Health & Exercise Forum

November is National Family Caregivers Month

More than 65 million people, almost 30% of the population in the United States, are actively involved in providing 20 or more hours of care for a chronically ill, disabled, or aged family member or friend each week. As our population continues to age, this number is expected to grow rapidly.

The role of a caregiver is multifaceted and often involves tasks and skills beyond the education or comfort level of most providers. Some examples include; managing money, paying bills, shopping, cleaning, maintaining and repairing a home, dispensing and injecting medications, cleaning wounds, changing dressings, catheter management, bed baths, assisting in position changes, transferring from the bed to the chair, ambulation, stair climbing, bathroom assistance for toileting and showering and many other responsibilities. Consequently, a caregiver is often at risk for mental, spiritual and physical fatigue or breakdown. It is no surprise that depression, illness and injury often plague a caregiver and eventually, the caregiver is in need of a caregiver. One of the most common injuries suffered by a caregiver is back pain.

Lower back pain (LBP) is one of the most common problems in our society. Over 90% of all Americans will suffer from it at least once in their lives. It is generally agreed that prevention is the best treatment for LBP.

TIPS FOR THE PREVENTION OF BACK PAIN FOR THE CAREGIVER

• Maintain Health & Fitness Level.
  • As little as 10 extra pounds puts great stress on your lower back. It also makes it more difficult to maintain good posture. Eat well and exercise regularly.
  • Aerobic Exercise: Aerobic exercise will help prevent weight gain and stiffness for a healthier lower back. It will also help with the stress and depression associated with providing care for a loved one. Perform mild aerobic exercise such as walking 3-5 times per week for 30-45 minutes. You can also use an elliptical or bike at home while your loved one is resting. Get outdoors and take multiple short walks …go around the block a few times per day.
  • Core Exercises: Core stabilization exercises designed to strengthen the abdominal and lower back muscles will help prevent injury. Some examples of core exercises are:Pelvic Tilt and Heel Slide - lying on your back, hold a pelvic tilt as you slide your one heel up and down and repeat with the other heel.
    • Core on Ball - Perform arm exercises such as biceps and triceps with light weight while sitting on a therapeutic ball while simultaneously trying to hold an isometric contraction of your abdominal and lower back muscles.
    • Pelvic Tilt - lying on your back and performing a pelvic tilt as you flatten you lower back into the floor.
• Do Not Smoke:
  • Smoking affects natural healing because it constricts the small blood vessels. Smokers have a much higher incidence of LBP and failure from lower back surgery.

• Practice Good Posture & Body Mechanics:
  • Good posture is critical for a healthy back. When sitting, standing or walking maintain a slight arch in your lower back, keep shoulders back, and head over your shoulders. In sitting, use a towel roll or small pillow in the small of the back.Caregivers spend much of the day with their spine bent over a bed or chair feeding, bathing, and lifting a loved one. Postural exercises are designed to stretch your back in the opposite direction of this forward flexed position. Examples include: Chin Tucks - tuck your chin back to bring head over shoulders.Standing Arch - while standing put your hands behind back, extend lower back 10-20 degrees. Perform slowly, hold for 3-5 seconds and repeat 6 times each 6 times per day.
    • Shoulder Blade Pinch - pinch your shoulder blades together.
  • Ergonomics
    • Sitting - When sitting, use an ergonomic work station and chair with a lumbar support and adjustable heights. Get close to your desk, keyboard and monitor.
    • Driving - If you drive long distances, use a lumbar support to keep an arch, sit close to your steering wheel to prevent bending forward.
    • Bending – Get an adjustable bed and raise it to a comfortable height when feeding, dressing or bathing your loved one.Lifting - Think twice. First bend your knees and arch your back. Then, brace your abdominal muscles. Bend your spine forward as little as possible to lift the patient. Bend your knees, maintain an arch in the back with head up, and bend over as little as possible. Bend the knees of your loved one; roll their trunk toward you to get their legs over the edge of the bed as you pivot their weight on their butt to get them sitting upright.Bend your knees, maintain an arch in the back with head up, and bend over as little as possible. Place your hands around the waist or on a transfer belt. Use your legs, turn with feet, and do not twist spine. Block the feet and knees of your loved-one with your feet and knees and use them to pivot and transfer from the bed to the chair. Be sure the chair is along side of the bed and arm of chair removed if possible before the lift.
    • Transfer Belt - Use a transfer belt around the waist of the patient. Grip the transfer belt, instead of the patient or clothing, during the lift or when ambulating. Lower Back Lifting Belt - Also, if you have a back problem, consider using a lifting belt or back brace to protect your back when lifting the patient. Immediately following the lift, stand up straight and stretch lower back into extension.Transfer belts and lower back lifting belts can be found online or at your local pharmacy.
    • Lift Chair – For patients that require maximum or moderate assistance and only one caregiver is available to lift or transfer, an electric lift chair should be considered.
    • From Lying to Sitting in Bed: See Photo #1 for proper technique.
    • From Sitting in Bed to Sitting in Chair: See Photo #2 for proper technique.

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”  in the Scranton Times-Tribune.

 This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton and is an associate professor of clinical medicine at The Commonwealth Medical College.

Visit your doctor regularly and listen to your body.