You have heard it before. “Bend your knees when you pick that up or you’ll hurt your back.” Well, that’s true, to a degree. The fact is though, simply bending your knees is not enough to prevent low back injury.
The reason chiropractors, physical therapists, and personal trainers alike advise bending your knees is because they do not want you to put stress on your low back. The thought is that bending your knees will shift the stress from the back to the knee, but this is not always true. Don’t get me wrong, you should always bend your knees when lifting, but there are other things that must be done as well.
To understand what you need to do to protect your back, you will first need to understand some basic bio mechanics. I promise to keep it very simple. You have 24 vertebrae sitting directly on top of one another that make up your spine. Your spine rests on top of a bone called the sacrum. The sacrum is positioned directly in between two bones called the pelvic bones. In between each of the 24 vertebrae and where the spine meets the sacrum is a disc which you have probably heard of before. While the vertebrae and the sacrum are bones, the discs are made of cartilage and fluid that is structurally not much different than a jelly doughnut; they are hard on the outside and soft in the middle.
Simply put, those vertebrae work together like a spring when you bend over. Imagine bending a spring back and forth over and over again. While that spring might be very strong at first, over time, it would weaken and eventually break. Most commonly with bending, the injury is to your disc. Imagine squeezing a jelly doughnut on one side, all the jelly would squirt out the other direction. This is a simplified example of a bulging or herniated disc. So how do we prevent this from happening?
The answer is very simple. Your back shouldn’t move. Your vertebrae shouldn’t be asked to bend on one another. Discs should not be squeezed on either side. The best way to prevent this is by bending from the hips and the knees at the same time. In case if you weren’t clear on where your hips are, they are the place where your legs attach to your pelvis. Run your hands down your sides, the first bone they come in contact with is the pelvis, as you continue to move your hands down towards your feet you will feel two large round bones, those are your hips. When lifting large, awkward objects from the floor, it is often advisable to drop to one knee in order to get the object off of the floor. For smaller objects or for objects that are located in an elevated position, bending at the hips and knees is advisable.
The first important point when lifting objects from below your hip height is the most simple. Stand close! I mean really close. You want the object that you are about to lift to be located as close to your legs as is possible. The closer the object is to your legs, the less it stresses your spine. Also, to avoid twisting, make sure whatever you are about to lift is directly in line with your belly button at all times.
Avoiding twisting when you lift...
Next comes the pelvic tilt. I give my patients a visual aide for this movement. You want to visualize yourself breaking a sheet of glass with your butt. Imagine that you are standing directly in front of a glass window, and you want to break it without bending your knees. You will have to thrust your butt backwards which will create a very stable arch in your low back. Once you have shifted your pelvis in this manner, your focus should be to continue to squat while reaching backwards with your butt as if you were hovering over a public toilet. Pairing the pelvic tilt with the squat will enable you to lock your lower back from any movement and thereby protect it from any injury! This will take practice to perfect, which is why I recommend to my patients that they practice the squat without weight daily.
So let’s recap. The first step in lifting an object is to stand close to it and make sure it is right in line with your belly button. The second step is tilt the pelvis forward to lock the low back. The third step is to squat while reaching your butt backwards the whole time as if hovering over a public toilet. If the object is too large or too low to squat down to, drop to a knee before lifting. My last piece of advice in regards to lifting is very easy to remember. If it’s too heavy, get help with it!
Every day people hurt themselves performing activities that should not cause them any pain or discomfort. If your form while performing these activities is perfect, you significantly reduce your likelihood of becoming one of these people. I recommend that you practice this technique a few times without any weight before you attempt to lift any objects in this manner. At first it will feel strange and unnatural. Give it time. You will quickly begin to take notice of how much better your low back is feeling, and you will be able to attribute that improvement directly to your new lifting technique. I wish you the best of success with this lifestyle change on your way to better health.
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Dr. Sean Pastuch, D.C.