Sitting, Waiting,

Wishing: How To
Prevent Low Back
Pain.Richard Pappas, Arvind Seth, Evan Venters
-Barry University Occupational Therapy
Back Pain by Definition

Back pain is one of the most common medical problems, affecting 8 out of
10 people at some point during their lives. Back pain can range from a dull,
constant ache to a sudden, sharp pain. Acute back pain comes on suddenly
and usually lasts from a few days to a few weeks. Back pain is called
chronic if it lasts for more than three months.
 Causes of pain

Back pain can be caused by different work factors. The exact cause is often unclear,
but back pain is more common in occupational roles that involve:
Repetitive tasks - such as manual use of equipments.
Force - heavy manual labor, handling tasks, pushing and pulling loads that require
excessive force
Posture - poor/ awkward postures such as stooping, bending over or crouching
Duration - maintaining the same position for long periods of time e.g. working with
computers or driving long distances. Also working when physically overtired
Vibration - operating vibration tools
 OCCUPATIONAL THERAPISTS
have the knowledge and the skills to help
people overcome these and other barriers they
may face in doing their everyday occupations!
ROLE OF OCCUPATIONAL THERAPY
The occupational therapist teaches the principles of body mechanics
related to static & dynamic postures as well as transition patterns. To
facilitate learning occupational therapist applies the biomechanical
principles to commonly perform task & shows the clients how to
integrate the principles into everyday tasks. Therapeutic activities , and
simulated activities of daily living are selected for practice
As an occupational therapist we enable people to do what they need
and want to do in all aspects of their lives. We believe that an
essential part of healing is being able to participate in the daily
activities that you find meaningful. For an adult, this might mean
being able to fix a meal for your loved ones, work, leisure,social
participation etc.
We call these meaningful daily routines
"activities of daily living." These basic building
blocks of daily life are what occupational
therapist help you participate in, when it has
become difficult to do so!
Community is defined as a group of
persons who are connected
through common activities, work,
interests, culture, beliefs,
geography, health conditions, or
other factors.
Community practice from Occupational
therapys perspective is that it is client
centered (i.e., tailored to meet the needs
of clients, involving clients in the process)
and that it addresses not only the person,
but also other societal and environmental
factors that affect health.
Anatomy of the Back

The back is composed of

numerous bony structures,
ligaments, tendons, nerves
and blood vessels, spinal
cord, vertebra, and
muscles.

There is a lot that can go

wrong!
What Causes Back Pain?

Degeneration such as arthritis, osteoporosis, narrowing of the spinal

canal, bulging discs/herniations, muscle spasms, sciatica, lumbago,
etc.
Muscle imbalances
Tight muscles
Poor posture
Poor body mechanics
Prolonged sitting
Obesity
Trauma
Types of Back Pain

Acute: sudden onset of back pain often caused by sudden injury to

muscles and ligaments supporting the back.

Chronic: pain that persists 12 weeks or longer.

Posture

Posture is the position in which we hold our bodies while standing,

sitting, or lying down. Good posture is the correct alignment of body
parts supported by the right amount of muscle tension against
gravity. Without posture and the muscles that control it, we would
simply fall to the ground.
Why is Posture so Important?

Helps us keep bones and joints in correct alignment so that our muscles are used
correctly, decreasing the abnormal wearing of joint surfaces that could result in
degenerative arthritis and joint pain.
Reduces the stress on the ligaments holding the spinal joints together, minimizing
the likelihood of injury.
Allows muscles to work more efficiently, allowing the body to use less energy and,
therefore, preventing muscle fatigue.
Helps prevent muscle strain, overuse disorders, and even back and muscular pain.
Consequences of Poor Posture

Excessive strain on postural muscles.

Misaligned joints.
Development of muscle imbalances.
Poor spinal health.
Effects of Prolonged Sitting

Sitting can lead to back pain because it puts more pressure on the spine than standing
Discs are designed to expand and contract with movement which increase nutrients and
blood flow
Prolonged sitting can cause the hip flexors to become tightened, which can contribute to
low back pain
Hip flexors are a group of muscles that allow us to bring our knee up towards our trunk.
The two main hip flexors are the iliacus and the psoas major, which come together to form
the extremely strong iliopsoas tendon that attaches the hip flexor muscles to the femur
A neutral spine can be maintained by activating the abdominal and gluteal muscles
Disc Pressure in Various Sitting Positions
Maintaining a Neutral Spine

Activating the abdominal and the gluteal muscles while sitting facilitates a neutral pelvis and
spine:
Spinal Bracing Sequence
Dead Butt Syndrome

Dead-butt syndrome has to do with reciprocal inhibition because the hip

flexors are activated while the glutes are relaxed and in an elongated position.

Inhibition of muscles contraction in the glutes while sitting, standing, and

walking can cause the lower back muscles to compensate for the glutes and
lead to low back pain from overuse

To avoid dead-butt syndrome, stand up from your chair every 45 minutes to

do stretches that will lengthen the hip flexors and strengthen the glutes .
How do you pick a box up?
Video: https://youtu.be/zDUg7zHYXxE
Proper Mechanics During Object Pickup
Added Disc Pressure With Different Types of
Bending
The Role of the Pelvis and Back Pain

The pelvis plays a major role in the presence of back pain.

Many muscles run across or through the pelvis. If there is an imbalance between muscle tension
and length, the pelvis may shift into a non-neutral position which places more pressure on the
low back.

Lets take a look at this picture!

 Achieving a balance pelvis...A great start to
optimal back health!

To achieve proper alignment throughout the rest of the spine, restoring proper pelvic alignment is
essential!

Steps to take:

1. Determine if you have anterior or posterior pelvic tilt.

2. Perform the designated strength and stretching exercises
3. Maintain improvements
Neutral Pelvis and Head Position
Force on the Cervical Disc
Anterior Pelvic Tilt
Psoas Major + Iliacus = Iliopsoas muscle
Posterior Pelvic Tilt
Single sided pelvic tilt (Pretzel pelvis)

Take a single sided approach if you notice one side of your hips is higher or
lower than the other side.

Lower Side Stretches- Hip Flexor Stretch, quadriceps stretch

Lower Side Strengthening- Gluteal strengthening, low back strengthening

Higher Side Stretches- Hamstring and gluteal Stretches, low back stretches

Higher Side Strengthening- hip flexors and quadriceps strengthening

Hip Flexor Stretches
Gluteal Activation Exercises
Hamstring Stretch
Quadratus Lumborum
Stretch
Gluteal and High Hamstring Stretch
Gluteal stretch
Mobility Goal

Your goal is to dedicate a minimum of 10 minutes a day for mobility and

flexibility.

Todays modern lifestyle involves an enormous of of sitting (deactivates and

tightens important muscles).

Find your weakness and work on it for 10 mins each day!

How long to stretch for?

Previous research suggested that we need to hold stretches for 15-30

seconds.

Modern studies suggest that muscle length does not occur during that
time frame.

All stretches should be performed for a minimum of 2 minutes.

Foam Rolling- Another Great Option!

Foam rolling is a myofascial release method that one may perform on

themselves with a variety of tools. While stretching lengthens a muscle, it
does not target specific tissue adhesions that also attribute to tightness and
pain.

Foam rolling is a great and easy method to reduce tissue adhesions and
muscle tightness/soreness to restore normal range of motion and movement .
Summary

What are some primary causes of low back pain that can be
modifiable?
Describe good posture.
Explain the role of the hip in relation to back pain.
Stretching!
Limit Sitting.
Turn posture into an involuntary reaction.
Get your Fellow Employees Involved!

Please ask us for demonstrations!

Any questions or comments?