Nursing Your Back for a Long Healthy Life

June 20th, 2012


By , BSN, RN

Nurses are notorious for not taking care of themselves while taking care of others. We counsel exercise and moderation and keep junk food in our break rooms. We tell people to never go spread their cold in public, stay home, and get better; and we say this as we surreptitiously wipe our noses and sip cough medicine.

Finally, here’s the big one, we love to tell our patients and each other to wait and get help when lifting heavy or awkward objects but when no one is around we just grab whatever it is and do it ourselves. And that’s where back pain comes into the picture. We are a stubborn lot and if we don’t feel the effects immediately we feel them later as our body, our spines in particular, suffer from our repetitive, inappropriate movements.

Body Mechanics

Being mobile and active are essential to being a good nurse. Whether you work in a hospital (on the floors, in the emergency department, or operating room), a school, or a doctor’s office, you need to be able to move. Good body mechanics is the efficient, coordinated, and safe use of the body to produce motion and maintain balance during activity.

The major purpose of proper body mechanics is to facilitate safe and efficient use of appropriate groups of muscles. Good body mechanics is essential to nurses and their clients to prevent strain, injury, and fatigue.

Body mechanics involves three basic elements:

  • Body alignment (posture) – This is the geometric arrangement of body parts to each other. Good body alignment and good posture are synonymous. When the body is well aligned, balance is achieved without undue strain on the joints, muscles, tendons, or ligaments. Proper body alignment enhances lung expansion and promotes efficient circulatory renal and gastrointestinal functions.
  • Balance (stability) – Defined as a state of equilibrium in which opposing forces counteract each other; balance is the result of proper alignment. A person maintains balance as long as the line of gravity (an imaginary vertical line drawn through an object’s center of gravity) passes through the center of gravity (the point at which all of the mass of an object is centered) and the base of support (the foundation of which an object rests). To put in the terms we all recognize: head up, shoulders back, abdomen in, pelvis under, and feet shoulder a little less than shoulder width apart.

    The broader the base of support and the lower the center of gravity, the greater the stability and balance. Flexing the hips and knees until a squatting position is achieved readily lowers the center of gravity. The importance of these alterations cannot be overemphasized for nurses.

  • Coordinated body movement – Whenever we move the three basic functions of movement, balance, and coordination work in concert to produce graceful, purposeful motions of body parts. This is actually quite a feat, because moving is a complex process.

    We hardly ever contract just a single muscle; practically all of our body motions involve several muscles working in sequence or at once. For example, walking is produced by contracting all the muscles of the legs in different intensities and at different times. The result is a well-coordinated movement—that is, a movement of a body part that actually consists of many movements of joints, occurring in proper sequence and of appropriate extent, such that the resulting motion is smooth, straight, and directed to the object of interest.

So these are all the elements necessary for us to do our jobs. And yet people in the healthcare professions are among the worst when it comes to respecting our bodies, paying attention to what we actually do know and putting that knowledge into action.

Preventing Back Injury

There are a lot of factors that increase the potential for lower back injuries. A major contributor is habitually poor standing and sitting postures, which produce exaggerated curvature of the lumbar spine, called lordosis. I will confess this is a very accurate description of the writer and of almost every nurse I know. So, what can we do? Here’s a list of actions we can all take to keep these all to common injuries at bay.

  • Become consciously aware of your posture and body mechanics.
  • Make a conscious effort to improve your posture and body mechanics. Seek assistance if you need it.
  • Minimize lumbar lordosis as much as possible.
    1. When standing for a period of time, periodically flex one hip and knee and rest your foot on an object is possible.
    2. When sitting, keep your knees slightly higher than your hips.
    3. Unless you have a pillow or other support beneath your abdomen, avoid sleeping in the prone position.
  • Use a firm mattress that provides good body support at natural body curvatures.
  • Exercise regularly to maintain overall physical condition: include exercises that strengthen the pelvic, abdominal and lumbar muscles.
  • Avoid exercises that cause pain or require spinal flexion with straight legs(toe touches and sit ups) or spinal rotation (twisting).
  • Avoid activities that require an excessive arching of the spine (hockey) and spinal rotations (golf, tennis) unless you are physically fit.
  • Apply principals of body mechanics when moving objects For example:
    1. Spread your feet apart to provide a wide base of support.
    2. Place your feet appropriately in the direction in which the movement occurs.
    3. Keep objects to be moved close to the body.
    4. Push, pull, roll, or slide objects rather than lifting them, whenever possible.
    5. When pushing or pulling an object, use the body’s weight to counteract the weight of the object.
    6. Avoid twisting the spine by pushing or pulling objects directly away from our toward the body and squarely facing the direction of movement.
    7. When lifting objects, distribute the weight between the muscles of the legs and arms.
  • Plan ahead how you will move a load and where you will move it. Make sure the area is free of obstructions.
  • Wear clothing that allows you to use good body mechanics and comfortable low-heeled shoes that provide good foot support and will not cause you to slip, stumble, or turn your ankle.

Round this out with a healthy diet, regular exercise, and more sleep and you and your back will be plenty healthy. If you are having troubles or recognize you are headed down that road get help. Seek out help from your physician, your occupational health, or physical therapy departments, or talk to the trainer at a gym. They will all be able to give you quick tips to improve you posture, balance and coordination and keep you working and living healthy.

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