The nature of care-giving can place great physical stress on you as the caregiver. Practicing proper body mechanics will decrease the stress and strain and help to safely manage the mobility of the care-receiver. The primary rule is to maintain the normal lumbar curve at all times. By following this one simple rule, injury to the lower back can be avoided. This means that you may need to get in different positions or use different transfer techniques, based on your own body type/size and that of the care-receiver. The following lifting principles will help keep the normal lumbar curve.

Principles of Safe Lifting

1. Maintain a sturdy or broad base of support. A stable position is necessary when assisting the care-receiver with moving. A wide base of support is stable—spread the feet at or greater than shoulder-width apart—but keep in mind that having the feet in a scissor position, with one foot forward and one foot backward, also offers a wide base of support. The physical space available will dictate which position to use when assisting with moving. For an example, when assisting someone with a car transfer, there may not be enough room to spread the feet shoulder-width apart; therefore, the scissor position may be the better option.

2. Keep the load close. This applies to lifting objects as well as to assisting a care-receiver with a transfer. For example, when lifting a chair, if the chair back is close to the body, it feels much lighter than if the chair is lifted with the arms extended, with the chair away from the body. Most likely, with the latter technique a strain will be felt in the low back. The farther away the object (or care-receiver) being lifted, the greater the lever arm, which makes the care-receiver or object feel heavier. It is much easier to lift and much easier to keep that normal lumbar curve when the load is closer. 

3. Bend with knees, not with the back. The take-home message here is that bending forward with a rounded low back (lumbar spine) loses the normal lumbar curve and causes stress to your low back. The larger, stronger leg muscles are more equipped to do the lifting than the low-back muscles. Remember to tighten up the stomach and bend down with your legs.

4. Push instead of pull, whenever possible. When pulling a load, it is much harder to keep the normal lumbar curve (neutral spine), so whenever possible, push rather than pull. For example, in assisting a care-receiver up from a low chair, it is better to stand on the side of the care-receiver and push him forward so that his center of gravity is over his feet—so that he can use his legs to transfer to standing—rather than standing in front of him and pulling forward where you are performing more work and potentially placing more strain on your lower back.

This article was adapted from The Pocket Physical Therapist: A Caregiver’s Complete Guide for Mobility and Independence in the Home due out in August of 2010 from Langdon Street Press. For more information: www.ohanapacificrehab.com.