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Safe movement - avoiding back injury and pain

Health professionals, specifically nurses, midwives and allied health professionals, are at a higher risk of back injury and pain due to the nature of their job, which often involves lifting. So, how do health professionals protect their back?

A common belief is that bending the back is dangerous, according to physiotherapist Scott Wescombe, which often leads to protective and fear-avoidance behaviours.

It is a misconception recently busted with research out of Curtin University, which found that lifting with a straight back may not be protective. The study suggests that neither lifting with a straight nor a rounded back results in a higher chance of back pain.

"In most cases, movement and exercise is a big part of what helps people get better and stay better - including moving the spine in the ways it's designed to be moved - forwards, backwards, sideways, rotation.
"It's nourishing for the spine to be moved in a variety of ways, and the body will adapt to how it gets used, which can make movements easier or harder depending on how people are using their body," said Mr Wescombe.

Rather than focusing on lifting with a straight back, it's important to consider other factors that promote safe lifting, such as the nine fundamental forces that influence the experience of back pain.

"[When we] try and isolate one thing that causes back pain, which in this case is lifting with a flexed back, misses the bigger picture of how humans work - we are not a piece of machinery."

Mr Westcombe said he uses nine key forces that influence one's experience of back pain, which helps clients feel better.

1. Modulate Movement [DO]
2. Filter Food [DO]
3. Settle Sleep [DO]
4. Create Calm [FEEL]
5. Verify Vision [FEEL]
6. Refine Recovery [FEEL]
7. Choose Community [THINK]
8. Master Meditation [THINK]
9. Bolster Beliefs [THINK]

"To keep it simple, it's a DO, FEEL, THINK framework that I call The WescombeMethod.

"We use a traffic light system - red, orange, or green - to rate each force.

"Red means it's not going well and needs to change; orange means it's so-so - some things are going well and others not so well - and green means it's doing well.

"If someone was to think that lifting with a flexed back causes damage to the spine, number nine, Bolster Beliefs, would be a red, and it would have a flow-on effect to Modulate Movement and then other forces like Create Calm and then Settle Sleep.

"People who believe bending their back is bad will release stress hormones and go into more of a fight or flight zone, which might send off pain signals in itself.

"They'll avoid certain movements, brace their body, move less and differently, and over time their body will adapt to how it's being used or not used, making it harder in future to perform those basic movements they've been avoiding. It turns into a vicious cycle," said Mr Wescombe.

Dr David McIvor, a workplace health and safety expert, says while the traditional message is to keep a straight back while lifting, it's challenging to do so. Instead, it may be more appropriate to focus on moving the legs.

"Our mantra is 'the more you bend your legs, the less you will bend your back," said Dr McIvor.

Selina Tannenberg, physiotherapist and Director of MoveMedics, agreed, stating that while a perfect posture is appealing, it's impractical.

"The human body comes in diverse shapes and sizes, so how can we possibly expect there to be one standard posture to suit all?

"It is not so much how you move but how well conditioned you are to a particular movement that matters."

What is critical is having the appropriate movement capacity, which involves strength, mobility, coordination, balance and skill, explained Mrs Tannenberg. Those without movement capacity will naturally be at higher risk than someone who is well-conditioned for the same movement.

"Often, it is when we attempt movements beyond our current capacity that we put ourselves at risk of injuries, lifting heavier than we have the capacity for and continuing physically demanding movement when fatigued.

"A good approach to safe movement is to move in ways you find comfortable and natural, get strong, and develop your movement options.

"Where lifting is a concern, lift in a position you feel strong in, one that you feel you have a good hold of the load and can handle sudden surprises such as a missed step or a sneeze.

"Perhaps most importantly, practise smart and honest lifting and only lift a load that you, not the hero in you, truly think you have the capacity to lift."

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Haley Williams

Haley Williams has a Bachelor of Communication in Journalism and over a decade of experience in the media, marketing and communications industries.

She is a widely published journalist with a particular interest in writing magazine features on parenting, health, fitness, nutrition and education.

Before becoming a freelance journalist, Haley worked as a writer for NeoLife (a worldwide nutrition company), News Limited and APN News & Media.

Haley also has extensive experience as an SEO Content Writer and Digital Marketing Strategist.