Back Safety & Lifting

Test your Spine Q True or False Very few people are affected by back pain Back injuries cost employers an estimated $10 billion a year The back is a complex system of bones, discs, muscles and nerves The spine is a straight column of rigid bones The 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

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 spine Your lower back is subject to greater mechanical stress than any other part of your body If you're under 50, there is no need to worry about osteoporosis Once you've injured your back you can never fully recover True False

Why have Training?? Second most common injury in the state Second (only to the common cold) most frequent visit to the doctors office Statistically, 8 out of 10 will suffer some sort of back pain throughout their life One of the leading causes of disability and time lost from work Direct costs estimated at $24 billion, indirect costs reaching $35 billion with a total of nearly $60 billion to the employer Last bullet - Total costs are anywhere from $40-$60 billion a year depending on the data read.

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 940 - less than all the other years shown. FYI - The average cost per claim in 1997 and 1998 combined was $5280.

National Statistics Percentage 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, 2000 Edition

5 Large Lumbar Vertebrae Anatomy of the Back 7 Cervical Vertebrae 12 Thoracic Vertebrae 5 Large Lumbar Vertebrae Sacrum Coccyx or Tailbone The back has a natural “S” shape There 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.

Lumbar Spine with Disc Details Spinal Cord Disc Vertebra Spinal Nerves The 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.

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.

Normal Spine Position Normal healthy spine position.

Deep Muscles of the Back Erector Spinae Posterior Serratus Muscles The 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. ]

Deep Muscles of the Back Serratus Anterior and Transversus External Oblique

The Force is Against You * 07/16/96 The Force is Against You * 2##

* The Forces Involved The amount of force you place on your back in lifting may surprise you! Think of your back as a lever. With the fulcrum in the center, it only takes ten pounds of pressure to lift a ten pound object. Discuss seesaw analogy. * 3##

* The Forces Involved If 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 a ten pound object puts 100 pounds of pressure on your lower back. * 4##

The Forces Involved When you add in the 105 pounds of the * The Forces Involved When you add in the 105 pounds of the average human upper torso, you see that lifting a ten pound object actually puts 1,150 pounds of pressure on the lower back. * 5##

The Forces Involved If you were 25 pounds overweight, it would add * The Forces Involved If you were 25 pounds overweight, it would add an additional 250 pounds of pressure on your back every time you bend over. Discuss shifting the fulcrum point by bending the knees. * 6##

Does SANTA have back pain??

Types of Back Injuries

Back Strain Definition: 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

Back Sprain Definition: A sprain occurs when a ligament -- the tissue that connects bones together -- is stretched or torn. Symptoms joint pain or muscle pain swelling discoloration of the skin, especially bruising impaired joint function

Bulging Disc A 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

Herniated Disc A 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.

Break Time 15 minutes

Causes of Back Injuries

Common Causes of Back Injuries * Common Causes of Back Injuries Anytime you find yourself doing one of these things, you should think: DANGER! My back is at risk! Try to avoid heavy lifting . . Especially repetitive lifting over a long period of time Be creative when it comes to repetitive lifting. [Use the chair lifting analogy learned by the ergonomist.] * 7##

Common Causes of Back Injuries * Common Causes of Back Injuries Twisting at the waist while lifting or holding a heavy load . . . this frequently happens when using a shovel. Always pick up your feet and turn rather than twist. * 8##

Common Causes of Back Injuries * Common Causes of Back Injuries Reaching and lifting . . . over your head, across a table, or out the back of a truck . . . . * 9##

Common Causes of Back Injuries * Common Causes of Back Injuries Lifting or carrying objects with awkward or odd shapes . . . . * 10##

Common Causes of Back Injuries * Common Causes of Back Injuries Working in awkward, uncomfortable positions . . . * 11##

Common Causes of Back Injuries * 07/16/96 Common Causes of Back Injuries Sitting or standing too long in one position. . . sitting can be very hard on the lower back . . . . * 12##

Common Causes of Back Injuries Improper Sitting If 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 body While standing or sitting, you should practice proper posture. Keep your head erect, your shoulders back but relaxed and your stomach in.

Common Causes of Back Injuries * 07/16/96 Common Causes of Back Injuries It is also possible to injure your back slipping on a wet floor or ice . . . * 13##

Prevention

Prevent Back Injuries Avoid lifting and bending whenever you can * Prevent Back Injuries 07/16/96 Avoid lifting and bending whenever you can Place objects up off the floor Raise/lower shelves Use carts and dolleys Use cranes, hoists, lift tables, and other lift-assist devices whenever you can Test the weight of an object before lifting by picking up a corner Get help if its too heavy for you to lift it alone 2nd 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##

* Prevent Back Injuries 07/16/96 Use proper lift procedures . . . Follow these steps when lifting . . . Take a balanced stance, feet shoulder-width apart Squat down to lift, get as close as you can Get a secure grip, hug the load Lift gradually using your legs, keep load close to you, keep back and neck straight Once standing, change directions by pointing your feet and turn your whole body. Avoid twisting at your waist To put load down, use these guidelines in reverse * 15##

Help your Back

* 07/16/96 Things You Can Do Minimize problems with your back by doing stretches and exercises that tone the muscles in your back, hips and thighs Note: Before beginning any exercise program, you should check with your doctor * 18##

Stretch and Exercise! Exercise regularly, every other day. Warm up slowly . . . A brisk walk is a good way to warm up Stretching loosens the muscles and prepares them for the workout Inhale deeply before each repetition of an exercise and exhale when performing each repetition.

Stretches To Help Your Back Double knee-to-chest stretch * Stretches To Help Your Back Double knee-to-chest stretch 07/16/96 Keep the back relaxed Hold for 45 to 60 seconds. Release. Repeat 2 times. Do once per day Lie down on back. Pull both knees in to chest until you feel a comfortable stretch in lower back. * 19##

Stretches To Help Your Back * Stretches To Help Your Back 07/16/96 Trunk flexion stretch On hands and knees, tuck in chin and arch back Slowly sit back on heels, letting shoulders drop toward the floor Keep the back relaxed Hold for 45-60 seconds Release. Repeat 2 times Do once per day * 22##

Stretches to Help Your Back Mid-back rotation stretch * Stretches to Help Your Back Mid-back rotation stretch 07/16/96 Lie on stomach. Lift body so that only hands and feet touch the floor Reach to each side as far as possible, keeping chest as low to floor as possible Hold for 45-60 seconds and release Do once per day * 26##

Stretches to Help Your Back Lower trunk rotation stretch * 07/16/96 Stretches to Help Your Back Lower trunk rotation stretch Lie on back Keeping back flat and feet together, rotate knees to one side Hold for 45-60 seconds Release. Repeat 2 times Do once per day * 25##

Exercises To Help Your Back Alternate arm-leg extension exercise * Exercises To Help Your Back Alternate arm-leg extension exercise 07/16/96 Face floor on hands and knees Raise left arm and right leg. Do not arch neck Hold for 10 seconds and release Raise right arm and left leg. Do not arch neck Hold for 10 seconds and release. Repeat 10-15 times on each side Do once per day * 20##

Exercises To Help Your Back Pelvic tilt exercise * Exercises To Help Your Back Pelvic tilt exercise 07/16/96 Lie 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 10-15 seconds and release. Gradually increase your holding time to 60 seconds Repeat 2 times Do once daily * 21##

Exercises To Help Your Back Curl-up exercise * 07/16/96 Exercises To Help Your Back Curl-up exercise Lie 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 floor Hold 10 seconds and release Repeat 10-15 times. Gradually increase your repetitions. Do once per day * 23##

Exercises To Help Your Back Diagonal curl-up * Exercises To Help Your Back Diagonal curl-up 07/16/96 Lie 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 release Repeat 10-15 times. Gradually increase your repetitions Do once per day * 24##

Take care of your back And it will take care of you Exercise daily * 07/16/96 Take care of your back And it will take care of you Exercise daily Avoid Heavy Lifting Get Help with heavy or bulky objects If you must bend over, do it properly Avoid twisting at the waist when carrying objects Always watch where you're going * 28##

What About Back Belts?

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 reminder Employees 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]

A Special Consideration

Pregnancy Muscles and ligament are already being stressed beyond normal levels Spine joints become less stable due to hormonal changes in the body The 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.]

In a Nutshell Employees need: An Atmosphere that Promotes a Safe Workplace Education Training on Proper Technique Proper Tools for the Job

Websites Used For This Program www.safetyinfo.com http://www.healthlinkusa.com/39 getpage.asp?http://www.orthop.washington.edu/bonejoint/zlvzzzzz1 1.html http://webmd.lycos.com/content/dmk/dmk article 6462859 http://www.txdirect.net/users/spbaylan/Sapmr.htm www.vesallus.com