INERTIA: A Therapist's Thoughts

'Tis the season!  For shoveling snow that is. So I thought this would be an appropriate time to discuss proper body mechanics for lifting. 

I was reminded of this issue while, of all things, watching old videos of my kids when they were just toddlers. You may ask, what does silly home movies have to do with shoveling snow? My wife is also a physical therapist. Yes, its fairly common for PTs to marry PTs. Since we share the same profession, we will often observe something in everyday things that reminds us of work.

Back to the family videos ... we were watching a video of our daughter from when she was about 18- 24-months-old. In the video, we observed how she squatted down to pick up a toy. We realized then that toddlers seem to use perfect body mechanics when picking up an object off the floor. They use their legs to squat down and keep their backs relatively straight. A toddler tends to use this technique to compensate for the weight of their head and developing balance.  But it is interesting to watch as it is an innate behavior that doesn't need to be taught.

Adults on the other hand, often need to be taught this behavior later in life after bad habits have developed. Poor body mechanics and improper lifting technique can be a major risk factor for lower back injuries. Given the time of year, physical therapists can usually count on a few snow shoveling-related back injuries every year. In an attempt to prevent those injuries, let's review some main concepts especially as they relate to shoveling snow.

1. Lift with your legs, not your back — keep your back straight and bend using your knees and hips. The quads, glutes, and hamstrings are large muscles that are well-equipped for heavy lifting.
   
   
2. Avoid twisting of the spine — instead turn with your legs and hips. The twisting motion of the spine especially with a large compressive load (i.e., shovel full of snow) is hard on the intervertebral discs. 
   
   
3. Take breaks and pace yourself. If you feel yourself getting winded or short of breath, take a break. Don't take more than you can handle on the shovel, especially with a wet heavy snow. 
   
   
4. Try a crooked shovel. Those funny looking crooked handles on shovels do serve a purpose. The angle in the handle improves the ergonomics of the shovel so you don't have to squat as far.

Be careful when shoveling!  Merry Christmas!

I am a fairly avid runner. I don't run competitively much but more for fun, fitness and to be able to eat a little more of what I want. I usually run about 3 days per week. 

As a runner, I now find myself in the same position as a lot of patients I treat ... needing new running shoes! Over the last month or so I have had more aches and pains after running. I notice that within 10-15 minutes after running the front of both of my knees ache. My feet and ankles get more sore the day or so after a run also. Another major clue that I've been ignoring is that I feel every crack or bump in the pavement.

Simply put, my shoes have lost their ability to help absorb some of the shock of running. The ground reaction forces transmitted up the leg from running can be as high as four times body weight. The amount of the ground reaction force is widely accepted and described further in this research abstract. 

In addition to the symptoms that I have personally been experiencing and describe, other common signs that running shoes have exceeded their useful life could include: increased muscle fatigue, onset of shin splints or plantarfascitis (arch pain), increased and uneven wear pattern on soles and decreased structural integrity of the shoe (easy to bend or twist). The typical lifespan of running shoes is 400-500 miles or about 4 months of running 25 miles per week.

Buying new shoes is not as simple as running to your nearest big box store and grabbing a pair in your size off the shelf. I am going to go to a store that specializes in running shoes and get my foot measured to ensure the proper fit. A specialty store is also more likely to be able to assist you in picking out the style of shoe that best fits your foot and running style. The three main types of shoes are: motion control, stability, and cushioning.  Don't just try them on: Try jogging in them a bit. Some stores have areas or treadmills set aside for you to do this. For a good pair of quality running shoes that fits properly, expect to pay a little more. I feel that it's worth it if you run regularly. 

As a physical therapist, I am a bit embarrased that I've let it get to this point because I know better.  That's a bit of human nature and also a bit of an attempt to economize, as many of us are doing these days. Well, off to buy my new shoes.  I'll let you know later how this worked out.