Lift At Your Own Risk

By Perry Nickelston, DC, FMS, SFMA

The proverbial holiday weight gain and increased sedentary lifestyle simply flame the fire. Add to that extreme cold weather conditions, icy surfaces, lifting boxes of presents, putting up trees, installing inside/outside lights, emotional stress, lugging the kids around, and the in-laws, and it's a wonder we survive.

Fear not, for there are many strategies and tips you can take into "holiday battle" to ensure you are the injury-free victor. As they say, "An ounce of prevention is worth a pound of cure."

Your body has a remarkable ability to respond to its external environment via a biological survival mechanism known as homeostasis. This mechanism has been a part of human nature since prehistoric times. Its only purpose is to protect you from harm and maintain the status quo of body function. Homeostasis is the tendency of a system, especially the physiological system, to maintain internal stability by coordinated response to any situation or stimulus that would tend to disturb its normal condition or function. Simply stated, your body does anything and everything necessary to adapt and survive to its surroundings. You can think of it as a compensation system for protection. And, if we ever needed protection, it's during the holidays. So let's go through our very own holiday checklist of risk management and injury prevention. Make a list and check it twice, because that back pain can be naughty or nice.

All Boxes Are Not Created Equal

I can't tell you how many times patients have crawled into my office with agonizing low back pain after attempting to lift a box that was heavier than they expected. The culprit is typically a smaller box that looks deceptively light because of its size. Don't fall for it! One safety tip is to lightly kick or push the box with your foot to determine how heavy it is before you commit to the lift. Muscles get injured from altered weight differences because your core stabilization muscles are not fully engaged in preparation for the movement.

Your core muscles stabilize and support your back to prevent injury. If they engage too late, your body does not have adequate time to catch up to your brain's signal for strength and stability. The result: Your body must now activate other smaller muscles to assist in completing the lift. These muscles are not designed to be the primary movers; therefore, they become overused and injury occurs. It only takes a second for everything to go wrong. So the lesson here is to take extra time to test the weight of an object before you lift. Every second counts.

Also remember to always lift with your hips, not your back. Proper lifting technique is crucial in preventing low back pain. How you lift makes all the difference in how much your back ends up disliking you. The average person who is not skilled in proper lifting techniques will simply bend over at the waist and pick something up without a second thought. Bad idea! This is what causes most low back injuries.

For example, you are headed to the kitchen for another cup of eggnog and you notice one of the kid's new toys on the floor. You make a small pit stop and bend over to pick it up - and feel that terrible pain strike the very essence of your soul. Now you are stuck! Sound familiar? The key to proper lifting is to lift with your hips and buttocks, not your back. The hip complex and buttock muscles are designed to give you powerful stability and control.

When you lift something, try this little trick beforehand and use your muscles to full advantage. Imagine yourself sitting back and down on a toilet seat. Yes, you read that right, a toilet seat. Sit back and down as you bend. This motion hinges your hip joints backward so you sit back into the lift, rather than bending forward over the waistline, significantly reducing the pressure on your low back and transferring it to the powerful hips.

When you rise up from the bottom position of a lift, use the power of your hip, buttock and leg base instead of the weakest link in the low back. Almost all low back injuries occur from dysfunctional movement at the hip joints. The low back simply overworks and becomes fatigued, increasing the likelihood of injury. Next time you go for that toy, remember to "sit back on the seat" and lift with your tush.

Slippery Slopes Will Get You Every Time

Depending on your geographical location, snow and ice may or may not be an issue for you this holiday season. If you have ever experienced the wonderful "black ice" shuffle, you know what it means to be vulnerable to the elements. Countless individuals are injured every year from icy sidewalks, stairs, roads and parking lots. You never know when and if it will happen to you. When it does, all you can do is hold on for the ride, right? Wrong! You can actually do proprioceptive training movements to enhance your stability and balance.

Proprioception is simply your body's ability recognize and adapt to positional changes for balance and control. So, even if you don't live in an icy, cold environment, these movements help prevent injury in case of a trip or fall. The first strategy is to expect the unexpected. Become aware of your surroundings and become very intent with every movement. In other words, concentrate on your environment!

Doing balance exercises is a great way to prevent falls. One of the main causes of injury is an asymmetry in movement from one side of the body to the other; that means you can do something better on one side than the other. Practice single-leg balancing to enhance symmetry from the left side to the right side. Stand with your bare feet together. Raise one leg up to waist height, bending at the knee with a tall spine (reaching the head toward the ceiling) and attempt to balance for 10 seconds. Repeat on the opposite side. Do you feel a difference? If so, you need to practice this maneuver until you become equally skilled on both sides.

Once you master this equally on both sides for 10 seconds each, attempt it with eyes closed. This is more challenging, so be prepared to open your eyes or grab something for stability until you feel comfortable.

In the event that you do slip or fall, it is important to learn the proper way to fall. Knowing how to fall or how to "break your fall" is crucial to lessening impact injuries. Many severe injuries can be avoided if you understand how to land so that the body properly absorbs the shock.

Keep your head up. This is the most important location of the body that you do not want to damage. You do not want to have your head connect with the ground. It is better to bruise your arms than to bruise your head. Slap your palms off the ground if falling forward. Make sure your whole palm slaps the ground. This is done only for a second to slow your fall slightly and prevent breaking your wrists. It is not meant to absorb all of your weight or "catch" you. Remember not to lock your elbows.

If falling from a height, roll as you hit the ground. This will distribute the force of the impact throughout your body, instead of just on one place. If falling backwards, try to bend at the knees and squat before the fall. Curl your back and roll on it. Don't try to break the fall with your arms. Lower your center of gravity as much as possible to lessen the distance to the ground.

It's A Long Way Down From Up There

Climbing up ladders or standing on stools/chairs to hang lights and decorations can be a dangerous adventure. You don't want to have a Clark Griswald "Christmas Vacation" moment. Take special care to ensure all ladders are functioning properly and you have a "safety spotter" to help in stabilizing any device you are standing on. Chairs can slip or break and ladders can fall. Equilibrium is affected when you are higher off the ground and your sense of proprioception is altered. What your brain interprets as distance is often incorrect. Do due diligence to move slowly and intently on platforms with limited foot space.

Falls from heights lead to greater impact trauma. Plan your intended task ahead of time so you are not caught off guard by unexpected surprises. When working with any electrical project, such as hanging lights or installing wired decorations, follow all safety and installation instructions. Just because something went smoothly last year does not mean it will this time around. Don't drop your guard for a moment because you have become complacent by routine. This is the perfect time for accidents to happen.

Basic safety tips include the following: Wear proper footwear with non-slip soles. Face the ladder while ascending and descending. Don't carry tools in hand; use a window cleaner's tool belt or a belt designed for the ladder work to be accomplished. Keep at least three points of contact when working, i.e., your feet and one hand. Do not set up ladders in high-traffic areas. (Watch for kids running on or around the ladder or stool area, and never leave erected ladder unattended). Test stools, steps or chairs for stability and weight limits.

Holiday Stretches Under The Mistletoe

When you become more sedentary, you inherently become less flexible. Your muscles shorten and become weak from inactivity, and the connective tissue in your body, known as fascia, tightens up, making you prone to injury. You can make significant improvements in loosening and releasing tight fascia to increase the performance of your body. The better you move, the more resistant you become to injury. Muscles are wrapped in connective tissue fascia, so rather than stretch muscles, you are going to stretch fascial attachment points to positively affect muscle. There are four key areas to stretch fascia for maxim impact. Here's how to stretch/massage each area (talk to your doctor for more information):

• Bottom of the foot: Roll a golf ball or lacrosse ball on the bottom of your bare feet for three minutes a day. You will feel immediate positive changes.
• Outside edge of the buttock muscle near the hip: Lean against the wall with a lacrosse ball or tennis ball into the outside edge of each buttock muscle. This releases tension in the lower back. Note: This area can be very sensitive if it needs lots of work. Rest assured, it will get better with time.
• Bottom of the rib cage as it goes into low back. Roll the tennis ball along the lower rib cage and spinal muscles by leaning against a wall. Be careful not to press too hard against the ribs. Stay close to the larger muscles alongside the spine.
• Back of the head at top of the neck (known as the suboccipital): Massage the back of your head on either side by hand to relax tension.

Getting into the holiday spirit can sometimes be difficult. However, once you get there it seems that everything feels better. Spending time with family, friends and loved ones, and remembering what is really important in life, give you a new perspective on the world. Get into the health spirit this season, too, because without our health, we really have nothing. We don't miss it until it's gone. Treasure your body. Give the gift of health to yourself and others. Have a happy, healthy and injury-free holiday.

Extra Weight = Extra Risk

Extra weight puts more pressure on your low back and your heart. Ten pounds on your stomach is 100 on your lower back. Magnify everything by 10! That is a major impact on your body. Sometimes it's inevitable to put on a few pounds during the holiday season. However, there a few simple strategies that can make a big difference in just how few pounds you add. Below are five tips compliments of Dr. Mike Roussell, a PhD in clinical nutrition:

• Eat and eat again. Portion size is paramount. This rule says only eat as much food in one sitting that you could comfortably eat two hours later. For example, if you had a large meal, could you eat the same amount two hours later? If not, then cut down your portions.
• Go from barcodes to bags. Eat less processed foods that come in boxes with barcodes, and eat more fresh fruit and vegetables in bags.
• Remove empty calories such as soda and juice drinks.
• Eat a fruit-and-fat snack daily. Combine fruits with cheese or nuts to control insulin levels, which decrease fat storage hormones.
• Don't skip breakfast. Skipping breakfast slows your metabolism throughout the day and makes you more likely to snack-binge.

Perry Nickelston, DC, is clinical director of the Pain Laser Center in Ramsey, N.J., where he focuses on performance enhancement, corrective exercise and metabolic fitness nutrition To learn more about Dr. Nickelston, visit www.painlasercenter.com/Our_Practice.html.


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