Injury Prevention for the Back and Neck www.csmr.org
We have created this brochure to provide you with information regarding: Common Causes of Back and Neck Injuries and Pain Tips for Avoiding Neck and Back Injuries Proper Sitting, Standing, and Sleeping Postures Suggestions for an Ergonomically Correct Workstation Proper Lifting Techniques General Core Concepts Consult with your physician if you have persistent low back pain, neck pain, or pain in the upper extremities so that early diagnosis can be made. Should your doctor determine that you would benefi t from therapy services, please contact our offi ce to set up an appointment.
So, what do we mean by core stablization? These therapeutic exercises focus on strengthening the abdominal muscles, known as the core muscles, which stabilize your spine as the rest of the body is in motion. We treat a variety of diagnoses related to back and neck pain, including Herniated disc Muscle strain and spasm Post-op cases (i.e. spinal fusion, laminectomy) Spondylosis deformans Facet joint dysfunction Joint instability Arthritic conditions Pregnancy-related low back pain Poor posture Vertebral fracture Sciatica Spondylolisthesis Spinal stenosis Sacroiliac joint pain...from Arthritic conditions......to Pregnancy-related ligamentous laxity...
Your neck and back region are vulnerable to a variety of stresses throughout your daily routine and work day. Bad posture and poor body mechanics can lead to malalignment and weakness in your spine, predisposing you to injury to these areas. A Physical Therapist or Occupational Therapist can teach you new habits and safety awareness with daily tasks to minimize the risk of injury and further pain. Common Causes of Back and Neck Injuries and Pain Improper Lifting Techniques Poor Posture Soft Tissue Injury Traumatic Injury Fatigue and Lack of Rest Muscle Weakness Bad Sleeping Positions Poor Fitness/Flexibility Smoking Poor Diet Obesity Emotional Stress
Tips for Avoiding Neck and Back Injury Keep your neck in a neutral position when possible- don t bend or hunch your neck forward for prolonged periods. Use upright posture in sitting and standing- keep your head in neutral and your shoulders rolled back. Always use correct lifting and moving techniques (see section on Proper Lifting Techniques). Maintain proper body weight to avoid extra stress on back muscles. Proper Sitting Postures and Workstation Suggestions When seated, keep your back and pelvis aligned properly with a lumbar roll placed at the small of your back. Keep your knees slightly lower than your hips, rest your arms if possible (i.e. on an armrest), and place one foot slightly in front of the other on the floor. When working at a computer, adjust the monitor so that the top of the screen is at eye level. Use a document holder that places your work at the same level as the screen. Sit close enough to your desk where you do not have to constantly reach for objects. Try not to sit in one position for a long time- get up and move around, change positions, and make sure you keep upright posture while in a seated or standing position. Pay attention to the floor on which you walk and stand at work. If it is a concrete floor, wear shoes with good support and cushioning. Standing on a rubber mat can ease the pressure on your low back and encourage more favorable ergonomic conditions.
How Can Physical Therapy Help? Our program not only treats the spine, but also extends stability, strength, and pain management to peripheral areas of the body (i.e. the extremities). Teaching the patient to use core stability and training helps the individual refine his/her posture, manage pain and physiological tension, and improve performance of sports, work duties, or everyday routine activities. How do we achieve this with our patients? The therapist teaches the patient how to achieve positions that minimize unwanted muscle activity which is often responsible for inefficient movement patterns and early fatigue, leading to injury. The patient also re-learns movement patterns to enhance general health. Thus, faulty movement patterns can be corrected and carried over to specific skills, whether they are sport-specific for the elite athlete or taskspecific for the post-partum female.
General Core Concepts The purpose of abdominal bracing is to gain awareness of the contraction of your abdominal muscles while you are maintaining a neutral spine. Strong abdominal muscles help to stabilize your low back while the rest of your body is in motion. Furthermore, our exercises address the strengthening needs of the intrinsic muscles of the spine, activating, awakening, and training them to protect the spine and provide stability during dynamic movements. Abdominal Bracing Exercises Finding Your Neutral Spine Finding your neutral spine position: Flatten your back by tightening your stomach muscles and buttocks. Keep your abdominal muscles tightened, paying particular attention to your lower abdomen. Hold this tightening for 5-10 seconds.* Repeat 30 times. Do 2-3 sessions per day. *Note: Do not hold your breath when you tighten your stomach muscles. Blow out as you tighten; breathe in as you release.
Gentle Stretching Routine for the Low Back 1. Lower Lumbar Rotation Stretch Slowly rock your knees side to side in a small and pain free range of motion. Allow your low back to rotate slightly. Do 10 repetitions to each side. Do 2 sessions a day. 2. Supine Hamstring Stretch Lying on your back and supporting your lower thigh just above your knee, slowly straighten your leg until a stretch is felt at the back of your thigh. Keep opposite knee bent. Hold 30-60 seconds. Do 3 repetitions with each leg. Do 2 sessions a day. Use a towel behind leg being stretched if necessary. 3. Supine Piriformis Stretch Place outside of ankle on opposite knee. Pull unelevated thigh toward chest. Hold 30-60 seconds. Do 3 repetitions with each leg. Do 2 sessions a day. Use a towel behind knee being pulled if necessary. 4. Single Knee to Chest Stretch Pull one knee toward chest until a comfortable stretch is felt in the low back and buttocks. Repeat with opposite leg. Hold 30-60 seconds. Do 3 repetitions with each leg. Do 2 sessions a day.
Proper Standing Posture What does it mean to have good posture? When you maintain the natural curve of your spine when standing, this will allow you to have good posture. You want to keep the S curve in your spine that you see when you look at yourself from the side. Here are some other ways to achieve good posture. Keep your head aligned directly over your shoulders and your shoulders aligned over your pelvis. Poor Posture Roll your shoulders back, tighten your abdominal muscles, and tuck in your bottom. Try to place your feet slightly apart with one foot in front of the other and knees slightly bent. Use a railing or box to prop one foot up while standing to help take pressure off of your back. Remember to change positions and change Good Posture Proper Sleeping Positions Does your pillow cause your neck to be at an angle while you are asleep? Your pillow should allow your head to rest in a neutral position with your spine. Use a feather or down pillow as they conform easily to the curvature of your neck. Place a pillow under your knees if you sleep on your back or between your knees if you sleep on your side. Avoid sleeping on your stomach as this position places pressure on the neck and low back.
Proper Lifting Techniques The neck and back are both vulnerable to injury when improper lifting techniques are used. Following these tips can help reduce your chances of injury to the spine, especially if your work or daily routine requires repetitive lifting. Size up the load before you lift the object- make sure you are capable of lifting an object of its size and weight. Stand up straight and stand close to the object to be lifted. Position your feet shoulder-width apart, with one foot slightly ahead of the other. Bend at your hips and knees and keep your back straight, in a neutral position, with your head and shoulders up. Firmly grasp the object close to your body and then rise up using your legs- DO NOT lift with your back! Keep the object close to your body as you rise up and as you carry it. When releasing the object, keep it close to your body, bend your knees,