What you can do to reduce your risk
By Deborah Jeanne Sergeant
Statistically, women experience more back pain than men. Women’s smaller frames can place them at greater risk for acute and chronic back pain.
In addition, “during pregnancy, there are fluctuations in hormones that increase ligament laxity,” said Cheri Sidoti, physical therapist with URMC. “Pregnancy in general changes spinal alignment. When compared to men, women also have less muscle mass to support the spine during heavy lifting.”
Women also tend to be primary caretakers of children and older adults and dominate caregiving roles in healthcare. Sidoti said that this tendency can lead to more opportunity for back injuries as constant bending, lifting and twisting can lead to back injuries.
“There are frequent, unexpected movements when working with people and it is almost an instinct to do whatever it takes to protect the person you are caring for, even when it puts your back in vulnerable situations,” she added.
Back pain can sideline people from fitness activities and for some, their job and activities of daily living like housework and yard care. With proper body mechanics, women can reduce their risk of back injuries. Sidoti said that keeping the load closer to the body with the elbows tucked in gives greater leverage for using strength more effectively, along with keeping the head up and the core straight and aligned, not twisted.
“You do not always need to do a deep squat to lift properly,” Sidoti said. “A partial squat lift is like an athlete’s power stance, with the focus on hinging at the hips.”
Renee Hetzler, physical therapy professor at Nazareth University, works per diem in physical therapy in the area, also offered a few tips for preventing back pain, including employing the proper ergonomics, including “using the legs for lifting” instead of bending the back.
Repetitively lifting moderate weight can cause injury just as much as one time lifting something that is too heavy. Hetzler said that every spring and winter, she sees patients who injure their backs because they dive right into gardening tasks or snow shoveling without being prepared for that level of activity.
“They haven’t had that level of activity for a while and they do too much all at once,” she said.
The same holds true for sports as the “weekend warriors” remain sedentary all week and then engage in very vigorous activities only one day a week. Sometimes, it’s a person who resolves to get more active but doesn’t do so gradually.
Workplace activity can also cause back injuries, “especially if you are in healthcare working as something like a nurse or CNA moving people,” Hetzler said. “A lot of times when we’re trying to help someone in bed the bed is too low. We should lift the bed up. I see a lot of times some staff members have a point of pride that they don’t need equipment for help but you have to invest in your body for the longevity for your career.”
She added that using proper equipment or getting help for lifting more than 30 pounds can help prevent a back injury. Pay attention to any company training on lifting policies.
“We don’t do enough physical activity to keep us in shape,” Hetzler said. “The activities you’re doing at work don’t necessarily keep your body healthy. A lot of people bend forward and lift. You need some of the opposite motions too. A disc issue may mean forward bending like weeding. But every 10 minutes, bend the opposite way too to balance out the load to not have it all be one-sided which can put you at risk for a disc problem.”
Hetzler believes that seeking physical therapy preventively can help people avoid back injuries. Learning the right body mechanics for their activities of work, leisure and life can help prevent the strain that causes back injuries. For many people, learning how to strengthen their core muscles can go a long way towards preventing back injuries and physical therapists can recommend exercises to do this. She added that in New York, patients can visit a physical therapist for 10 visits or 30 days without a referral from a primary care provider.
Regularly strength training can also help prevent back injuries. If a gym membership is out of budget, look into resources such as the local high school fitness center. Many of these offer free or low-cost access.
“Pick three different machines if your fitness experience is limited,” said Erica Gurak, a physical therapist supervisor with Rochester Regional Health Unity at Brockport. “Try a light weight. You can go for the amount of reps until you feel fatigued. You won’t know you’ve done too much until you feel sore the next day. Aim for basic strength training three to four times per week. You can build the program more as your body can tolerate more.”
Using weight machines is helpful because they promote better body mechanics compared with free weights. Many machines offer posted directions.
Keeping up with strengthening exercises is also helpful for people who have experienced a back injury. Before discharge from physical therapy, patients should talk with the therapist about at-home exercises and how they can prevent reinjury.
“If we start to experience that pain again, the go-to is a good place to start like doing stretches you used to do,” Gurak said. “Stick with a core group of exercise that balance strength training and flexibility.”
She added that patients who’ve had a back injury are 80% more likely to experience it again. Gurak promotes maintaining good core and hip strength so that undue stress is not placed on the back.
“Pull the belly button inward and upward when you reach for something heavy or bend down to pick up something,” she said. “It helps stabilize your back better. Maintain hip strength by standing at the counter and moving your leg backwards and to the side. Good hip stretches can help with hamstrings, glutes and hip flexors. A lot of times people injure themselves through compensation if they have poor mobility or strength elsewhere.”
Work on core strength through exercises like planks.
Genevra Petito, owner-operator of Supergirl Fitness in Rochester, said that one reason people have back problems is that hours of sedentary life shortens the psoas muscles attached at the lumbar vertebra.
“When the psoas shortens, it can pull the lumbar joints out of alignment which can lead to pain, weakness, stiffness and a greater risk of injury when lifting something heavy,” Petito said.
She encourages women who sit a lot to take movement breaks such as walking, chair yoga poses and chair lunges on both sides. Use stable objects such as a countertop to help stabilize balance if there’s risk of falling. The “cat–cow” yoga positions can also help, as these offer flexing and extension of the spine.