The one action that can make or break even a strong back is a forward bend. Doctors confirm that behind most cases of backaches, there is a history of lifting some heavy object incorrectly. Does that mean that we should never bend forward? It is impossible to perform daily chores without these essential actions; we have to bend and straighten many times a day. So the question ought to be: ‘How should we bend forward?’   

When bending forward, you must keep the following points in mind:

Hinge at the hip

A healthy forward bend involves a forward hinge at the hips with a straight lower back. The length of the back ought to be maintained all through the bend. Such a bend does not affect any disc anywhere in the spine. The discs remain decompressed and are not under any strain. A healthy bend at the hips is a beneficial exercise for the muscles of the back as they get a stretch. Such a bend brings muscles that run along the length of the spine into action. This keeps the back aligned rather than rounded. As these muscles strengthen, the hamstrings get a healthy stretch and tone.

Soft knees

We are taught to bend our knees to preserve our backs. This does preserve the back as it does not round. However, it stresses the knees and reduces the opportunity for the hamstrings to stretch.  In general, you must avoid bending forward with the knees bent too much as this can put undue pressure on the knee joints. You can bend knees for lifting heavy objects or when the back is injured or in pain.  Bent knees also facilitate a hinge at the hip for those with tight hamstrings. In such cases, tight hamstrings pull the sitting bones [to which they are attached] down. This forces the pelvis to tip backward. Bent knees ease the demand on the tight hamstrings and facilitate the hinge forward at the hips.

How to move when you bend forward and come up?

In the beginning, a correct forward bend requires concentration and slow motion. With time, it becomes an automatic process. Practise the following method a few times to get a feel of the ideal mechanism of bending forward and coming up.

• Stand with the feet parallel at hip-width distance. If the forward bend is deep, you can place your feet wider apart.
• Place the fingertips of one of your hands in the midline groove of your lower back. This is to monitor the bend.
• Place the edge [little finger side] of your other hand in the crease or the fold between the torso and the thigh. When you bend, feel the hinging on the hip joint on this hand.
• Unlock your knees and keep them soft. You can bend them as necessary to accommodate the tightness of your hamstrings.
• Start the bend from the hip joints. Feel your pelvis come forward as your back follows it.
• The fingertips of the hand on your lower back should not feel any change in the midline groove. If the groove begins to disappear or if it becomes deeper, straighten up a bit and proceed again.
• If the hamstring muscles behind the thighs and the knees are tight, the lower back groove tends to disappear. To preserve the shape of the back, you will have to bend your knees. The bend at the knees should be smooth and not jerky. It should be coordinated with the hip hinge. The knees should not turn inward [they should not go close to each other]. The knees should point in the same direction as the feet.
• If the lower back groove begins to deepen, it reflects that the abdominals are weak and lax. The muscles along the length of the back begin to over-contract to deepen the groove. In such a case, remember to engage your inner corset and come up. Restart the forward bend with your core muscles activated to support your lower back from being pulled down.
• For the safety of the neck, do not allow your neck to protrude forward. Imagine that your neck is an extension of the spine and keep it aligned with the head, the neck and the shoulders in the same manner as you would when you stand.
• When you are ready to come up, engage your inner corset and start unhinging at the hip joints so that the trunk moves up along with the pelvis. The groove in the back should remain the same.

Backaches related to forward bends

If the lower back hurts when you bend forward, it means that the back muscles are in a state of spasm. Forward bends stretch the back muscles, making the back round. This leads to pain. To keep the back supported and the lower spine discs safe, observe these safeguards:

• Navel in: Engage your inner corset before you begin to bend. This helps to maintain the torso as a single unit.
• Gentle bend at the knees: If the back still hurts, start with a small bend in the knees along with the inner core tone. Practise lower back stretches and abdominal strengthening exercises regularly.
• In case of an acute prolapsed disc, take rest to relax the back muscles and follow the doctor’s advice. Apply these principles once you have been advised to resume normal activities.

Lifting heavy objects

Lifting heavy objects exerts further pressure on the joints of the spine. It is estimated that lifting a 12 kg weight with bent knees and a straight back puts around 140 kg of force on the bones of the spine. If the same weight is lifted with straight knees and bending from the waist, the force exerted on the back gets almost doubled. You can save your back all this anguish.

• Assess the load and its weight by pushing it with your foot. If it is too heavy, ask someone for help.
• Avoid bending and lifting anything first thing in the morning as one is more vulnerable to disc injury at that time.
• Go close to the load. The closer we are to the object, the lesser is the strain on the joints. The weight evenly distributes over the spine, the pelvis and the legs. Also, you are less likely to lose balance and fall. The pressure on the back increases when the distance from the object increases.
• Face the object. Do not venture to lift objects when the body is twisted. Most injuries caused while lifting objects occur when the spine is twisted. The remedy is to face the load before we lift the object. Lifting sideways is a definite ‘NO’.
• Before the lift, tighten the abdominal muscles as much as you can. This accords a firm support to the lower back. So, take a deep breath and pull the navel in as much as you can, as if you are zipping up a pair of tight-fit trousers. Keep the abdominals drawn in when you lift or put the weight down. However, do not forget to breathe simultaneously!
• Do not bend from the waist. Bend the knees and the hips. This allows the larger muscles of the legs to work. If you bend from the waist to lift objects, the back muscles have to work twice as hard to do the job. In addition, if they are already compromised, the pressure gets transmitted to the discs – a dangerous proposition.
• Pick the load and bring it in close to the body. Push the ground firmly with both your feet as you straighten your legs.
• If you need to carry the load, keep the stomach muscles tight as you breathe.
• Maintain a neutral spine.
• As you carry the object, hold it as close to the body as possible. Again, the closer the object to the body, the lesser the strain on the spine and the muscles.
• Never raise a heavy object above the waist level.
• If you need to turn, do not twist at the waist with the object in your hands. Instead, turn your feet with small steps to turn the body.
• To lower the load, again bend your knees and hips. Stick the buttocks behind as you go down.

Adapted with permission from The Power Of Posture by Renu Mahtani; Published by Jaico Books

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The way we sleep often becomes a cause for aches and pains during the day. Sometimes it can lead to morning sleepiness. If you want to cure the problems that arise from bad sleeping posture, you need to change your habits.

You can first adopt the changes when going to bed. Slowly, start telling yourself this is how you need to sleep through the whole night. It also helps to alternate between various sleeping positions. That way, the body does not get used to any one posture and does not bear the pressure on the same points day after day.

Let us look at the various ways in which people sleep, what goes wrong and how we can adjust the position to take us towards the ideal way of lying down for our nightly rest.

Sleeping on your belly

In the long run, people who sleep on their stomach experience discomfort. Long hours of sleeping with a curved pelvis lead to stiffness in the lower back. The discomfort doubles if you have a protruded belly because it causes the lower back to sink in further.

Solution: Use support

People who suffer from chronic headaches or neck-aches find relief when they correct this position and take the pressure off the neck and the pelvis. For those who find it difficult to change their ‘tummy sleeping’ posture, it can be made safer by following these simple suggestions.

• Place a rolled towel or a small pillow under the abdomen to prevent a sag in the lower back.
• One knee can be bent towards the chest.
• The pillow placed below the head should be as flat as possible so that the neck does not get arched or twisted to one side.

While these tips may aid you, the best way to rid yourself of aches is to slowly change your habit of sleeping on your belly.

Sleeping on your back

Sleeping on your back significantly reduces the pressure on your back as compared to sleeping on the stomach, as your weight is evenly distributed across the widest surface of the body. However, people suffer from aches and pains even when they sleep in this position. The reason they feel stiff is that the muscles in their back are taut and not relaxed during sleep.

Since the lower back is overarched, the lower spinal muscles are tightened. The curvature puts pressure on the joints and the nerves of the back. This leads to a stiff and sore back in the morning.

Solution: Sleep stretched

This involves elongating the spine when you lie down.

• Lie down on your bed with your head resting on a pillow.
• Fold your knees with the feet flat on the bed.
• Hold your hips lightly with your palms, fingers facing down.
• Push the hips away from your lower back, towards your feet. This is the same way we align the pelvis when we stand.
• Roll your shoulders down so they are rested on the bed and away from the ears.
• To stretch your neck, lift it off the pillow and stretch it away from the body. Maintain the extra length created as you gently place the head back on the pillow.
• Ease out. Straighten your legs. Keep your arms by your side, palms face the ceiling.
• Check your lower back again. It should not be arched up too high. You should be able to slide the fingers of one hand into the natural gap between the back and the bed. If the gap is too much, do all these steps with a pillow placed below your knees.
• If you have tight lower back muscles or suffer from backaches, place a medium-sized, firm pillow under your knees and lower legs. This support stretches the back and reduces the arch. The padding also reduces the pressure on the spine and the discs.

Sleeping stretched has many advantages. Not only does it improve the quality of the sleep, it is also conducive to the spine. It decompresses the discs and the spinal nerves, improves blood circulation and resets the resting length of the tight back muscles. There is also an improvement in breathing when you sleep in this specific position.

Sleeping on your side

People who sleep on their side tend to lean forward from the top, so the top shoulder and the top hip fall ahead. This misaligns the said joints and twists the spine.

Solution: Stack the joints neatly

If you are habituated to sleeping on one side, these guidelines will come in handy.

• While sleeping on any side, the major joints of the body should stack on top of each other—knee on knee, hip on hip and foot on foot.
• When seen from the top, the head, the back, the hips and the feet should be in one line.
• The lower arm can be folded and placed comfortably on the bed or under the pillow.
• The top palm should rest on the top thigh.
• With the top shoulder rolled back, the nerves going from the neck to the arms do not get compressed. The upper shoulder should not get rounded or roll forward as this only reinforces the unhealthy habit of slumping.
• Alternate on each side to prevent muscular imbalance between the two sides of the body.

The pillow debate

It is commonly assumed that using a pillow aggravates the pain of cervical spondylosis. This is a generalisation as each person has different body proportions. Pillow selection may be compared to tailor-made clothes. It is important to choose a pillow according to the alignment of the neck and the spine. You should aim to keep the neck at a neutral position so that the muscles in the back of the neck are comfortable and do not get strained during the night. These muscles’ should get a gentle traction-like stretch with the help of a good pillow.

A good pillow should help neutralise the tightness and the altered curvature of the neck and the upper back. It should encourage the neck to stretch gently. A good pillow is firm enough to hold the baseline shape, yet soft enough to nurture a good sleep.

Cervical rolls [neck pillows] are made to support the natural curvature of the neck or to create one. If the neck muscles are too tight and it is difficult to stretch them due to muscle spasms, cervical rolls can be used temporarily. It is better to support the neck rather than leave it unsupported.

Yet, anything that exaggerates the cervical curvature should not be used. Over time, stretching the neck with the help of an appropriate pillow helps the most.

The thumb rule when choosing a pillow is that the forehead and the chin should be at the same level, when you lay down.

Choosing the mattress

The mattress we choose to sleep on plays an important role too. A person’s specific body type dictates the type of support he needs.

• The mattress should be firm and comfortable and not too soft as it makes the body sag.
• If the mattress has become lumpy and the coils can be felt, or if it sags in the middle, it is time to change it.
• If your hips are wider than your waist, opt for a softer mattress to accommodate the width of the pelvis and allow the spine to remain neutral.
• If the hips and the waist are in a relatively straight line, a more rigid surface offers better support.

So settle in for a good night’s sleep with these tips in mind.

Adapted with permission from The Power of Posture by Renu Mahtani
published by Jaico Publishing House.

This was first published in the February 2015 issue of Complete Wellbeing.

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