Here are some quick tips to keep your back happy while making your garden smile!

Of course, you will need to start with a good garden bed. This may mean lifting heavy bags of top soil, compost, and mulch.

To lift the bags:

1. First, assess the weight of the bag. Ask for help if it is too much for you to manage alone safely.
2. Using gloves may keep the bag from slipping, preventing you from having to assume an awkward posture.
3. Stand directly in front of the bag.
4. Place feet shoulder width apart.
5. Bend your knees to get down to the level of the bag.
6. Although the bags may be smelly and dirty, the best way to protect your back is to hug a heavy load close to your body.
7. Then, keeping trunk erect, tighten tummy muscles and gluteal muscles and lift using your leg muscles, not your back.
8. Turn by stepping around, not twisting with feet planted. This may help you to avoid back and knee injuries.

To lower the bags:

1. Bend at the knees, keeping back straight, tummy muscles tight.
2. Place bag on the ground in front of you, close to where you are squatting. Do not twist.

Now that you have a beautiful garden bed, let’s plant…
No!!! Not like that! That will put undue strain on your back! There are very inexpensive items that can make your gardening experience more comfortable. Try a small stool you have around the house to sit low to the ground. Or, for between $5-$10 you can get a kneeling pad at a garden center so you can get low near to the plants you are working with. (These are also good positions to use for weeding in upcoming weeks.)

Now you are on a roll! But don’t get too carried away with your success! Stop and stretch. Your gardening will require a forward flexed posture throughout. Occasionally stand up and straighten out your back. Roll your shoulders back. Extend your neck. Take a deep breath of spring air and… happy gardening!

References:

http://orthopedicsinternational.com/conditions-and-treatments/spine-neck-back-arm-and-leg/preventive-care/body-mechanics/

By Roosevelt Collier PT, DPT

As the calendar turns from winter to spring young athletes across the United States will begin playing outdoor sports again. As health care practitioners one of our chief concerns are injuries to theses young athletes. An often injured area of the body is the knee and the ACL is the leading ligament in the body which requires surgical intervention. Female athletes have disproportionally higher rates versus males for ACL injuries and tears. It is our duty as healthcare professionals to implement prevention strategies to decrease the incidence of ACL injuries in the female athlete.

The first step in prevention of ACL injuries in the female athlete is to understand why the incidence rate is higher. ACL injuries are divided into sub categories such as contact injuries in which a direct blow or hit to the knee caused the tear or non-contact injuries in which a movement such as running, cutting, or landing caused the tear. There are extrinsic factors such as playing surface, footwear, and level of competition and intrinsic factors such as age, posture, muscle strength, and balance. It is the intrinsic factors which should be the focus of the practitioner during an evaluation or screening of a young female athlete.

Risk Factors Associated with Injury to the ACL in Female Athletes:

• Muscle Imbalances Between The Hamstring and Quadriceps
• Lack of Balance and Proproception
• Core Weakness (abdominal, lower back, pelvic muscles)
• Posture – Valgus Deformity (knock-knee), Pronation of foot
• Ligament Laxity
• Decreased size of Structures within the knee when compared to males
• Hormone Changes – the ACL has estrogen and progesterone receptor cites
• Differences among the genders in running, jumping, and landing

Screening Tool used By the Detroit Medical Center for Sports

• Core and Lower Body Stability and Flexibility
• Foot Type/Posture
• Strength – Quadriceps vs. Hamstring
• Strength – Hip Strength and Control of the Lower Leg
• Strength – Left to Right Asymmetries, deficits of greater than 20% are significant
• Ligament Dominance Test during jump

In the event that a young female athlete is found to have risk factors for a possible ACL injury, it is our job to implement an injury prevention program in which we address the identified risk factors. A comprehensive program would include lower extremity neuromuscular training, core stabilization, plyometrics, balance and proprioception training, agility and endurance training, and stretching. Training programs can last from six to eight weeks with the goal to address the risk factors identified and reduce the incidence of a non-contact ACL tear. Many studies have shown that female athletes have a higher incidence of ACL injuries and tears when compared to their male counterparts and effective evaluation, education, screening, and prevention programs have proven to be effective and should be considered before any female begins a sport.

References

1. Sports-Related Knee Injuries in Female Athletes What Gives?, Dugan, Sheila A., American Journal of Physical Medicine & Rehabilitation 2005.
2. 2. Rationale and Implementation of Anterior Cruciate Ligament Injury Prevention Warm-Up Programs in Female Athletes. Bien, Daniel P., Journal of Strength and Conditioning Research 2011.
3. Prevention of Non-Contact Anterior Cruciate Ligament Injuries in Soccer Players. Part 1: Mechanisms of Injury and Underlying Risk Factors. Alentorn-Geli et al., Knee Surg Sports Traumatol Arthrosc 2009.
4. Female Athlete ACL Screening. Detroit Medical Center Sports Performance Academy.
5. Anterior Cruciate Ligament Tear. Spindler and Wright., The New England Journal of Medicine 2008.
6. Prevention of Anterior Cruciate Ligament Injuries in Female Team Handball Players: A Prospective Intervention Study over Three Seasons. Myklebust et al., Clinical Journal of Sports Medicine 2002.

By Dorina Bodner, DPT

Shoveling snow is more than just another household chore. It can be a very rigorous aerobic activity much like exercising at the gym. This task can be physically demanding on the back and shoulder muscles as well as the heart. Anyone with any type of heart condition should consult their physician before participating in snow removal activities to ensure safety. There are many ways to reduce the risk of back strain and reduce stress on the heart during the task of snow removal.

• First, it is important to remember to shovel snow early and often. Freshly fallen snow is typically lighter than snow that has been sitting, which can be heavily packed and melted.

• Before shoveling, it is important to warm up your muscles as you would before any aerobic exercise activity. A light exercise routine lasting ten minutes should be performed including stretching the shoulders, back, and legs.

• When gripping the shovel, try a wide grip separating the hands about 12 inches apart in order to get increased leverage when removing snow.

• Stand with a wide base of support–feet about shoulder-to-hip width apart–and always step in the direction you are shoveling to prevent twisting, which can cause injury to the back.

• Never throw snow over your shoulder. In fact, try to push the snow to the sides rather than lifting it at all to reduce stress on your back.

• Keep your core engaged and back straight–bending and lifting with knees rather than the back.

• It is very important to stay hydrated, take frequent rest breaks, and listen to your body. Remember that shoveling snow is like weight lifting–you need to take breaks in order to let your muscles recuperate between sets.

• Most importantly, if you experience shortness of breath, dizziness, and/or chest pain or tightening, stop shoveling and seek immediate medical attention.

Stay safe this winter season!