Lifting heavy or awkward loads

Why you should consider how you lift things?
Simply, because at least 93 million working days are lost each year through back pain and there are also 500,000 cases of back illness in the same period.  Thirty seven per cent of all adults suffer with back pain, the highest incident being in the 16-44 age group.
Research shows that lifting, dragging and the handling of heavy loads is likely to increase the risk to your spine.  You should, therefore, look after your back and then reduce the risks.

Andrew Gilmour has produced this advice to help you minimise the risks involved when moving objects, either in the work place or at home.

Lifting at work or at home
Whilst at work, your employer has a continuing duty to help you to avoid hazardous lifting as far as it is reasonable to do so.  Your employer also has a responsibility to assess those lifting operations which cannot be avoided, with a view to reducing the risks as far as is reasonably possible.  The Manual Handling Operations Regulations produced by the Health and Safety Executive are referenced at the bottom of the page.
When you are involved in daily tasks such as in the home, gardening, sport or hobbies, you should always consider how you lift anything.
Firstly, it is helpful to consider all the lifting tasks you might undertake during an average day.  From picking up the milk in the morning, lifting the groceries from the back of the car, moving a pile of bricks or pulling out that stubborn tree root.  Very often these are the tasks which we take for granted and there may be better ways of doing some of them.
The following checklist has been put together by Andrew Gilmour, from the framework of the Government Guidelines on lifting and manual handling but simplified for your ease.  Use it to analyse tasks in your daily life which you think are likely to cause problems:-

Consider each particular task

- The closer to your body you hold or move a load, the less there will be to your back and the easier it will be to control whatever you are lifting.  For example, a load held at arms length puts far more stress on the back than one held close to your body. 
- The more stable you are, the less likely you are to let the load suddenly slip or fall.  Try to have your feet flat on the floor, shoulder width apart and stand as upright as possible.
- If this involves reaching upwards, stooping and/or twisting the stress on your back will increase.
- Try to avoid lifting heavy objects above your head, particularly from the floor or above waist level. If you have to then it may need a change of grip which can increase risk.
- If the load is carried for more than 10m the risk to your back is greater than lifting or lowering.
- Try to avoid pushing or pulling, either above shoulder or below mid-thigh height, and make sure you are stable. 
- Try to ensure the load will not shift making you unbalanced increasing the stress on your body.
- Prolonged lifts cause risk through fatigue as does frequent lifting.
- Frequent rests are important with demanding jobs, particularly those involving prolonged postures or work where there is no variety in the rate of process.
- Handling loads whilst sitting, causes particular difficulties because use of the powerful leg muscles are not possible and it is difficult to move the load without bending.
- When lifting as a team, the team should lift less than the sum of the individual’s capabilities.  Emphasis should be placed on an understanding of how the load is to be lifted – the ground surface etc.
Consider the nature of the load
- Particularly the weight, ease of movement, shape, size and rigidity.  All these factors will influence the amount of effort you have to put into lifting in addition to the stress upon your spine.
- Loads greater than 75cm in height, depth or width, increase risk or injury.
- Bulk loads can interfere with your visibility and unwieldy loads can present difficulties with balance and they – or you – may hit obstructions.
- Loads which are difficult to grasp require more strength, particularly if wet, greasy or slippery.  Correctly placed handles of reasonable size will make it easier.
- If the contents are likely to move then the risk is increased.  This includes the shape and texture of the load and if it is hot or cold.
- Always consider the working environment. For example, is there sufficient space to adopt the necessary posture so the task is not awkward?
- Is the surface you are standing on slippery, uneven, mobile or dirty?
- Are there steps or a variation in the surface?  A ladder can pose difficulties – grasp it well in a balanced position.
- Extremes of temperature or humidity may mean your muscles are cold – particularly in winter.  Your hands may be slippery in hot weather.
- Is there sufficient light?  Poor visibility will increase your chances of making a mistake when grasping the load or moving it.

What about your own ability?

Now that you have looked at the task, load and environment you should consider your own ability in relation to these factors.  Is the job one which could be achieved by most reasonably fit people?

- How do you compare in terms of age, general health, any previous spinal problems or your weight for example?
- Do you have any current health problems, have a cold or taking medication?  Do you feel well enough to carry out the task?
-Is this a task which you are familiar with and feel confident to do and is there anything else you feel you should know before attempting to go any further?

You may find that assessing your own capability is difficult, particularly if you have suffered from spinal problems.  It is part of an Osteopath’s job to assess your capability in relation to your employment and lifestyle.  Please ask Andrew Gilmour for advice if you need further help.

Reducing the risk

Firstly, do you need to lift the object in the first place?  Perhaps mechanical equipment could be utilised to avoid you having to do the lifting.
Secondly, if the lifting has to be done, make changes in the areas of task, load, environment and your capability, to reduce the stress as much as possible.

A) The Task

- Changes in the layout of the task.  For example, better storage positions.
- Using the body more efficiently to reduce stooping and twisting.
- Reduce the load.
- Stand closer to the load.
- Remove any objects in the way.
- Use your legs rather than bending your back. 
- Improve the work routine to ensure the task is not prolonged or repetitive – organising breaks to combat the fatigue.
- As a guide, reduce the weight by 30% if the operation is twice a minute, by 50% if five times per minute and 80% if twelve times per minute.
- Ask someone to help you.
- Use the right chair for seated tasks (HSE Booklet entitled – Seating At Work).

B) The Load

- Make it lighter, smaller or easier to manage.
- Make it easier to grasp – hand-holds, size and positioning.
- Increase the stability of the load.
C) The Working Environment
- Clear the space of obstructions and ensure the area is as clean and as level as possible.
- Avoid different levels and slopes.
- Avoid working outside in extreme weather conditions.
- Ensure there is plenty of lighting.
D) Individual Capability
- Be aware of any weaknesses and work within them.  For example, if you are pregnant, have just returned to work after an illness or injury etc.
Training in the way to lift things will reduce the risk of injury and will teach you to devise various ways of avoiding these injuries by applying good handling techniques.
The role of the Osteopath
During the course of an examination and treatment, it is usual for Andrew Gilmour to assess the way in which your body works and identify mechanical strengths and weaknesses which are particular to you.  This will enable the Andrew to identify particular movements and positions which will put your body at most risk of injury.
By discussing the nature of your job and lifestyle with you in detail, the Andrew Gilmour will be able to determine which situations in your life will be most likely to cause injury and devise ways of eliminating those risks as much as possible. If necessary, treatment can be given and exercises prescribed.
Task Analysis, Risk Assessment and Risk Reduction are respected methods used in the field of health and safety and ergonomics to reduce injury and suffering in the workplace.  The same techniques used informally can improve the quality of life for patients in all aspects of their life.
References for further reading
- Manual Handling Operations Regulations 1992 (Health & Safety Executive).
- Health & Safety (Display Screen Equipment) Regulations (Health & Safety Executive 1992).
- Seating at Work (Health & Safety Executive).
- Manual Handling – Solutions You Can Handle.
Other Leaflets
Getting to Grips With Manual Handling – HSE.
Ergonomics at Work  - HSE.
If the Task Fits – HSE.
Lighten the Load – HSE.
(HSE Information Centre Free Leaflet Line – Tel. 0845 345 0055)

A System for Reducing the Risks Connected with Lifting Tasks in Your Life

  • They may be connected with work, home, sport hobbies or recreation for example.
  • Select those which you think are likely to cause most problems.
  • Consider different aspects (task, load, environment, your capability) of these tasks in relation to the checklist.
  • Identify the areas of most risk.
  • Make changes to reduce the highest risks e.g. reduce the size of the load, enlist a helper, make more space to work in etc.
  • Ensure you have reduced the risks in as many areas as possible.
  • Are there any you have forgotten?

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