1. Back Safety and Safe Lifting

2. Back safety Learning goals:
Understand anatomy and balance (how your back works)
Learn safe body mechanics (lifting, standing, sitting, lying)
Get your back in shape (exercises for strength, flexibility)
A. Understand anatomy and balance (how your back works)
1. Your back is strong enough to support the weight of your head and body
2. Your back is flexible enough to allow you to walk, sit, move
3. The secret to its suppleness and strength is in its balance of curves
4. Knowing how the back works can help you avoid any strain or injury
B. Learn safe body mechanics (lifting, standing, sitting, lying)
1. We are constantly using our backs to hold ourselves upright, sit, bend, we use our backs even when we are lying down
2. Poor posture can cause back problems
3. The back is most vulnerable to injury during any lifting
C. Get your back in shape (exercises for strength, flexibility)
1. We often do “back-breaking” activities without any proper preparation
D. Exercise can
1. Prepare muscles for work (cold muscles are prone to injury)
3. Keep bones and muscles strong, supple and aligned
4. Ease back pain
5. Rehabilitate injured backs

3. Back safety Definitions
Manual handling: force exerted to lift, lower, push, pull, carry or otherwise move, hold or restrain something
Manual handling injury: sprains, strains or fractures to muscles, tendons, ligaments and joints

4. Common causes of back injury/pain
Traumatic injury (auto, industrial or sports accident)
A. Traumatic injury (auto, industrial or sports accident)
B. Poor posture and alignment
1. Any posture that compromises the natural curve of the spine puts strain on the supporting back muscles and weakens them
2. Without proper support, the vertebrae are forced to carry weight they are not meant to carry: premature spinal degeneration
3. Also makes movement difficult and awkward, increasing the chances of injury
Poor posture and alignment: makes movement difficult and awkward

5. Common causes of back injury/pain
Overexertion: failure to ease off activity or change position
C. Overexertion
1. Failure to ease off strenuous activities
2. Failure to change position for long periods of time
3. Ignore the twinges.
4. Strain or muscle discomfort is a warning sign!
D. Cumulative strain
1. Excess body weight, repetitive movements, working in awkward positions, age (wear and tear)
2. Happens over time, not all at once
Cumulative strain: excess body weight, repetitive movements, working in awkward positions, age (wear and tear)

6. Common causes of back injury/pain
Emotional stress and muscle tension
Emotional stress and muscle tension
1. Stress causes the muscles to contract
2. Contracted muscles stop circulation of blood and oxygen: atrophy

7. Back anatomy
Spine
Made of 24 moveable bones (vertebrae) “stacked” in three flexible curves
Supports head and trunk, protects spinal cord, provides flexibility to bend/rotate
Spine
1. Primary component of your back
2. Supports head and trunk, protects spinal cord, provides flexibility to bend/rotate
3. Made of 24 moveable bones (vertebrae) “stacked” in three flexible curves
a. Cervical vertebrae
1. Support head and neck
2. Smaller and more flexible than other vertebrae
b. Thoracic vertebrae: support ribs forming chest cavity
c. Lumbar vertebrae (lower back)
1. Largest and carries most of body’s weight (“workhorse” of the spine)
2. Area most prone to injury
d. Sacrum: five fused vertebrae
e. Coccyx: tailbone
Most of body weight falls on lumbar region, making it prone to injury

8. Back anatomy
Discs
Flexible spacers between the vertebrae allow smooth movement
Act as spinal “shock absorbers”
Compress and release, like springs
“Slipped” disc occurs when jelly-like center squeezes out of the disc
Discs
1. Each vertebrae is separated from its neighbor by a cartilage cushion
2. Discs allow smooth movement; act as hydraulic “shock absorbers”
3. Compress and release, like springs
4. Disc anatomy
a. Dense outer ring of criss-crossed fiber, like a radial tire
b. Interior is soft and squishy, like thick jelly
1. 1/3 rd of height of spine is made up of discs
2. when lying down, they soak up nutrients and water from blood, making average person taller in the morning (up to 2 inches)
5. Disc injuries
a. “Slipped” disc
1. Occurs when outer ring wears out like worn tire tread
2. Jelly-like center squeezes out and presses on a nerve (severe pain)
b. Disc degeneration
1. Disc loses moisture, narrows
2. Bones grind together, irritating nerves (nerve damage)

9. “Slipped disk”
jelly-like center squeezes out and presses on a nerve

10. Back anatomy Spinal Cord Central nervous system (with brain)
Pair of spinal nerves exit below each vertebrae
Cervical nerves go to the arms; lumbar area to the legs
Spinal Cord
1. With brain forms the central nervous system
2. Pair of spinal nerves exit below each vertebrae
3. Cervical nerves go to the arms: pinched nerve in neck
4. Nerves in lumbar area go to the legs: sciatic nerve from tailbone down legs

11. Back anatomy
Muscles
Spinal (back) muscles: stabilize spine- not made for lifting
Buttock and thigh muscles: strong and durable
Stomach muscles: also used in lifting
1. Spinal (back) muscles
a. Stabilize the spine: very strong because they support body
b. But they are not made for lifting!
2. Buttock and thigh muscles: strongest in body and very durable
3. Stomach muscles
a. Used in lifting
b. When stomach muscles weaken, back muscles tighten (increasing chance of injury)

12. Muscles Dynamic muscle work: Static muscle work
Involves muscle contraction and movement
Blood flushes out lactic acid which causes muscle fatigue (can work for lengthy periods)
Lifting and stacking boxes an example
Static muscle work
Muscles hold the body without movement
Sustained contraction halts blood flow to muscles: lactic acid builds up, causes fatigue
Bending over workbench, sitting at computer are examples
4. Dynamic muscle work
a. Involves muscle contraction and movement
b. Blood flushes out lactic acid which causes muscle fatigue (can work for lengthy periods)
c. Lifting and stacking boxes an example
5. Static muscle work
a. Muscles hold the body without movement
b. Sustained contraction halts blood flow to muscles: lactic acid builds up, causes fatigue
c. Bending over workbench, sitting at computer are examples

13. Spinal balance Posture is important.
Spine is aligned in three “S” shaped curves
Balanced to keep weight evenly distributed on spine
Proper balance places least amount of stress on spine
Vertebrae pushed out of line causes pain, invites injury
A. Spinal balance
1. Spine is aligned in three “S” shaped curves
2. Column of curves is balanced to keep weight evenly distributed
3. In proper balance, the spine and all its structures are under the least amount of stress and muscles are at their strongest
4. Spine is out of balance when it loses its three natural curves
5. Good posture is important: simplest way to help keep back healthy and pain-free
B. Laying down
1. Lay on side with knees slightly bent toward chest
2. Lay on back with a pillow beneath knees
Posture is important.

14. Posture
Standing
“Stack” ears, shoulders, hips, knees and ankles in a straight line
Tuck in chin
Shoulders back and down
Suck in gut: a pot belly can act as a load and pull spine out of balance
a. Standing
1. “Stack” ears, shoulders, hips, knees and ankles in a straight line
2. Tuck in chin
3. Shoulders back and down
4. Suck in gut: pot belly can act as a load and pull spine out of balance
5. Elevate one foot to reduce stress in lower back

15. Posture
If standing for long periods, elevate one foot to reduce stress in lower back

16. Posture
Sitting
Sit with ankles, knees, thighs and elbows at right angles
Keep head balanced over shoulders
Keep shoulders relaxed (not hunched)
Sit back in chair for support
b. Sitting
1. Sit with ankles, knees, thighs and elbows at right angles
2. Keep head balanced over shoulders
3. Keep shoulders relaxed (not hunched)
4. Sit back in chair for support

17. Safe body mechanics
Body mechanics:
The relationship between your posture and your movement
Good body mechanics avoids putting undue strain on your back

18. Safe body mechanics
Principles of levers: A weight, a short distance from the fulcrum requires less effort to move than the same weight a farther distance from the fulcrum
1. A weight, a short distance from the fulcrum requires less effort to move than the same weight a farther distance from the fulcrum

19. Principles of levers
The worst lifting situation occurs when the body is used like a lever and extended over the load
If the load is further away, there will be a greater strain on the person doing the lifting

20. Principles of levers
The further the load, the greater the strain on the person doing the handling
If the load is further away, the greater the strain on the person doing the lifting

21. Principles of levers
The lower back becomes a fulcrum supporting the weight of the body plus the load
The worst lifting situation occurs when the body is used like a lever and extended over the load
If you bend at your waist and extend your upper body to lift an object, the lower back becomes a fulcrum supporting the weight of the body plus the load.
this situation is called “overload”

22. Techniques for safe lifting
Get a firm footing: keep feet shoulder width apart, toes out, distribute weight evenly on soles of both feet
a. Keep feet shoulder width apart, toes out
b. This adds stability and reduces stress on muscles
c. Distribute weight evenly on soles of both feet
This stance adds stability and reduces stress on muscles

23. Techniques for safe lifting
Bend your knees: not your waist
a. Bending at the waist puts tremendous pressure on the vertebrae
b. The legs serve as a shock absorber for the body
c. When the knees are bent, the weight comes first into the thighs and hips instead of the spine
When the knees are bent, the weight come first onto the thighs and hips, not the spine

24. Techniques for safe lifting
Bending at the waist puts tremendous pressure on the vertebrae

25. Techniques for safe lifting
You can also lower your body down on one knee and glide the object up into your body to get a good grip before pushing your body upward.

26. Techniques for safe lifting

27. Techniques for safe lifting
Tighten stomach muscles: they support spine when lifting, reducing force of the load
Get a good grip: use both hands
“Hug” the load: hold it as close as possible to your body; the closer it is to your spine, the less force it exerts on your back
3. Tighten stomach muscles
a. They support the spine when lifting, reducing force of the load
b. Keep center of gravity in the abdominal cavity
4. Get a good grip: lifting with one hand throws you off balance
4. “Hug” the load
a. Hold it as close as possible to your body
b. The closer it is to your spine, the less force it exerts on your back

28. Techniques for safe lifting
Lift with your legs
Gradually straighten to a standing position
Lift steadily and smoothly without jerking
a. Gradually straighten to a standing position
b. Lift steadily and smoothly without jerking

29. Carrying
Keep back straight: to help shift weight onto the legs

30. Techniques for safe lifting
Avoid twisting Twisting can overload the spine and cause injury to the feet, knees and torso.
Your feet knees and torso should always be in the same direction

31. Techniques for safe lifting
Pivot with your feet, not your back.

32. Techniques for safe lifting
Use the same technique to set down the load.

33. Lifting awkward loads Reaching into a bin or car trunk:
Stand with feet shoulder distance apart
Slightly bend knees and squat, bending at hip joints, not waist
Slide the load as close to your body as possible
Raise yourself with leg and hip muscles
If possible, rest knees against edge for support

34. Hard to reach loads
Do not reach above the shoulders: use a stepstool or ladder
Test the weight before removing from shelf
Slide it toward you and hug it close to your body
Lifting above your shoulders is hard on your arms and back.
If possible, reduce the amount of weight being lifted by removing some of the contents of the box or container.
Try using a step stool or ladder to get closer to the target area, instead of lifting above your shoulders. If possible, place the item on a lower shelf.

35. Hard to reach loads Place item on lower shelf
Don’t reach above shoulders
Place item on lower shelf

36. Two person loads (Team lifting)
- Both persons should be about the same height.
- One person should charge of the lift, so that you are working together not against each other.
- Lift together, walk in step and lower the load together.

37. Two-person long load Shoulder on the same side Keep load level
Walk in step

38. Loading truck or shelf
Put the load on the edge and push it into place.

39. Awkward location Don’t force your body to conform to the workspace
Use the golfer’s lift to pick up light, small loads when you can’t bend your knees or get close to the object.
Swing one leg straight out behind you.
Keep your back straight while your body leans forward.
To help support your body, place one hand on your knee or on a nearby solid object.

40. Awkward loads
Instead of lifting, push a load
Push, don’t pull!

41. Repetitive lifting If you must lift many items:
Design workspace so items to lift are in your safe lift zone

42. Repetitive lifting
Use mechanical assistance or
get help!

43. Safe lifting
Don’t:
Lift anything that exceeds 1/3 - 1/2 your body weight
Lift from the floor if possible
Twist and lift
Lift with one hand (unbalanced)
Lift loads across or over obstacles
Lift while reaching or stretching
Lift from an uncomfortable posture
Fight to recover a dropped object

44. Exercise Benefits: Muscle strength helps maintain natural curves
Keeps back strong and supple
Warm muscles increase ease of movement
Benefits of back exercises
1. Healthy backs require strong supporting muscles
a. Muscle strength helps maintain natural curves
b. Keeps backs strong and supple
2. Greater flexibility
a. Joint flexibility lets you move freely and easily
b. Warm muscles increase ease of movement

45. Exercise
More energy: increased blood and oxygen flow flushes out lactic acid
Cool down exercises decrease potential stiffness
3. More energy: increases blood and oxygen flow, flushes out wastes like lactic acid
4. Balanced workout: some muscles get overworked while others “sleep in”
5. Cool down stretches decrease potential stiffness

46. Exercise “dos” Change your posture/position often
Stretch frequently throughout the day
Keep body flexible (not rigid or fixed)
Warm up before any strenuous work or lifting
Move slowly and gently
Stop if there is any discomfort

47. Exercise Wall slides to strengthen back, hip, and leg muscles
Stand with your back against a wall and feet shoulder-width apart. Slide down into a crouch with knees bent to about 90 degrees. Count to five and slide back up the wall. Repeat 5 times.

48. Exercise Leg raises to strengthen back and hip muscles.
Lie on your stomach. Tighten the muscles in one leg and raise it from the floor. Hold your leg up for a count of 10 and return it to the floor. Do the same with the other leg. Repeat five times with each leg.

49. Exercise Leg raises to strengthen stomach and hip muscles
Lie on your back with your arms at your sides. Lift one leg off the floor. Hold your leg up for a count of 10 and return it to the floor. Do the same with the other leg. Repeat five times with each leg. If that is too difficult, keep one knee bent and the foot flat on the ground while raising the leg.

50. Exercise Partial sit-up to strengthen stomach muscles
Lie on your back with knees bent and feet flat on floor. Slowly raise your head and shoulders off the floor and reach with both hands toward your knees. Count to 10. Repeat five times.

51. Exercise Back leg swing to strengthen hip and back muscles
Stand behind a chair with your hands on the back of the chair. Lift one leg back and up while keeping the knee straight. Return slowly. Raise other leg and return. Repeat five times with each leg.

52. Exercise
Stretch
Stand with your feet slightly apart. Place your hands in the small of your back. Keep your knees straight. Bend backwards at the waist as far as possible and hold the position for one or two seconds.
Give participants the Back Exercise handout and explain it contains exercises to warm up, relieve pain, and exercises for people who sit a lot.