BodyMechanics

Posture and Body Mechanics for Activities of Daily Living

Proper posture and body mechanics should be common practice but are particularly important after injury or
surgery. The spine, the discs between each vertebra, the ligaments and muscles attaching to the spine, are all
engineered to work most efficiently when aligned correctly. Good posture maintains the curves and aligns the
body in a way that promotes the most efficient movement patterns with the least amount of stress. This is
important for healthy as well as injured areas and allows for quicker healing.

General guidelines and recommendations for correct posture and body mechanics to be practiced while lifting,
getting in and out of bed, sitting, sleeping, standing, and others are outlined below. Please consult a physician or
experienced Physical Therapist if you have any pain or questions.

The spine is divided into to in three regions: the cervical (neck), thoracic (mid-section), and lumbar (lower back)
and each has a unique curve that when looking from the side resembles an “S” shape. The cervical and lumbar
spine has an inward curve that is commonly referred to as a lordosis and the thoracic curve, opposite the cervical
and lumbar curve, a kyphosis. These are natural curvatures. If the “normal” or “healthy” degree of curvature is
exaggerated in either direction pain and/or injury can occur, therefore it is important to maintain a “neutral” spine
posture whenever possible, especially when lifting, sitting, carrying and standing. It is this ‘neutral’ alignment that
best absorbs and distributes potentially injurious forces of gravity, bending, extending and twisting. Lordosis is
lost whenever the low back is rounded and this usually occurs during sitting or bending forwards. If lumbar spine
lordosis is lost often and for long enough periods, then low back problems may develop.

Most low back pain is caused by prolonged overstretching of the spinal ligaments and other surrounding tissues.
Pain produced by this overstretching is very common and usually arises because of poor postural habits.
Whenever we remain in a relaxed, slumped or “forward flexed” position such as in standing, sitting, or lying,
prolonged overstretching can easily occur. The following are some common postures and strategies that will help
maintain proper posture and reduce stress on our low back.

Abdominal Bracing is frequently mentioned below. If you are not already familiar with what it is and how to do it,
please read and practice the following. You should not have any pain with this movement. Please speak with a
doctor or experienced Physical Therapist if you have any questions. The purpose of this exercise is to learn to
create a co-contraction of the abdominal and low back muscles in a “neutral spine” posture. It is in this posture
that the spine and muscles around it are able to absorb and distribute forces most effectively while minimizing
stress on the spine, ligaments, discs and muscles. It is also in this posture, when our core is “braced”, or
“engaged”, that our body and extremities move most efficiently; and why we want to perform all exercises in
neutral with abs engaged. Lying on your back, knees bent, feet flat on the floor, arms at your side, find the
neutral spine position, where your lower back has a small and comfortable arch. While maintaining this neutral
spine position, make a hard “SSSS” sound and feel your low back and abdominal muscles tighten (you can place
a hand under your low back to ensure your spine doesn’t change positions.) Hold this position for 5 seconds and
be sure not to hold your breath. Repeat 5 times. Once learned, abdominal bracing in neutral should be utilized,
however subtle, during most activities of daily living that involve lifting or bending forward, all strength exercises
and even some stretches for an added measure of protection to the spine and back muscles.

LIFTING
Bend forward at the waist while maintaining the curve in your low back and lift with your legs, not your back.
Proper lifting technique:
1.        Stand close to object.
2.        “Brace” your abdominals/core, bend your knees and bend forward at the waist while maintaining a “neutral
spine”, a straight back with the normal curves.
3.        Grab and hold the object as close to you as possible.
4.        Lift slow and steady, no jerking.

SITTING
Even with proper sitting posture, without some kind of support the low back muscles will eventually fatigue
resulting in poor posture, usually in the form of slumped sitting.
When sitting in a chair:
1.        Stand with the chair against the back of your legs.
2.        Brace your abdominals in neutral spine and while maintaining good posture carefully lower yourself into the
chair, using the arms of the chair if needed.
3.        Slide back into the chair until the natural curve (lumbar lordosis) of your lower back is supported.
4.        Knees should be slightly lower than hips and feet should flat on the floor.
5.        Use a lumbar support if needed.
6.         Also, get up and move every 60 minutes or so, if possible - walk around for a few minutes and do some
stretching.

GETTING IN AND OUT OF BED
Getting in:
1.        Sit on the edge of the bed, slide back until the back of your legs are touching the bed and feet are still on
the floor.
2.        Without twisting or bending the neck or low back, brace your abdominals and lower yourself down onto
your side and onto the bed, using your arm for support.
3.        While lowering, your legs should come off the floor with your knees still bent until you are lying on your side.
4.        If you need to roll on to your back, be sure to employ the “log roll” where your head, shoulders, and hips all
roll together in order to avoid twisting.
Getting out:
1.        Above process is reversed. If you’re lying on your back, brace your abdominals, bend your knees and log
roll on to your side. Use the arm that you’re not lying on to push your torso up as you let your feet move towards
the floor.
2.        Keep your head in line with your body as you move from lying to sitting up.

POSTURE AT THE SINK
(Shaving, brushing teeth, washing dishes, applying make-up, etc.)
1.        Do not lean or “push” your head forward to get closer to the mirror - this causes a misalignment in the
cervical spine (neck). If possible, bring the mirror closer to you. Brace your abdominals.
2.        If you do have to bend over a sink, stand with your feet greater than shoulder width apart and bend at the
knees and hips while maintaining the natural curve in your lower back and neck. Maintain a braced abdominal
posture.

SLEEPING
Your mattress itself should not be too hard. A soft mattress on a firm support is ideal.
1.        Side-lying position with knees comfortably bent is best.
2.        Pillow between knees to maintain alignment of thighs, hips, pelvis and spine.
3.        Hug a pillow at your chest to minimize strain on your neck and shoulder.
4.        Support your neck with a pillow that fills in the space between your head, neck, and bed - your ear and
shoulder should be aligned.
5.        Sleeping on your back with legs elevated with pillows, your neck supported by a pillow but not elevated out
of alignment - ear aligned with shoulder.
6.        DO NOT PROP YOUR HEAD UP OR WATCH TV IN BED!
7.        DO NOT SLEEP ON YOUR STOMACH!

STANDING
1.        Feet should be hip distance apart and body weight evenly distributed.
2.        Knees should be soft not locked.
3.        For long periods of standing, put one of your feet up on a small step or stool.
4.        Use your abdominal muscles to support your lower back (brace).
5.        Keep your shoulders back and chest out, don’t slouch.
6.        Shoulders and neck should be relaxed.

The SOFA
1.        Most sofas are not supportive and laying or sitting one does not give your back the support it needs and
can actually strain your back and neck. Try to use extra pillows to provide support if you have to sit on a sofa and
don’t allow yourself to slouch (but don’t worry about bracing in this relaxed position).

WORKING
Activities or jobs that require you to be bent over at the waist for prolonged periods such as gardening, medical
work, or cleaning can obviously be very stressful on the back.
1.        Try to interrupt the forward bending position at regular intervals before pain starts and move around in a
normal upright posture before returning to your working posture.

COMPUTER AND DESK POSTURE
1.        Your computer monitor should be directly in front of you with the top line of text at eye level. The distance
from the anti-glare monitor screen to your eyes should be approximately 18 to 24 inches.
2.        If you are typing copy, prop it next to the monitor so it is also at eye level. You     should shift your eyes
from copy to monitor without turning your head or neck.
3.        Your elbows should be at a 90° angle and your forearms should be parallel with the floor. If the keyboard
is too low your shoulders will roll forward causing the neck and upper back into poor posture. Too high, you will
elevate your shoulders causing muscular tension in the upper back and neck muscles.
4.        If possible, use a slant board for writing and reading to prevent looking down for prolonged periods of time.
5.        Avoid reaching - keep the mouse near the keyboard and the most frequently used items within easy reach.
6.        Don’t hold the telephone receiver between your head and shoulders. This creates tension and
compresses the small facet joints in your neck. Use a headset if possible.
7.        There should be writing space directly in front of the chair - not off at an angle.
8.        The area under the desk should be kept clear to ensure adequate leg room and proper posture.
9.        Ideally, the chair should have a 5-point wheelbase and adjustable for seat height, seat angle, seat depth to
seat back, seatback height, and arm rests. The seat back should not be higher than the bottom of the shoulder
blades and should offer good lumbar support.