Back Safety

Back Safety

 

Back Safety: Getting Into and Out of Bed

Safety Tip: After you stand up, wait a moment before walking to be sure you're not dizzy.

Good posture protects your back when you sit, stand, and walk. It is also important while getting into and out of bed. Follow the steps below to get out of bed. Reverse them to get into bed.

1. Roll Onto Your Side

  • Keep your knees together.

  • Flatten your stomach muscles to keep your back from arching.

  • Put your hands on the bed in front of you.

2. Raise Your Body

  • Push your upper body off the bed as you swing your legs to the floor.

  • Keeping your back straight, move your whole body as one unit. Don't bend or twist at the waist.

  • Let the weight of your legs help you move.

3. Stand Up

  • Lean forward from your hip and roll onto the balls of your feet.

  • Flatten your stomach muscles to keep your back from arching.

  • Using your arm and leg muscles, push yourself to a standing position.

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Back Safety: Bending

Bending can strain or even injure your back. Follow the tips below to move safely and protect your back as you perform everyday activities.

Always face the object you're bending in front of.

Bending Over

  • Keep your feet shoulder-width apart.

  • Move your whole body as one unit.

  • Bend at your hips and knees, not at your waist.

  • Flatten your stomach and tighten your leg muscles.

  • To keep your spine straight, let your buttocks move out behind you. Don't try to tuck them under.

  • If you need to, place one hand on a sturdy object for support.

Bend at your hips and knees instead of at your waist.

Bending to the Floor

  • Lower yourself to one knee. If you can, rest one hand on a sturdy object to help lower yourself.

  • Rest one arm on your raised knee.

  • Don't bend at the waist.

  • Do not hunch your back or neck to reach to the floor. Instead, bend more at your hips and knees to get closer.

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Back Safety: Lifting

Lifting can strain or even injure your back. Follow these tips to keep your back safe while you bend, lift, and carry.

Step 1:

  • Face the object.

  • With your back straight, get down on one knee.

  • If you can, tilt the object so one side lifts off the ground.

  • Keep the object close to you.

Step 2:

  • Tighten your stomach muscles.

  • Use your legs, arms, and buttocks to lift, not your back.

  • Avoid twisting.

  • Lift the object to your knee.

  • Grasp the object firmly.

Step 3:

  • Lift with your arms and legs, not your back.

  • Move quickly to help make this easier.

To Carry an Object:

  • Hold it close to your body.

  • Bend your knees slightly as you walk. The heavier the object, the more you should bend your knees.

  • Get help with heavy or unbalanced objects.

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Back Safety: Pushing and Pulling

Pushing can be hard on your back. Pulling can be even harder. So, push rather than pull when you can. Follow the tips on this sheet to help protect your back.

Pushing a Light Object

  • Bend your knees slightly. Keep your ears, shoulders, and hips in line.

  • Tighten your stomach muscles.

  • Lean in slightly toward the object you're pushing.

  • Use your legs and the weight of your body to move the object.

  • Take small steps.

Pushing a Heavy Object

  • Tighten your stomach muscles.

  • Bend your knees.

  • Lean in toward the object you're pushing. The heavier the object, the more you should lean.

  • Try not to hunch your back: Keep it straight.

  • Use your legs and the weight of your body to move the object.

  • Take small steps.

Pulling

  • Face the object you're pulling.

  • Keep your knees slightly bent.

  • Step backward and pull the object with you.

  • Don't twist your body. If you're using one hand, putting the other hand on your hip can help keep you from twisting.

  • When pulling heavy objects, lean back, bending at the knees and hips. Keep your arms straight. Let your body weight pull the load.

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Back Safety: Sleeping Positions

Good posture protects your back when you sit, stand, and walk. It is also important while sleeping. Keep your ears, shoulders and hips in line. Try the tips below. Also, be sure to follow any guidelines from your health care provider.

If You Lie on Your Back

Place pillows under your legs from your thighs to your ankles.

Safe Sleeping

  • Ask your health care provider how firm your mattress should be.

  • Find a position that keeps your back aligned and comfortable.

  • Fill gaps between your body and the mattress with pillows.

  • Never sleep on your back without bending your legs.

  • Never sleep on your stomach.

If You Lie on Your Side

Support your upper body and top leg with pillows.

Turning in Bed

  • If you change positions, you will need to move your pillows. This can become so natural that you hardly wake up.

  • When you turn in bed, move your whole body as one unit.

  • Tighten your stomach muscles. Bend your knees slightly toward your chest.

  • Roll to one side, keeping your ears, shoulders, and hips in line.

  • Be careful not to bend or twist at the waist.

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Back Safety: Sitting

Sitting can strain your back if you don't do it right. Learn the right moves to protect your back.

Sitting Down

Follow these steps to sit down. Reverse them to get back up.

  • Make sure the chair is behind you.

  • Place one foot slightly behind the other.

  • Tighten your stomach muscles. Bend forward from the hips, keeping your back straight.

  • Hold the armrests or sides of the seat for support.

  • Bend your knees. Use your leg muscles to lower yourself onto the seat.

  • Scoot back in the seat until you are comfortable.

Sitting Safely

  • Keep your feet flat. Don't cross your legs.

  • A low footrest (no higher than 8 inches) may help.

  • A support behind your lower back or between your shoulder blades can help make you more comfortable.

  • When sitting for long periods, change your position from time to time. Also, get up every half hour and move around.

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Back Safety: Standing

Good posture decreases back pain by reducing strain on your muscles. Remember to check your posture, using the self-help tips below, every time you move or adjust position.

Standing

  • To help keep your spine straight, line up your ears, shoulders, and hips.

  • Stand with your feet shoulder-width apart. Or, place one foot slightly in front of the other.

  • Keep your knees relaxed and stomach muscles slightly flattened.

Bending Over

  • Bend at your hips and knees.

  • Don't bend at your waist or round your back.

  • Rest your weight on your arms if possible.

Working

  • When standing for a long time, put one foot on a footrest. This may help ease strain on your back. The footrest should be about 5-8 inches high.

  • When reaching for objects over your head, use a stepladder. When you can't, be sure to tighten your stomach muscles to keep your back from arching.

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Back Safety: Turning

Protect your back while you stand or turn. Turning can twist your spine if you don't do it right. Keep the tips on this sheet in mind as you move.

1.

  • To turn, move your feet instead of twisting your body at the waist.

  • Turn your hips and shoulders together.

2.

  • Take short steps around.

  • Try pivoting on the heel closest to where you're headed.

3.

  • Step forward out of the turn.

  • Keep your knees relaxed and your stomach muscles tightened.

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Back Safety: Basics of Good Posture

Good posture protects you from injury. It also increases your comfort. Aim for good posture throughout the day.

Check Your Posture

The human body works best when it is properly aligned. To improve your standing posture, follow these steps:

  • Take a moment to close your eyes and feel your body. Then breathe deeply and relax your shoulders, hips, and knees.

  • Now, from the very top of your head, lift up just a bit. Think of a line linking your ears, shoulders, hips, and ankles. Adjust your body to follow the line. You may need to relax your hips and tuck your buttocks under a bit.

  • Next, take a look at yourself in a mirror. Is one ear, shoulder, or hip higher than the other? They should be level.

Check How You Sit

When you sit properly, pressure on your back is reduced. Try these steps:

  • Sit so that the curve of your lower back fits easily against the chair. Keep your gaze level.

  • Support your feet. They should be flat on the floor or on a footrest. Your knees should be level with your hips.

  • Adjust the chair height as needed. Sit so your forearms are level with the work surface.

Proper Posture Helps

When your back is aligned, it's more likely to stay safe throughout the day.

  • Standing in place. Rest one foot on a stool or low box to ease pressure on your lower back. Switch feet often. If you can, adjust the height of your work surface so your neck and shoulders aren't under strain.

  • Driving. Sit close enough to the steering wheel to keep your knees slightly bent. For comfort, your knees should be level with your hips or just a bit lower. Sit as straight as you can. The curve of your lower back should be fully supported.

  • Walking. Stand tall and walk with your head up. Let your arms swing while you walk. This helps relax muscles. Wear shoes that fit and support your feet. If you will be standing or walking for a long time, don't wear high heels.

  • Sitting and sleeping. Choose your furniture with care. Make sure it's not causing or increasing your back pain. Chairs should allow for comfortable, correct sitting posture. Use pillows for added support if needed. Your bed should support your back's natural curves without being too hard or too soft.

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Back Safety: Poor Posture Hurts

An unhealthy spine often starts with bad habits. Poor movement patterns and posture problems are common causes of back pain. Disk, bone, nerve, and soft tissue problems can all be affected by poor posture. They can lead to pain, stiffness, and other symptoms.

Poor Posture Backfires

Poor posture can cause pain. Too much slouching puts pressure on the disk. An excessive lumbar curve can overload and inflame the vertebrae. As a result, the back muscles may tighten or spasm to "splint" and protect the spine. This adds to the pain you feel.

Proper Posture: The Key to Safe Movement

An excessive lumbar curve (extension) harms the vertebrae.

Your spine bears your weight throughout the day. This is true whether you're sleeping, standing, or bending. Certain positions strain your spine more than others. But by maintaining proper posture in all positions, you can reduce the stress on your spine.

To improve your standing posture, follow these steps:

  • Breathe deeply.

  • Relax your shoulders, hips, and ankles.

  • Think of the ears, shoulders, hips, and ankles as a series of dots. Now, adjust your body to connect the dots in a straight line.

  • Tuck your buttocks in just a bit if you need to.

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Using Crutches: Sitting, Standing, Through Doors

These instructions will help you get around while on crutches.

Sitting Down

  1. Back up until you feel the chair with the back of your leg. Hold both crutches in the hand on the affected side.

  2. Grab the armrest or the side of the chair with your free hand.

  3. Lower yourself onto the front of the chair, then slide back.

  4. To get up, reverse the 3 steps.

TIP: Find sturdy, high-seated chairs with arms. If you must use a chair that swivels or has wheels, back it against something stable before you sit down.

Getting Into Cars

  1. Follow the first step above for sitting in a chair. Use the doorjamb or the dashboard for support as you lower yourself. Watch your head. Don't hold on to the car door, or it may close on you.

  2. With your hands, lift your affected leg into the car. Or use your unaffected leg to hook your affected leg behind the ankle and lift it in. 

Through Doors

  • To push a door open, stand sideways and push the door open with your body.

  • To pull a door open, stand to the side. Get your balance and pull the door fully open with your hand. Plant the tip of the nearest crutch inside the door to act as a doorstop. Leave the crutch in place until you've walked through.

TIP: Avoid revolving doors. Instead, use entrances designed for disabled persons.

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Fitting Your Cane

Proper fitting helps you use your cane safely and effectively. When fitting the cane, stand up straight and wear the shoes you will normally use to walk. If your cane doesn't feel right, ask your doctor, nurse, or physical therapist (PT) to check the fit.

To check fit: Place the tip 2 inches in front and 6 inches to the side.

Getting to Know Your Cane

A cane is often used after crutches or a walker. It helps with balance as you regain strength and mobility. Many different kinds of canes are available. Some have only one tip. Others have four tips to aid balance. Hold the cane on theunaffected (stronger or uninjured) side unless told otherwise.

The Cane Fits If:

  • Your wrist is even with the handgrip when your arms hang at your sides.

  • Your arm bends slightly at the elbow when you hold the handgrip.

Press the buttons to lengthen or shorten an adjustable metal cane. A wooden cane must be cut to the right height.

Precautions

  • The cane should have nonskid rubber tip(s) to prevent slipping. Change tip(s) that look worn.

  • Keep the cane away from your feet so you don't trip.

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Fitting Your Walker

Proper fitting helps you use your walker safely and effectively. When fitting your walker, stand up straight and wear the shoes you will normally use to walk. If your walker doesn't feel right, ask your doctor, nurse, or physical therapist (PT) to check the fit.

To check fit: Stand in the center of the walker. Make sure that the walker is locked open and that all four legs are on a level floor.

Getting to Know Your Walker

A walker is often used for injuries involving the leg or hip. It may also be used for nerve or muscle problems that affect balance. A walker gives more stability than crutches. Some walkers have wheels, others do not. Your healthcare provider will help you choose the best type of walker for your needs. Follow any special instructions you are given.

A Walker Fits If:

  • Your wrists are even with the handgrips when your arms hang at your sides.

  • Your arms are slightly bent at the elbows when your hands are on the grips.

Precautions

  • If your walker does not have wheels, it should have nonskid rubber tips to prevent slipping. Change tips that look worn.

  • If you're using a folding walker, be sure you know how to lock it open. Check that it's locked open before use.

  • Keep all four legs of the walker at the same length.

  • Keep your back straight. Don't hunch over the walker.

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Walkers: Up and Down Curbs

Use these instructions to help you get around when using your walker. Remember to step up with your unaffected (uninjured) leg and down with your affected (injured) leg.

Up with the unaffected leg.

Up Curbs

  1. Move your feet and the walker as close to the curb as possible.

  2. Put your weight on both your legs, then lift the walker onto the sidewalk.

  3. Step onto the sidewalk with the unaffected foot. Using the walker to support your weight, bring up the affected foot.

Down with the affected leg.

Down Curbs

  1. Move your feet and the walker as close to the edge of the curb as you safely can.

  2. Lower the walker onto the street, keeping its back legs against the curb.

  3. Using the walker to support your weight, lower the affected foot. Then step down with the other foot.

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Fitting Your Crutches

Proper fitting helps you use your crutches safely and effectively. When fitting crutches, stand up straight and wear the shoes you will normally use to walk. If the crutches don't feel right, ask your doctor, nurse, or physical therapist (PT) to check the fit.

To check fit: Place the tips 2 inches in front and 6 inches to the side.

Getting to Know Your Crutches

Crutches are often used for injuries to the knee, ankle, foot, or hip. Using crutches requires good coordination, balance, and upper body strength. If you're using only one crutch, keep it on the unaffected (uninjured) side unless told otherwise.

The Crutches Fit If:

  • You can put 2 to 3 fingers between your armpit and the top of the axillary pad.

  • Your arms are slightly bent at the elbows when your hands are on the handgrips.

  • Your wrists are even with the handgrips when your arms hang at your sides.

Precautions

  • Crutches should have nonskid rubber tips to prevent slipping. Change tips that look worn.

  • Don't let armpits rest on the pads-this can cause tingling, numbness, and loss of muscle strength.

  • Don't use crutches that are too short or mismatched. They can cause back pain and falls.

  • In wet weather, dry crutch tips when coming indoors.

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Using a Cane with Your Prosthesis

Learning to walk with your prosthesis takes practice. To prevent falls, you may need a cane for balance and support. Work with your physical therapist and prosthetist (an expert who makes and fits your prosthesis). They'll teach you how to use the cane properly. Follow all instructions from the physical therapist and prosthetist closely.

Walking with a Cane

  • Hold the cane on the side of your intact limb (unless told otherwise by your healthcare team).

  • Put your weight on your intact limb and find your balance.

  • Move the cane and the prosthetic limb forward at the same time.

  • Support your weight on both the cane and your prosthesis.

  • Step through with your intact limb.

  • Put your weight on your intact limb and take the next step, using the cane and your prosthesis.

    When climbing stairs, always lead with your intact limb.

Using Steps

  • If there is a railing, hold on to it with your free hand.

  • Step up with your intact limb first.

  • Then move the cane and prosthetic limb together to the same step as your intact limb.

  • To walk down steps, hold the railing with your free hand.

  • Step down with your prosthetic limb and the cane first.

  • Then follow with your intact limb to the same step.

Note: Consult with your physical therapist and prosthetist to learn how to handle steps without railings.

Home Safety Tips

Making a few changes at home can reduce hazards and help prevent falls. Ask a family member or friend to make these changes before you go home.

  • Remove objects that could cause you to trip, such as area rugs.

  • Store supplies between waist and shoulder level. This will help you maintain balance as you reach for things.

  • Make sure all rooms are well lit.

  • Move all electrical cords out of the way or tape them securely to the floor.

  • Pick up clutter. Keep floors clear at all times.

  • Reduce stair use by making the most of each trip (do more than one task per trip).

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Preventing Falls: Moving Safely Out of a Chair and Bed

You can move safely, whether you're at home, in a hospital, or out and about. Plan your movements. Don't rush. The phone or doorbell can wait. And learn how to perform daily tasks safely, like getting in and out of a chair or bed. The more careful you are, the less likely you are to fall.

Find sturdy, high-seated chairs with arms. If you must use a chair that swivels or has wheels, back it against something stable before you sit down.

Getting In and Out of a Chair

When you can, choose chairs with long armrests.

To sit down:

  • Back up until you feel the chair against the backs of your legs.

  • Grasp the armrests with both hands and sit down.

To stand up:

  • Scoot to the edge of the chair. Place both feet firmly on the floor.

  • Grasp the armrests or put both hands on your thighs and slowly push yourself up.

If you use a walker, place it close to the side of the bed before you lean on it.

Getting Out of Bed

If you're using a hospital bed, make sure it's locked and in a low position. Put the head of the bed up.

To get up:

  • Move to the edge of the bed and roll onto your side. Push yourself up with your hand. At the same time, swing your legs over the side of the bed.

  • Sit on the edge of the bed for at least 30 seconds before standing up.

  • With both feet firmly on the floor, put your hands beside you on the bed and slowly push yourself up.

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Preventing Falls: Moving Safely Using a Cane or Walker

Keep the cane away from your feet so you don't trip.

A walking aid, such as a cane or walker, can help you stay more independent and avoid falls. Remember to keep your walking aid within easy reach when you're in a chair or in bed. And learn how to use it safely so you don't injure yourself.

Using a Cane

If you have a stronger side, hold the cane on that side.

1. Get your balance.

2. Move the cane and your weaker leg forward.

3. Support your weight on both the cane and your weaker side.

4. Step with your stronger leg.

5. Start again from step 1.

If you're using a folding walker, be sure you know how to lock it open. Check that it's locked open before each use.

Using a Walker

1. Roll the walker (or lift it, if you're using one without wheels) forward about 12  inches.

2. Step forward with your weaker leg first.

3. Use the walker to help keep your balance.

4. Bring your other foot forward to the center of the walker.

5. Start again from step 1.

Helpful Tips

  • Check with your healthcare provider about the right walking aid to use. Ask about a walker with a seat attached.

  • Check the tips of your cane or walker to make sure they have nonskid covers.

  • Move slowly from room to room. Don't rush.

  • Sit down to get dressed.

  • Use a fanny pack or backpack to keep your hands free.

  • Get help for jobs that mean climbing, even on a stepstool.

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Preventing Falls: Moving Safely Outside

Moving safely outside your home can be a challenge. Take care when walking up and down stairs and curbs. And be sure to wear sturdy, comfortable shoes and pay attention to where you step. Here are more tips to keep you from falling.

 

When stepping off a curb with a walker, lower the walker onto the street first, then step off the curb.

Using Curbs and Stairs

Curbs, steps, or uneven pavement can trip you. Take care when near them.

  • Check the height of a curb before stepping up or down. Be careful with uneven and cut-out sections of curbs.

  • Don't rush when crossing the street. Watch for changes in pavement height.

  • On stairs, grasp the handrail and take one step at a time. If you ever feel dizzy on stairs, sit down until you feel better.

Wearing Shoes That Keep You Safe

When you shop for shoes, keep these things in mind:

  • Choose shoes with rubber or nonskid soles. Athletic shoes are a good choice.

  • Choose flats or shoes with low heels. Avoid high heels or platforms.

  • All footwear should be sturdy and well-fitting. Don't wear flip-flops or backless shoes or slippers.

  • Don't walk around in stocking feet. Shoes are your safest bet, even when indoors. If you like, keep one pair of shoes just for indoors.

Moving Objects from Place to Place

Carrying objects can be hard, especially if you use a cane or walker. These tips can make it easier:

  • Use a rolling cart to carry things like groceries.

  • Wear clothes with large pockets for carrying small objects.

  • Divide large loads into smaller loads. That way, you can always keep one hand free for grasping railings.

  • Don't carry objects that block your view. That's a sure way to trip.