The life of a tradie is one that is particularly physical and involves a lot of repeated bending, lifting and squatting. I have met a few older tradies in the clinic who have come in with lower back, neck and shoulder problems. I have also met a few who have changed jobs because of the physical toll their trade has taken on their bodies.

People are living and working longer than ever before, which is why it’s so important to look after your body.

Here are SIX STRATEGIES FOR TRADIES that can help them stay the course a bit longer.

1. Take regular breaks from prolonged positions such as crouching and bending forward. Try alternating between tasks more regularly.
2. Use these breaks to stand up, walk around, and do a few back extensions to stretch out your lower and mid back, and add a few neck stretches. This is particularly important for electricians and painters as their necks can experience pain from prolonged periods of looking up with ceiling work.
3. Try to avoid repeated bending in the same way. You could try changing the way you pick something up by squatting and bending at the hips and knees or lunging forward to pick up an object. Mixing it up is the important thing.
4. Stretch out the upper and mid back. When this area becomes stiff through a lot of lifting, it affects the lower back, neck and shoulders, making it far more likely to injure one of these areas.
5. Use the correct lifting technique, which keeps your lower back straight so you can bend at the hips and squat with your knees.
6. Make sure you brace before you lift. Brace the abdomen and engage the pelvic floor muscles before you lift a heavy object.

These strategies, along with THREE SIMPLE STRETCHES that can be done throughout the workday, will help.

Here are a few you can try:

BACK EXTENSIONS
1. Stand with your legs at hip width apart and straight.
2. Place your hands on your hips.
3. Lean your body backwards, trying to arch in the lower back as much as you can, lifting your chest up towards the ceiling.
4. Try to avoid allowing your hips to swing forwards too far.
5. Hold this position before returning to the start position.

SEATED TRUNK ROTATION
1. Sit upright in a chair.
2. Rotate your body round to one side, using your arms on the back of the chair to pull yourself round further.
3. This should feel like a stretch through the torso.

COMBO STRETCH
1. Step out to the side and bend this leg, feeling a stretch through the inner thigh of the extended leg.
2. Next, turn into a prisoner stretch, dropping the back knee down to the floor and pushing your hips forward with your hands behind the head as you lean into the bent leg.
3. You will feel the stretch in the front of the back hip.
4. Finally, go into a pigeon stretch, tucking the front leg underneath you, and sitting down to stretch through the buttock muscles.

Hope this helps, Deb

Farmers are a group of people that often present to my clinic with lower back pain. Their job involves a huge variation in the physical tasks they do. This ranges from repeated and heavy lifting, bending, prolonged sitting on a tractor twisting repeatedly in the seat, and activities like driving a quad bike or a horse (with the occasional fall).

Often farmers will come in with chronic lower back pain. Often, it’s pain that has been on and off for a number of years but mostly fixes itself after a few days. Then comes the time that it doesn’t get better – and that’s when they usually seek help.

Repeated lifting, heavy lifting, prolonged sitting or twisting create the perfect mix for predisposing factors that are most likely to cause disc lower back problems. Typically, farmers often don’t look after themselves with regular stretching; nor do they see a doctor or physio early enough to sort out the problem before it gets worse.

However, back care for a farmer – or anyone really – is absolutely critical.  A healthy back is key to functioning well so you can keep doing what you want and need to do. Back pain can be debilitating and stop you from doing what needs to be done. But it is also is preventable and manageable.

Below are just a few strategies that have shown to help reduce lower back pain and can be particularly useful for farmers:

  1. Use the correct lifting technique:
    Bending from the hips and knees rather than the lower back is critical in protecting the discs, joints and the soft tissue around the lower back (lumbar spine). The muscles in the legs are designed to take larger loads while the lower back muscles which are much smaller are not. So, try to bend from the hips and knees.
  2. Plan the lift:
    A small amount of time spent planning (even 10 seconds) can help reduce the chance of injury – getting the load closer to the body or removing objects in the path of the lift can be part of that planning.
  1. Keep your core strong:
    A strong group of core muscles combined with correct bracing will help protect the lower back with repeated lifting or when lifting heavy objects. Brace the abdomen and engage the pelvic floor muscles before you lift a heavy object.
  2. Correct sitting position:
    Sit upright on the tractor or quad bike – try not to slump. Invest in a supportive seat that helps to keep the lower back supported.
  3. Stretch key muscle groups including:
  • Hamstring – this is the muscle group at the back of each thigh and will get very tight and short with long periods of sitting on a tractor, driving, office chair or horse
  • Hip adductors – these are the muscles on the inside of the thigh and will become very tight with horse riding, or long periods of sitting.

These strategies alongside a few simple daily stretches will help.

Here are a few you can try:

  • Hamstring stretches:
    • Place the foot of your affected leg onto a chair or step.
    • Keep your knee straight and foot pointing ahead.
    • Keeping your back straight, tip forwards from your hips, pushing your buttocks out behind you until you feel a stretch down the back of your thigh.
    • Hold this position.
  • Piriformis stretches seated:
    • Start in a seated position.
    • Cross the symptomatic leg your ankle is resting on, to the opposite knee.
    • Apply gentle pressure to the knee as you lean forward, increasing the depth of the stretch.
    • Hold this position, you should feel a comfortable tension with no pain.
  • Back extensions
    • Stand with your legs at hip width apart and straight.
    • Place your hands on your hips.
    • Lean your body backwards, trying to arch in the lower back as much as you can, lifting your chest up towards the ceiling.
    • Try to avoid allowing your hips to swing forwards too far.
    • Hold this position before returning to the start position.

 

Many of our farmers are doing it tough at the moment with so little rain for their crops, paddocks and stock. Regardless, their work still goes on so please share this post to a farmer you know.

Deb

 

 

 

 

Last week we looked at the basics of what can cause back pain including what activities can lead to back pain driven by disc problems .

We often adopt poor postures for greater amounts of time than we used to, mainly due to our use of hi-tech devices including computers and smart phones. Sitting frequently in bad positions puts an unnatural load on the lumbar discs, the building blocks of our spine in our lower back. Problems with lumbar discs can be painful and debilitating but are surprisingly simple to avoid, and manage.

We know that loss of the natural curves of the spine puts excess pressure on the discs. Loss of the natural curves happens when we are slumped forward in sitting for instance at the computer. This position involves loss of the neck and lower back curves and if this goes on for hours – can lead to overload on the discs resulting in pain.

However, our spine and the discs can withstand considerable loads in a neutral position. So maintaining the natural curves of the spine whenever you are engaging in any activity, including sitting at a computer desk will help avoid that onset of pain in the back.

In the office, there are 2 very important things to remember in order to protect your lumbar discs and avoid lower back pain:

Maintain the natural inward curve of the lumbar area (lower back). If you reduce the time you spend slumped in your chair by even 10 percent percent each day, you will reduce the likelihood of lower back pain and will eventually find that the healthier positions will help to form new habits which take less effort over time.

Move around the office as much as possible and avoid ‘prolonged’ positions in 1 place. We know that by moving around adopting different positions and using the major muscle groups in you arms and legs, you not only help to unload the discs in the spine but you also you reduce the perception of pain you may have. Movement and exercise are effective tools to help lessen the perception of aches and pains. So use any excuse to move around the office. –

So here are a few tips to help you look after your back in the office.

Make it easy to maintain the natural inner curve of your lower back:

  1. Support your device so that you are looking ahead not down.
  2. Adjust your back rest to support your lower back and sit with your bottom right at the back of the chair.
  3. Add a rolled up towel or lumbar roll across your lower back if you need extra back support.
  4. Move around as much as possible. Try and get up from your chair for 10 minutes every hour
  5. Set a timer to help keep a track of the time.
  6. Take phone calls while standing and walk around the office.
  7. Put the rubbish bin outside the door.
  8. Walk in your lunch break.
  9. Stand up for meetings and morning tea.
  10. walk to deliver a message to another colleague.
  11. Invest in a sit to stand desk.

Here are a few exercises you can do to help:

Thoracic extensions in sitting

  1. Sit up straight on a chair.
  2. Place your hands behind your head and extend your upper back over the top of the chair.
  3. Hold this position.

Back Extension in Standing

  1. Stand with your legs at hip width apart and straight.
  2. Place your hands on your hips.
  3. Lean your body backwards, trying to arch in the lower back as much as you can, lifting your chest up towards the ceiling.
  4. Try to avoid allowing your hips to swing forwards too far.
  5. Hold this position before returning to the start position.

Try 5–10 repetitions 3–4 times a day.

Hope this helps and have a great week

Deb

Elderly woman bending over to pick up bags

Commonly someone with back pain will just put up with the pain, not understanding what the problem is, and not knowing what they can do to manage it.

Over the next few weeks I will be looking at back care, each week focusing on different groups of people involved with specific work or styles of living. I will discuss back care for office workers, back care for the over 50s, farmers, the busy person, and so on. Firstly however, it is important to look at back care in general, the anatomy of the spine and what and why things go wrong. This will give you a good understanding how it all works, so you can understand why you may get back pain when doing or not doing certain activities.

The first thing to understand is the spine and its anatomy. The spine is made up of blocks of bone stacked one on the other forming a column. These blocks are the vertebrae and are classified into 4 groups – the cervical (neck), the thoracic (mid-back), the lumbar (lower back) and the sacrum. Sandwiched between each vertebra is a disc. The discs are soft tissue and act as the suspension pads of the spine absorbing the impact and pressures experienced by our bodies as we move around from day to day. Ultimately the aim of the vertebra and discs is to protect the brain and spinal cord which distributes nerves to the limbs, thorax and head via the vertebral column. The discs are subject to different pressures depending on what we are doing. Essentially, the discs experience the least amount of pressure when we are lying down – simply because we are not upright with the weight of the body bearing down of the discs. They also are happiest when we maintain the ‘natural curves’ of our spine – the cervical and lumbar spine (neck and lower back) have an inward curve and the thoracic or mid- back curves outwards. When we bend forward the lumbar spine changes its position and the pressure within each of the lumbar disc increases. This is a normal phenomenon and our bodies are designed to do this.

So what goes wrong?

Problems occur when the discs undergo pressure for sustained and prolonged periods of time. The integrity of the disc tissue can wear down over time and the disc can bulge putting pressure on the structures around the vertebrae and disc – in particular the nerves and facet joints. The disc experiences micro tears in the disc wall which over time build to become a bulge as the fluid inside the disc seeps through the small tears to press on the nerves. This can translate into pain either in the back or as referred pain elsewhere in the leg or arm as the disc bulge presses on to a nerve root that travels down the limb. This disc bulge can also occur suddenly with a rapid and unexpected increase in pressure that will pop the disc wall. This is often the result of lifting a very heavy load or repeated bending forward with the disc giving way suddenly.

Essentially there are 3 main ways that disc problems lead to back pain including:

  1. Sustained and prolonged pressure on the discs. An activity that I commonly see that can cause this problem is slumped forward sitting at the computer or driving. This position involves loss of the neck and lower back curves and if this goes on for hours – can lead to overload on the discs resulting in pain
  2. Repeated forward bending – such as continually picking things up off the ground
  3. Picking up heavy objects with a bent lower back

Back pain from disc issues are often recurring. Once you have experienced this sort of back pain you are susceptible to recurrent episodes. However, this can be managed with appropriate rehabilitation including education and strengthening.

This sets the scene for the next few weeks as we talk about back care. There are other structures that cause back pain apart from the discs (which I will go into over the coming weeks), however the main driver of back pain tends to be the vertebral discs.

When I have someone come to see me with back pain, I will often ask them to count how many times they bend forward for one whole day. This includes picking things up off the ground such as shoes, a child or two, the family pet, dirty clothes, unloading the dishwasher, milk from the fridge etc. This is worth trying – you may be surprised how often you repeatedly bend forward and inadvertently load up the discs in the lower back.

In my next blog I will look at back care for office workers.

Have a great day, Deb

Staying strong as you age is critical to helping you stay in the work force and allow you to keep doing what you want and need to do. It is important to focus on exercise programs that are likely to enhance performance of daily activities such as getting out of a chair and climbing stairs rather than seated exercises which are often seen as a ‘safe’ option. Exercises focusing on daily activities are also more likely to improve balance and help prevent falls. It is also important to consider exercises that can be incorporated into your everyday lifestyle, so you remember to do them.

The following 2 exercises are central to many programs a physiotherapist or exercise physiologist may prescribe to help someone stay strong:

1. Sit to stand. This is probably the most important exercise anyone can do to help maintain their independence. It helps strengthen the lower limbs and abdominals, and we know that once you lose the ability to get out of a chair by yourself then you lose your independence.

– Start in a seated position.
– Bring your bottom to the edge of the chair with your feet underneath you.
– Try to do this exercise without using your hands.
– Stand up until you are completely upright and then gradually sit back down.
– Control this movement and then repeat.
– If you do need to use your hands, try to limit their use as much as you comfortably can.

2. Step ups. This exercise helps keep the legs strong as well as helps balance.

– Stand in front of a stair or step.
– Place one foot up onto the step and then follow with the other foot.
– Step back down to the start position using the same leading leg.
– Make sure your knee travels forwards over your toes during this exercise. Repeat, starting with the other leg.

My key piece of advice to help you stick to your exercise program is to be realistic. Set small goals. In the beginning, outline achievable goals – ones that you can keep up with. The aim is to establish an exercise habit by setting up a schedule you will stick to. So, set the bar low to begin with, then build on it once you have established a habit of it.

Hope this helps. Have a great day! Deb

Picture of woman hunched over laptop

Laptop computers have helped make our working and study life far more flexible, however evidence that suggests that spending long periods of time using a laptop can lead to neck pain from looking down at the screen. Laptop use can also affect other areas of the body including:

• Our wrists and hands from typing
• Our lower back from being flexed into a chair or on the bed
• Our mid back can stiffen up from lack of movement
• Our hips can get tight from being at a right angle all day when seated

So what can you do about it? There is evidence that demonstrates that specific strengthening of the neck and other areas of the body has a significant impact on reducing neck and back pain in office workers.

Here are a few strategies that have shown to help reduce the pain experienced from use of the laptop:

  • Good general fitness levels in office workers has shown to decrease the development of neck and back pain. Good fitness levels improve the integrity and health of muscles and can allow you to be at the laptop for longer periods before experiencing pain
  • A good ergonomic desk set up helps to manage and prevent common computer related problems
  • Taking regular breaks and alternating between sitting and standing is equally important
  • These strategies along with a few simple stretches that can be done throughout the workday will help.

Here are a few you can try:

1. Wrist and arm stretch

  • Extend your affected arm straight out in front of you with your palm face down, and drop your hand towards the floor
  • With your other hand, apply a gentle pressure to the back of your wrist and hold.
    You should feel this stretch down the back of your forearm

2. Finger stretch

  • Sitting in a chair, take your arm out in front of you
  • With your opposite hand, pull back four fingers
  • Hold this position
  • Turn your hand over and pull down on the fingers
  • Pull down and back on the fingers again, leaving the thumb out of the stretch
  • Keep your elbow straight

3. Upper back stretch in a chair

  • Start in a seated position, with your feet on the floor.
  • Place a rolled up towel between the backrest and your upper spine.
  • Place your hands on your neck and your fingers.
  • Point your elbows to the front. From this position, lean backwards over the towel.
  • Hold this position for the required time.
  • After this, you can move the towel upwards or downwards.

4. Lower back and hip stretch in standing

  • Stand with your legs at hip width apart and straight.
  • Place your hands on your hips. Lean your body backwards, trying to arch in the lower back as much as
  • you can, lifting your chest up towards the ceiling.
  • Try to avoid allowing your hips to swing forwards too far.
  • Hold this position before returning to the start position

Hope this helps and have a great weekend, Deb

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