: Before beginning any exercise program, you should check with your doctor*18##
40 Stretch and Exercise! Exercise regularly, every other day. Warm up slowly A brisk walk is a good way to warm upStretching loosens the muscles and prepares them for the workoutInhale deeply before each repetition of an exercise and exhale when performing each repetition.
41 Stretches To Help Your Back Double knee-to-chest stretch *Stretches To Help Your Back Double knee-to-chest stretch07/16/96Keep the back relaxedHold for 45 to 60 seconds.Release. Repeat 2 times.Do once per dayLie down on back.Pull both knees in to chest until you feel a comfortable stretch in lower back.*19##
42 Stretches To Help Your Back *Stretches To Help Your Back07/16/96Trunk flexion stretchOn hands and knees, tuck in chin and arch backSlowly sit back on heels, letting shoulders drop toward the floorKeep the back relaxedHold for secondsRelease. Repeat 2 timesDo once per day*22##
43 Stretches to Help Your Back Mid-back rotation stretch *Stretches to Help Your Back Mid-back rotation stretch07/16/96Lie on stomach. Lift body so that only hands and feet touch the floorReach to each side as far as possible, keeping chest as low to floor as possibleHold for seconds and releaseDo once per day*26##
44 Stretches to Help Your Back Lower trunk rotation stretch *07/16/96Stretches to Help Your Back Lower trunk rotation stretchLie on backKeeping back flat and feet together, rotate knees to one sideHold for secondsRelease. Repeat 2 timesDo once per day*25##
45 Exercises To Help Your Back Alternate arm-leg extension exercise *Exercises To Help Your Back Alternate arm-leg extension exercise07/16/96Face floor on hands and kneesRaise left arm and right leg. Do not arch neckHold for 10 seconds and releaseRaise right arm and left leg. Do not arch neckHold for 10 seconds and release. Repeat times on each sideDo once per day*20##
46 Exercises To Help Your Back Pelvic tilt exercise *Exercises To Help Your Back Pelvic tilt exercise07/16/96Lie on back with knees bent, feet flat on floor and arms at sides.Flatten small of back against floor. (hips will tilt upward.)Hold for seconds and release. Gradually increase your holding time to 60 secondsRepeat 2 timesDo once daily*21##
47 Exercises To Help Your Back Curl-up exercise *07/16/96Exercises To Help Your Back Curl-up exerciseLie on the floor on back.Keeping arms folded across chest, tilt pelvis to flatten back. Tuck chin into chest.Tighten abdominal muscles while raising head and shoulders from floorHold 10 seconds and releaseRepeat times. Gradually increase your repetitions.Do once per day*23##
48 Exercises To Help Your Back Diagonal curl-up *Exercises To Help Your Back Diagonal curl-up07/16/96Lie on back on floor with arms folded across chest and knees bent.Keeping arms folded, tilt pelvis to flatten back and tuck chin into chest.Lift head and shoulders from floor while rotating to one side.Hold to 10 seconds and releaseRepeat times. Gradually increase your repetitionsDo once per day*24##
49 Take care of your back And it will take care of you Exercise daily *07/16/96Take care of your backAnd it will take care of youExercise dailyAvoid Heavy LiftingGet Help with heavy or bulky objectsIf you must bend over, do it properlyAvoid twisting at the waist when carrying objectsAlways watch where you're going*28##
51 NIOSH Study A Lack of Scientific Support After a review of the scientific literature, the results cannot be used to either support or refute the effectiveness of back belts in injury reduction.There is insufficient scientific evidence to show they actually deliver what is promised.The Institute does not recommend the use of back belts to prevent injuries among workers who have never been injured.*May act as a reminderEmployees have a tendency to try and lift more or think they can lift more when fitted with a back belt because it does feel good and supported with on. However, it can also act as a crutch or cast and actually cause more damage in the long run.Proper education and lifting techniques are the KEY. [Discuss the power lifter analogy]
53 PregnancyMuscles and ligament are already being stressed beyond normal levelsSpine joints become less stable due to hormonal changes in the bodyThe curve in the lower back increases. The back muscles must work harder to help maintain balance[Remind audience of difference of pressure on the lower back for non-pregnant vs. pregnant women - 65 pounds vs. 150 pounds.]
54 In a Nutshell Employees need: An Atmosphere that Promotes a Safe WorkplaceEducationTraining on Proper TechniqueProper Tools for the Job
55 Websites Used For This Program getpage.asp?http://www.orthop.washington.edu/bonejoint/zlvzzzzz1 1.htmlarticle