Industrial studies have shown that nursing has the second highest incidence of all types of non-fatal work-related injuries in the United States. The main factors contributing to back injury and/or back pain for healthcare professionals are lifting or transferring patients and bed-making. In hospitals, nurses working on orthopedic floors, in operating rooms and in the ER are at the greatest risk for occupational injury.
Once a back injury or back pain has occurred muscular stretching and toning is an important part of the healing process. A serious strength and training routine for the back should be faithfully executed as soon as the back is no longer inflamed and painful. Muscular strengthening exercises are important once the back irritation has subsided to help build stability in weak tissue. However, muscles can become damaged further if strengthening exercises are started premature to the healing of the injured area.
It is also equally important to follow a muscular strength and toning regime before back pain or injury occurs. It is important to keep in mind that the body’s musculoskeletal system is all connected. Muscles do not act independently, so in order to stretch and strengthen the back muscles it is also necessary to stretch and strengthen the muscles connected to the back, i.e. the shoulders, neck, arm, hip, thigh, calf and foot muscles. When exercising it is not necessary to feel the stretch in the back itself. For instance, stretching the hamstring loosens the leg muscles, but also takes the strain off the back without directly exercising the back area.
Muscle stretching is a very important element in the healing of most stressed back muscles. Strengthening and lengthening shortened back muscles is essential in preventing further back injury, especially for nurses who go back to work and immediately return to the same tasks that initially caused the back strain.
Talking to a doctor before undertaking an exercise program is recommended. The most effective exercise regimes for back pain are specifically designed for individual cases. Most people who experience back pain find relief from the pain in one of two ways; either by sitting, where the back and hips are in a flexed position, or by standing, where back and hips are extended.
Exercise should be geared toward movements that place the body in the most comfortable position to be of positive effect. For people who find sitting to be an alleviating position, flexion exercises that bend the body forward such as knee to chest movements and sit-ups or curl-ups are recommended. Flexion exercises stretch the back and strengthen the stomach and abdominal muscles.
For those in which standing is the most comfortable position, i. e. usually those with herniated discs, extension exercises which stretch the tissue in the front of the spine are usually more effective. Press up back exercises such as those recommended by Australian doctor Robert MacKenzie often can bring fairly immediate relief from back pain. Back bridges can also serve to strengthen lower back muscles.
Aerobic exercise is recommended to make the heart and other muscles that use oxygen function more efficiently and remain healthier. Aerobic exercise includes walking, swimming or walking in waist-deep water. For those with current back pain, non-weight bearing exercises like those done in water or while swimming are beneficial. Walks should be kept short and easy, avoiding inclines and rough terrain. It is helpful to do aerobic exercise every day.
In addition to the appropriate flexion or extension exercises the following exercises can help prevent or reduce pain:
• Aerobic exercise
• Prone buttocks squeeze
• Pelvic tilts
• Hamstring Stretch
• Hip flexor stretch
• Wall sits
If low back pain is present, there are some exercises that can aggravate back injury and accompanying pain. It is best to avoid the following exercises:
• Straight leg sit-ups
• Bent leg or partial sit-ups if acute back pain is present
• Lifting both legs while lying on the back
• Toe touches while standing.
One often forgotten aide to help prevent back pain, or if injury and pain is already present, is to always wear a nursing shoe with a broad heel for good stability and good support through the arches. A tie shoe that can be tightened with the laces as the shoe stretches is ideal. Comfort should be a priority when choosing shoes. Nursing shoes with run down heels should be replaced as they can result in improper alignment of ankles, knees and hips, making the body more susceptible to injury.
Remember, it is important to work all the connected areas of the body when strengthening the back. Exercise and staying active can make the body less susceptible to occupational injury and may relieve back pain and speed recovery from back injury. Strong stomach, back and leg muscles support the spine better, reducing pressure on the spinal discs and lessening the chances of occupational back injury.