Exercises and Ergonomics
Regularly exercising muscles in a balanced way is important for the following reasons:
- restores a sense of balance
- reduces load on tendons and ligaments
- reduces forces acting on the spine
- enables energy efficient motion
Typically, a patient goes to a doctor complaining of back pain, and leaves the clinic with a recommendation to do exercises. But how can the patient know which exercises to do?
Going to the gym is a great thing to do in terms of getting out and moving about, getting into shape and keeping fit. However, doing exercises without any guidance is not so healthy for our musculoskeletal system. We are unaware of weak muscles that are not playing their role in maintain muscle balances, and tend to strengthen muscles that already function well, and then reinforce certain pathological patterns of movement that were already there previously to a lesser degree.
A patients’ posture and gait gives us a good picture of muscle imbalances and can therefore guide as to which exercises the patient can do in order to restore an ideal balance. The most common example of gross muscle imbalance is seen in the typical “C” shaped spine so rampant in today’s society (see figure 1). Many of us sit in front of computers all day long, with our arms stretched out to the front pulling on our scapulae outwards. The chest muscles are in a shortened position for many hours of the day; the upper back muscles become stretched and weak. We are then unable to hold ourselves in an erect sitting or standing posture. Our upper back muscles are so weak, sometimes even two minutes of sitting up straight is too demanding and cause pain! This does not mean that is it bad for you. It means you need to do some work to strengthen these weak muscles. A good physiotherapist will be able to diagnose this muscle imbalance and prescribe exercises to strengthen the upper back muscles and not the chest muscles.
Finally, prevention is better than cure. Here are a couple of tips which are helpful in preventing relapse of the pain if this comes from a musculoskeletal source.
It is very important to learn how to correctly sit, get up and particularly how to bend down and lift things. Instruction regarding the height of the table you sit at, the computer, the type of keyboard and mouse in use, are all important. If working at the computer for long periods of time, try to focus on a faraway object for a few seconds every 20 minutes or so. Try and a chose something at least 3-4 metres distant. This allows the eyes some rest and prevents excess strain on them.
Sprains to back muscles come not necessarily from lifting heavy things but mainly from bending down incorrectly. Bending down on an angle to pick up even a piece of paper can lead to a sprain of the back muscles, causing excruciating pain for weeks. If you have to pick something up the following steps must be made to safeguard your back:
Bring yourself close to the object you want to lift
- Face the object
- Bend down while bending your knees
- Grab the object as close as possible to your feet so you don’t have to stretch out far
- Raise yourself by slowly straightening your knees.
- Straighten your spine LAST