Low back injury from lifting is a major source of disability in western society. Every week hundreds of individuals In New Zealand will visit their Doctor, Physiotherapist or Health Care Professional seeking relief from the discomfort and loss of function of low back pain related to lifting.

The cost to the country in compensation claims and lost work time is considerable. Less measurable is the loss of enjoyment in life suffered by the individual. The vast majority of these injured will recover but a small percentage will go on to experience chronic low back pain.

As a Physiotherapist I have concerns that the general public have a relatively poor understanding of how to lift safely.

Campaigns in the past have focused on ‘Bending your knees, not your back’ and have helped increase the awareness of lifting safely.

Despite this improved awareness we still see significant numbers of patients presenting with lifting injury. What is most interesting is the large number of lifting injuries resulting from lifting less than 5% of body weight.

It would be reasonable to assume poor technique must play a major role in the development of these injuries.

Competitive weight lifters are an interesting group to observe. They are frequently lifting up to twice their body weight, yet are not a group that present with a high incidence of back injury.

These weight lifters have extremely strong trunk muscles, excellent technique and utilise very strong hip and leg muscles to produce power for a lift.

The key to safe lifting relies on the ability of the trunk muscles to maintain a straight lumbar spine (not necessarily vertical) and increase the intra-abdominal pressure during lifting. This reduces the load on the lumbar discs significantly. Coupled with a greater amount of flexion at the hips than the knees the lifter can utilize the power that can be generated in the large leg muscles to perform the lift.

For the majority of us this type of movement pattern does not come naturally and one of my common tasks as a Physiotherapist is to retrain this movement. Coupled with a specific strengthening programme for the trunk musculature you should be well on the way to safer and more comfortable lifting.

Mike Stewart is a Manipulative Physiotherapist at the Oamaru Physiotherapy Clinic. He has post graduate qualifications in Manipulative Therapy and Sports Medicine and is a Registered Physiotherapy Acupuncturist.

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