Proper Forward Bending to Minimize Back Injury

Key points

1. Perform movements properly versus complete avoidance


2. Ensure good joint movement, flexibility, strength, nutrition, and mental health


3. Bend at the hips and not at the back


4. Bend the knees and push the buttocks out backwards


5. Stretch the hamstrings and gluteal muscles


6. Strengthen hamstrings, gluteals and lower back muscles


7. Have a health care professional, specializing in backs analyse, your movements

Studies have found that 80% of the population will have experienced some type of back pain sometime in their lifetime. If you haven't experienced it yet you probably will sometime in the future. Back pain leads to lost work days, lost wages, the inability to enjoy social activities and an overall stress on your body.

In our society we have developed very poor habits towards our overall health. We over work our body by repetitively performing the same activities multiple times or performing stationary activities for extended periods of time. Our body can not handle these stressors because we lead inactive lives. We tend to be overweight because of this inactivity. We consume foods that are poor for our body's overall health. We lead lives that are both stressful on our body and on our minds. As a result we have developed imbalances in strength and flexibility and an inability to recuperate after even mildly strenuous activity. In essence, we tend to perpetuate the factors that cause back pain.

When we are in pain, we tend to us medication so that we can continue to work and play. This doesn't fix the problem but only masks it. We simplify our self-treatment by following the old adage of, "If it hurts, don't do it". Avoid any movement that causes pain. Avoiding may help with the pain and allow for healing but is will not fix the problem. The advice of avoidance comes with good intentions but we must realize that our body is an amazing machine and it requires us to be active to heal and strengthen. To take care of our backs, and our body as a whole, we have to ensure that our joints are moving well (with chiropractic care), our muscles are strong and flexible (stretching, exercise, yoga, Pilates, massage and/or Active Release Technique), we consume a healthy diet, we manage our mental stress, we don't over work our body, and we need to move properly.

In the case of back injuries, specifically muscular strains and intervertebral disc injuries, most injuries occur when the person is in a flexed position (bending forwards). These injuries are common in architects, welders, dental hygienists, manual labourers, movers, mothers changing babies, golfers, chiropractors, etc.

What we see happening is that in these jobs people flex forward for long periods of time. The repetitive nature alone can be too much for the spine. But it is how the person flexes forward that makes the difference. Flexing forward from the lower back causes the natural concave curve of the lower back to flatten out or even become convex. This puts the lower back muscles on a stretch and thus causes them to be weaker. This makes them more prone to being strained. It also puts excessive amounts of strain onto the ligaments and the intervertebral discs between the vertebrae. This leads to sprains to the ligaments and possibly a "herniated disc".

The proper way to perform these moves is to ensure that you bend at the hips. This is called a hip hinge. The reason people don't perform this move correctly is because of three reasons. One reason is that they have developed a bad habit of performing the move incorrectly. Another reason is that their hamstrings and gluteal muscles are too tight. These muscles help pull the pelvis backwards thus preventing the hip from hinging. If they do not move well the lower back has to perform more of the work. The second reason is that the muscles on the back side of the body are too weak and thus proper technique is unable to be held.

To fix this problem we have three goals to achieve.

The first goal is to train the body to perform the movement properly. This can be done using a broom handle. Place a broom handle along the length of your spine. Grab hold of the broom handle at your tailbone and the other on your upper back. Then bend forward. Make sure you do this by imagining you are pushing your buttocks out behind you. This will give you the sensation of the front of your thigh coming closer to your abdomen. You are bending at your hip. To assist with hip flexion if you bend your knees slightly your hip flexion will improve. The reason is that the hamstrings cross two joints, the knee and hip, and thus by bending your knees you shorten the hamstrings at the knee which allows you to lengthen the hamstrings at the hip. Incorrect movement of this exercise results in the upper back moving away from your club/broomstick or feeling your lower back press up against the club/broomstick. When performed correctly the buttock sticks out and the concaved curve in the lower back is maintained. As you raise up from the bent over position make sure that you clench your buttocks to help activate these muscles; lifting with your legs and not your back. This activity can also be performed while squatting as well as while standing up from sitting in a chair.

Goal number two is to improve flexibility in the hamstrings and buttock muscles. To stretch the hamstrings effectively there are numerous methods which have you standing, sitting or laying down. An effective way to improve the flexibility of your gluteal muscles is the lying down gluteal stretch. To improve range of motion these muscles should be stretched for 30 seconds, three times per side and should be performed 3 to 5 times a day.

Goal number three is to improve the strength of the back and leg muscles. The bridge and its variations as well as the hamstring ball curl are excellent exercises to strengthen the gluteal muscles and hamstrings as well as the lower back. Another great exercise for the lower back is the superman exercises at its progressions. The stiff legged deadlift is a great all round exercise provided the technique has been perfected.

If you are having back problems seek out a health care professional who specializes in back pain. The above information is for interest only. It is not meant to be used as a diagnosis or treatment. Perform these exercises at your own risk. It is best to see a professional for the proper treatment of your injuries.

Just remember, " Don't avoid it, do it right".