Theory

Anatomy

The spine is one of the main components of the skeleton.

It is made up of 33 vertebrae – 7 cervical, 12 thoracic, 5 lumbar, the rest forming the sacrum and coccyx. Its functions are to provide central support for the body, attachments for muscles and ligaments, allow movement and provide protection for the spinal cord.

Between the vertebrae are the discs, these act as spacers between the bones of the spine, as shock absorbers in the spine, aid smooth movement, and try to maintain the weight bearing pressures through the spine as evenly as possible.

The most vulnerable areas of the spine are the lumbar (lower back), and the cervical (neck) regions. They are the most mobile, and susceptible to injury. The lower back is also the main weight bearing part of the spine.

The spine is supported by muscles and ligaments. The trunk muscles are postural muscles and are not as strong as the muscles found in the arms and legs. There are many causes of pain and discomfort, but can be broadly divided into 2 groups – problems with the bony structures of the spine, and problems with the soft tissues the muscles, ligaments and the discs.

Apart from some specific medical conditions, the majority of musculo-skeletal problems come about as a result of mechanical loading of the spine – the 2 most common culprits are lifting of loads and poor working postures.

Posture

Correct posture is essential for everyone, it brings with it many advantages, particularly to the spine because it:

There are 33 vertebrae in the human spine
Re-aligns the spine, and keeps the weight-bearing stresses through the bodies of the vertebrae and the intervertebral discs as even as possible.
Causes less weight-bearing stresses on the soft tissues of the spine, the muscles, and ligaments, which are not designed to be over-stretched.
Maintains a good head position, particularly important if the person works in a sitting position, as there is less stress on the neck and upper limbs.

Good posture encourages a healthy spine and goes some way to reducing the risk of injury to the spine.

Poor posture, standing or sitting in a slumped position, results in:

Mechanical damage to the soft tissues of the spine – the discs, muscles, and ligaments.
Increasing fatigue in these soft tissues.
Herniation of the discs – a “slipped disc”.
Increasing neck and low back pain.

In recent years research has shown that there is a link between poor working postures and cumulative back problems.

Good posture can be attained by:

Making the effort to sit and stand correctly.
Regularly changing position – standing, walking, and stretching the spine.
Working at the correct height for the particular task to be carried out.
Adjusting seating, if available, for the individual.
Wearing appropriate footwear.

Lifting

As the majority of injuries related to the moving of objects affect the spine, changes to the way we lift things are essential to reduce injuries.

This entails

Risk Assessments to be carried out, to identify problems and promote safe working.
Assessing each situation as it arises.
Using appropriate equipment that is available to help you.
Altering how you manually lift anything – instead of the smaller, weaker muscles in the back, use the longer and stronger muscles in the legs and arms.

At all times, good posture and handling techniques will help to protect the spine from musculoskeletal injury.

Moving Loads

A load is a discrete moveable object – a thing (inanimate), a person (animate), or an animal (animate).

It takes too long.
It is perceived as being more difficult, to bend the knees rather than bend the back.
We have become lazy and have developed bad lifting habits.
We do not perceive the risks in lifting lighter and smaller objects compared to larger, heavier objects i.e. boxes of files compared to tables and furniture.

As many, if not more, back problems result from cumulative stress, so repeated lifting of lighter, smaller objects incorrectly is as bad for you as moving a single heavier or larger object.

Principles of Safer Handling

Wear appropriate clothing and footwear.
Never manually handle, unless you have no other option. Always ask – “do I need to lift this?”
Assess the object to be moved before commencing a maneuver.
Always select the appropriate maneuver and equipment for the task at hand.
Make the load smaller/lighter if possible.
Identify a team leader, to give instructions and explanations to everyone.
If it is a person to be moved, explain the procedure to them.
Prepare the area, clear away objects, and try to create space.
Apply the brakes on any equipment if necessary.
Make a stable base with your legs and feet, feet apart for balance, and knees bent so you can make use of the power in your leg muscles.
Keep the object or person as close to you as possible.
Make sure of a good hand grip.
Avoid static stooping i.e. legs straight, spine bent forwards, arms stretched, as much as possible.
Know your limit or capacity, if you cannot move something, ask for help.
Give clear, precise instructions.
Raise the head on movement, this keeps the spine in good alignment and gives you good visibility.
Do not twist your spine, this generates increased weight-bearing forces within the discs and soft tissues of your lower spine.

All of these principles reinforce the need to assess the situation, keep your balance and make use of the power in the stronger leg muscles rather than the weaker back muscles.

Good posture is encouraged, as this also reduces the strain on the soft tissues in the back.

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