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Be Good to Your Back: An Illustrated Guide

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Most back problems are not caused by a

single injury, but rather a combination of

factors over a period of months or years. Proper

body mechanics should play an important role in

our everyday life activities in order to prevent

back pain or back injuries. This monograph offers

basic explanation and animated demonstrations of

proper body mechanics during everyday life

activities, i.e. bathing, dressing, transfers,

home management and child care.

Common causes

of back strain/injury:

  • Bad posture
  • Incorrect movement

    during daily activities

  • Poor pacing of

    daily activities

  • Decreased


  • Poor general

    physical fitness

Basic Spinal Anatomy

Spine The Spine is made up of 24 bones (the vertebrae).

The vertebrae are aligned in three natural curves

forming an "S" shape. Each curve is

labeled by the region it is located.


Neck – cervical curve (lordosis)


Mid Back – thoracic curve (kyphosis)



Back – lumbar curve (lordosis)

Muscle ..surrounds

the spine to support the back in this balanced

position. But the abdominal muscles are extremely

important as well.

Intervertebral Discs are located between each vertebrae,

discs act as shock absorbers or cushions and

allow joints to move smoothly. Discs are

generally labeled by the vertebrae they are

between, i.e. the "L1-L2 disc" is

located between the first and second lumbar


Spinal nerves connect

the central nervous system (the spinal cord) to

the peripheral nervous system (nerves going to

muscle, internal organs, skin). They exit from

round openings ("foramena") between


Ligaments are

strong bands of tissue which are much less

stretchable than muscle or skin. Ligaments

surround the bony vertebrae to provide support.

The ligament in the front of the spine is wide

and strong. The ligaments located in the back of

the spine are relatively thin and narrow.

Key Elements of Body Mechanics

The following pictures

illustrate the key principles of body mechanics. They

form the foundation for the proper way all activities

should be performed to prevent back injury.

Center of Gravity

Center of gravity

is the point of balance between the upper and

lower body. For women, this point is

approximately at the belly button and for men, 1

inch above the belly button. The difference is to

accommodate for anatomical structure with men

generally having wider shoulders and women wider hips. Although one can not actually

"see" center of gravity, we can

illustrate where it is and how it works.

To prevent back injuries while doing

activities, center of gravity should remain close to

one’s body (see figures 2 -4 above). It is very important

to bend knees and lower oneself with a straight back when

lifting. Lifting this way takes strain off of back

muscles and enables the stronger leg muscles and arms to

do the work. If one should attempt to lift something by

bending forward over it, the center of gravity shifts

forward and back muscles have to work very hard to

prevent one from falling forward (figure 1). This can

place tremendous strain on the back.

Base of support is that which supports

an individual’s center of gravity. When standing, base of

support equals the feet shoulder distance apart. This

stance is important when doing lifting activities because

it gives one a better "base" for balancing and

avoids using the smaller muscles of the back to keep one

upright and prevent falling.

Additional Back-saving Tips:

  • Avoid twisting at the


  • Always face what you

    are lifting or working with;

  • When moving objects,

    ‘lift only what you can’t pull and pull only what

    you can’t push’

  • Functional Application During Common Daily Tasks

    The following

    illustrations show examples of sitting, bending, and

    reaching which contribute to back strain and some

    preventive alternatives.

    Poor MechanicsNotesGood Mechanics
    Without support



    • Take breaks from sitting

      every 20 to 30 minutes.

    • Sit in a chair that

      provides support to your low back.

    • A small pillow (or

      "lumbar cushion") can be used

      to provide proper support to your lower



    Lumbar cushion
    Wrong way to make bed


    making a bed…

    • Kneeling to do a bed

      corner is much better than bending

      forward while making the bed.

    • Do not try to reach across

      the bed to do an opposite corner. Walk

      around to complete the far side.

    • If the bed is in a tight

      space, so that one normally needs to move

      it during linen changes, consider getting

      some form of low-profile ‘caster’ like

      device to put under the bed feet (if

      design allows).


    Right way to do bed corner

    More "Back

    Saving" Strategies:



    lift" can be used to load/unload a washer.

    Squatting is better than bending from the waist

    when unloading a front-loading washer or dryer.

    Washer/Dryer Use
    Using hand support Place one foot on lip

    of open cabinet under sink to effectively broaden

    your "base of support". Place the

    opposite hand on counter top for support to keep

    back straight.


    standing at a counter for extended periods of

    time, place a foot on the bottom shelf of the

    open cabinet below . This reinforces a good

    posture while washing dishes.

    Good standing position
    Golfer's stance in kitchen


    lift" can be used to load the dishwasher.

    Kneeling on one knee can also be used to load and

    unload dishwasher.


    • Bend at your hips and

      knees, not your waist.

    • Keep the shovel close to

      your body.

    • Lift the load using your

      legs, not your back.


    Index to Back Saving Animations

    The following section

    contains links to animations which demonstrate proper

    forms of movement/lifting in various situations.

    Animation image file sizes range from 175K to 398K but

    typically start "moving" during the download.

    To view the animations, you do not require any special

    "plug-ins" but you will need to be using a

    browser that can display animated GIFs (Netscape 2.0 and

    above; Internet Explorer 3.0).

     To view an

    animation, just ‘click’ on a thumbnail image below.

    Side lying position

    Getting into bed and into

    side-lying position [375k].

    Prone Position

    Getting into bed and into

    prone position [219K].

    Getting into bed and into

    supine position [293K].

    Golfer's Lift

    "Golfer’s Lift"

    for picking up something light/small [212K].

    Straight Lift

    "Squat Lift" for

    picking up something heavier [191K].

    Lifting baby

    "One-Knee (Baby)

    Lift" [204K]


    Loading a shopping cart


    Reaching above

    Reaching and stooping to

    move light-medium weight objects [177K].

    Tub positioning

    Using a tub while being

    easy on the back [194K].

    Getting out of a car

    Getting out of a car


    Getting into a car

    Getting into a car [208K].

    Printed Resources for Patient Education:

    • Back Owner’s Manual. Krames


      San Bruno, CA. 1991

    • Back to Backs: A Guide To

      Preventing Back Injury. Krames


      San Bruno, CA. 1988.

    • Meinik M, Saunders R, Saunders HD.

      Back Pain. Saunders Group, Chaska,

      MN. 1989.

    • Saunders, HD. Evaluation,

      Treatment and Prevention of Musculoskeletal Disorders.

      Viking Press. Minneapolis, MN. 1985, pp. 260, 317.