How To Fix and Prevent Back Pain
When Lifting and Carrying Loads
© Jolie Bookspan, MEd, PhD, FAWM
Director Neck and Back Pain Sports Medicine
Academy of Functional Exercise Medicine, The Fixa U School of Healthy Medicine
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This page covers preventing pain and injury when lifting loads. By using healthy lifting and carrying body positioning, you can use the lifting itself to get stronger during your ordinary daily life activities, and prevent pain, instead of being told not to lift daily loads and to go to to physical therapy to lift weights to get stronger - that's backwards and misses out on the most important things - health should come from your real life - carrying babies, backpacks, handbags, book bags, and all the daily things you need to carry and do. That is your fitness as a lifestyle. Done right, you can do more, not less, and prevent injury at the same time.
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How This Work Is Different
Often, articles of "do's and don'ts" to prevent back pain from lifting have rules that restrict movement, that restrict healthy fun normal life, and are often not even true. Instead, this article will show you the concept of how back pain occurs so that you can move in healthier ways that are fun, active, and let you do more than before.
Healthy lifting and carrying is more than, "Lift with your knees" although few people do even that much to prevent back pain. There are often more achy backs at the end of the day from poor carrying technique than from bending wrong to pick things up in the first place. This goes for anything you lift and carry: groceries, packages, suitcases, a backpack, laundry baskets, the baby, a pet, lifting things up to shelves, lifting weights in the gym, and even carrying around the weight of your own body.
Mystery Back Pain #1 Leaning Back When Carrying Things in Front
A common bad habit is to lean the upper body backward, and.or tilt your pelvis forward when carrying something in front of you, like a package, a chair, or a baby. Both are slouching posture, not a structural condition. Both increase the inward curve of the lumbar spine making swayback. Leaning backward does make lifting and carrying easier, because it shifts the load to your lower spine joints instead of using core muscles (you don't have to do work). You lose free exercise, and compress your lower back soft tissue and the low back joints called facets. This is a major cause of "mystery" lower back pain - that commonly occurs when standing and carrying.
Both drawings below show swayback. Drawing on the left shows primarily leaning the upper body backward. Right shows both tilting the pelvis forward front and also leaning the upper body backward, folding the lower spine - painfully.
When carrying loads in front, check if you increase the inward curve (arch) of your lower back by leaning backward (left), or lean plus tilt or push your hip forward (right). Increasing inward curve (increased lumbar sway) shifts upper body weight onto your lower spine, resulting in achy lower back pain after standing, carrying, and walking.
To prevent back pain from swayback, and get abdominal muscle exercise at the same time, try this to stand upright against the load instead:
- Stand up and pick up and hold any load in front of you, like a backpack, a baby, or a chair. Stand sideways to a mirror, if you can to better be able to see if you are doing what you think you are doing.
- Notice your upper body. If you notice yourself leaning your upper body backward, straighten your body to an upright position: Pull forward enough to take the excessive arch out of your lower back. Don't curl so much forward that you round your shoulders or crane your neck. Simply straighten your body against the pull of the load.
- Notice your pelvis. See if you are tilting it forward in front and out in back. Tilted pelvis is not healthy neutral position (even if many gyms and PIlates studios think so, it still causes much pain and spine compression). Bring your pelvis to vertical. Many people who have never heard of this, or who have heard they are supposed to tilt the pelvis, and have back pain often have trouble learning this at first. It can be simple and straightforward. Stand with your back against a wall. Put your heels, backside, and upper back against the wall. Gently, easily, without any tightening of any muscles, simple move your lower back closer toward the wall. Don't touch all the way to the wall, just learn to move your pelvis a little closer. This is a pelvic tilt that you learn in order to change a painful, unhealthy tilt to a vertical pelvis. Done right, you will feel lower spine pressure go away right then. If it hurts, it's wrong. This is all explained with photos and details in the Abs Article - Fix Back Pain When Standing.
- This new neutral spine is how to stand up straight against any anterior load. You will feel your abs working (but not tightening when done right. You don't want tightening because you can't breathe normally that way and muscles do not work properly when tight). Your bags, groceries, and babies could be a built-in abdominal muscle exercise.
Left drawing shows neutral spine. Pelvis is vertical from top of the leg bone to the side of the hip, with no tilt.
Middle and right drawings show slouching that produces swayback and an achy lower back - Middle drawing shows tilted pelvis. Right drawing shows leaning the upper body backwards.
You may have heard the common, but false statement that being pregnant makes your back arch. This is not true; the pain is preventable by not leaning back to counter the weight in front. Use your abdominal muscles to fix your posture so you can stand upright without leaning backward. Of all times to prevent swayback, pregnancy it is.
A surprising way to help your back is to strengthen your arms. When your arms are weak, its more tempting to rest a carried weight on your hip and lean back, letting your low back take the brunt. But even with strong arms don't lean back. It's not strengthening, but using your knowledge to position your muscles that will fix your back pain.
Mystery Back Pain #2 Leaning Back When Lifting Overhead
When reaching your arms overhead to do anything from stretch, to reach a shelf, to taking a picture, to taking off your shirt, check to see if you arch your back or lean back. This shifts weight to your low back. Instead, tuck your hips under you and don't lean back, to reduce the arch of your low back. Try to reach up again holding straight position. You should feel that there is no more pressure on the lower back. You may pleasantly feel your muscles working more in your abs and shoulders.
Check if you increase the inward arch of your lower back or lean backwards when reaching upward.
Don't lean back. Don't let your lower back increase in arch or your hip push forward. Use neutral, pictured above.
Mystery Back Pain #3 Leaning Back When Carrying Things On Your Back
Heavy bags and backpacks don't make you arch your back, lean, or have bad posture. You do. Straighten your pelvis to neutral spine using your abdominal muscles to counter the pull, and prevent lower spine overarch. Notice if you lean back. Straighten your upper body by beginning to curl your torso, as if "doing a crunch." Don't learn forward, round your shoulders, or crane your neck. Straighten your body against the pull of the load to take the large arch out of your low back and regain healthy posture. You will feel your abs working to do this. Your bags could be a built-in abdominal muscle exercise.
Mystery Back Pain #4 Leaning Forward When Carrying Posterior Loads
With posterior loads like knapsacks, its common to lean or round forward to counter the weight, or to rest the weight on your curved spine instead of holding the weight using muscular effort. Leaning forward is easier because you don't have to support the load with your muscles. But by leaning forward you shift the weight of the load onto your spine bones. That means your spine does the work instead of your muscles. You lose free exercise, promote a round-shouldered posture, and strain your back.
With extremely heavy weights, for example when rescuing a heavy person or getting a truck out of a ditch you will need to lean. Whether you need to lean to unhealthful angles depends how well you prepared ahead of time. Strengthen your muscles and learn good positioning skills so you can minimize damage to your back during the few situations where the weight is too heavy. But for most carrying, prevent rounding forward, and get good exercise at the same time. Stand straight without leaning backward or forward. You will feel your muscles working.
Good Carrying Habits for All the Time
Is it natural to slouch? As natural as wetting your pants, but you learn to "hold it" even when you don't feel like it. Good body positioning is the same - learn to hold it.
Use your muscles to hold your body in healthy positions when standing and carrying gear and you'll get great exercise without going to a gym, and save your back when carrying all the things, big and small, you need to carry.
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How Long Does It Take To Stop Lower Back Pain With Good Carrying Mechanics?
If your pain comes from overly arching or rounding forward when carrying loads in front or back, you should feel the pain and pressure stop the moment you straighten position when carrying. If you're not feeling better right away, check what you are doing compared to what is presented above (if it still hurts you ARE doing it wrong):
- Are you still leaning your upper body backward? Did you push your hips forward instead of tucking (tilting) under to straighten? DId you round your upper body forward instead of becoming straighter?
- Are you tightening or clenching any muscles? Tight muscles can hurt and impede healthy movement. Although it was an almost universal fad to "tighten" ab muscles, tightening does not change faulty movement, inhibits normal breathing, and can make pain of its own.
- Are you overcompensating? Are you making new bad movement habits that seem opposite of original unhealthy movement thinking that will "undo" or fix?
- Are you changing this work from exactly the way it is presented into something you have heard elsewhere? This work is different.
- Is something else causing the pain, such as infection, shingles, growths, or other non-movement based situations?
It is is almost always quick and easy to start getting your life back and start feeling better right now. Don't wait.
To Help You Remember
- If you are not sure how to tilt your hip into neutral position, use the summary Abdominal muscle article.
- Watch other peoples posture, gait, and movement habits when lifting and carrying.
- Notice injurious postures, especially those featured in fitness and health magazines
- Notice your own habits.
- Send me photos showing the principles in action. Prizes for best candid.
- Send me your success stories about using these principles.
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- How to tell how to move in healthier ways - Bad Exercises and Ones To Do Instead
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