Safe Lifting Techniques To Help Avoid Neck & Back Pain Problems
Although there is increased energy required to squat instead of stooping, the benefits to squatting (bending knees and using legs) include decreased pressure on the back muscles and discs, thus providing safe lifting and should be used for proper lifting techniques. Lifting techniques employing the correct method may become tiresome and is often ignored when repetitive lifting is required.
Above all, you should try to maintain the normal curve of the lower back and neck by keeping it as straight as possible for proper lifting techniques. Tightening your abdominal muscles while bending can help with this. Additionally, tightening your abdominal muscles and buttocks muscles can help prevent over extending (arching of the back) when reaching overhead. Likewise, keeping your neck in a neutral posture helps to maintain the proper curve for safe lifting. Adequately designed back support belts can assist in retaining the backward c-curve in the small of the back as you bend, and a neck brace can help prevent bending the head too far downward. Maintaining the curves is more important in proper lifting techniques than exactly how you lift.
With the normal curves maintained, safer lifting is increased because ligaments are not stressed and the discs are not bent, thus they are at low risk for failure. The muscles are activated and give more control and feedback regarding the more vulnerable structures.
- A 2014 study in the Journal of Orthopaedic Research used finite element models and found when holding a weight, maintaining the normal curve in the lumbar spine caused the loading to minimize disc pressure; whereas the more straight the curve, the more loading and shear forces in the disc increase as it shifts from the middle of the lumbar spine to the bottom at the areas most associated with disc herniation (red dots above).
When Proper Lifting Techniques Are Most Important
When you lift may be more important than how you lift. After lying down when sleeping or reclining, there is an increase of fluid in the disc which becomes pressurized. This can increase the bending stress on the disc by 300% and the stress on ligaments by 80%. The chances of safe lifting are decreased early in the morning when the discs are most pressurized. Like a water balloon, it is easier to break when it is most filled with water. Additionally, prolonged sitting, even as little as 3 minutes, can make the back as well as the neck more vulnerable to lifting, therefore, using supports, and corrective posture measures like ergonomics to help maintain the normal curve while sitting is a good idea to help promote proper lifting techniques.
Why sitting? Sitting places a high degree of strain on the discs in the lower back. Sitting in poor posture, where the curve is not maintained increases this stress. What happens? The pressure causes fluid to press out of the disc and the poor posture causes the inside part of the disc, the part that herniates, to move towards the back of the disc. This is the position it moves to when there is a disc herniation. So, there is less load relieving capability of the disc because it has less water content and it is in a better position to herniate. Therefore, it is a good idea when you just get out of bed to not lift anything heavy.
Give it some time to move around and de-pressurize the disc a bit prior to lifting. Likewise, when sitting for prolonged periods, it is important to get up and move around some before lifting. If you have been sitting in a slumped posture for a while, you need to learn proper ergonomic techniques, however, you should get up and do the stretches illustrated at back pain exercises, as this can help hydrate the disc and move it to a more forward position, decreasing the likelihood of injury with proper lifting techniques.
Similarly, poor neck posture can cause strain on the neck muscles. Therefore, proper lifting techniques should also include keeping the head and neck positioned properly, maintaining the correct curve to avoid strain when lifting. A neck brace can help stabilize this, reminding you to not bend your head forward as you lift as part of safe lifting. Additionally, if you have been sitting for an extended period of time, you should take a small amount of time with the neck exercises prior to lifting.
Basically, everyone knows that correct lifting techniques can help prevent back strain, however, most are not aware that the neck is just as important regarding proper lifting techniques.
Proper Lifting Techniques And Neck Pain
The neck is also involved in lifting tasks. Just like the lower back, injuries to the neck may result from not observing safe lifting techniques. Neck pain frequently is involved in jobs that require lifting. There is a relationship between lifting and the muscles of the neck which can be strained and loose necessary supporting function to protect structures in the neck that are sensitive to pain.
Primarily, the upper part of the trapezius attaches to the head and the levator scapula, which attaches directly to the neck and are involved with lifting as they originate from the shoulders. The scapula bones link these muscles to the head as well as neck and demands from lifting with the arms are directly transferred to the neck. We know that poor posture leads to strain and weakening of these muscles. Prolonged postures with the head bent forward, often called forward head posture, increases the pull of gravity from the head.
As the head moves forward, this greatly increase the forces on the neck muscles to balance the head. Your head weights about as much as a bowling ball. If you hold a bowling ball close to your body, you can hold it relatively easily for a period of time. If you extend your arms and hold the bowling ball outward from your body, the force of gravity places a tremendous amount of pressure on your arm muscles and you will not be able to hold it in this position very long without strain and compensating posture (leaning back) to help balance the increased weight.
Therefore, from working at computer, reading and other occupations or activities which require your head to be bent forward, places demands on the neck muscles that cause chronic strain and altered posture. This makes your neck more vulnerable to pain and injury. All this is prior to any lifting, regardless of lifting techniques. So, many are starting out with a disadvantage and can benefit from learning proper lifting techniques.
Now add lifting. Regardless of the condition of your neck, lifting with your head bent forward will place and excessive amount of force into the neck and shoulder girdle, which, in turn, transfers the loading directly to the neck. The neck bones, joints, ligament and muscles depend on the best mechanical advantage to function properly for lifting.
Therefore, an important part of proper lifting techniques involves keeping the head in a neutral posture. Bending the neck when lifting seems natural, however it is not a part of proper lifting techniques. You want to look at what you are lifting. However, lifting in this manner can lead to neck injury and strain on the muscles and ligaments which, if repeated over long periods, can lead to more serious neck problems like disc herniation, early onset of degenerative disc disease and joint issues like facet syndrome.
So, the best posture to prevent neck injuries using safe lifting techniques is to keep your head in a neutral or straight ahead position. This should minimize neck strain. So, part of better lifting is taking some time to observe your surroundings; where you will be lifting and where you will be placing any heavy object ahead of time so that you are not placing your neck in extreme postures while you are lifting. Don’t lift and then look for where you will put the object. This can lead to excessive strain as you turn your head about looking for a suitable location. Part of proper lifting techniques is having this planned out in advance. Your neck and back will thank you!
Proper Safe Lifting Techniques Illustrated
Most belts that claim to provide support are really meant to increase awareness related to proper lifting techniques. This is beneficial, however, choosing a back brace that actually provides significant support can offer particular benefits, especially for those with existing lumbar spine conditions.
Safe Lifting Techniques:
- Begin with your feet around shoulders length apart and one foot a bit in front of the other foot.
- You will need to lower your entire body through bending your knees, in no way flex through the waist or even rotate using the waist when lifting. Enable your strong leg muscles to perform the job, never the less strong lower back muscles.
- Tighten up the stomach muscles when you start to move to a vertical posture.
- Maintain the extra weight in close proximity to your body as well as your back up-right. Raise gradually and request assistance if required.
- To put things all the way down, bend the knees while keeping the back up-right, reverse the actions.
- The compressive load on the back is greatly increased by twisting. For proper lifting techniques, make sure the object is not awkwardly placed and keep at waist level if at all possible. Move your legs and feet to turn instead of twisting.
- To reduce the pressure on the back muscles, keep the weight as close to your body as possible. It is simple physics, the further the object is from your body, the greater its mass and the pressure it will put on your back. Keep this in mind if you have young children that you lift to put in a car seat as this is essential with proper lifting techniques.
- Remember to use safe lifting especially when immediately getting up from a chair or after a good night’s sleep. When packing a suitcase, try 2 smaller ones instead of 1 large one so you can balance the load when lifting. Given a choice, pushing is easier than pulling on you back because the legs can be used more efficiently.
Practicing Proper Lifting Techniques
Many individuals with neck, back or knee problems indicate they cannot bend or perhaps were instructed by a doctor not to bend or squat. Nevertheless, even with these conditions, the majority could benefit even more through finding out how to bend properly instead of evading it. This can help with safe lifting techniques.
All of us bend or squat frequently throughout the day regardless of whether don’t performing it as physical
exercises. For example, we all assume a squatting position whenever getting up from sitting, picking up an object from the floor, getting in or out of a vehicle… Bending excessively from the waist or knees can result in repeated strain of these areas. The main objective is learning to bend from the hips, thus alleviating the strain on the knees or back muscles.
The key to bending or squatting effectively and safely is to bend at the hips. You can practice doing the illustrated movements to help train proper lifting techniques. If you are going to use weights, you should consult with your health care professional first.
Pick a spot on the floor about six feet ahead. Begin lowering your body and let the elbows brush the inside of the thighs. As you do this, you should be able to feel the weight of your body sink into the heels of the feet. When you are fully down, it is important that you are capable of wiggling the toes. This will make sure the gluteal muscles are engaged to a greater degree than the quadricep muscles. The low back must be arched slightly forward, neck in a neutral posture and avoid lifting or shrugging the shoulders.
Begin slowly, perhaps only going down half way or as far as you can without experiencing any pain. There may be some muscle soreness, but no increase in any current symptoms or painful sensations. The goal being to be able to perform one complete motion correctly, with proper form. This may take some time. As you become proficient, you may do repetitions according to your tolerance and capability.
In preparing for daily activities, I like to do some morning warm ups about 1 hour after waking. In consideration of my chronic pain conditions, I do the squats, without weights – 2 sets of 15 repetitions. I also do 2 sets of 15 repetitions of the back pain exercises in the standing position, reaching up with the arms. One set of squats, then 1 set of back exercises, and repeat.
Scientific Support For Safe Lifting Techniques
- A 2014 study in the journal Manual Therapy found that bent down and forward neck posture significantly effects deformation of the dorsal neck muscles when lifting and contributes to overloading or strain of these muscles. The authors recommend lifting activities be evaluated for possible neck problems to avoid any negative consequences.
- A 2021 study in Ergonomics shows that neck flexion is detrimental to the spine when lifting or lowering. Having the head down position affects the entire spine and when loading can increase the risk of low back pain by increasing lumbar the flexion angle and spine awkward posture.
- A 2023 study in Ergonomics found that externally rotating your feet (toes pointed out) prior to lifting allows an individual to reach further down without rounding the lower back.
- An analysis in the 2014 edition of the Journal of Occupational and Environmental Medicine studied the effects of lifting on back pain. The authors, in an extensive review of the scientific literature, noted a relationship between increased weight and number of times lifting to be a significant factor in predicting the occurrence of low back pain. They further indicated that heavy lifting may have a substantial impact on the musculoskeletal system of workers.
They recommended guidelines and workplace design to help prevent low back pain. It is reasonable to suggest safe lifting techniques as well as the use of back belts employing mechanical advantage for strong support can help.
- There is a relationship between lifting and medication use for back pain. In a backworks prospective cohort study published in a 2014 Journal of Occupational and Environmental Medicine issue, the authors found lifting of loads is directly associated with an increase in the risk of low back pain resulting in medication use.
- Another study of 1131 workers in a 2014 issue of the Journal of Occupational and Environmental Medicine lifting loads had a cumulative effect from the accumulation of fatigue and microdamage. The authors recommended prevention focusing on the reduction of cumulative low back loads by reducing working in awkward body postures and handling heavy loads.
- A 2019 study in Studies in Health Technology and Informatics found the consequences of repetitive heavy lifting in factory workers were over 90% of the study group suffered low back pain and demonstrated postural malformations.
- A 2014 issue of the International Archives of Occupational and Environmental Health featured a study regarding low back pain and bending/twisting at work. They found that work exposure to bending and twisting has damaging effects which persist even when leaving the workforce and after retirement. Considering lifting and bending/twisting places a much greater strain on spinal structures, learning some of these techniques can really make a difference years down the road.
- You need to be extra careful when you lift if you have chronic pain. This is really where these techniques come into play. If you have chronic pain, you may have difficulty in judging the lifting task at hand. A 2013 article in the journal Human Movement Science provides interesting information as to the neural pathway mechanisms involved in why chronic pain interferes with weight judgment tasks.
- A study in the 2013 Human Movement Science journal indicated chronic low back patients had impaired judgment in visually determining difference in weight handling, particularly with body rotation.
- A 2021 study in Musculoskeletal Science & Practice found that individuals suffering chronic low back pain have an altered sense of effort, where the trunk extension force is overestimated.
- A 2015 study in the Journal of Biomechanics found that lifting with a hand on the thigh can substantially reduce loads in the low back while lifting. It is somewhat natural and we see in many cases that those suffering from back pain will help to support the upper body when picking up things from the floor by using a hand on the thigh. The study shows that it actually helps to reduce pressure on the back.
They recorded reductions of up to 26% with this method, using various objects such as a pencil and crates. It was noted that stooped lifting was still superior to the hand supported method. The supported hand on thigh method increases asymmetrical motions. This can cause more torsion in the back and may lead to lead to balance issues. So, its best to use proper lifting technique, however, give yourself a supporting hand when needed.
- A 2020 study in International Journal of Environmental Research and Public Health found that young women lifting a load almost half their body weight significantly influenced stability, triggering random movements and increasing dynamics of postural stability control required in a standing posture. The authors stated, “The results of our study indicate that inferior postural control mainly results from insufficient experience in lifting such a load.”
- A 2020 study in BMC Musculoskeletal Disorders found bending and twisting/turning of the back more than a quarter of the workday was associated with lower work ability in workers with low-back pain and neck-shoulder pain. The authors also concluded, “Work that involves high demands of the lower back seems especially problematic in relation to work ability among physical workers with musculoskeletal pain.”
- A 2020 study in Spine indicated, unsafe lifting leads to greater injury risk compared to safe lifting. Shear strains lead to protrusions progressing to herniations and frequent disc endplate failure.
- A 2023 study in the Journal of Manipulative and Physiological Therapeutics indicates postural control was more challenged during the lowering phase in lifting tasks, possibly as a result of a stiffening strategy. Therefore, pay specific attention to both phases in lifting and lowering.
Proper Lifting Techniques Side Note…
While we are on the subject of safety and safe lifting techniques, a few words about exercise. Exercises nourish the tissues of the spine and can increase flexibility and strength. Being sedentary is a prescription for back and neck pain. When recovering from injury or pain, exercises can help the tissues heal faster. There are some exercises that can actually cause injury. Toe touches can stretch the back of the hamstrings which may be dangerous. When doing sit-ups, never come up all the way because the disc pressure is too high. They can also be bad for your neck if you pull your neck or poke your neck forward as you come up. Hamstring curls can over-arch the low back. Moving your head around in circular motions for exercising can be damaging to the cervical joints.
Weightlifting is a popular sports training to develop strength and size of muscles and has has become prevalent with young adults to enhance body image and physique. Unfortunately, it is a common source of injury and lower back pain is one of the most common complaints, although I have treated many neck and shoulder injuries as well.
- A 2020 study in Cureus found significant injuries in young adult weightlifters, especially the lower lumbar spine with localized as well as radiating pain or sciatica. Some required surgery. The authors concluded, “Medical and sports personnel should raise awareness on the biomechanical properties of the lumbar spine and the correct spine-protective posture during training to help prevent these injuries in the future.”
- A 2020 study in Magnetic Resonance in Medical Sciences showed suppression of water movement in the lumbar discs is suppressed by deadlift exercise indicating high mechanical stress, in particular, the L5/S1 disc.
Safe Lifting: To Push or Pull?
- A 2020 study in Safety & Health at Work indicates when moving a cart up or down ramps, pushing is recommended instead of pulling to reduce shearing and compressive spinal loads and the risk of injury. When necessary to pull on the cart going down a ramp for better sight, the cart handle should be high to avoid bending which increases force, therefore, an adjustable handle is recommended. Keeping the body in an upright position and the arms in line with the direction of force is best.
So, these are some useful tips on proper lifting techniques to make it more safe on your neck and back. For more information on preventing back injuries from at work, please visit the Occupational Safety & Health Administration Webpage.