Understanding the Neutral Spine Position

Management and prevention of back pain begin by understanding the neutral spine position. Three natural curves are present in a healthy spine. The neck, or the cervical spine, curves slightly inward. The mid back, or the thoracic spine, is curved outward. The low back, or the lumbar spine, curves inward again. The neutral alignment is important in helping to cushion the spine from too much stress and strain. Learning how to maintain a neutral spine position also helps you move safely during activities like sitting, walking, and lifting.
The natural curves of the spine are the result of the muscles, ligaments, and tendons that attach to the vertebrae of the spine. Without these supporting structures, the spine would collapse. They support the spine - much like guide wires support the mast of a ship. This guide wire system is made up mainly of the abdominal and back muscles. The abdominal muscles provide support by attaching to the ribs, pelvis, and indirectly to the lumbar spine. The muscles of the back are arranged in layers, with each layer playing an important role in balancing the spine. By using these muscles together, it is possible to change the curves of the spine.
Controlling pelvic tilt is one way to begin helping to balance the spine. As certain muscles of the back and abdomen contract, the pelvis rotates. As the pelvis rotates forward, the lumbar curve increases. As the pelvis rotates backward, the curve of the low back straightens. Rotation of the pelvis is like a wheel centered at the hip joint. The muscles of the upper thighs also attach to the pelvis and contraction of these muscles can be used to change the curve of the spine.
The abdominal muscles work alone, or with the hamstring muscles to produce a backward rotation of the pelvis. This causes the slight inward curve of the low back to straighten. If these muscles cause the curve of the low back to straighten too much, this may produce an unhealthy slouching posture.
In the other direction, as the hip flexors contract and back extensors contract, the pelvis is rotated forward - increasing the curvature of the lower back. If this curve is increased too much, another unhealthy posture may result. This condition is called lordosis in medical terminology, or swayback in common terms.
A balance of strength and flexibility is the key to maintaining the neutral spine position. This balance is the basis for optimal muscle function. Like a car, an imbalance may lead to wear and tear, eventually damaging the various parts of the car.
Muscle imbalances that affect the spine have many causes. One common cause of muscle imbalance is weak abdominal muscles. As the abdominal muscles sag, the hip flexors become tight, causing an increase in the curve of the low back. This leads to the swayback posture mentioned above. Another common problem results from tight hamstrings. As the hamstring muscles become tight, the pelvis is rotated backwards. This produces an abnormal slouching posture. Read More....>>>

Three Key Components in Back Injury Prevention

The cause of back pain in about 90% of cases is strain or sprain of back muscles, ligaments or soft tissue. These conditions generally heal completely, but often recur if prevention strategies are not used. Back pain in the remaining 10% of cases is due to more serious conditions such as degenerative disk disease or herniated disks in the spine. However, even these cases may be prevented – or treated – with proper posture, conditioning and body mechanics.

Proper posture, conditioning and body mechanics are the key components of any program designed to prevent back injuries.

Posture
Proper posture includes standing and sitting in an upright position without slouching, rounding of the shoulders or accentuating the natural curves of the spine. Poor posture typically involves holding the head too far forward or allowing the belly to pull the back forward. If possible, get in the habit of holding in the belly to keep it from protruding and putting excess force on the spine. When standing, bend your knees slightly. Years of poor posture can lead to weakened spine and abdominal muscles that contribute to back pain and injury.

Proper sleeping posture is also important to prevent and relieve back pain. Sleep on a mattress that is firm, not sagging, but not too hard. Do not sleep on your stomach. Instead, sleep on your side with a pillow between your knees or sleep on your back with a pillow under your knees.

Conditioning
Proper conditioning involves overall conditioning of the body and cardiovascular system with aerobic exercise, as well as strengthening and stretching core muscles of the spine and abdomen. Studies have shown that smoking can contribute to back pain and injury, so if you still smoke, you have yet another reason to think about quitting. Walking, swimming, bicycling and, for some people, slow, short-distance running are excellent ways to condition the entire body and improve cardiovascular health. In addition to improving general levels of health and fitness, these activities increase blood flow to the spine.

Aerobic activity, along with a healthy diet, helps prevent weight gain, which is a risk factor for back injury. To begin exercising, try walking for 10 minutes twice per day at a moderate pace and build up to at least one 30-minute walk per day three days a week; walking every day is preferable.

Stretching to increase back and abdomen flexibility should be done 5-7 days per week, and strengthening exercises should be done at least 4-5 days per week. Because back conditions vary, strengthening and stretching the muscles of the spine and abdomen should be done under the direction of a physician or physical therapist. These stabilizing exercises improve support for the spine itself, but proper technique is essential.

Body Mechanics
Body mechanics refers to the way we use our bodies to complete various tasks during activities of daily life. When lifting, bending or stretching, we should think of how we are using our back to avoid provoking an acute injury. There may be a simpler, less strenuous method or posture that can be used to get something done. Don’t be afraid to ask for help.

Instead of bending at the back to pick something up off the floor, stoop down at the knees. Keep the back as straight as possible and maintain proper posture. Instead of reaching overhead, use a sturdy stepstool. Push or pull with your entire body, not just your arms. Wear comfortable, low-heeled shoes.

When lifting, avoid reaching too far out for the object to be moved; instead, stand close and grasp the object close to the body. Maintain proper posture with back straight and head up. Bend at the knees and hips, not at the back or waist, and use your legs to lift. Pivot at the hips, not the back. If possible, lift from a tabletop or from waist height, rather than from the floor or over your head.

When working, whether sitting or standing, pace your activities and take frequent breaks. Vary the position of your body when standing. Stand on a cushioned mat, if possible. When sitting at a desk, think in terms of right angles (90°, or the shape of an L). Knees should be at 90° angles when the soles of the feet are touching the floor. The back and thighs should form 90° angles when the body is sitting properly in a chair. Wrists should be straight and elbows at 90° angles when the hands are on the desk or keyboard. Use a chair with proper low-back support and keep your head back and shoulders relaxed.

Some studies have found that back belts worn to prevent back injuries while lifting are not effective; however, they may help remind you to lift with proper body mechanics. When doing something that you haven’t done in months, whether it’s yard work or golfing, do some simple stretches for your entire body and for the particular muscles involved, before, during and after the activity. Maintaining your level of fitness throughout the year will make injury less likely. Read More....>>>