Prevention and Management of

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Prevention and Management of Neck and Back
Injuries James Grubinskas DC, CEAS Chiropractor Al
liance Occupational Medicine
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Objectives

• Understand proper posture to prevent neck back
  injuries
• Understand the types of neck back injuries
• Understand risk factors associated with neck
  back injuries
• Understand the common causes of neck back
  injuries
• Identify ways to prevent neck back injuries
• Identify what to do in the event your neck or
  back is injured

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Statistics

• Financial impact of occupational injury and
  illness in the US is 250 Billion (2007)
  affecting 3.8 million injured workers
• Back injuries account for 1 out of 5 workplace
  injuries or illnesses (Bureau of Labor
  Statistics)
• 186 million work days are lost each year to back
  pain alone.

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Impact of Obesity on Musculoskeletal Disorders
and WC Costs

• 37.5 of adults are currently obese
• CA. WC Institute claims with obesity as a
  comorbity vs. those without had the following
  characteristics
• - more claims lost time from work (83 vs. 29)
• - increased lost work days (approx. 80 greater)
• - more frequent attorney involvement (approx.
  68 vs.
• 15)
• - greater use of opiods (approx. 69 vs. 19)
• - higher medical cost claims (51K vs. 7503)
  and
• indemnity costs (59K vs. 5400)

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Non Work Combined Medical Conditions

• Age
• Gender
• Genetic Predisposition
• Smoking
• Weight
• Prior Injuries
• Hobbies
• Medical Conditions (diabetes, RA, thyroid
  disease, heart disease, liver, kidney
  disfunction)

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Neck Pain

• Neck muscle pain can be caused by the following
  neck muscles
• becoming tight.
• Scalene muscles (three pairs of muscles that help
  rotate the neck)
• Suboccipital muscles (four pairs of muscles used
  to rotate the head)
• Pectoralis minor muscles (a pair of thin
  triangular muscles at the upper part of the
  chest)
• Subscapularis muscles (a pair of large triangular
  muscles near each shoulder joint)
• Levator scapulae muscles (a pair of muscles
  located at the back and side of the neck).
• If alignment of head and spine is not optimal,
  the neck can be
• predisposed to injury and/or the degenerative
  effects of wear and tear over time.

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Top 3 Bad Postures That Can Cause Neck Pain
   

• Hunchback
• Rounded Shoulder
• Forward Head

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Bad Posture 1 - Hunchback
   
Cause Sitting for long hours with bad posture.
For instance, sitting hunched over a computer
screen. Pain Neck, shoulder, and
back. Problem The bad sitting posture causes
the chest muscles to tighten leading to an
excessively curved back in the upper back or
thoracic region. The muscles of the upper back
loosen and eventually weaken. Recommendation
The following exercises are very effective

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Bad Posture 2 Rounded Shoulder
   
Cause Sitting with a bad posture while typing,
or imbalanced exercise regime involving excessive
chest pressing. Pain Neck, shoulder,
back Problem Sitting in that position results
in the chest muscles tightening, causing the
shoulders to rotate forward internally. The
muscles of the upper back weaken and
loosen. Recommendation Stretching to relax the
tight chest muscles

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Bad Posture 3 - Forward Head
Cause Sitting hunched over in an office chair
for long hours, staring at a computer. Pain
Neck  Problem Tightness of the muscles of the
back of the neck, along with the muscles of the
upper back (levator and upper trapezius). Recomme
ndation Stretches to loosen tight muscles in
the back of the neck

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Poor Posture
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Poor Posture
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Correct Posture
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Back
   
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Anatomy

• Vertebrae (Bones)
• Spinal Discs
• Muscles and Tendons
• Ligaments
• Spinal Cord
• Nerve Roots

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Vertebrae

• Stacked
• Interlocking
• Flexibility flexion/ extension/
  rotation/ lateral bending
• Protect spinal cord
• Center of gravity located in front of the sacrum

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Spinal Discs

• Cushioning Shock Absorber
• Like a jelly donut
• Disc anatomy
• - Tough outer covering
• - Soft gelatinous center
• - No blood supply
• - Few nerve endings
• - Helps the spine be flexible
• Mostly water that dehydrates with age
• Can deteriorate, protrude, herniate

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Types of Back Injuries

• Strain and Fatigue
• Nerve Injury
• Fractured Vertebrae
• Tears in Disks
• Disc Fractures and
• Ruptures

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Risk Factors

• Posture
• Force
• Repetition
• Stress
• Other Factors-Physical Fitness,
• Aging, Diet, Smoking.

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Posture
What posture are you exhibiting?
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Causes of Back Injuries

• Improper lifting techniques (95)
• Overexertion
• Work Area Conditions
• Path of travel
• Arrangement of work area

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Risky Moves

• Certain actions are more likely to cause back
  injuries than others. If you
• are doing these things think DANGER! Im at
  Risk!
• Heavy Lifting
• Repetitive Lifting
• Twisting at the Waist
• Reaching and Lifting Overhead
• Lifting Objects with Unusual or Awkward Shapes
• Working in Awkward Uncomfortable Positions
• Standing or Sitting for Long Periods

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Lifting Hazards
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Safe Lifting Zone

• Lifting items between the hips and shoulders is
  the safest
• The further from the lift zone, the riskier the
  lift

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Safe Lifting Zones
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Lifting Ratio

• Your waist acts like the fulcrum in a lever
  system
• Your lifting ration is about 101. Lifting a 10lb
  object puts
• 100 lbs of stress on your lower back
• Add in the 106lbs of the average human upper
  torso, lifting a 10lb object actually puts 1,150
  lbs of pressure on your lower back!
• It is easy to see how repetitive lifting and
  bending can lead to back problems
• Even leaning forward while sitting at a desk can
  eventually lead to back injuries.

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Correct Lifting

• Keep your lumbar spine in neutral. To find
  your lumbar neutral arch and bow
  your back to the maximum in each direction.
  Mid-range is your lumbar neutral
• Engage your abdominal muscles
• Use your legs/thigh muscles to lift
• Hold the load as close as you can to your
  center of gravity. This
  decreases the stress on your back
• Always remember DO NOT lift heavy loads higher
  than waist- height and lighter ones higher than
  chest height

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Proper Lifting Technique
Tighten Abdominals
Plan Lift, Then Lift
Get Close
Lift with your legs
Hold Close
Turn by stepping
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Prevention

• Always be aware of your technique
• - Poor body mechanics e.g. stooping,
• repetitive bending
• - Prolonged activity e.g. sitting or
• standing
• - Fatigue (take a small break)
• - Heavy loads (use tools/machines
• when possible)
• Adjust workplace to the worker
• Do not adjust worker to the workplace

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Thank You!

• Any Questions?
• James Grubinskas, DC., CEAS
• Alliance Occupational Medicine
• 315 South Abbott Ave., Milpitas
• 2737 Walsh Ave., Santa Clara
• 1901 Monterey Rd. Ste., San Jose