1. Back Safety The topic of today’s session is back safety.
Everyone’s had a minor back problem at one time or another. Symptoms can arise from everyday wear and tear, overuse or injury. Back problems occur both on and off the job. But they have some things in common: Back injuries can be extremely painful and they take a long time to heal, affecting almost everything you do.
Back injuries are the most common source of back pain. Minor injuries might occur from improper lifting, tripping, falling or by twisting your spine too much. Severe injuries can be caused by car accidents or by hard falls.
You can save yourself a lot of pain and a lifetime of hassles by learning proper lifting techniques and the basics of back safety. The purpose of today’s session is to help you minimize your risk of back injury and pain. We’ll look at what causes back pain, common types of injuries and what you can do to prevent them.
Copyright ã2006 Progressive Business Publications
Suggestions for the Speaker
An effective ice breaker would be to ask the trainees the following questions:
Has anyone ever hurt their back, either on the job or at home?
What were you doing when you hurt your back?

2. Back Injuries: Sobering Facts
50% of the workforce experiences some sort of back pain each year
One in every 5 workplace injuries is a back injury, costing between $20 billion and $50 billion a year
Overexertion is the most common cause of back injuries
Let’s look at why learning how to prevent back injuries is so important.
It’s estimated that 50% of the workforce experiences some form of back pain each year, from mild to severe. Physicians say back pain is the second-most common reason people visit a doctor. Back pain can have a serious effect on even the simplest activities – sitting down and standing up, walking, sleeping and more. You can be restricted from most tasks at work and at home.
Back injuries account for nearly 20% of all injuries and illnesses in the workplace, and occur twice as often as any other injury. These injuries cost us between $20 billion and $50 billion a year.
Overexertion is the most common cause of back sprains, strains and injuries. Of these injuries, three out of every four occur while lifting.
Those are sobering facts. But after today’s session, you should know how to avoid back injuries and keep from becoming a statistic.
Copyright ã2006 Progressive Business Publications

3. Structure of the Back Vertebrae Discs Ligaments Muscles Tendons Nerves
Why are back injuries so common? To help you understand this – and prevention techniques – it helps to know a little bit about how the back works.
What people commonly call the backbone, your spine, is really a column of 24 moveable bones. These small bones, known as vertebrae, are stacked on top of each other.
Between each of these vertebrae is a disc, which is like a cushion. The discs are filled with fluid and act as shock absorbers, preventing the vertebrae from rubbing against each other when you move.
The vertebrae are held together by strong tissue, called ligaments, and muscles, which are attached by bands of tissue called tendons. Ligaments and muscles keep the back aligned in three balanced curves.
Picture each vertebrae as a donut. If you stacked them one on top of another, all the holes would line up, forming a hollow canal down the center. The spinal cord is located in this column. Then nerves from the spinal cord branch out through spaces in the vertebrae to the rest of your body.
Since the lower back holds most of the body’s weight, even a minor problem in this area with the vertebrae, discs, muscles, ligaments or tendons can cause serious pain when you stand, bend or move around.
Copyright ã2006 Progressive Business Publications

4. Types of Injuries Strains and sprains are caused by:
Muscles or ligaments that become over-stretched or tear
Sudden movement or trying to lift something that’s too heavy
Overuse can lead to muscle spasms
Excessive lifting or a fall can lead to injury
Every time you bend over, lean forward or lift a heavy object, you’re putting stress on your back and the parts that make up your spine.
Strains and sprains, the most common back injuries, occur when muscles or ligaments become over-stretched and tear. Generally, sprains and strains are caused by a sudden movement or trying to lift something that’s too heavy. While these injuries lead to reduced mobility and can be quite painful, they usually heal quickly - within a couple of days or weeks - with no lasting damage to your health.
Muscle spasms can occur because of overuse. A spasm occurs when back muscles suddenly and uncontrollably tighten up or cramp. Severe spasms may last hours, followed by days or week of less severe pain.
Sometimes excessive lifting or a fall can cause some of the discs in your back to pop out of place and bulge into the spinal canal. These are known as herniated, slipped or ruptured discs. At times, this condition can be extremely painful. Back surgery may be the only method for full recovery.
Just like when the tread on your tires goes bald, your discs naturally wear down over time. This natural deterioration makes it more likely for slipped or ruptured discs to occur. Improper lifting and carrying will accelerate this deterioration.
Studies have also shown that severe stress can also increase minor back pain.
Copyright ã2006 Progressive Business Publications

5. Common Causes of Back Injuries
Cumulative damage over time
Repeatedly using improper lifting techniques
Bending over at waist
Twisting with a load
Reaching for elevated loads
Carrying or lifting awkwardly shaped objects
Sitting, standing or working in one position too long
How do you injure your back? Back injuries usually result from cumulative damage suffered over a long period of time - basically, “micro injuries” that add up. That one last lift is merely the last straw.
There are certain actions, motions and movements that are more likely to cause and contribute to back injuries. The more you repeat these movements, the more minor injuries begin to accumulate and weaken the affected muscles or ligaments. Eventually enough’s enough and a more serious injury occurs.
Lifting is the single largest cause of lower back pain. Repeated heavy lifting or attempting to lift more than you can handle puts tremendous strain on your back.
Lifting objects by bending over at the waist can aggravate your back. Twisting with a load, for example, like when using a shovel, is another movement that puts unnecessary and harmful stress on your back. Reaching for elevated loads (or loads above your head) can also be harmful.
Carrying or lifting awkwardly-shaped objects can hurt your back. Objects slip or shift weight, putting your back in a potentially harmful position.
Sitting or standing too long without shifting position or working in awkward positions also puts added strain on your back and can lead to injuries.
Copyright ã2006 Progressive Business Publications
Suggestion for the Speaker
You might want to ask the trainees for examples of activities on the job that could cause back injuries.

6. Contributing Factors Poor posture and slouching Being out of shape
Extra weight around the middle
Stress
There are other contributing factors, in addition to work injuries, that may put you at greater risk of back injury than the person sitting next to you.
You can avoid a lot of back problems by learning how to sit and stand correctly. Slouching strains the back ligaments and puts pressure on your vertebrae. Poor posture puts added stress on the back, even when a person isn’t engaged in any lifting or strenuous activity.
If you’re out of shape, strains and tears can occur more frequently because your muscles may not be as flexible. A sudden strain on a muscle that has gone largely unused can lead to a serious injury, especially when there’s sudden twisting or turning of the back.
“Beer bellies” and extra weight around the middle puts extra strain on your back and stomach muscles, especially when you bend over. Also, having weak stomach muscles means your back has to do more. That’s because your abdominal muscles aren’t sharing the load.
Stress is another factor that can lead to back pain. Stress causes muscles to contract, which can stop the circulation of blood and oxygen, resulting in pain and atrophy of muscles. Stress can also cause muscle spasms.
Copyright ã2006 Progressive Business Publications

7. Proper Lifting Techniques
Plan the lift in advance
Should you get help?
Test load before lifting
Be cautious with long or awkwardly shaped objects
Make sure the load is properly packed and balanced
The single most effective thing you can do to prevent back injuries on the job is to make sure you’re using proper lifting techniques.
First, plan your lift in advance. It may sound simple, but taking a moment to think about what you’re going to do can save you from a severe injury. Visualize the lift. Think about the weight of the object you’re moving and where you’re heading with it. Will you need help? Are there any obstructions or slick surfaces in your path?
Next, perform a lift test. Pushing the object lightly with your hands or feet to see how easily it moves will give you an estimate of its weight. Ask yourself: Is this a job that would be done easier with a dolly or cart? Can I reduce the amount of weight lifted? You also should consider: Is this something I should get someone’s help with?
Be especially cautious with long or awkwardly-shaped objects. Inspect objects for sharp corners, slippery spots or other potential hazards. Also make sure the load is packed correctly and balanced, so it won’t move around. Loose pieces inside a box can cause accidents if the box becomes unbalanced.
Copyright ã2006 Progressive Business Publications

8. Proper Lifting Techniques (continued)
Stand close to load, with your feet shoulder-width apart
Squat down, bending at the knees
Use palms, not fingers, to grip the load
Lift straight up
When you’re ready to lift, stand close to the load with your feet shoulder-width apart. One foot should be slightly ahead of the other for balance.
Squat down, bending at the knees.
Tuck your chin in while keeping your back as straight as possible.
Using your palms, not your fingers, to get a firm grasp of the object before beginning the lift.
Begin your lift, using slow and smooth movements.
Lift straight up. Make sure you’re using your legs, not your back. Make sure your back is as upright as possible. Push with your legs straight up to a vertical position. Don’t twist your body during this step.
Avoid quick jerky motions. These types of sudden movements can cause a strain or sprain.
Try to carry the load in the space between your shoulder and your waist while keeping the object as close to your body as possible. Think of it as “hugging” the load. The further away the load’s center of gravity is from the body, the greater the stress placed on your lower back.
Copyright ã2006 Progressive Business Publications
Suggestion for the Speaker
You might want to demonstrate the proper lifting techniques using an object your workers frequently lift on the job.

9. Proper Lifting Techniques (continued)
To change directions
Do not twist
Turn feet in direction of intended travel
When moving with load
Keep it close to body
Watch for slip and fall hazards
To put it down, follow same steps in reverse order
Consider other lifting techniques
It’s also important to consider how you’ll get where you want to go safely.
Once you’re standing with the load, you’ll need to be very careful about changing direction. That’s because twisting while carrying a load is extremely dangerous. To turn or change direction, point your feet in the direction you want to go and turn your whole body.
When moving with a load, keep the object close to your body and continue to be alert for anything that could cause a trip or fall. Never turn your upper body while carrying the object or you could strain or sprain your back.
To place the object down, follow the same procedures in reverse order. Keep the load close to your body, move evenly and slowly, and remember to bend at the knees and keep your back as straight as possible.
There are other lifting techniques you might want to try. One is called the “golfer’s lift,” and can help you avoid injury when picking up small objects out of a bin or off the floor. How to do it: Keep your knees straight, and lift one leg behind you as a counter-balance. One arm reaches to pick up the object while the other arm hangs on to a stationary object for support.
Another technique that can help avoid injury is by using the half-kneeling approach. This technique is good for lifting awkwardly shaped objects off the floor. First, you kneel behind the object and lift it onto your bended knee. Now, you can either straighten out your back knee, to move forward, or push with your front knee, to move backwards.
Copyright ã2006 Progressive Business Publications

10. Avoiding Trouble Spots
Can you reduce the size or weight of the object?
What mechanical aids might be available?
Can the height of the object be adjusted?
Keep the object between your shoulder and your waist.
A recent study determined that up to one-third of on-the-job back injuries could be prevented through ergonomics – better job design, and making sure you’re using the safest and most efficient way to lift a load.
First, see if it’s possible to reduce the size or weight of the object you need to lift. Check to see if there are handles, and test the stability of the load you’re trying to handle.
Sometimes mechanical aids, such as hoists, lift tables, pallet jacks, carts or dollies, can help reduce the impact of the load. For some of us, it may feel more comfortable to pull rather than push, depending on what we’re using. Studies have shown that we’re less likely to suffer a back injury if we push a load rather than pull it.
Other times, you’ll want to adjust the height of a pallet or shelf, if possible. Lifting that occurs below the knee or above the shoulder is more strenuous. Consider if it’s possible to use a ladder or step stool.
The best area to begin a lift is between your shoulders and waist. When you start to bring the object down, remember to keep it as close to your body as possible. Don’t use your arms to swing it down sideways or you could strain your back.
Copyright ã2006 Progressive Business Publications
Suggestions for the Speaker
Use this time to demonstrate proper lifting techniques for overhead items. Ask workers to name where ladders and stools are located.

11. Preventing Back Injuries
Ask for help
Can it be broken into smaller loads?
Pace yourself
Back belts don’t help
If you can recognize those situations where your back is most at risk, you can take measures to avoid injury.
It’s not a sign of weakness to ask for help when it’s obvious a load can’t be lifted by one person because of its weight or its general shape.
If no one is available, can you break the load into smaller ones? Would a cart, a dolly or a pallet jack help you move the load?
Another way to help avoid injury is to pace yourself. If you’re lifting several loads, take a short break between each one.
Make sure you’ve cleared enough space around an object so you have enough room to lift it safely.
Check to see if there are any slippery, uneven surfaces, so you won’t walk across them.
Finally, don’t rely on one of those back belts to help you. There’s no scientific proof that back belts will help you avoid back injuries. In some cases, they cause injuries because they lead to overconfidence on the part of the wearer.
Copyright ã2006 Progressive Business Publications
Suggestion for the Speaker
Now might be a good time to tell your employees the locations of mechanical lifting aids such as dollies, carts and pallet jacks.

12. Basic Back Care Stretch before lifting
Give yourself time between lifts
Take rest breaks for your back
Sleep on a firm mattress
Get in shape
Use good posture
There are other measures you can take ahead of time to avoid injury and keep your back healthy.
Before you begin work you know will be hard on your back, take the time to stretch your muscles - just like an athlete would. Give yourself time between lifts to let your back recover. When you start to feel sore, that’s your body telling you to take a time out. So take a break and stretch.
Sleeping on a firm mattress is another thing you can do that will help you avoid injuries on the job. The best sleeping position for your back is either on your back with your knees slightly elevated or on your side with your knees slightly bent.
We’d all like to get in shape. Now here’s another reason to do it. It’s actually great for your back. Exercising increases your flexibility, which helps to prevents strains and pulls. Also, just keeping trim helps reduce the amount of weight on your lower back in those cases where you do have to bend over or lift something.
Posture affects the amount of strain you put on your back. For good sitting posture, put your knees slightly higher than your hips, with your hips toward the back of the chair. Your shoulders and upper back should be straight, not rounded.
If you’re on your feet for a long time, good posture also is important. Stand up straight and keep your weight evenly balanced on both feet. If you lean on one foot, be sure to shift foot positions frequently.
Copyright ã2006 Progressive Business Publications

13. Exercises for Your Back
Wall slides
Leg raises
Front leg raises (on your back)
Partial sit-ups
Back swing
Regular exercise strengthens and improves the flexibility of the back and abdominal muscles. Exercise also lessens the severity of a back injury when it occurs and promotes healing.
Exercises to strengthen your back are easy to do. Here are a few to get you started:
The first are wall slides. Stand with your back against the wall, feet shoulder-width apart. Slide down into a crouch with your knees bent at a 90-degree angle. Count to five and slide back up the wall. Repeat 5-7 times.
Next are leg raises. Lie on your stomach. Tighten the muscles in one leg and raise the leg off the floor. Hold for a count of 10 and return leg to the floor. Do the same with your other leg. Repeat 5-7 times with each leg.
A variation of this exercise is the front leg raise. Lie on your back with your arms at your sides. Lift one leg up for a count of 10 and return it to the floor. Do the same with the other leg. Repeat 5-7 times with each leg.
Partial sit-ups are a great way to get your abdominal muscles into shape. Lie on your back, knees bent and feet flat on the floor. Slowly raise your head and shoulders off the floor and reach both hands toward your knees. Count to 10. Repeat 5-7 times.
Next comes the back swing. Stand behind a chair with your hands on the back of the chair. Lift one leg back and up, keeping the knee straight. Return slowly. Raise the other leg and return. Repeat 5-7 times with each leg.
Bear in mind, always consult with a physician before beginning any exercise program, especially if you have had pain or problems with your back in the past.
Copyright ã2006 Progressive Business Publications

14. If Back Pain Occurs Use cold packs to relieve pain (initially)
Use heat (after 48 hours)
Use over-the-counter pain relievers
Gradually begin gentle stretching
Consult physician if:
Pain persists after resting for 72 hours
You have feeling of numbness in lower limbs
No matter how careful you are, from time to time back pain can still occur.
For strains and sprains, you may use cold packs for starters. After 48 hours use heat, such as a warm bath or a heating pad to relieve the pain.
Over-the-counter pain relievers such as Ibuprofen or Tylenol (acetaminophen) can also provide some relief of minor back pain.
You’ll heal fastest if you continue your normal activities while avoiding for several days what may have caused the pain in the first place. Also avoid heavy lifting, pushing or pulling, repetitive bending and twisting. Get plenty of rest, but avoid long periods of bed rest, as this can actually make the situation worse.
There may be times when rest and relaxation don’t cut it. Consult a physician if pain persists after 72 hours or if you have a feeling of numbness in your lower limbs.
Copyright ã2006 Progressive Business Publications
Suggestion for the Speaker
Now might be a good time to review what workers should do if they suffer a back injury. What are your company’s procedures when a back injury occurs on the job?

15. Points to Remember Use proper lifting techniques Know motions to avoid
Don’t overdo it - get help
Help your back by caring for it
The most important thing to remember is how to lift properly. Stretch before lifting. Lift with the legs, slowly, keeping the back straight. If you’re doing repetitive lifting, give your back a rest from time to time.
Remember the motions to avoid - bending over to lift, lifting objects above your shoulder, twisting while carrying objects and carrying objects away from your body.
Also, don’t overdo it. Don’t lift things that you know are beyond what you’re capable of. Ask a co-worker to help you. Use a dolly or cart instead of carrying.
And lastly, help your back be good to you by being good to your back. Use good posture when standing or sitting. Try to lose the spare tire and get in shape. Sleep on a firm mattress.
Doing these things and what we covered earlier, will help you avoid back injuries on the job and save yourself a lot of pain.
Copyright ã2006 Progressive Business Publications
Suggestions for the Speaker
Now might be a good time to let workers ask questions about anything covered in the session.
Consider giving workers the handout provided in this training module before the session breaks.