San Diego Chiropractic Care Center        www.SanDiegoChiropracticCare.com 4764 Convoy Street, Suite B, San Diego, CA. 92111 858 292 -1555 Dr. Alex Pozhitsky DC Patient Education Back Pain Prevention Advice Exercise regularly. Low-impact aerobic exercises protect the back by keeping muscles strong and supple. It also tones abdominal and thigh muscles, which help take the strain off the back. Swimming is the best exercise for the back, because the weightless environment puts no pressure on the spine. Brisk walking and bicycling are also recommended. Shed some pounds if you are overweight. Excess weight puts extra stress on the back and makes it difficult to maintain good posture. Always bend from the knees, never the waist. Kneel or squat instead of stooping over. Lift objects properly. The key is to bend at the knees, not the back. Tuck in your buttocks and pull in your abdomen. Bring the object close to your body. As you stand, put the burden on your thigh muscles, not your back. If you cannot move the object close to your body (as when lifting luggage or groceries out of the trunk of a car) extend one of your legs backward as a counterweight. Don't try to lift something that is too heavy. Stop when you have to strain and ask for help or use a lifting tool (such as a dolly) for assistance. Avoid twisting while lifting. Twisting increases the chance of injury. Even garbage collectors, who usually have strong backs, are prone to injury because of the twisting involved. Maintain good posture. Stand with the back straight, pelvis tucked, shoulders down, head erect and chin tucked in. Poor posture increases pressure on the discs in the spine, stresses muscles and stretches ligaments so that they are unable to provide adequate leverage when lifting. Avoid sitting too long. No other position puts as much pressure on the back muscles and discs. Sit correctly. Sit with your feet flat, back straight, shoulders back and head up. Find a chair that supports your lower back or roll up a towel to use as back support. If standing for long periods, change your position often. Prop one foot on a stool, ledge or telephone book, if possible. Condition yourself for high-risk sports. If you enjoy sports that involve bending and twisting on impact, prepare yourself first. Start a conditioning program at least six weeks before you go downhill skiing. Avoid infrequent bursts of activity. This is especially important if you have a sedentary job or lifestyle. Make back exercise part of your daily routine. Although no specific back exercises have been found to improve pain relief or increase functional ability in people who already have acute back pain, flexion and extension exercises keep back muscles flexible and others strengthen back and abdominal muscles. Push instead of pull. If you have a choice between pushing and pulling an object, push it. That allows the leg muscles to power the job. Don't sling a heavy purse or briefcase over your shoulder. Instead, place the shoulder strap across the body to better distribute the weight and switch shoulders frequently. When driving, use the lumbar support in your car seat. You can make a makeshift support by rolling up a towel and putting it behind the small of your back. Stop and walk around every hour during a long drive or flight. Vibration during driving and flying tires the back. Sit correctly during air travel. Use the airline pillows behind the small of your back and put your feet up on a briefcase or bag under the seat in front of you. Get plenty of sleep. Fatigue underlies many causes of back strain. It also hinders good posture. Sleep in a healthy position. The best sleep positions are on your back with a pillow under your knees or on your side with knees bent and, if desired, a pillow between them. Don't slump over a desk or keyboard. Sit as close as possible to prevent slumping. Adjust your desk or workstation to a comfortable height. Women should wear high-heeled shoes as little as possible.