How to Get and Keep a Healthy Back. Amy Eisenson, B.S. Exercise Physiologist

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2 How to Get and Keep a Healthy Back Amy Eisenson, B.S. Exercise Physiologist

3 Lesson Objectives Statistics of Back Pain Anatomy of the Spine Causes of Back Pain Four Work Factors Core Muscles Connection Tips for a Healthier Back Exercises and Posture Alternative Treatments

4 Statistics $90 Billion per year in healthcare expenses attributed to back pain year olds are the largest sufferers of back pain #1 cause of doctor visits each year that is not illness related.

5 Anatomy of the Spine Cervical Spine Thoracic Spine Lumbar Spine Sacrum and Coccyx The back has 2 main parts: the spine the back muscles

6 Anatomy of the Spine Normal vertebrae Normal Spinal column with ligaments

7 Anatomy of the Spine Normal vertebrae Normal Spinal column with ligaments

8 Anatomy of the Spine

9 Anatomy of the Spine Normal Disc Bulging Disc

10 Anatomy of the Spine Erector spinae- Group of muscles and tendons that runs vertically up the spinal column.

11 Anatomy of the Spine Multifundus- Consists of a number of fleshy and tendinous fasciculi, which fill up the groove on either side of the spinous processes of the vertebrae, from the sacrum to the axis.

12 Symptoms of Back Pain Persistent aching or stiffness from neck to hips Sharp, localized pain in the neck, upper back, or lower back Chronic ache in the middle or lower back, especially after sitting for long periods Pain that radiates from the low back to the buttock, down the thigh and into calf and toes Inability to stand straight without having severe spasms in the lower back

13 Types of Back Pain Muscle spasm Can occur by awkward movement, twisting, or even a sneeze Disk Degeneration With age the disk lose water and become stiffer and lose their cushion Injury due to an accident Can effect the facet joints, tail bone or injure the discs themselves Can lead to chronic pain Congenital abnormalities of the spine

14 Types of Back Pain Sciatica Pain, burning or tingling in the rear of the leg made worse by sitting Can lead to weakness, numbness and difficulty moving the leg or foot Bulging Discs Also called herniated, or ruptured Spinal Degeneration Spondylosis (arthritis between the joints), Spondylolisthesis (vertebra slippage), spinal stenosis (narrowing of the canal)

15 Common Factors for Development of Back Pain Poor Posture Muscular Imbalances Inflexibility Sitting for long periods of time Improper lifting techniques Repetitive use injuries Stress

16 Four Work Related Factors 1. Force- Exerting too much force on your back. If your job is physical in nature, you might face injury with heavy and/or improper lifting. 2. Repetition- The number of times you perform a certain movement. Overly repetitious tasks can lead to muscle fatigue or injury. Poor ergonomics and workstation layout is a primary cause. 3. Posture- Refers to your position when sitting, standing, or performing a task. In general your body can tolerate one position for about 20 minutes before needing to adjust. 4. Stress- Pressures at work and home can increase your stress levels and lead to muscle tension and tightness, which in turn lead to back pain.

17 Treatment of Common Back Pain Most low back pain can be treated with conservative therapy including: Ice and Heat- 20 minute cycles Anti-Inflammatory if recommended by your MD. Exercise- Resuming exercise as soon as possible has best results Stretching- Moving a joint through its full ROM Strengthening- All core muscles through a variety of modalities Keep your weight in check- extra weight increases the stress on the joints

18 Core Connection The core is traditionally assumed to originate most full-body functional movement, including most sports. The core is the body s center of gravity In addition, the core determines to a large part a person's posture. The core muscles align the spine, ribs, and pelvis of a person to resist a specific force, whether static or dynamic.

19 Muscles of the Core Muscles of the Core Abdominals Rectus Abdominis assists with posture and respiration Internal and External Obliques- torsion of the abdominal cavity, twisting, and exhalation Transverse Abdominis core stabilizer, posture, align spine, chest and pelvis stability Pyramidalis

20 Muscles of the Core Pelvic Floor Erector Spinae Multifundus Latissimus Dorsi Glutieus Maximus Trapezius Hip flexors

21 Tips for a Healthier Back Strengthen your Core #1 way of reducing chronic back pain Pay attention to posture Lift properly Adjust your workspace STRETCH Wear comfortable-low heeled shoes Control body weight Quit smoking (reduces blood flow to the spine)

22 Exercises to Strengthen the Back Should Include strength, endurance, control and power Utilize all the muscles of the core. Use a full range of motion Use resistance- body weight or other Use a variety of body positions Examples: Yoga, Pilates, Tai Chi, functional training

23 Posture

24 Posture Standing Posture- Don t slouch or stand swaybacked. These can lead to muscle fatigue and injury

25 Posture Standing Posture- Don t slouch or stand swaybacked. These can lead to muscle fatigue and injury If you stand for long periods of time, occasionally rest one floor on a stool or small box. Hold reading material at eye level. Don t bend forward to do deskwork

26 Posture

27 Sitting Posture Posture

28 Sitting Posture Posture Choose a chair that supports your back or use a towel or pillow if needed Feet should be flat on the floor or on a stool Remove bulky objects like your wallet from your back pockets Keep your chair on a flat surface. Make sure a floor mat in under your chair Keep your shoulders back when sitting and don t wear them as earrings

29 Workstation Setup 1. Support the S-curve in your back with a properly adjusted chair 2. Height of the chair should have elbows at a 90 angle and your feet flat on the floor or on a stool 2 1

30 Workstation Setup 3. Position your keyboard and mouse a. 4-6 inches from the edge of the desk b. Wrist should be kept straight while typing c. Mouse should be same distance as keyboard d. No twisting in the spine to reach keyboard or mouse 4. Screen should be level with the height of your eyes and the 3b distance to the tips 3a of your fingers 4 5. Take frequent breaks 3d 3c

31 Proper Lifting

32 Alternative Treatments Acupuncture Chiropractics Biofeedback Interventional therapy TENS (transcutaneous electrical nerve stimulation) Ultrasound Surgery

33 Oh my aching Back pain is the # 1 complaint for office workers There are easy activities you can do to relieve the pain. Strengthening and Stretching are two great places to start.

34 Questions

35 References Van Dusen, Allison, How to Prevent Back Pain at Work; Forbes, American Academy of Orthopedic Surgeons, Exercise Guide The Patient Education Institute. How to Prevent Back Pain; Mayo Clinic. Back Pain at Work: Preventing Aches and Pains; National Institute of Neurological Disorders and Stroke. Low Back Pain Fact Sheet: