Backs get bent out of shape

Tuesday, May 19, 2009
Physical therapist Todd Wasilewski unhooks a traction unit from Chelsea Sellers on Monday at Saint Francis Medical Center in Cape Girardeau. Sellers, 20, who has back treatments three times a week, thinks cheerleading in high school might have led to her current back problems. (Kit Doyle)

Moving forward may be hurting your back. The average person bends forward hundreds of times a day -- to tie a shoe, pick up a penny from the sidewalk, reach into a file cabinet -- and that motion wears on the back.

Chelsea Sellers, 20, thinks cheerleading caused a bulging disc in her back, and her job as a server in a local restaurant doesn't help. She said she's constantly bending, lifting and twisting at work.

The discs in the spine are made of two basic components: the gel-like nucleus encapsulated by the annulus fibrosus, a fibrous connective tissue. The nucleus gets pushed to the back of the disc whenever a person bends forward or sits for a long period of time. Over time, it starts to break down. The breakdown puts more pressure on the spinal cord and the nerve routes, which is where the pain kicks in.

Movement isn't the only cause. Sitting or standing in the same position for extended periods of time can have the same effect.

Sellers said her doctor at Saint Francis Medical Center told her, "Whatever I'm doing when it hurts, I do the opposite. If I'm sitting and it's hurting, stand up. If I'm standing, sit down."

Physical therapist Katrina Voelker works with a variety of patients at HealthPoint Plaza who have pains in their backs, knees, shoulders, hips and more. She emphasizes core stabilization and engaging lower abdominal muscles in daily activities like getting in an out of the car, picking children up from the bathtub or reaching to the top shelf for something.

"Before you do those things you should pull your belly button into your spine," she said. "It's like you're trying to button a pair of pants two sizes too small."

Using muscles in the front helps support the muscles in the back.

"When you do all those normal life things, that's when you're going to apply that thought process," she said.

Reverse motions can also slow deterioration, according to Todd Wasilewski, a physical therapist at Outpatient Rehabilitation Services at Saint Francis Medical Center who's certified in the McKenzie method of evaluation and treatment for back pain. He recommended gently leaning backward every 30 minutes or so to counteract some of the displacement that comes with sitting and bending forward.

"You want to change that ratio of forward to backward bending," he said.

While standing, he said, put your hands on your hips and lean backward at the waist "within a comfort range."

"People really need to squat rather than bend at the waist," he said. When bending, keep the spine in a neutral position.

Wasilewski said people who bend at the waist because of knee problems can pick things up with the "golfer's bend," standing on one leg and lifting the other as you lean your torso down toward the object.

"In general, the more flexible you make yourself, that's going to help you," Voelker said.

She said ways to protect your back include increasing hamstring flexibility, maintaining a healthy body weight and participating in aerobic exercises, though they don't have to be the same ones your neighbor uses.

"If it makes you hurt worse, that's probably not the exercise for you," she said.

Part of the wear on the back can come from other body parts. Voelker said tight hamstrings can cause low-back pain. The hamstrings run from the back of the knee to the pelvis. When a person sits, if the hamstrings aren't long enough, they pull on the back and can reduce the natural curve in the small of the back.

"When you make your hamstrings longer they put less pressure on your spine," she said.


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