Dr P.V. Ramana is associated with a new-age Backache Clinic at CARE Hospital in Visakhapatnam.

Creating and maintaining a good posture reduces your risk of developing back problems. Achieving comfortable and good posture will provide a functional range of movement that will allow you to perform daily activities safely.

Keys to proper lifting:

a) Stand close to the object to be lifted.
b) Spread your feet wide apart to straddle the object.
c) Squat, bending your knees and hips, keeping your back in proper alignment.
d) Contract your stomach muscles.
e) Lift by using the work of your leg muscles, not your back muscles.
f) When lifting with another person, one person should say when to lift, walk and unload.
g) Do not twist as you lift. Instead, pivot with your hips and shoulders in line and shift your weight.
h) Mentally prepare yourself by planning what you are going to do.

Keys to Pushing and Pulling Objects:

a) Push, don't pull, whenever possible.
b) Stay close to the object.
c) Do not lean forward.
d) Use both arms and tighten your stomach muscles.
e) Never push or pull with a bent back.

Keys to Prolonged Standing:

a) Change position often.
b) Wear comfortable shoes and stand on a soft surface.
c) Bring your work to a comfortable level, do not bend over it.
d) Rest one leg on a stool to reduce stress on the back.

Keys to Sitting:

a) Sit in a chair that supports your lower back. If the chair does not support your back sufficiently, you can place a lumbar cushion (which can be bought at your local pharmacy) at the level of your low back, for added support.
b) Position your chair so that your knees are at least as high as your hips when your feet are flat on the floor.
c) Your desktop should be slightly above your waist.
d) Sit close to your work desk, do not lean over it.
e) Do not slump over while sitting.
f) Take frequent breaks to get up and stretch.

Keys to Bending and Leaning:

a) Let your legs do the work.
b) Stand with your feet shoulder length apart, one foot ahead of the other.
c) Contract your stomach muscles.
d) To lower you upper body, bend with your knees and hips, keeping your back in proper alignment. Rest one knee on the floor for extra support, if needed.

Keys to Doing Repetitive Movements:

a) Keep loads small if possible.
b) Tighten your stomach muscles before lifting.
c) Change positions frequently.
d) Turn your entire body by taking little steps or pivoting, do not twist.

Summary of Good Posture:

a) Keep proper spinal alignment.
b) Bend knees.
c) Keep stomach muscles tight.
d) Use larger muscle groups.
e) Keep loads close to the body .
f) Maintain stability and balance throughout.
g) Mentally prepare and plan before lifting.
h) Avoid twisting.

Sleeping Positions:

a) Sleep on your side with your knees bent and a pillow between your legs to allow your back to rest in a natural position.
b) Sleep on your back with support under your knees to reduce strain and provide support for the lower back.

Back exercises:

a) Perform Spinal Mobility Exercises daily.
b) These exercises should be carried out slowly and deliberately. If you have pain when you perform any of them, limit the particular exercise movement so that you are comfortable. If you feel pain when you start any movement, then it should not be carried out.

1. Starting position for all exercises is on all fours. Hands should be placed shoulder width apart, arms and thighs vertical. Use an exercise mat if you have one.

2. Slowly walk the hands around to the right, back to the starting position then around to the left. Repeat 5 - 10 times

3. Raise one hand off the floor, reach underneath your body as far as you can.
On the return, swing the arm out to the side as far as you can then return to the starting position. Follow the moving hand with the eyes. Repeat 5 - 10 times.

4. Draw alternate knees to the opposite elbow. Repeat 10 times.

5. Stretch one arm forward in front, at the same time stretching the opposite leg out behind. Repeat 10 times.



6. Swing the seat from side to side in a controlled manner. Repeat 10 times.

Spinal stabilization exercises:

Neutral spine position

Back Stabilization (Exercise 1) Lie on back, left knee bent. Tighten abdominals and buttocks, keeping back in neutral position. Raise right leg 12 inches, knee straight. Hold for 3 counts. Lower leg. Repeat 10 times. Repeat with left leg. Progress to making circles and squares with raised leg.
Back Stabilization (Exercise 2)   Start in the kneeling position. Tighten abdominals and buttocks, keeping back in neutral position. Hands on hips. Raise right foot and place on floor in front of you, kneeling on left knee. Lunge forward, moving at hips. Hold 3 counts. Return to kneeling. Repeat 10 times. Repeat with the opposite side.

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