The document discusses understanding and preventing low back pain. It notes that 80% of Americans experience debilitating back pain at some point, and back pain is second only to the common cold as a cause of missed work days. It describes spinal anatomy and common back conditions like disc injuries and sciatica. It provides exercises to strengthen the core and back like planks, bridges, and cross crawls. It also discusses proper posture and ergonomics at the workstation to reduce back strain from prolonged sitting.

1. Understanding and
Preventing Low Back Pain
Kevin Christie D.C.
Health-Fit Corporate Wellness

2. The Back Facts
 Relates to Everyone
 80% Americans have debilitating back pain
 Second only to the common cold for missed
days at work
 30-40% increase in intradiscal pressure
during seated position.
 Majority of Americans have seated
dominate jobs.

3. Spinal Anatomy
 Spine-24 moveable segments,
sacrum and coccyx
 Spine
 Protect
 Motion
 Shock Absorber
 Support and Stability
 Kyphosis
 Lordosis

4. Loss of Curvature
 Decrease Range of Motion
 Decrease Strength
 Muscle Imbalances
 Increase Chance of Injury
 Increase Disc Pressure
 NEUTRAL SPINE IS EXPONENTIALLY STRONGER

5. Common Low Back
Conditions
 Mechanical Low Back Pain
 Disc Related Pain: Disc Herniation vs Disc Bulge
 Sciatica
 Piriformis Syndrome
 Myfoascial (Muscular Pain)
 Facet Syndrome
 Fibromyalgia
 Spinal Stenosis

6. DISC
 Shock Absorbers or Weight Bearers
 Increases Range of Motion
 Maintain Curves
 Size of the Foramen
 Material
 Annulus Fibrosus- Outer cartilage
 Nucleus Pulposes- Central
 The Jelly Donut Analogy

7. Lower Crossed
Syndrome
 Lower Body Muscle Imbalance
 Tight Hip Flexors
 Tight Low Back
 Weak Abdominals
 Weak Glutes
 Related Pain Syndromes
 Low Back Pain
 Mid Back Pain
 Hip Pain
 Lower Extremity Pain
Syndromes

8. WHEN TO HAVE YOUR PAIN EVALUATED?
WARNING SIGNS
 Chronic Back Pain
 Greater 72 Hours
 Off and On for
weeks
 Acute with History
 Worse in the Morning
 Brushing Teeth
 Shaving
 Washing Face
IMMEDIATE REFERAL
 Radiating Leg/Arm
Pain, Numbness,
Tingling
 Loss of ROM
 Weakness
 Past Medical History
 Loss of Bladder/Bowel
 Frank Trauma

9.  Foot-Stability
 Ankle-Mobility
 Knee- Stability
 Hip- Mobility
 Lumbar (core)- Stability
 Thoracic- Mobility
 Scapular- Stability
 Shoulder- Mobility
Alternating Pattern of Mobility & Stability
Yellow = Stability
Red = Mobility

10. Body Positioning and Spine Protection
 Proper Desk Ergonomics
 Sitting Posture
 Abdominal Bracing
 Power Zone
 Sternum Up
 Neutral Spine
 Hip Hinging

11. The Abdominal Brace
Abdominal Bracing- When all of your core muscles work
together, a "Super Stiffness" occurs, and all 3 layers of the
abdominal wall are activated to protect and stabilize the
spine and discs.
Without bending forward, contract the abdominal muscles
(like you are about the get punched in your gut - feel them
tighten with one hand) and the buttock muscles (as if you
are holding in a bowel movement).
You will feel the lower back muscles contract (with the
other hand) when you contract your abs and buttocks.

12. The Power Zone
Power Zone- The zone that
will optimize lifting strength
and injury reduction.
a. Bend your elbows at a 90-
degree angle and you are in the
“Primary Power Zone”
b. The area up to the
shoulders and down to the hips
is acceptable.
c. The more you can work in
the “power zone” the less
fatigue on your body.

13. Sternum Up
Sternum Up- Keeping the sternum up
automatically sets the body into good posture
and maintains:
 Neutral Spine: Maintaining good spinal
alignment decreases the stress placed on
the spine and discs.
 Hip Hinging: Bending at the hips, and not
the low back, decreases the stress
placed on the low back and increases
strength & power.

14. The Cross Crawl
Perform 2-3 Sets
6-12 repetitions
Perform on each side

15. The Glute Bridge
 2-3 Sets
 8-12 Repetitions

16. The Standing Back Extension
 1 Set
 10 Second Hold
 2-4 Repetitions

17. The Front Plank
 1-3 Sets
 30 second to 2
minute holds

18. Other Low Back Considerations
The Can Opener The Side Bridge
Brueger’s Posture Relief

19. The Micro-Break

20. Workstation self-assessment
 Y/N Does your feet rest flat on the floor or a footrest?
 Y/N Are your knees bent at approximately a 90-degree angle?
 Y/N Does your chair support your lower back?
 Y/N Is there about 2-3 inches between the front of the seat pan and the back of your knees?
 Y/N Can you easily reach your work without interference from the arms of your chair?
 Y/N Are your arms and shoulders relaxed without interference from the arms of your chair?
 Y/N Are your shoulders relaxed and not elevated when you work on your keyboard?
 Y/N Are your arms resting at your sides rather than stretched out in front of you?

21. Workstation self-assessment….continued
 Y/N Can you reach your mouse without rotating your arm outward or reaching to the side?
 Y/N Is your keyboard at approximately elbow level, with your forearms level and flat?
 Y/N When typing, are your wrists in line with your forearms and not bent upward or to the sides?
 Y/N Is the top of your computer screen at or just below eye level?
 Y/N Can you see detail comfortably on the screen without leaning forward?
 Y/N Are you able to read the entire screen comfortably without tilting your head up or down?
 Y/N Do you have an adjustable document holder for reference materials if you type from paper to the
screen?
 Y/N If you spend more than an hour a day in combined computer and phone work, do you have a headset?

22. Workstation self-
assessment…continued
 Y/N Are all your input devices (mouse, tablet, etc.) at the same level as your
keyboard?
 Y/N If you use an adding machine, is it close and easy to reach?
 Y/N Are your keyboard and monitor located on a centered line in front of you?
 Y/N Do you take short and frequent breaks throughout the day to reduce
fatigue?
 Y/N Are you comfortable and free of pain while working.

23. Healthy Solutions for the Desk Worker
Podcast

24. Any Questions?