Proper lifting techniques for EMTs and Paramedics
Strengthening exercises and body awareness can help prevent back injuries
Low back injury is the most costly and most debilitating of all work injuries in America today. So how do we avoid it? Proper lifting technique and proper exercise are the 2 best ways to stave off this injury.
Low Back Pain
If you are already in pain, many of the suggestions below will be improper for you at this time. If you are interested in learning more about self care of low back pain, click here, http://www.fireagility.com/articles.php, scroll down to the 3rd article read the article on low back pain. You may need to see a doctor. Make sure it is safe before you do anything that is discussed below.
Proper Lifting Technique
In order to lift heavy objects and people safely, one must have a very good awareness of their body, and which muscles are contracting with any given movement. For the purposes of this article, I am going to assume that the reader is familiar with the major muscle groups of the trunk, pelvis, hips and legs.
First: get yourself into proper position. Get yourself as close to the object you are intending to lift as possible. Feet are apart for a stable base. If it’s possible, have your toes underneath the edges of the gurney, or feet as close to the body board as possible.
Second: get your abs tight and you back flat. Hold those to until the lift is complete.
Third: As you lift, do so with your legs. Keep your weight in your heels and the balls of your feet. Push up, tightening your hips, hamstrings and gluts as you rise. Keep the object close to you. Keep your back flat and your abs tight.
Fourth: Once you have risen, and want to put the gurney into the ambulance, do so with your feet. Try not to pivot at your waste, but do so with your feet. Try to keep your shoulders in the same plane with your hips. You may need to shuffle your feet to keep them properly under your base. That’s fine.
Again, as you slide the gurney in, shuffle your feet sideways rather than twisting at your waste. The discs in your low back will thank you for your efforts.
Support of the low back is very important. If you have had trouble with your low back, it might be due to weak, untrained muscles in your core. Below is a discussion of things you can do to strengthen and prevent further and later back injuries. Do not start this workout if you are in the midst of a low back episode. Do not continue it if it makes you extremely sore, or sore for more than 2 days!
In order to protect your low back in awkward situation, I suggest training in four "ranges of motion". I will show and explain three very simple exercises to work: forward flexion, rotation, lateral flexion, and extension.
Forward Flexion and Rotation:
I find the best, fastest and most effective exercise to be bicycle abs. It works upper and lower abs, plus obliques.
One can do these on the floor, or on a bench as shown here. Rotate and lift the upper body to touch the elbow to the opposite knee, and hold for 1 second . Exhale as you touch the elbow to the knee, and inhale as you cross the center to go to the other side. The other elbow should be below the level of the bench, allowing for maximum rotation.
The Extensors of the low back can be trained on a ball, as shown below.
Lay on top of the ball, belly button at the highest point on the ball. Hands are behind your head. Feet in the corner where the wall meets the floor, toes out. Lightly squeeze the ball with your inner thighs, and take a deep breath. Lift up until your spine it totally straight, exhaling as you lift. Inhale as you lower. Try 6 reps the 1st time out. This exercise is difficult. Stop if your low back hurts! Work up to 4 sets of 20 over several months.
You can also accomplish the same on the hyper extension bench in the gym.
Here’s a pic of the hyper-extension bench, under event #3 on this site: http://www.fireagility.com/cpat_events.php. Note, the bench in this photo is being used in lateral flexion. I intend that you use the bench face down here. You would hook the backs of your heels under the same place where you see my feet braced. Flex forward, arms over your chest. Come up only to straight. It is called a hyperextension bench, but DO NOT hyperextend. Come up only to straight/level with your legs/the floor. Hold for 2 seconds, and lower slowly.
Start with 2 sets of 10, and work up over several months to 4 sets of 20. You may add weight later. If your bench is at an angle, with your feet down, this exercise will be a lot easier, and you will need to hold a weight to your chest. By the way, this exercise and make your hamstrings really sore. Stretch them when you are done!
Look again at the lateral flexion bench picture here: http://www.fireagility.com/cpat_events.php (event #3) As shown in this picture, your hip is right in the middle of the pad to the caudal end. There should be a split there in the bench for it. Your feet should be wrapped around the post at that end of the bench. Top leg should be back. Keep your range of motion small at first, and make it bigger over months as you get stronger. Start with a set of 6 on each side the first time, and see if you are sore the next day. Be very careful! Of all these exercises, this is the toughest one.
You can work up 4 sets of 12 on each side over several months. Since I started doing this exercise, I NEVER have low back pain any more. The musculature in my trunk simply won’t allow my low back to go past it’s safe range of motion! Try it, but listen to your body. If you have pain, stop.
Most gyms also have this bench at a slant, or flat like I have shown here. The slanted one makes the exercise much easier! If you are a real beginner, start there! Please know your body, and exercise at your own risk!
We are made to have really strong ab muscles. So, I do 1000 bicycle abs every day if I can. (Thus the 6 pack) If you get really sore, take a day or 2 off, and let yourself heal! Very few people injure their abs muscles from over training.
The other exercises are pretty tough and should not be done more than every other day at most. BUT: No less than 2 times per week.
Always stretch these areas out after training them!