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Monday, January 21, 2013

Preventing Back Injuries.


Preventing Back Injuries


Dr. Alan Himmel

Other than car accident care, I see my share of patients who simply "pulled their back out."  The mechanism behind this type of injury is different than a whiplash, or a hyper-flexion / hyper-extension injury, where the persons body is quickly flung in the direction of the impact (Newton's Law) and the muscles and tissues are quickly stretched beyond their limits.  The result of course is pain, inflammation, disc injury, etc.

But a "pulled back" is different.  Generally a person calls me up and says that their back is killing them.  They cannot stand up straight and cant even get out bed, in many cases.  They tell me that they were just bending over to put on their shoes, or they simply turned to reach for something, and the pain started.  Very often they describe it like a rubber band that all of a sudden lost its tension, and just gave out.  At that moment, there was severe pain and the inability to move.  The medical treatments for this type of injury are anti-inflammatory medications, muscle relaxers, and pain meds.



But, the truth is that all the symptom relief remedies in the world will not offer anything in the way of prevention.  The deal with these patients that I quickly find out is that its not the first time the person has had this type of injury.  What I have found actually is that its a recurrent type injury and the patient has done this before.  One interesting thing that I have observed with these patients is that each time they pull their back out, its worse than the time before, or it happened much easier than the time before.  This is because the injured tissues are damaged and are weaker with each successive injury.


                                Watch Peter Griffin as he explains the "improper way" of lifting.


There is something that you can do however, which works pretty well to reduce the frequency of these injuries, and maybe prevent them from happening altogether.  It requires a little work on your behalf, but the alternative is continued back injuries.

This is what it requires:

First, it requires knowing how to properly lift and bend.  This alone can prevent most of your injuries from happening in the first place.

1. Never bend from your back to lift.
2. Always bend at your knees to lift.
3. Never reach forward to lift anything.

(Number three requires an explanation.)  Never reach forward to lift anything. Step up to the object you want to lift, and carry it close to your body.  Its all about leverage.  A one pound object held out in front of you too far is like lifting 10 times its actual weight.  The next time you pick up a hammer, you will see that its easier to swing if you choke up on the grip closer to the head and claw.  And, conversely, if you hold it at the very and of the handle you will see that it is much more work to swing that hammer.  Just this little fact right here, will help prevent back injuries.



Next, in order to prevent injuries is strengthening your back.  This can be done by doing a few specific exercises.  You need to work on stability and strengthening.  Its a fact that these low back injuries frequently occur because of an inherent weakness in the muscles that support your body.  Again, its all about leverage.  You put a lot of stress on the low back muscles because from a leverage standpoint, the low back is very far away from the end of your body, which is your torso and arms and head. Let me give you another analogy:  Its like holding that hammer on the end of the handle.  The injury happens when the handle breaks, or the muscles in the low back just "give out."

So, here are a few excersises that really help.

1.  The plank.


2.  Abdominal crunches.



3.  Weight loss.



4.  Walking, biking, running, and not sitting.  (all require muscles of balance.)




One of my favorite exercises involve doing the eliptical excercise machine, and doing it hands free.  In other words, do not grab the two handles that go up and back.  You will find that you have a difficult time at first balancing, but it gets better over time.  When you let go of the handles, your body is forced to work the intrinsic muscles of balance and posture.  These are the muscles that you have that you have no control over.  But I assure you that if you are standing on your feet right now, they are there and are keeping you upright without you even knowing it.