Category Archives: Back

Safe Lifting Practices for Back Injury Prevention

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Whether at home or at work safe lifting practices can keep your back healthy and safe. Before lifting heavy objects decide how you will lift carry & place the item before you pick it up. Test the weight of the load by moving or tipping it. Figure out if you can break the load down by placing the contents of large containers into a number of smaller ones before moving them. Is the path clear? What is the weight of the load? How much stress will be placed upon your back? Is there traffic, a tripping hazard, a doorway to go through, or a stairway to go up or down? Avoid carrying an object that requires two hands to hold, either up or especially down a flight of stairs. Use the elevator. Plan a rest stop, if needed. Knowing what you’re doing and where you’re going will prevent you from making awkward movements while holding something heavy. Clear a path, and if lifting something with another person, make sure both of you agree on the plan.

KEY STEPS FOR SAFE LIFTING PRACTICES

Establish a Base of Support: Use a wide, balanced stance with one foot in front of the other. Make sure that you have firm footing and that your feet are a shoulders-width apart. This staggered stance gives you the stability of not falling over and being able to secure the load.

Keep Your Eyes Up: Looking slightly upward will help you maintain a better position of the spine. Keeping your eyes focused upwards helps you keep your back straight.

Get a Good Grip: With your palms and make sure you have an adequate hold on the object. Be certain you will be able to maintain a hold on the object without having to adjust your grip later. You can use gloves to help maintain an adequate grip, but don’t rely on gloves because they can desensitize the fingers and make you unable to feel the object.

Lift Gradually with Your Legs: Without using jerky motions. By using your leg strength, your chance of lower back injury is greatly reduced.

Tighten you stomach muscles: As you begin the lift and keep you head and shoulders up.

Pivot – Don’t Twist: Move your feet in the direction of the lift. This will eliminate the need to twist at the waist.

Weight: A lighter load normally means a lesser risk of injury. The weight of the object should be within the capacity of the person to handle safely.

Handling: It is easier to pull or push a load than it is to lift, put down or carry.

Keep the Load Close: Holding a 20lb object with your hands 20 inches from the body creates more compressive force on your low back than holding it 10 inches away. This is because the muscles in your back have to work to counterbalance the weight when it is further from the body. As the compressive force on your low back increases, so does the risk of muscle strains, ligament sprains and damage to the disks in the spine.

Frequency: The more times a load is handled, the more tired the muscles become, making it easier for the person to be injured.

Distance: The farther the load has to be moved, the greater the risk of injury.

Duration (TIME): Where the job involves repetitive movements, reducing the time spent on handling will help to ensure the movements are not causing unnecessary strain.

Forces Applied: Forces should be applied smoothly, evenly and close to the body. Forces exerted should be well within the capacity of the person, and the person should maintain proper posture.

Nature of the Load: Loads that are compact, stable, easy to grip, and capable of being held close to the body are much easier to handle.

Terrain: Rough ground, steep slopes, slippery and uneven floors, stairs and cluttered floors make moving a load awkward and increase the chance for injury.

Environment (Climate & Lighting): If it is too hot, too humid, too cold or the lighting is inadequate, the capacity to work safely is reduced.

Condition of the Workplace: Safe and comfortable working conditions, with adequate space to perform the task, and tools and equipment that are well-maintained, make their job safer.

Age/Gender: Young and old workers alike may be at an increased risk of injury from manual materials handling activities. Ensure abilities of employees are in line with functional job requirements.

Training: Proper training for the specific task is vital to reduce injury.

Team Lifting: If one person cannot lift or move a heavy, large or awkward object safely, organize a team lift. Team lifting reduces the risk of injury, reduces fatigue and makes the task much easier.

Raise/Lower Shelves: The best zone for lifting is between your shoulders and your waist. *Put heavier objects on shelves at waist level, lighter objects on lower or higher shelves.

Avoid Lifting from the Floor: Lifting from the floor can greatly increase your risk of injury for two reasons. Firstly, it is difficult to bring objects close to your body when picking them up from the floor, especially large objects where your knees can get in the way. Secondly, your low back must now support the weights of your upper body as you lean forward, in addition to supporting the weight of the item you are lifting. Lifting the same 20lbs from the floor more than doubles the amount of force on your low back when compared with lifting is from waist height. Even a one pound object lifted from the floor increases you risk of injury if you use a bent over posture.

Get Help When You Need It: Don’t try to lift heavy or awkward loads on your own. Even though the muscles in your upper body may be strong enough to handle the load, the muscles, ligaments and disks in your lower back may be injured because of the additional forces they have to withstand. Get help from a co-worker, and whenever possible, use a cart, hand truck or other mechanical device to move the load for you.

This content was written by Fit2WRK who has partnered with PT and Me to give a comprehensive look into the services physical and occupational therapists provide. For more information on Fit2WRK click here.

chronic back pain

Effective Chronic Back Pain Treatment

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For chronic back pain, exercise, physical therapy, manual therapy and mindfulness-based stress reduction have the best evidence for effectiveness.

Chronic back pain is one of the most frequent reasons people visit the doctor — it’s estimated that 31 million Americans experience low-back pain at any given time. Yet doctors are finding drugs should actually often be the last line of treatment for it. A new guideline out Feb 14th 2017, from the American College of Physicians (ACP) suggests doctors recommend exercise and treatments like heat wraps, yoga, and mindfulness meditation to their patients before turning to medications like opioids or even over-the-counter painkillers. “That marks a big departure from previous guidelines,” Roger Chou, a professor at Oregon Health and Science University, told Vox1. (Chou’s evidence review can be found at: https://goo.gl/MWzWvK)

Why Send Patients to Physical Therapy for Chronic Back Pain?

It is the long term benefits of physical therapy interventions such as multifidus, transversus abdominus and pelvic floor neuromuscular reeducation that benefits your patients.
• Multifidus muscle recovery requires specific, localized, retraining.3
• PT + meds 30% recurrence versus 84% meds only (1 year follow-up).4
• PT + meds 35% recurrence versus 75% meds only (2-3 year follow-up).4
• Less likely to have further healthcare costs.4

Back Pain Conditions Commonly Seen by physical therapists include:
• Low Back Pain (LBP)
• Arthritis Pain
• Strains & Sprains
• Muscle Spasm
• Herniated Discs
• Degenerative Discs
• Radiculopathy/Sciatica
• Piriformis Syndrome
• Sacroiliac Joint Dysfunction
• Scoliosis
• Spondylosis
• Stenosis

In physical therapy our goals are to Improve:
Mobility — Knowledge of Safe Positions — Movement Awareness — Functional Strength — Coordination

“Exercise or alternative therapies, the ACP noted, can work as well as or better than medications, but don’t come with the side effects.1” Physical Therapy is a safe, proven way to treat patients experiencing back pain.

Evidence showed that acetaminophen was not effective at improving pain outcomes versus placebo. Low-quality evidence showed that systemic steroids were not effective in treating acute or subacute low back pain2. (ACP Newsroom)

back pain 3

Treatment
We offer a comprehensive approach incorporating manual therapy, prescriptive therapeutic exercise and modalities. Our programs improve the patient’s physical condition and symptoms. We also provide the patient with movement awareness, knowledge of safe positions, functional strength, and coordination. All of this promotes the management of low back pain (LBP).

Treatments offered include:
• Comprehensive Evaluation with an emphasis on determining the source of the problem.
• Individualized & Specific Exercise Programs
• Manual Therapy (hands-on treatment)
• Modalities as Needed
• Progressive Home Program to help restore independence and self-management

Information provided by North Lake Physical Therapy – Portland, OR
To learn more about North Lake Physical Therapy click here.

References:
1. http://www.vox.com/science-and-health/2017/2/14/14609508/doctors-admit-drugs-cant-fix-back-pain
2. https://www.acponline.org/acp-newsroom/american-college-of-physicians-issues-guideline-for-treating-nonradicular-low-back-pain
3. Spine (Phila Pa 1976). 1996 Dec 1;21(23):2763-9. Hides JA, Richardson CA, Jull GA.
4. Spine (Phila Pa 1976). 2001 Jun 1;26(11):E243-8. Hides JA, Jull GA, Richardson CA.

 

For more information about back pain physical therapy click the links below.

Low Back Pain Physical Therapy  beware bed rest for back pain  low back pain relief

Seeing a Physical Therapist After an Accident

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Anyone who has been involved in an accident and is now struggling to cope with a resulting injury should seriously consider visiting a physical therapist. The documented benefits of physical therapy are numerous, and in many cases physical therapists are able to greatly improve their patients’ quality of life. Whether you are mildly hurt or are suffering from a long-term debilitating injury, read on to learn what physical therapy is, which types of accident injuries physical therapists commonly work with, and about the numerous benefits of physical therapy

What is Physical Therapy?

Physical therapy is a type of rehabilitation aimed at bringing injured patients back up to their optimal level of health via various treatments and exercises. Physical therapists create patient specific plans designed to enable the patient to perform their daily tasks at the highest possible level of function. While a physical therapist will set different goals for different patients, common goals of therapy include:

  • Improving physical function and movement
  • Decreasing/managing the patient’s pain
  • Preventing re-injury
  • Increasing the patient’s strength, endurance, range of motion and flexibility

Wondering how physical therapy helps achieve these goals? While different therapists may approach these goals in slightly different ways, physical therapy programs rely mostly on progressive exercises and manual therapy in order to reach a patient’s goals. For example, a therapist will generally start you out with simple stretches and gradually work towards more challenging exercises tailored to suit your injury, limitations, and recovery goals. Additionally, manual therapy, such as soft tissue mobilization and joint mobilization, can help decrease a patient’s pain, reduce swelling, and restore motion.

Accident Injuries that Physical Therapists Commonly Work With

While physical therapists are well equipped to assist patients with minor as well as serious injuries, many people who visit a physical therapist in Houston do so because of a long-term debilitating injury that they suffered as a result of a boat, truck, or car accident. For example, physical therapists commonly work with patients who have been involved in an accident and are suffering from:

  • Back and neck pain
  • Arm and shoulder pain
  • Leg and knee pain
  • Foot and ankle injuries
  • Hand injuries
  • Decreased range of motion

car accident

The Benefits of Physical Therapy

Individuals who are injured in an accident often find that attending physical therapy improves their well-being in a number of different ways. While each case and each patient are different, the benefits commonly associated with physical therapy include:

  • Pain Management: Many people who are injured in an accident attend physical therapy primarily in order to reduce or eliminate the pain caused by whiplash, disc herniation, fractures, and other injuries. The therapeutic exercises and manual therapy techniques utilized by physical therapists are often able to help reduce a patient’s pain and allow them to rely less on pain medication.
  • Can Help Avoid Surgery: In some circumstances physical therapy has been known to help a patient avoid having surgery altogether. This can be beneficial as surgeries sometimes involve a lengthy recovery, not to mention the inherent risk of undergoing the surgery itself.
  • Quickens Recovery: Individuals who attend physical therapy after an accident often recover much faster than they otherwise would have. Additionally, these individuals also tend to ultimately achieve better range of motion and muscle strength than those with comparable injuries who did not attend rehab.
  • Helps Prevent Chronic Pain: People injured in car accidents often suffer from chronic pain and other symptoms long after the accident occurred. Additionally, some car accident injuries, if left untreated, will worsen over time. Fortunately, accident victims who promptly attend physical therapy tend to experience much less chronic pain than they otherwise would.

Of course, if you have been injured in a wreck due to another person’s negligence, you may wish to speak with a car accident lawyer for help. Indeed, an attorney can help advocate on your behalf to ensure you receive the compensation necessary to pay for your recovery.

feet cause pain

Can Your Feet Cause Pain in Your Knee, Hip or Back?

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Can your feet cause pain in other areas of the body?  Yes it can.  The foot is an arch and arches decrease compressive forces by distributing them across the span of the arch. Engineers use arches in building and bridges to hold up greater weight across longer spans.  The human foot has 3 arches that all work together to distribute the forces our bodies put on it.  This allows us to walk, run and jump.

We start running into problems when the arch is either too flat or too high – causing the forces put through the foot to be abnormally distributed, resulting in strain.

  • Flat feet limit the range of motion of our ankle, causing our hips to rotate inward and move towards the center of our body.
  • High arches do the opposite to our hip joints.
  • These changes cause strain to our ankle, knee and hip joints, and our back.

knee pain

People can be unaware that their feet cause pain throughout the body because they were born with flat feet or high arches and they do not know what “normal” feels like.   As physical therapists we have treated many children who didn’t realize that their feet are not supposed to be sore.  But instead of seeing them for prescribed foot pain, they come for pain in their joints or back.

Orthotics were developed to correct or adapt to changes in the foot.  Orthotics should be fitted by a healthcare professional trained in assessing the foot and gait.  Standing on a pressure plate in the store is not good enough.  Why?  If your foot hurts are you going to stand on it normally?  Probably not.  This results in an abnormal reading.

An orthotic by itself is not the best treatment.   A physical therapist will assess your function, strength, flexibility and range of motion.  Patients will present with other problems as the result of abnormal arches.  Treatment with orthotics combined with strengthening and stretching exercises, balance training, functional training and manual therapy is necessary to restore full function.

This article was written by Scott Van Bramer, PT, Partner/Clinic Director of Phoenix Physical Therapy.  Phoenix Physical Therapy is an outpatient physical therapy clinic in Canal Winchester, OH. For more information about Phoenix Physical Therapy in Canal Winchester, please call the clinic directly at 614-834-2995 or visit them online at www.phoenixptohio.com

reduce back pain

No Turning Back: Reduce Back Pain with These Spine-Stabilizing Exercises

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We take so many things about our bodies for granted. They feel good, we go about our daily activities and we never think about the complex mechanisms at place. That is until something goes wrong. Take your back: it serves as stabilizer, flexor, movement and relaxor too. But unfortunately, back pain troubles many of us — about 8 in 10 people in their lifetime will experience back pain. But you don’t have to rely on pills to relieve symptoms or even countless trips to a doctor. Exercises offer a proactive approach to reduce back pain, and this graphic can help with ideas.

reduce-back-pain-with-these-spine-stabilizing-exercises-web-1

lifting safety PTandMe holidays

When Lifting During the Holidays…

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During the holidays back injuries become more prevalent as patient maneuver themselves up and down ladders and stairways while carrying or lifting heavy objects. A little bit of lifting safety can go a long way to keeping the holidays merry. When Lifting large or heavy objects make sure you:

1. SIZE UP THE LOAD
Check to ensure the load is stable and balanced.

2. PLAN THE JOB
Consider all possibilities. Is the path clear? What is the weight of the load? How much stress will be placed on your back? Is there traffic, a tripping hazard, a doorway to go through, or a stairway to go up or down? Avoid carrying an object that requires two hands to hold, either up or especially down, a flight of stairs.

3. ESTABLISH A BASE OF SUPPORT
Use a wide, balanced stance with one foot in front of the other. Make sure you have firm footing and that your feet are a shoulders-width apart. This staggered stance gives you the stability of not falling over and being able to secure the load.

4. BEND YOUR KNEES, KEEP YOUR HEELS OFF OF THE FLOOR AND GET AS CLOSE TO THE OBJECT AS POSSIBLE.
Always lift with your legs and not your back.

santa

5. BE CERTAIN YOU WILL BE ABLE TO MAINTAIN A HOLD ON THE OBJECT WITHOUT HAVING TO ADJUST YOUR GRIP LATER.
You can use gloves to help maintain an adequate grip, but don’t rely on gloves because they can de-sensitize the fingers making you unable to feel the object.

6. LIFT GRADUALLY with your legs without using jerky motions.

7. KEEP THE LOAD CLOSE TO PREVENT ARCHING YOUR LOWER BACK.
As you begin the lift, tighten your stomach muscles and keep your head and shoulders up. The closer the load is to your spine, the less force will be placed on your back.

8. PIVOT
Don’t twist. Move your feet in the direction of the lift. This will eliminate the need to twist at the waist.

Information can be found at: http://www.tdi.state.tx.us/pubs/videoresource/stpbkinj.pdf

dry needling physical therapist

Trigger Point Dry Needling

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Dry needling uses small, thin needles to stimulate underlying myofascial trigger points, muscular and connective tissues for the management of many orthopedic conditions, both acute and chronic. By inserting a needle into the dysfunctional tissue, it often leads to a contraction of the muscle which then stimulates a relaxation. This leads to a reduction of pain, improvements in flexibility and a restoration of normalized movement when combined with corrective exercises.

WHAT IS A MYOFASCIAL TRIGGER POINT?
A myofascial trigger point is a hyperirritable spot within a taut band of skeletal muscle that produces local or referred pain. The trigger point can lead to increased pain, decreased flexibility and decreased muscle function if not treated. Trigger point dry needling is a safe, effective and efficient treatment technique to release these painful spots.

dry needling

WHAT TYPE OF PROBLEMS CAN BE TREATED?
Muscle dysfunction can be the primary or secondary contributing factor to many neuromusculoskeletal conditions.

WHAT YOU NEED TO KNOW:
• Dry needling must be specifically prescribed by a physician.
• Dry needling is not covered by insurance, it is a cash based modality.

This information was written by The Jackson Clinics, a locally owned physical therapy practice in multiple locations throughout Northern Virginia. They specialize in outpatient orthopedics and sports rehabilitation. Their therapists and assistants possess advanced clinical skills in spinal disorders, sacroiliac joint dysfunction and peripheral joint problems, including rotator cuff injuries, knee injuries and foot and ankle pain. They also also have specialty programs in breast cancer rehab, vestibular rehab, pediatrics, post-cancer rehab, aquatic therapy and women’s health. For more information click here.

Safe Lifting Practices

Safe Lifting Practices: Back Injury Prevention

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Whether you are getting ready for a move, or need to lift things at work, it’s important to use safe lifting practices. Don’t end up with a hurt back – use these tips to keep yourself injury free.

• ESTABLISH A BASE OF SUPPORT: Use a wide, balanced stance with one foot in front of the other. Make sure that you have firm footing and that your feet are a shoulders-width apart. This staggered stance gives you the stability of not falling over and being able to secure the load.•

• KEEP YOUR EYES UP: Looking slightly upward will help you maintain a better position of the spine. Keeping your eyes focused upwards helps you keep your back straight.

• GET A GOOD GRIP: with your palms and make sure you have an adequate hold on the object. Be certain you will be able to maintain a hold on the object without having to adjust your grip later. You can use gloves to help maintain an adequate grip, but don’t rely on gloves because they can desensitize the fingers and make you unable to feel the object.

• LIFT GRADUALLY WITH YOUR LEGS: without using jerky motions. By using your leg strength, your chance of lower back injury is greatly reduced.

• TIGHTEN YOU STOMACH MUSCLES: as you begin the lift and keep you head and shoulders up.

• PIVOT  DON’T TWIST: Move your feet in the direction of the lift. This will eliminate the need to twist at the waist.

• WEIGHT: A lighter load normally means a lesser risk of injury. The weight of the object should be within the capacity of the person to handle safely.

• HANDLING: It is easier to pull or push a load than it is to lift, put down or carry.

• KEEP THE LOAD CLOSE: Holding a 20 lb. object with your hands 20 inches from the body creates more compressive force on your low back than holding it 10 inches away. This is because the muscles in your back have to work to counterbalance the weight when it is further from the body. As the compressive force on your low back increases, so does the risk of muscle strains, ligament sprains and damage to the disks in the spine.

• FREQUENCY: The more times a load is handled, the more tired the muscles become, making it easier for the person to be injured.

• DISTANCE: The farther the load has to be moved, the greater the risk of injury.

• DURATION TIME: Where the job involves repetitive movements, reducing the time spent on handling will help to ensure the movements are not causing unnecessary strain.

• FORCES APPLIED: Forces should be applied smoothly, evenly and close to the body. Forces exerted should be well within the capacity of the person, and the person should maintain proper posture.

• NATURE OF THE LOAD: Loads that are compact, stable, easy to grip, and capable of being held close to the body are much easier to handle.

• TERRAIN: Rough ground, steep slopes, slippery and uneven floors, stairs and cluttered floors make moving a load awkward and increase the chance for injury.

• ENVIRONMENT (CLIMATE & LIGHTING): If it is too hot, too humid, too cold or the lighting is inadequate, the capacity to work safely is reduced.

• CONDITION OF THE WORKPLACE: Safe and comfortable working conditions, with adequate space to perform the task, and tools and equipment that are well-maintained, make their job safer.

• AGE/GENDER: Young and old workers alike may be at an increased risk of injury from manual materials handling activities. Ensure abilities of employees are in line with functional job requirements.

• TRAINING: Proper training for the specific task is vital to reduce injury.

• TEAM LIFTING: If one person cannot lift or move a heavy, large or awkward object safely, organize a team lift. Team lifting reduces the risk of injury, reduces fatigue and makes the task much easier.

• RAISE/LOWER SHELVES: The best zone for lifting is between your shoulders and your waist. Put heavier objects on shelves at waist level, lighter objects on lower or higher shelves.

• AVOID LIFTING FROM THE FLOOR: Lifting from the floor can greatly increase your risk of injury for two reasons. Firstly, it is difficult to bring objects close to your body when picking them up from the floor, especially large objects where your knees can get in the way. Secondly, your low back must now support the weights of your upper body as you lean forward, in addition to supporting the weight of the item you are lifting. Lifting the same 20lbs from the floor more than doubles the amount of force on your low back when compared with lifting is from waist height. Even a one pound object lifted from the floor increases you risk of injury if you use a bent over posture.

• GET HELP WHEN YOU NEED IT: Don’t try to lift heavy or awkward loads on your own. Even though the muscles in your upper body may be strong enough to handle the load, the muscles, ligaments and disks in your lower back may be injured because of the additional forces they have to withstand. Get help from a co-worker, and whenever possible, use a cart, hand truck or other mechanical device to move the load for you.

PROPER LIFTING TECHNIQUE

proper lifting

IMPROPER LIFTING TECHNIQUE

improper lifting

POSTURE

Posture diagram

GOOD POSTURE

good posture

BAD POSTURE

bad posture

McKenzie Method

McKenzie Method: Diagnosis & Treatment

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MECHANICAL DIAGNOSIS PHASE:
This system is based on the symptomatic and mechanical responses of patients to various repeated movements or static loading forces(that is a mechanical evaluation). It allows the classification of patients into broad, rather than tissue-specific, categories and thus leads to the formulation of treatment. Rather than seeking to make a diagnosis, which is the identification of a disease by the means of its signs and symptoms, The McKenzie system concentrates on syndrome identification. A syndrome is a characteristic group of symptoms and pattern responses characteristic of a particular problem. The system is now widely used to classify and treat patients with mechanical disorders.

PHYSICAL EXAMINATION PHASE:
• Explanation of problem to patient and reason for required exercise program
• Time scale
• The appropriate loading strategy, or strategies needed to manage the condition demonstrated to and practiced by the patient.
• The repetitions and regularity of exercise program explained to patient
• The expected pain response explained to patient

knee stretch

ASSESMENT PHASE:
• Symptomatic diagnosis
• Mechanical Diagnosis

PATIENT MANAGEMENT PHASE:
• Patient education component of management
• Information about the problem itself
• What patients can do to help themselves
• Information about tests, diagnosis and interventions
• Active Mechanical Therapy component:
• The specific exercises should be demonstrated to the patients, they should practice these, the expected pain response should be explained, as well as any warnings against lasting aggravation of their condition and as necessary progressions and alterations should be given.

This information was written by Hamilton Physical Therapy Services, L.P., an outpatient physical therapy group with five locations in Mercer County, New Jersey since 1978. Their modern state-of-the-art facilities are equipped to offer patients an excellent opportunity to reach their optimal functional abilities. Managed and operated by physical therapists mandates that patient care is our number one priority. For more information click here.

Backpack Safety

Backpack Safety 101

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It’s that time of the year again when the kids are heading back to school. Learn the proper guidelines and precautions about backpack safety in this week’s PTandMe blog post.

Size
• Should Not Extend Above Shoulders
• Should Rest In Contour Of Low Back (Not Sag Down Toward Buttocks)
• Should Sit Evenly In Middle Of Back

Fit
• Shoulder Straps Should Rest Comfortably On Shoulders And Underarms, With Arms Free To Move – Tighten Shoulder Straps To Achieve This Fit
• Tighten Hip And Waist Straps To Hold Pack Near Body
• Padded Straps Help Even Pressure Over The Shoulders

Weight Of Pack
• Should Never Exceed 15% Of The Child’s Weight To Avoid Excess Loads On The Spine

backpack

Lifting Of Pack
• Proper Lifting Is Done By Bending The Knees, Squatting To Pack Level, And Keeping Pack Close To Body To Lift First To Waist Level And Then Up To Shoulders

Carrying The Pack
• Keep Both Shoulder Straps In Place And Pack Centered
• Spinal Forces Increase With Distance From The Body’s Center

Posture
• Uneven Stresses On The Spine Can Cause Muscle Imbalances. This Can Lead To Pain And Possibly Functional Scoliosis.