Safe Lifting Techniques
Ainslie graduated from the New Zealand School of Physiotherapy in 1974 and has been a Member of the New Zealand Society of Physiotherapists (NZSP now called Physiotherapy NZ) since 1975. She completed a Diploma of Educational Studies in 1980 and an Advance Diploma Physiotherapy specialising in paediatrics in 1990. She has been an associate member and later a Member of the New Zealand College of Physiotherapy since 1990. She has also served on the College Board and various NZSP branch committies over the years. Currently she is a Member of the NZ College of Physiotherapists with Advanced Practitioner status in Paediatrics, a Member of Physiotherapy New Zealand and also a member of the neurology and paediatric special interest groups. And holds a current NZ Annual Practising Certificate.

Back in the late 1970’s Robyn McKenzie – the internationally recognised specialist in treatment of back injuries – noticed that a large group of his clients who had back pain had been injured when lifting groceries after a trip to the supermarket. A closer look at the group identified that the majority had injured themselves lifting the groceries out of the car. Only a very few had been injured lifting the groceries into the car. Robyn correctly identified the position of the nucleus of the disk within the disk space as being a critical factor in whether a lift is likely to cause back injury or not.
Modern CT and MRI scans can show the position of the nucleus of disk and what is happening when we move into different positions. As we bend forwards the vertebrae – the individual bones of the spine - angle slightly closing the gap at the front and opening the gap at the back. The disk is thus compressed at the front and expanded at the back. The soft jelly like nucleus filling the centre of the disk space oozes back to fill the space. As we bend backwards the opposite happens and the nucleus moves forwards. (See last weeks article for pictures of the spine and disks.)
Walking causes alternating movements from a relatively neutral position into slight extension – backward arching – that tends to move the nucleus of the disk forwards in the disk space. Sitting to drive the car places the lower spine in a slightly flexed – forward bent – position and the nucleus of the disk moves slowly backwards in the disk space. If the nucleus is pushing back on the outer wall of the disk – the annulus- and the annulus is slightly weakened and then the whole system is loaded with a large bag of groceries a back injury may result. Even with a slightly weakened annulus if the nucleus is more in the front part of the disk space when the load is added the pressure backwards is less likely to cause a bulging of the posterior – back - disk wall.

Bulges in the disk wall to the front or sides are not likely to cause pain as the bulge is less likely to press on a sensitive structure. The spinal cord runs down through the spinal canal immediately behind the disk. A pair of nerve roots come off the spinal cord, and pass out the supply the right and left sides of that part of the body at each disk level. The spinal cord and nerve roots are all very sensitive to pressure as these structures are vitally important to our function and nerves are difficult to repair.

Before starting a lift make sure you prepare your back by arching backwards several times especially if you have just been sitting or bending forwards.

We often hear the admonition ‘Don’t use your back like a crane when you lift’, but perhaps we should take note of some of the rules of safe use of a crane before we start to lift.
• Cranes are to be operated only by qualified and trained personnel.
• A designated competent person must inspect the crane and all crane controls before use.
• Be sure the crane is on a firm/stable surface and level.
• During assembly/disassembly do not unlock or remove pins unless sections are blocked and secure (stable).
• Fully extend outriggers and barricade accessible areas inside the crane’s swing radius.
• Watch for overhead electric power lines and maintain at least a 10-foot safe working clearance from the lines.
• Inspect all rigging prior to use; do not wrap hoist lines around the load.
• Be sure to use the correct load chart for the crane’s current configuration and setup, the load weight and lift path.
• Do not exceed the load chart capacity while making lifts.
• Raise load a few inches, hold, verify capacity/balance, and test brake system before delivering load.
• Do not move loads over workers.
• Be sure to follow signals and manufacturer instructions while operating cranes.
For more complete information:

Occupational
Safety and Health
Administration
U.S. Department of Labor
www.osha.gov (800) 321-OSHA

All the rules of crane safety can be applied to human lifting. The first two refer to the knowledge of the person about to do the lift and the state of his/her body. Is this a safe lift for you today?

Next come several about the environment of the lift –
• Is the base of the crane on a flat stable surface and are the outriggers extended? Are you standing on a flat surface – no high heels, and are you using a wide stable stance.
• Watch for overhead power lines and barricade clearance round the crane. Check your environment for any obstacles, rough ground, boxes or other items in the way.
• Be sure to use the correct load chart for the crane’s current configuration and setup, the load weight and lift path. Do not exceed the load chart capacity while making lifts. Is the weight you are planning to lift within your capabilities today and are you able to carry it the required distance comfortably? Do you have somewhere to put the load down before the destination if the load becomes uncomfortable?
• Raise load a few inches, hold, verify capacity/balance, and test brake system before delivering load. Do not move loads over workers. When your first take up the load check that it is comfortable and safe for you to continue with the lift. As you continue check for changes in the environment – people or animals moving or vehicles moving after you started the lift.
• Be sure to follow signals and manufacturer instructions while operating cranes. The manufacturers instructions for using a body effectively for lifting includes
o Keep it strong with regular strengthening exercises.
o Keep it flexible with regular stretching exercises
o Keep it fit with regular cardiovascular exercise
o Keep it properly powered by good nutritional habits and good breathing techniques.
o Prepare the back before and after lifting with some backward arching.
o Keep the load as close to the body as possible.
o Use the big strong muscles of the legs to do the main lifting work.

Herald Issue 554 09 March
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- Briefs from PM’s media conference Tuesday
- Tourism Industry ponders $5 million draft strategy
- Norman George resigns from Cook Islands Party
- Letter of Resignation from CIP
- Norman selfish says Prime Minister