Injury prevention and rapid return to work of injured workers is a major focus of industries throughout the world, predominantly because back injury represents an enormous cost in both money and suffering. The past 20 years have shown a significant decrease in the number of days lost from work due to sickness and injury; minor illnesses were the most common reason given for sickness absence but more days were lost to back, neck and muscle pain than any other cause, accounting for 31 million working days lost in 2013.
This means that reducing injury at work is crucial, for both employees and employers.
How many of us are taught when lifting to “bend the knees and not the back”? This is the conventional method used when teaching us how to lift and avoid low back injury, but the issue is that the worker knows that it’s not always possible to use this method. Objects have to be lifted from the floor, from above, from parts bins, leaning over tables- any number of different positions, and so a conventional lifting technique won’t help you avoid injury in these situations.
The thought process behind a conventional lift is that it reduces physiological load (the amount of stress put on your joints and muscles) and is more energy efficient, however the validity of this depends on a number of different factors, such as the size, weight, and density of the object, coupled with where we are moving it from and to, over which terrain, and how many times we have to repeat the lift. Squatting repeatedly throughout the day is physically tiring, and we know that many workers end up stooping to lift objects as they tire throughout the day.
So if there is no one perfect lift, how do we help avoid injury?
– Remove the stressors that are causing or aggravating the injury
– Enhance the activities that build healthy supportive tissues
As practitioners, we often hear, “I don’t know what I did to make my back hurt”– this is because injuries are often the result of a number of events which accumulate over time, until they reach a level at which the body is unable to cope with any additional demands placed on it and we enter into what is known as a “acute pain episode”. As chiropractors and osteopaths, we want not only to help you recover from this acute pain episode, but also to address the cumulative causes of the injury and provide specific strengthening exercises in order to prevent reoccurrence in the future.
A common way to avoid injury is through ergonomic changes (such as lifting hoists, pulleys, back supports) and modifying your activities, yet despite these, injuries are still prevalent in the workplace, in both those who have physical jobs, and those who are more sedentary. Gagnon (2003) studied “expert lifters” and concluded that their personal body movements, as well as their individual lifting strategies, were key to their avoidance of injury- in fact some evidence exists to suggest that our personal spine movements (how we naturally move our backs) can influence whether or not we will become injured. (Click here to see the article)
Olympic weightlifters often provide the best example of lifting technique, as they have recognised the importance of avoiding lumbar flexion (bending from the lower back) to prevent injury. We therefore need to stop emphasising the importance of stooping or squatting to lift, and instead work on placing the load closer to the body to help reduce forces on our joints, and avoiding full flexion of our lumbar spines when lifting.
This avoidance of full flexion is really the key element in lifting.
So what other lifting techniques could be used?
Here’s three alternatives for the conventional technique and when they could be used.
When to use: Great for picking up light objects out of deep bins/containers or picking up small objects off the floor
- Place one hand on a stable surface next to the object to be lifted- this is to help stabilise your upper body during the lift.
- Keeping your back straight, lean forward, allowing the leg opposite the stabilising hand to swing out straight behind you as you lean down. This will act as a counterbalance to the weight of your body.
- Prepare for the lift: Look forward, and begin to push down on the stable surface with your hand as you lower your leg to the floor. Focus on keeping your spine straight.
Tips: Good for people with knee problems.
When to use: When objects are too large for you to straddle.
- Put one foot in front of the other using a wide stance, standing as close to the load as possible. 2- Keeping your back straight, push your buttocks out and use your hips and thighs to lower yourself on to one knee.
- Grasping the object, prepare for the lift- look up!
- Pushing your buttocks out, extend your bent knee and focus on keeping your spine straight as you progress to an upright position.
Tips: Your centre of gravity is pushed forwards in this lift, pushing your buttocks out helps to compensate for this.
When to use: Good for heavy objects with uneven weight distribution (such as sacks of food)
- Put one foot next to the object, keep your spine straight, push your buttocks out and lower yourself down to the floor, keeping one knee bent up, one knee on the floor.
- Position the object close to the knee on the ground.
- Slide the object from the ground on to the mid-thigh of the knee on the ground.
- Keeping your spine straight, lift the object on to the opposite thigh.
- Palms upwards, put both forearms under the object and hug it into your chest.
- Prepare for the lift: Extend your legs with your back straight, pushing your buttocks out, keeping the load held close to your body.
Tips: Not suitable if you suffer from knee pain.
There are a further lifting techniques that may be helpful, and you can always ask your practitioner for advice if you’re unsure of whether your technique is appropriate or correct.
It’s important to be sensible- ask for help if you think an object is too heavy for you to lift alone, try (where possible) to avoid awkward twists and bends, minimise the distance you have to carry the objects, and consider whether you could use a lifting aid instead. Accidents and injuries can occur almost anywhere at work, through heavy manual labour, awkward postures, pre-existing injuries, and repetitive movements. It is important that both you and your employer take steps to minimise the risk of these injuries occuring.