Injury Prevention Tips
Airbags and Auto Safety
Before the early 1970s, seat belts and shoulder restraints were not standard equipment in automobiles. And it wasn't until 1985 that the first airbags began appearing in cars.
The positive impact those two innovations have had on the reduction of spinal cord injuries cannot be underestimated. In fact, motor vehicle accidents are the number one cause of spinal cord injury. Motor vehicle accidents have accounted for more than a third of all reported cases of spinal cord injury, according to the National Spinal Cord Injury Database. In addition, motor vehicle accidents also account for other spinal-related injuries, such as whiplash, fractures, and herniated discs.
A respected eight-year-long university study, for example, confirmed without a doubt that the combination of airbags and seat belts effectively reduced spinal injuries from automobile accidents.
Larger vehicles such as trucks and sport utility vehicles (SUV's) have statistically trailed the safety requirements for passenger vehicles, as well as such innovations as padded dashboards, collapsible steering columns, anti-lock brakes and side airbags.
Airbags have been controversial over the years because some people have been severely injured or killed from their deployment. Significant advancements have been made to airbags in recent years, resulting in greater safety. The important lesson is this: Always wear your seat belt and allow 10 inches between your breastbone and the steering wheel to prevent injury from airbag deployment. Children age 12 and under should ride in the back seat properly restrained. Children riding in the front passenger seat should sit as far bag from the airbag as possible.
In recent years, evidence has come to light that we are placing our children at risk for debilitating muscle and joint injuries from overloaded backpacks-a staple among elementary and high school-aged kids.
- Cause the shoulders to round, leading to poor posture later in life
- Distort the natural curves of the spine, leading to muscle and joint strain, as well as stress on the rib cage
- Force the child to lean forward, losing balance and risking a fall
One study found that as much as 60 percent of children experience back pain from carrying backpacks.
Here are some backpack safety tips:
- Tell your child to avoid carrying the backpack on one shoulder. This can cause a muscle strain from the uneven weight. When children do this, the spine often leans to the opposite side, stressing the middle back, ribs, and lower back more on one side than the other. Excessive weight on one side also pulls the neck muscles, and can cause headaches as well as neck and arm pain.
- As a rule of thumb, do not allow your child to carry a backpack that is more than 10 percent of his or her body weight.
- Don't allow the backpack to hang more than four inches below the waistline. This increases the weight on the shoulders, causing your child to lean forward when walking. Choose backpacks with wide, padded straps that are adjustable. Make sure that backpack is snug (but not tight) against your child's back. The shifting weight of the backpack causes strain on the child's neck and back muscles.
Beds/Mattresses & Sleep
Since most of us spend at least a third of our lives lying down, a good quality mattress goes a long way in avoiding a whole host of musculoskeletal problems later in life. In addition, a quality mattress will help you get a good night's sleep, which most health practitioners agree is essential to a well-balanced, healthy life-physically and emotionally.
A quality mattress allows you to maintain the same natural spinal alignment that you have while standing. It can be innerspring, foam, flotation (water beds) or air. The most important thing is choosing a mattress that offers you the most support and comfort.
- Comfort - Before buying a mattress, "test drive" it by laying down on it in several positions you normally sleep in. It will pay dividends down the road and help ensure that your spine's natural curve is supported. "Orthopedic" mattresses are generally a marketing gimmick, and nothing more.
- Durability - This criterion applies both to the "guts" of the mattress, as well as its covering. Ensure that the manufacturer guarantees the mattress at least 8–10 years.
- Firmness - Softness and firmness are generally a matter of personal preference and have little to do with a good night's sleep or avoiding back problems. Overly firm mattresses don't support the body evenly, while overly soft mattresses tend to sag, preventing your spine from maintaining its proper alignment.
- Foundation - The foundation, or box spring, absorbs the brunt of the stress and weight of your mattress, and so, helps extend the useful life of your mattress. It is advisable to buy a new box spring when you replace your old mattress, and ensure that the box spring, or foundation, is suited for the type of mattress you are buying.
Replace your bed if:
- The mattress is worn a frayed, or the box spring creaks
- The mattress sags, is out of shape or doesn't return to its shape after you lie down on it
- You are constantly waking up sore or irritable, which could be a sign that your body isn't getting the support it needs during sleep
Best sleep positions
Believe it or not, the position in which you sleep can make a big difference in your waking disposition, and help you avoid skeletal, muscular or nerve problems down the road. Here's why: One of the best positions is on your side, with knees slightly bent and a pillow between your knees. Place a pillow under your knees if you are a back sleeper; this helps maintain the curve in your lower back. If you are a stomach sleeper and sleep with your head on an oversized pillow, it sometimes forces your lower back to curve excessively, putting pressure on your diaphragm and lungs.
- Make sure your body is properly conditioned when doing outside work. Warmed up muscles will be less likely to tighten up or snap when under the strains of bending, pulling, pushing, reaching or stooping. You can warm up by taking a brisk walk or doing simple stretching exercises such as knee-to-chest pulls, trunk rotations, and side bends with hands above your head and fingers locked.
- Always carry objects close to your body, near your center of gravity. This minimizes the strain to your lower back and neck.
- Change positions if you're involved in doing a task such as kneeling or sitting. This will improve your circulation and mobility.
- Don't overdo it. Alternate between several tasks to keep yourself alert, and take regular rest breaks.
- Let your arms, legs and thighs-not your back-do the work when lifting heavy items such as bags of mulch or dirt. Bend and straighten at the knees instead of your back and hips. Never pick up a load that causes you to grunt-this is your body telling you that you're overdoing it.
- The longer the handle on your garden tools, the greater leverage you have and the less force and twisting motions you need to perform routine tasks. Imagine having to rake leaves with a six-inch handle. The longer the handle, the less work and strain. This is especially true for chores involving raking, digging, pushing, and mowing.
- When doing ground-level chores, such as weeding or planting, do not repeatedly bend over. Rather, get close to the ground by either kneeling or sitting (foam pads or small benches are made especially for these kinds of chores).
- When doing prolonged tasks, such as raking, hoeing, or digging, frequently switch hands. This helps to maximize the amount of energy reserves you use in muscles on both sides of your body. Repetitive motion on one side of your body can lead to serious problems, such as muscle spasms in the neck, shoulder, and lower back.
- When you stand up after crouching or kneeling for a long period of time, do so slowly and gently to avoid muscle pulls or even joint dislocations. Straighten your legs at the knees, and do not lift your torso at the waist.
Untold musculoskeletal injuries occur every day when people lift heavy or even slightly heavy objects without following techniques.
Even a so-called simple task of lifting a box from the ground to place on a higher level such as a shelf or table can cause muscle and back strain.
The simple rule to remember when lifting: never bend from your waist when standing upright to pick something up. Keep your back straight and crouch first by bending at the knees or hips, depending on where the item is that you are lifting. This allows your arms and shoulder muscles-not your back-to do the brunt of the work.
Back injuries from improper lifting techniques generally lead to three kinds of injuries-to the muscles, vertebral discs, and joints. Here is a brief synopsis of those types of injuries:
- Disc injury - Improper lifting can cause the soft cushions between your vertebrae, called discs, to tear, rupture, or shift out of position. Often, the fibrous rings surrounding the soft leathery discs can bulge and even rupture. Such an injury can cause the dislocated or ruptured disc to press against a nerve, causing pain and numbness to radiate down into your buttocks and/or leg.
- Joint injury - You may be surprised to know there are numerous joints in your spinal column connecting all of the various bony structures. A bad lift can cause excessive strain on these joints, irritating tissue within them, and in some cases, causing them to lock up.
- Muscle injury - If you change your position during a lift, you place a lot of stress on your lower back muscles. This can easily strain and injure, usually in the form of a small twist or tear, a muscle or group of muscles. Muscle strain is a very common form of back injury. A muscle pull or strain is often painful and can disable key body parts such as your back, hips, shoulders, neck, and knees.
Here are some simple lifting techniques to help you avoid these kinds of injuries:
- Make sure you have a place to put the object you have lifted. Do not try to figure this out while holding the object.
- Position your body close to, and in front of the object. Your feet should be flat on the floor about a shoulder-width apart. If you need to turn during the lift, use your feet to pivot.
- Keep your elbows bent while carrying an object.
- Your leg muscles-not those in your back-should be the ones providing the power during your motion to stand erect.
- Keep the load as close to your body as possible to maximize the use of your arms and shoulder muscles. The further an object is from your center of gravity, the more force that is required to hold that object up.
- Keep your chest forward and bend at your hips - not the lower back-or your knees, depending on how far down the items is that you want to lift. Keep your shoulders in line with your hips to avoid twisting motions. When lifting, push your chest out, pointing forward. Avoid twisting or turning during the lift.
- Lead with your hips, not your shoulders, keeping your shoulders in line with your hips. If you need to change direction, move your hips first; this way, your shoulders will move in unison with your hips. If you move your shoulders before your hips, this will make it easier for your body to twist during the lift, leading to possible strains and other injuries to your back and pelvis.
- Don't lift an object that is obviously too heavy. Test the weight of the object by pushing it with your foot. If it is very difficult or impossible to push with your foot, it is likely that the object is more than your muscles can handle.
- If you have asthma or allergies, wear a mask.
- Stand as straight as possible, and keep your head up as you rake or mow.
- Try to mow during the early morning and early evening hours, when the sun is not so hot. Drink plenty of fluids to keep your muscles hydrated. Protect yourself by wearing a hat, shoes, earplugs, and protective glasses.
- Use as much as your body weight as possible to move your mower (unless it is self-propelled). This will minimize excessive strain to your arms and back.
- When picking up piles of leaves or grass from the grass catcher, bend at your knees, not at your waist.
When raking leaves, use a "scissors" stance. This entail keeping your right foot forward and left foot back for a few minutes. Occasionally switch by putting your left foot forward and right foot back. Always bend at your knees, not the waist, as you pick up leaves. Make piles small to minimize the possibility of straining your back.
Tips about shoe features/selection
Some serious back disorders and even more common conditions, such as muscle strain, can be linked to one avoidable thing: inappropriate, poor quality, or ill-fitting shoes. A good quality, properly fitting shoe pays big dividends for your spine down the road.
When shopping for shoes, always make sure to not force your feet in order to conform to the shape of a pair of shoes.
The most important quality to look for in shoes is durable construction that will protect your feet and keep them comfortable.
Here are some tips to help reduce the risk of back problems from poorly fitting, or inappropriate shoes:
- Fit new shoes to your largest foot. Most people have one foot larger than the other.
- Have both feet measured every time you purchase shoes. Your foot size increases as you get older.
- If the shoes feel too tight, don't buy them. There is no such thing as a "break-in period."
- Most high heeled-shoes have a pointed or narrow toe box that crowds the toes and forces them into an unnatural triangular shape. As heel height increases, the pressure under the ball of the foot may double, placing greater pressure on the forefoot as it is forced into the pointed toe box.
- Shoes should be fitted carefully to your heel as well as your toes.
- Sizes vary among shoe brands and styles. Judge a shoe by how it fits on your foot - not by the marked size.
- There should be a half-inch of space from the end of your longest toe to the end of the shoe.
- Try on both shoes.
- Try on new shoes at the end of the day. Your feet normally swell and become larger after standing or sitting during the day.
- Walk around in the shoes to make sure they fit well and feel comfortable.
- When the shoe is on your foot, you should be able to freely wiggle all of your toes.
- Women should not wear a shoe with a heel higher than 2.25 inches.
What to look for in a good shoe
- Avoid shoes that have seams over areas of pain, such as a bunion.
- Avoid shoes with heavy rubber soles that curl over the top of the toe area (such as seen on some running shoes), as they can catch on carpets and cause an accidental fall.
- Flat shoes (with a heel height of one inch or less) are the healthiest shoes for your feet. If you must wear a high heel, keep to a heel height of two inches or less, limit them to three hours at a time and take them off coming to and from an activity.
- Laced, rather than slip-on, shoes provide a more secure fit and can accommodate insoles, orthotic devices, and braces.
- Look for soles that are shock absorbing and skid resistant, such as rubber rather than smooth leather.
- The shoe should be made of a soft material that has some give, like glove leathers.
A word about high heels
When a normal person is standing flat-footed or bare-footed, their body is completely balanced. Their hamstrings are taut and both parts of the pelvis are stabilized so that the support is normal. Bringing the heel up in shoes, such as high heels, encourages the hamstring muscles to shorten.
High-heeled, pointed-toe shoes can cause numerous orthopedic problems, leading to discomfort or injury to the toes, ankles, knees, calves and back. Most high-heeled shoes have a pointed, narrow toe box that crowds the toes and forces them into an unnatural triangular shape. These shoes distribute the body's weight unevenly, placing excess stress on the ball of the foot and on the forefoot. This uneven distribution of weight, coupled with the narrow toe box characteristic of most high heels, can lead to pain or discomfort, and possible injuries to your back down the road.
The height of the heel makes a dramatic difference in the pressure that occurs on the bottom of the foot. As heel height increases, the pressure under the ball of the foot may double, placing greater pressure on the forefoot as it is forced into the pointed toe box.
To relieve the abusive effects of high heels, women can limit the time they wear them, alternating with good quality sneakers or flats for part of the day.
By their very nature, sports and other kinds of recreational activities are inherently risky ventures for your entire body, none the least being your neck, spine, joints and muscles. If you or your children are active participants, proper body conditioning is as essential as the equipment used in these kinds of activities.
Though there is no such thing as a "safe" sport, highly competitive sports such as football, weightlifting, gymnastics, and wrestling pose particularly higher risks of injuries, especially among children.
According to experts, as much as 20 percent of all sports-related injuries involve the lower back or neck. Running and weightlifting, and other sports that involve repetitive impact, expose children to a high risk for lumbar (lower back) injuries. Contact sports, such as soccer and football, expose the cervical spine, or neck to injury. More than one-third of all high school football players sustain some type of injury. Soccer participants are easy candidates for mild to severe head traumas, neck injuries, cervical spine damage, headache, neck pain, dizziness, irritability, and insomnia. Heading the ball, the act of using the head to re-direct the soccer ball, has been linked with cervical injuries in children and adults. The trampoline and gymnastics also present significant risks for spinal cord injuries from unexpected and brute falls or contact with hard surfaces.
There is no substitute for proper conditioning, both long-term and just before play, and its role in preventing injury or minimizing the impact of injuries sustained during participation.
Here are some warm-up tips:
- Low-impact activities such as walking will help gradually increase the flow of warmed blood to the muscles and ligaments of the back. This helps to prepare those muscles for the work they'll be called on to do during the activity.
- Simple lower and upper back stretches, as well as hamstring and quadriceps stretches, can help you stay flexible and limber.
- To prepare for winter sports, such as skiing, skating, sledding, and tobogganing, do simple squats, lunges, and knee-to-chest stretches.
- After you have finished playing, don't ever neglect the all-important cool-down, which allows your muscles to return to their normal, relaxed state. Without this important step, you run the risk of having your muscles tighten up or cramp.
Even so-called minor sports-related injuries may require that you seek medical treatment.
For minor injuries such as sprains or strains, follow the RICE (Rest, Ice, Compression, Elevation) protocol. Apply ice on the site of a minor sprain or bruise at least until any noticeable swelling has dissipated. Avoid keeping ice applied for more than 20 minutes because ice can actually begin wearing out your blood vessels, which in turns, increases the likelihood of additional swelling. After an hour has passed, re-apply an ice pack to the site if pain or swelling has not gone away.
Make sure to contact your physician if pain or swelling persists.
Tips for your kids:
- Always strive to maintain the recommended weight for your child's age and size-not the rigors of the sport.
- Be wary of so-called energy or power bars.
- Don't allow your child to load up on candy bars or carbonated rinks before or during a game. These foods will sap energy. Sports drinks are a better alternative.
- Encourage proper conditioning, including a supervised weight training program.
- Ensure your child is well-rested before an event. A tired body is much more prone to suffering an injury.
- Insist on warm-up exercises before any sports activity.
- Invest in and wear proper equipment, including safety equipment such as mouth guards, shatterproof goggles, and elbow and knee pads. If any equipment is excessively worn, replace it immediately.
Never forget the importance of proper nutrition (avoid high-fat foods, such as candy bars and fast food) and hydration (at least 8-10 glasses of water a day).
Traveling by car:
- Make sure your car seat is adjusted to the point that it allows you to sit comfortably and firmly against the seat back without having to lean forward or stretch. Engage your seat and shoulder belts and ensure that your headrest supports the center of the back of the head.
- If you are the driver, adjust the seat so you are as close to the steering wheel as comfortably as possible. Make sure that your knees are slightly higher than your hips. Place four fingers behind the back of your thigh closest to your knee. If you cannot easily slide your fingers in and out of that space, you need to re-adjust your seat.
- Foam back supports or pillows designed especially for driving can help minimize fatigue and strain on your lower back. Make sure that the widest part of the support is between the bottom of your rib cage and your waistline.
- Exercise your legs while driving by opening your toes as wide as you can and counting to ten. During a five count, tighten your calf, thigh and gluteal muscles (in that order), followed by relaxing those muscles. Roll your shoulders forward and back, making sure to keep your hands on the steering wheel and your eyes on the road.
- Take frequent rest breaks on long trips.
- Before embarking on your trip, try to do a quick warm up by taking a brisk walk or doing simple stretching exercises, such as knee-to-chest pulls, trunk rotations, and side bends with hands above your head and fingers locked. Also, cool down once you reach your destination. Take a brisk walk to stretch your hamstring and calf muscles.
- As a rule, check all bags that are heavier than 10% of your body weight.
- Do not overload your carry-on baggage Overhead lifting of a carry-on can lead to a muscle strain or sprain. When lifting your baggage to place in the overhead compartment, stand directly in front of the compartment so the spine is not rotated. Don't lift your bags over your head, or turn or twist your head and neck in the process. Ask the flight attendant for assistance.
- Use suitcases with wheels and a sturdy handle. Carrying heavy suitcases is a surefire way to strain your shoulders, back, hips, and knees. Do not overload the suitcase. Invest in a smaller, "Pullman-type" suitcase to handle overflow.
- Vary your position occasionally while seated on the plane. This helps to improve your circulation and avoid leg cramps. Occasionally exercise your legs and hips by bringing your legs in and moving your knees up and down. Try propping your legs up on a book or a bag under your seat.
- Avoid sitting directly under the air vents above you. The draft can increase tension in your neck and shoulder muscles.
- When stowing something under the seat in front of you, use your feet to gently guide the object. Avoid bending over and crouching.
- When you are seated, use supports, such as rolled-up pillows or blankets, to maintain your spine's natural curve. Tuck the support behind your back and just above the belt line and lay another pillow across the gap between your neck and the headrest.
Safe Travel For Children:
- Always use a car seat in a car when traveling with children below the age of 4 and weighing less than 40 pounds.
- Ask the airline for their policy on child car seat safety. Car seats for infants and toddlers provide added resistance to turbulent skies, and are safer than the lap of a parent in the event of an unfortunate accident.
- Make sure the car seat is appropriate for the age and size of the child. A newborn infant requires a different seat than a 3-year-old toddler.
- Car seats for infants should always face the rear. In this position, the forces and impact of a crash will be spread more evenly along the back and shoulders, providing more protection for the neck.
- Car seats should always be placed in the back seat of the car-ideally in the center. This is especially important in cars equipped with air bags. If an air bag becomes deployed, the force could seriously injure or kill a child or infant placed in the front seat.
- Make sure the car seat is properly secured to the seat of the vehicle and is placed at a 45-degree angle to support the head of the infant or child.
Working Around the House
There are hundreds of ways-some subtle and some readily apparent-that we can injure ourselves working or relaxing in and around the home. By not following basic safety precautions and just simple common sense, we put our health at risk doing even the simplest of tasks.
Following are some simple tips to follow.
- Avoid cradling the phone between your neck and shoulder. This can lock up the spinal joints in the neck and upper back. Consider a speakerphone or wireless headset.
- If you need to turn to carry what you've picked up, step in the direction of the turn to avoid twisting your body and straining your spine.
- Raise one foot slightly when standing doing ironing, or rest one foot on a small stepstool or box.
- Standing for long periods of time, during dishwashing, for example, can put a great deal of strain on your neck, back, knees, and feet. When standing at the sink, rest one foot on the inside cabinet below the sink and bend the knee on that leg. This will take some of the pressure off.
- Use pillows or some other firm support when sitting in a chair or couch watching television. Don't use the arm of the chair or couch for a headrest. This strains your neck.
- When lifting, don't bend from the waist. Squat down by bending both knees, keeping your back straight. This way, you are using your arms and shoulders-not your back-to do the lifting.
- When vacuuming, use the "fencer's stance" by putting all of your weight on one foot while stepping back and forward with your other. Use the back foot as a pivot when you need to turn.