Minimizing Strain On Your Lower Back

Minimizing Strain On Your Lower Back

 

 

When performing any type of exercise in the prone position (lying on your stomach), whether for fitness or rehabilitation, in order to minimize the strain on your lower back, consider placing 1 to 2 pillows under your pelvis. 

 

Observe that just by being in the prone position, the lumbar spine is already in an extended position.  Lifting your arm or leg will create hyperextension in the lower back , which may be uncomfortable particularly for anyone recovering from lower back injury/surgery

 

At rest, with a pillow under the pelvis, you can see that the lower back is in a neutral position

 

Upon lifting an arm or leg now, lumbar hyperextension is avoided and the lower back is spared.



Postural Habits

Forming New Postural Habits

 

 

As a Home Care Physical Therapist, I see how my patients spend a great deal of their time during the day.  Some try to be very active, while others try to do as little as possible.  Upon arriving at their home, I observe their postural habits quickly.  Some of them don't seem to move between visits.  They may be slumped to one side in their recliner.  Upon standing up to walk, they take on the same posture, slumped to one side.  This slouching posture creates muscle tightness, which may later affect lung expansion and the ability to take deep breaths.  I explain to them that if they are not motivated to perform an entire exercise routine, then they should just focus on one thing, maintaining proper sitting posture.  This would improve their walking and standing tolerance.  Considering the fact that they spend the majority of their day sitting in their chair, sitting with correct posture is not much to remember, but it is more difficult than you think. 

 

 

Some want to just place pillows at their sides to stop them from collapsing in the chair.  However, this does not allow them to strengthen their trunk.  It only passively positions them.  Pillow propping is useful with patients who have such weakness in their trunk that they can not safely maintain the seated position.  It also helps prevent the development of sores.  However, I am not talking about patients who have these deficits.  I am focusing on patients who do have the strength to make postural corrections, but choose not to because it is "too difficult" for them.

 

Quick Tip:

 

I frequently recommend to family members or caregivers that if the patient is not compliant with the requests to correct their seated posture, then they can do little things throughout the daily routine, such as relocating the silverware or their glass of water to the side that the patient is slouching away from.  They can do the same thing with the remote to the TV.  This would force the patient to actively move their trunk in the position that they are frequently avoiding.  You just have to remain persistent about placing the remote or the dinner utensils to the "avoidance" side.  If this becomes consistent, you would be amazed at how many times your patient will correct their posture in order to reach for their cup of water.  This repetitive activity will be part of their exercise program. 

 

 

 



If You Are A Caregiver, These Tips May Help

If You Are A Caregiver, These Tips May Help

 

 

When I go to people's homes to provide Physical Therapy, many of the caregivers/family members ask the same questions.  They are having difficulty transferring their family member into the shower (even though it is a step-in shower and not a tub) because the patient is unable to lift their leg high enough to clear the shower opening.  There are a few options that we try.  

 

 

 

First, if the patient has a wheelchair, I will wheel them right up to the shower step so that the wheels are touching the step.  Instead of having them stand outside the shower, and then step into the shower, I will keep them seated and place both feet on the shower floor.  Then I will help them to stand and they will be inside the shower already.  When they are finished with their shower, I tell their family member to just reverse the technique and have the patient sit in the chair and then take their feet out of the shower by wheeling the chair backward.

In this picture, I use a regular chair with wheels instead of a wheelchair, but you get the point.  My feet are already inside the shower and all I need to do is stand up.

 

If he/she has difficulty stepping into the shower, you can also try to step in/out laterally (sideways).  This is usually easier than forward.

 

Some tools that may also help with this transfer are grab bars placed inside and outside the shower as well as a shower chair for the patient to sit on once they get inside the shower