When teaching a patient how do you lift a heavy object properly Which of the following instructions will be included?

There are many reasons why you should practice proper lifting techniques. Not only does proper form work the appropriate muscle groups you’re aiming to strengthen, but it also reduces the risk of both short and long-term back injuries. Whether you’re lifting weights, strength training, or carrying heavy objects on the job, your form is extremely important for your overall health. Bad, improper form while lifting can cause muscle strains, tears, serious back problems, joint pain, and much more. These injuries can take weeks or even months to heal properly. One of the main causes of lower back pain is sprains and strains to the low back. This accounts for most acute back pain individuals experience in their lifetime. Sprains and strains are often caused by overstretching or tearing ligaments, which often occur from lifting an object improperly or something too heavy. Practicing proper form throughout your lifting exercises leads to better results, prevents injury, and allows your muscles to work harder to increase overall strength. We’ve compiled a list of tips and tricks to keep in mind the next time you’re lifting a heavy object:

1)

Before lifting the heavy object, make sure to keep a wide base of support. Always make sure your feet are shoulder-width apart, with one foot slightly ahead of the other. This will ensure good, proper balance during your heavy lift. We call this the Karate Stance.

2)

When you are ready to lift the object, simply squat down as close to the object as possible, bending at the hips and knees with your buttocks out. If the object is extremely heavy, you may want to put one knee to the floor and your other knee in front of you bent at a right angle.

3)

As you begin your lift upward, make sure to keep good posture. Do so by looking straight ahead, keeping your back straight, your chest out, and your shoulders back. Having poor posture can lead to not only back pain, but migraines, lower energy levels, and even heart problems. This form will help keep your upper back straight while having a slight arch in your lower back at the same time. If you believe you have bad posture, try wearing a posture brace daily to help train your shoulder, back, and abdomen muscles to sit up straight.

4)

Slowly lift the object by straightening your hips and knees (not your back). Extend your legs and breathe out as you lift. Do not twist your body or bend forward as you lift the heavy object.

5)

Hold the heavy object as close to your body as possible, at the level of your belly button. (In the Power Zone) Never lift a heavy object above your shoulders or with your arms extended outward. 

6)

Use your feet (not your body) to change direction, taking slow, small steps. Lead with your hips as you change direction. Keep your shoulders in line with your hips as you move.

7)

Set down the heavy object carefully, squatting with your knees and hips only.

Pairing these techniques with our Back Brace for Heavy Lifting will allow for the safest, most efficient heavy lifts. This unique lifting back belt encourages proper lifting techniques and prevents the damage associated with improper lifting. This back belt does so by compressing the lower back during heavy lifts. The compression allows for more stability in your abdomen and lower back. This increase in stability will allow your lower back to carry more weight and prevent injury to this area as well. Looking for other back braces to help support your lower, middle, or upper back? Check out our wide selection of supports!

As noted in step 5, to avoid injury, you should always lift in the power zone. The power zone for lifting is close to the body, between mid-thigh and mid-chest height. This zone is ideal for lifting because it’s where the arms and back can lift the most with the least amount of effort. The power zone, also known as the “comfort zone”, minimizes excessive reach and ensures a neutral position during heavy lifts. Lifting in the power zone reduces the risk of injury, while also allowing for more efficient and pain-free lifting.

Here is a quick reference listing the "Do's and Don'ts" of lifting heavy objects. Print it out and keep it nearby the next time you're performing heavy lifts!

Body mechanics involves the coordinated effort of muscles, bones, and the nervous system to maintain balance, posture, and alignment during moving, transferring, and positioning patients. Proper body mechanics allows individuals to carry out activities without excessive use of energy, and helps prevent injuries for patients and health care providers (Perry, Potter, & Ostendorf, 2014).

Musculoskeletal Injuries

A musculoskeletal injury (MSI) is an injury or disorder of the muscles, tendons, ligaments, joints or nerves, blood vessels, or related soft tissue including a sprain, strain, or inflammation related to a work injury. MSIs are the most common health hazard for health care providers (WorkSafeBC, 2013). Table 3.1 lists risk factors that contribute to an MSI.

Table 3.1 Factors That Contribute to an MSI

Factor	Special Information
Ergonomic risk factors	Repetitive or sustained awkward postures, repetition, or forceful exertion
Individual risk factors	Poor work practice; poor overall health (smoking, drinking alcohol, and obesity); poor rest and recovery; poor fitness, hydration, and nutrition
Data source: Perry et al., 2014; Workers Compensation Board, 2001; WorkSafeBC, 2013

When health care providers are exposed to ergonomic risk factors, they become fatigued and risk musculoskeletal imbalance. Additional exposure related to individual risk factors puts health care providers at increased risk for an MSI (WorkSafeBC, 2013). Preventing an MSI is achieved by understanding the elements of body mechanics, applying the principles of body mechanics to all work-related activities, understanding how to assess a patient’s ability to position or transfer, and learning safe handling transfers and positioning techniques.

Elements of Body Mechanics

Body movement requires coordinated muscle activity and neurological integration. It involves the basic elements of body alignment (posture), balance, and coordinated movement. Body alignment and posture bring body parts into position to promote optimal balance and body function. When the body is well aligned, whether standing, sitting, or lying, the strain on the joints, muscles, tendons, and ligaments is minimized (WorkSafeBC, 2013).

Body alignment is achieved by placing one body part in line with another body part in a vertical or horizontal line. Correct alignment contributes to body balance and decreases strain on muscle-skeletal structures. Without this balance, the risk of falls and injuries increase. In the language of body mechanics, the centre of gravity is the centre of the weight of an object or person. A lower centre of gravity increases stability. This can be achieved by bending the knees and bringing the centre of gravity closer to the base of support, keeping the back straight. A wide base of support is the foundation for stability. A wide base of support is achieved by placing feet a comfortable, shoulder width distance apart. When a vertical line falls from the centre of gravity through the wide base of support, body balance is achieved. If the vertical line moves outside the base of support, the body will lose balance.

The diagram in Figure 3.1 demonstrates (A) a well-aligned person whose balance is maintained and whose line of gravity falls within the base of support. Diagram (B) demonstrates how balance is not maintained when the line of gravity falls outside the base of support, and diagram (C) shows how balance is regained when the line of gravity falls within the base of support.

Figure 3.1 Centre of gravity

Principles of Body Mechanics

Table 3.2 describes the principles of body mechanics that should be applied during all patient-handling activities.

Table 3.2 Principles of Body Mechanics

Action	Principle
Assess the environment.	Assess the weight of the load before lifting and determine if assistance is required.
Plan the move.	Plan the move; gather all supplies and clear the area of obstacles.
Avoid stretching and twisting.	Avoid stretching, reaching, and twisting, which may place the line of gravity outside the base of support.
Ensure proper body stance.	Keep stance (feet) shoulder-width apart. Tighten abdominal, gluteal, and leg muscles in anticipation of the move. Stand up straight to protect the back and provide balance.
Stand close to the object being moved.	Place the weight of the object being moved close to your centre of gravity for balance. Equilibrium is maintained as long as the line of gravity passes through its base of support. Hold objects close to your centre of gravity
Face direction of the movement.	Facing the direction prevents abnormal twisting of the spine.
Avoid lifting.	Turning, rolling, pivoting, and leverage requires less work than lifting. Do not lift if possible; use mechanical lifts as required. Encourage the patient to help as much as possible.
Work at waist level.	Keep all work at waist level to avoid stooping. Raise the height of the bed or object if possible. Do not bend at the waist.
Reduce friction between surfaces.	Reduce friction between surfaces so that less force is required to move the patient.
Bend the knees.	Bending the knees maintains your centre of gravity and lets the strong muscles of your legs do the lifting.
Push the object rather than pull it, and maintain continuous movement.	It is easier to push an object than to pull it. Less energy is required to keep an object moving than it is to stop and start it.
Use assistive devices.	Use assistive devices (gait belt, slider boards, mechanical lifts) as required to position patients and transfer them from one surface to another.
Work with others.	The person with the heaviest load should coordinate all the effort of the others involved in the handling technique.
Data source: Berman & Snyder, 2016; Perry et al., 2014; WorkSafeBC, 2013

Assistive Devices

An assistive device is an object or piece of equipment designed to help a patient with activities of daily living, such as a walker, cane, gait belt, or mechanical lift (WorkSafeBC, 2006). Table 3.3 lists some assistive devices found in the hospital and community setting.

Table 3.3 Assistive Devices

Type	Definition
Gait belt or transfer belt	Used to ensure a good grip on unstable patients. The device provides more stability when transferring patients. It is a 2-inch-wide (5 mm) belt, with or without handles, that is placed around a patient’s waist and fastened with Velcro. The gait belt must always be applied on top of clothing or gown to protect the patient’s skin. A gait belt can be used with patients in both one-person or two-person pivot transfer, or in transfer with a slider board. Gait belt
Slider board or transfer board	Slider board (red) on a stretcher Placing a slider board (transfer board) under a patient A slider board is used to transfer immobile patients from one surface to another while the patient is lying supine. The board allows health care providers to safely move immobile, bariatric, or complex patients.
Mechanical lift	A mechanical lift is a hydraulic lift, usually attached to a ceiling, used to move patients who cannot bear weight, who are unpredictable or unreliable, or who have a medical condition that does not allow them to stand or assist with moving. Mechanical lift
Data source: Perry et al., 2014; WorkSafeBC, 2006

Video 3.1

Special considerations:

• Use assistive devices only if properly trained in their safe use.
• Always tell patients what you are about to do and how they should assist you in the procedure.
• Always perform a patient risk assessment or mobility assessment prior to using any assistive devices. The following link provides additional information regarding assistive devices from WorkSafeBC.
• Use proper body mechanics when using assistive devices.

1. How do body alignment and body balance contribute to proper body mechanics?
2. John is asked to lift a heavy box from a table onto a trolley. Name five principles of body mechanics John can implement to prevent an MSI.