The other day, I drove past a man doing yard work, and the first thing that caught my eye was that he was wearing a back brace. It was one of those black, stretchy bands that went around his waist with straps over his shoulders. Being a PT, I of course wondered what type of injury he may have had in the past or if he was wearing it as a preventative measure, a sort of reminder to keep his back safe and use good lifting techniques.

Well, with much concern I watched as he bent over, lifted a huge bag of mulch, and twisted at the waist as he moved it over. He might as well have never bothered with the brace. It won’t prevent any trauma or injury to the spine, but provides some warmth and gentle compression/comfort for the spine, and can often times be a reminder to use good body mechanics on order to avoid back injuries.

So, for those of you out there wearing back braces, allow them to be a tool for increasing your awareness of your posture and how you use and move your body. Don’t rely on them as a means of external support and protection, or you may be disappointed.

Many of my patients with back pain experience an increase in pain when they get in and out of bed. And believe it or not, there is a right and a wrong way to get out of bed, or at least a way to do it that minimizes the forces on the spine.

If you are on your back, roll onto your side with your knees bent. If you are a side sleeper, you will already be in this position. Bring your legs over the side of the bed as you simultaneously push your torso up to a sitting position. The incorrect method is to transition from supine (flat on your back) to a long sitting position (sitting with legs straight in front of you). This movement requires significant abdominal strength and places strain on the lower back. Particularly if you have tight hamstrings and upper back muscles, this will be a difficult and potentially aggravating way to do it.

Using this “logroll” technique to get back into bed is also effective. Start by sitting at the edge of the bed. Start to lower onto one arm as you bring your legs up with the knees bent, into a side lying position. Keeping the knees bent, you can then roll onto your back.

Sitting on the floor may be something you do often, or for some it may be a position they never assume. Personally, I never felt comfortable sitting on the floor, but when I had children, I found myself constantly on the floor with them. I would vary my position between sitting cross legged, kneeling, lying on my side, or propped up on my elbows while on my stomach. These frequent position changes helped my stave off stiffness and soreness, but it still wasn’t ideal to change my posture every few minutes.

As my yoga practice deepened, I began doing more spine and hip opening postures which certainly helped in terms of flexibility for being able to maintain these seated on the floor positions. The other technique I applied at home was to sit on a bolster pillow or folded blanket to help lift my hips up a little. By lifting the hips higher than my knees, the pressure on the muscles along the spine is reduced, and I am able to maintain these seated positions for longer periods and feel much more comfortable doing so. With my hips elevated, I can vary between sitting with my legs crossed, with my legs straight out in front of me, or with my legs out to the sides. It has helped me to gain better strength through sitting with an upright spine, and also improved the flexibility of my hamstrings and thighs.

You can experiment with sitting on a firm, folded blanket or a firm pillow. Allow your “sit bones” (the bony prominences within the flesh of the buttocks also known as the ischial tuberosities) to rest at the front edge of the blanket, so the pelvis starts to spill forward slightly, bringing the lower spine into it’s natural curve. This alignment through the lower spine translates to better posture through the ribcage, upper back, shoulders, and neck. If you find this to be particularly helpful, I recommend investing in a yoga bolster. They are made specifically to aid with seated postures on the floor and are the right size and firmness for doing this.

As always, listen to and respect your body. If something doesn’t feel right to you (stiffness, aching, throbbing, or other pain/discomfort), immediately bring awareness to your body, change your position, and eliminate the strain on your body. This will help reduce the likelihood of and assist in recovery from musculoskeletal injuries.

Sitting with the legs crossed is something many people do. If you have any back, hip, or knee problems, it may be best for you to try to break this habit and there’s a few reasons why.

1. It creates an imbalance in the pelvis. When you sit with let’s say the right leg crossed over the left, the right side of the pelvis shifts higher than the left. This creates an uneven alignment throughout the lower spine that translates all the way up to the neck. Anatomical imbalances such as these, particularly when prolonged or sustained, can eventually contribute to dysfunctional posture and pain. Sciatica, sacroiliac instability, and low back pain can be caused or exacerbated by this way of sitting.

2. You probably always cross the same leg on top. The majority of people always cross the same leg on top. It’s a habit, the body gets used to it, and the muscles around the hips, knees, and pelvis change in response to this. This also applies to when you sit cross legged on the floor. If you sit down on the floor without thinking about it, then change which leg is positioned in front, it will most likely be a very obvious difference in how comfortable you are. (I always have students in my yoga classes switch which leg is in front to create better balance in the body.)

3. Crossing the legs places strain on the knees. When the leg that’s crossed is positioned with the top knee out to the side and the ankle resting on the opposite knee, the ligaments on the knee can be stressed. There can be compression of the cartilage within the knee which can also be damaging over time.

4. Circulation is compromised when the legs are crossed. The compression that occurs from the legs being crossed makes it more difficult for the veins to return blood from the legs back to the heart. This is why the legs can sometimes be felt to “fall asleep” if the legs are crossed for prolonged periods.This can be problematic especially for individuals with vascular disease, diabetes, and other problems with circulation.

So if you find that you cross your legs and you’re having a hard time breaking the habit, be aware of your body and switch which way you cross periodically to restore symmetry and reduce your likelihood of pain or injury.

As I sat in the waiting room at my daughter’s yoga class, I watched as some of the mom’s read magazines with their heads down, the magazine on their lap. This position with the head down in a flexed position for a sustained period can be very taxing on the neck. It should be avoided during activities such as reading and when using a computer.

Try to keep your chin level, so the neck remains in it’s neutral, upright position. In order to do this, you may need to prop something on your lap to rest the book or magazine on, so the book is more upright and the eyes can gaze forward or slightly down without straining the neck.

If you look down at your laptop screen, you could invest in a lap tray that would raise the height of your computer allowing the eyes and head to stay more level. If you find you’re always looking down at a keyboard, you could consider taking a typing class so you are able to type comfortably and accurately without looking down. If you look down at papers while working at a computer, a document holder could be an excellent investment for the health of your neck. It brings your work closer to eye level and reduces the pull on the muscles and ligaments of the neck.

So remember, whether reading, writing, working, or playing, the more neutral you align your spine, the less likely you will develop muscle imbalances and pain.

Congratulations…you did it! You survived pregnancy, successfully delivered your baby, and are getting to know this very special little person. Like many mothers, you may be sleep-deprived or overwhelmed, and feel a great sense of accomplishment if you can get showered and dressed before noon. You certainly don’t have the time or energy to let back pain interfere with your busy life.

Back pain? But wasn’t that only supposed to be a problem during pregnancy? Although most women believe that to be the case, many women develop upper back and neck pain post-partum. This can often be attributed to the new positions you assume while caring for your newborn. You tend to look down at your adorable child, and this repetitive forward bending of the neck and upper back can be straining. Awareness of posture and movement when you feed, carry, diaper, lift, and play with your baby can make a significant difference in how you feel and reduce your risk of injury. In general, take care when performing the following activities:

• Feeding: Sit in a comfortable, supportive chair that allows you to rest with your back straight and your head and neck upright. You may benefit from placing a pillow in the small of your back to help you sit taller. If breastfeeding, you can use a specially designed nursing pillow to support the baby and your arms, or you can cradle the baby keeping your arms supported on the armrests of the chair or pillows. If bottle-feeding, place a pillow under your elbow for support. Your shoulders should be relaxed, not shrugging up towards the ears.

• Carrying: Keep your baby centered along your midline to avoid unnecessary twisting and bending of the spine. Newborns can be held with both of your arms cradling them against your belly. Try not to look down excessively to minimize neck and upper back strain. If you carry your newborn in a car seat carrier, try to hold it with both hands in front of your body for short distances. Consider leaving the car seat in the car or connecting it into the stroller if you are walking more than a few feet. Front wearing baby carriers may be another comfortable way to carry your little one. As your baby gets older, it’s very common to carry her on one hip, which creates uneven forces on the spine. If you do this (and we all do), alternate on which hip you carry her.

• Diapering: When changing your baby, try to bend your knees (rather than bending at your waist) and keep your spine straight as you work over him. Although it may feel awkward, eliminating this slight amount of bending can significantly alleviate pain.

• Lifting: Try to always keep your back straight, hold your baby very close to your body, and lift with your legs. When lifting your baby in and out of the crib, lower the crib rail.

• Playing: Play at eye level with your baby. When he has tummy time, lay on your belly facing him. When she plays in her baby seat or learns to sit, sit on the floor in front of her. If baby lies on his back, play on all 4’s over him. Playing at eye level varies your posture, allows you to maintain better spinal alignment, and allows baby to enjoying looking at her favorite face in the whole world.

A regular exercise program is also helpful for reducing post partum pain. If you typically don’t exercise, this is a great opportunity to start incorporating regular exercise into your life so you will be able to keep up with your child who will be running around before long. You should discuss any pain you are experiencing with your health care provider, who may refer you to a specialist for an individualized treatment program.

I commented in a post on shoulder pain about the issues that can arise from carrying a heavy weight on one shoulder. In the past few years, there has been an increase in the number of school-age backpack related causes of musculoskeletal pain. With students required to carry multiple heavy textbooks between classes and to and from school, there has been an increase in postural dysfunction and back pain in this typically healthy age group.

Some students in front of my local high school use the wheeled, luggage style backpacks, likely to ease the burden from carrying the weight. Others load on a heavy backpack on one or both shoulders, and there are of course the few who seem to exit the building just carrying a piece of paper and a pencil. What I’m going to focus on here are the backpack wearing crowd.

A heavy weight, as previously mentioned, carried on just one shoulder can predispose the individual to imbalances in the neck, shoulder, and spinal muscles. This could potentially result in injury and pain in these areas. It is better to wear the back pack with both shoulder straps on, but even then a very heavy load can cause the individual to alter their posture. There are a few different scenarios.

An individual may unknowingly have the backpack strap on one side adjusted tighter than the opposite side. I have first hand experience with this…I went on a long hike wearing my then 6 month old daughter in a hiking pack. I noticed about an hour into the hike that more weight seemed to be distributed on my left shoulder. That night and for the following week I experienced significant shoulder and rib pain. The shoulder pain resolved, but the rib pain persisted for many months until I was able to re-align and strengthen my spine. Take home message here: be sure the weight is evenly distributed between the right and left shoulders.

The next possibility is that to compensate for the heavy load on the back, the person may bend forward at the hips or spine to counteract the tendency to fall over backwards. This places stress on the spine and hamstrings, and can create problems for the lower back and hips. In other instances, the individual may not attempt to counter the weight of the pack behind them and allow their chest and spine to hyperextend. This places stress on the shoulders and spine as well and can contribute to similar injuries mentioned above.

The best thing to remedy this would be to try to minimize the weight you carry. Only transport the items that are necessary. I had one high school student I worked with who carried a large binder with class notes in addition to all his books to and from school. We worked out a system where only the relevant notes were placed in a paper folder which took a couple of pounds out of the equation. He also invested in an ergonomic backpack designed to help reduce some of the stress on the spine. (The same applies to those of you carrying heavy pocketbooks…only carry the essentials!)

I hope some of these suggestions are helpful if you find yourself carrying too heavy of a load this week.

My husband often comes home from work at his computer all day complaining that his eyes are “bugging out.” This is one complaint associated with eye strain, in addition to dry, red, itchy, or tired eyes. If you spend a lot of time on a computer, you may have experienced these symptoms yourself. Here are a few suggestions for reducing eye strain and its associated symptoms:

1. Ensure there is adequate, indirect lighting in your area.

2. Avoid glare on your computer screen. You do not want your monitor to be opposite or directly in front of a large window or light source. Using window blinds, light filters, or an anti-glare computer screen can correct these problems.

3. Your monitor should be positioned directly in front of you, about 18-30 inches away from you. In addition, the top of the monitor should be roughly at eye level.

4. Give your eyes a break. At least every 30 minutes, look away from your computer and focus on something else for a minute. This allows your eyes to relax, most likely will allow you to blink more than you do when staring at your monitor, and provides all the eye muscles with a much deserved rest.

Shoulder pain is a common complaint among athletes, men, women, people who sit at computers, and people who work with their hands. I’m referring to the kind of shoulder pain that’s not a result of trauma which would be different in many regards. I’m talking about the kind of shoulder pain from overuse, poor posture, weakness or tightness in the shoulders or of an unknown cause. This type of shoulder pain can be frustrating and significantly limit day to day function, particularly if the dominant side (if you’re a righty, your right shoulder) is affected. Here are a few suggestions to help ward off and relieve the burden of shoulder pain.

1. Be proactive. As soon as your shoulder starts to feel sore, ice and rest it. This will relieve any acute inflammation and may prevent you from developing a more serious or chronic problem.

2. Be mindful and aware of your posture. The majority of people with non-traumatic shoulder injuries have associated postural dysfunction. Slouching, rounding of the shoulders, and the head jutting forward are all abnormal postures which place stress on the muscles that connect the nec, shoulder blades, collar bone, and upper back to the shoulder. This can cause an abnormal pull/tightness or stretch/weakness. When any of the mechanics in the shoulder are altered, pain and injury are more likely to occur.

3. Strengthen your rotator cuff…particularly the external rotators. These muscles which are not usually strengthened in an isolated way with typical exercise programs help orchestrate the movement of the shoulder and when weak can contribute to tendinitits, impingement, and rotator cuff tears. Click here to learn how to strengthen the rotator cuff.

4. Do not carry bags, packages, or a purse on the involved shoulder. The weight of the item and the pressure it places on the shoulder can contribute to increased pain, swelling, and imbalances in the muscles surrounding the shoulder. An ergonomically designed backpack worn with the weight evenly distributed between both shoulders may be a safer option if you need to carry things with you.

5. Avoid any and all activities that reproduce or increase your pain. Certain activities, such as yard work, cleaning, blow drying and styling hair may best be left undone until your shoulder pain resolves. If it isn’t possible to postpone these tasks, do short periods of activity followed by rest and ice to limit inflammation and irritation.

As with any injury or painful condition, it’s always best to consult with your health care provider to rule out a more serious condition and to get an accurate diagnosis for treatment. And an earlier diagnosis and path to relief means a lower likelihood of suffering with a chronic condition. Be proactive and get it taken care of.

The chore of vacuuming can be taxing on the spine if done without care. Instead of reaching, leaning and twisting while standing in one spot, move with the vacuum cleaner keeping it close to you, and work in one small area at a time. If you catch sight of dirt off to your side, turn to face it with the vacuum cleaner. It may seem to take a little longer, but if it prevents you from experiencing pain, it will be well worth it.