BAD BACK? YOU DON’T NEED IT IN YOUR LIFE!
In our continuing efforts to consider the physical wellbeing of PHTM readers (as well as mental wellbeing, which is why you read our paper! lol) we bring you another delve into the realms of looking after your bod. This time we are talking about backache... which for most people – it is said, four out of five adults - can affect you at some point in your life. This is far more likely for individuals, such as licensed hackney and PHV drivers, who spend long hours behind the wheel.
Like oil and water, driving and back pain are not an ideal mixture. Not only can chronic back pain make life miserable for drivers, particularly if driv- ing is one’s occupation (yep! we qualify...) but the very act of sitting in one position for hours on end can aggravate and even be a leading cause of back pain.
According to the Mayo Clinic, back pain is ranked second only to headaches as the most frequent cause of pain. Even though back trouble is not deemed to be life-threatening, its total cost to society ranges in the billions of pounds every year. And it can strike people of all ages; it’s most common in the 45-64 age group... but it can affect anybody at any age.
Professor Mark Porter of Loughborough Universi- ty believes that cars are responsible for a substantial portion of back ailments in the UK. Having led a major project called “Reducing Back Pain in High Mileage Drivers” for the Department of Health and the Health and Safety Executive, he says: “Your back may be telling you a lot about the state of your back and its relationship with your car. And it is worth listening to because it can give you an early warning of serious prob- lems that may start with minor discomfort.” Professor Porter found that absence from work because of back pain is six times higher for driv- ers who are at the wheel for more than four hours a day; and with congestion and delays increasing, those numbers go up yearly. “Long periods at the wheel can seriously damage your health, particu- larly if seats do not allow optimum posture and drivers do not ‘fit’ their cars,” he says.
Unfortunately, seating is a styling element, so a good design may be sacrificed to freshen up the look of a car’s interior to the detriment of the dri- ver’s health. Porter also believes that seat suppliers may not become involved sufficiently early with the design of a new car: “Seats are integral to vehicle design; but my understanding is that suppliers sometimes get only scant infor- mation on what is needed.”
Establishing the “ideal” driving position is a prob- lem because people’s height and weight vary so widely. In a pamphlet on back pain, the HSE says poor ergonomic design is only part of the prob- lem, particularly for occupational drivers. Vibration is another important factor that can lead to injury and disablement. So all those potholes and poorly surfaced roads are more than just a stand-up joke then, right?
Other factors which can cause or increase back pain include poor driving posture; poor design of controls making them difficult to operate; poor driver visibility making it necessary to twist and stretch; and personal factors such as level of gen- eral fitness, being overweight, and choice of leisure pursuits.
Teaching grandmother to suck eggs? Don’t you believe it... there are enough folk out there who are concerning themselves with drivers’ wellbeing in the spinal department. For a start, there’s the
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Chartered Society of Physiotherapy, who have published a leaflet on alleviating back pain and difficulties. This is just a sample:-
POSTURE
Any posture, no matter how good it is, can lead to discomfort if it is held for too long. Therefore it is important to adopt a range of comfortable driving positions and to make frequent changes to avoid, or help delay, the onset of discomfort. You should also take regular breaks and avoid driv- ing for more than four hours a day. (Yeah, right!) The Highway Code recommends taking a break of at least 15 minutes every two hours. This should be the maximum length of time you drive without a break, and on each break you should change your position, ie. get out of the car and walk around. This of course is also strongly recommended to alleviate DVT – see last month’s PHTM.
The following tips should assist in finding seating positions which are comfortable for you:- Take the time to familiarise yourself with ALL the adjust- ments – eg. seat, steering wheel, seat belt. Start by getting the seat into the “initial set-up posi- tion”. This means:- • Steering wheel fully up and fully forward • Seat height at its lowest • Cushion tilted so that front edge in lowest position • Back rest approximately thirty degrees reclined from vertical
• Lumbar adjustment backed off • Seat fully forwards
STEP ONE: • Raise the seat as high as is comfortable to improve your vision on the road
• Check you have adequate clearance from the roof • Ensure you have maximum vision of the road
STEP TWO: • Move the seat forward until you can easily fully depress the clutch pedal (if there is one) and accelerator
• Adjust seat height as necessary to give good pedal control
STEP THREE: • Adjust cushion tilt angle so that the thighs are sup- ported along the length of the cushion • Avoid pressure behind the knee
STEP FOUR: • Adjust back rest so it provides continuous support along the length of the back and is in contact up to shoulder height
• Avoid reclining the seat too far as this will cause excessive forward bending of the head and back, and you may feel yourself sliding forward on the cushion.
STEP FIVE: • Adjust lumbar support to ensure even pressure along the length of the back rest
• Ensure lumbar support ‘fits’ your back, is comfort- able with no pressure points or gaps
STEP SIX: • Adjust the steering wheel rearwards and down- wards for easy reach
• Check for clearance for thighs/knees when using pedals
• Ensure display panel is in full view and not obstructed
STEP SEVEN: • Adjust the head restraint to ensure the risk of injury is reduced in the event of an accident
Repeat steps 1-7 and fine tune as necessary. Be aware that many cars will not allow you as much flexibility of driving posture as you may wish. Par- ticular cars may cause you to adopt a ‘coping’ posture. For example, limited headroom forces a reclined posture, making reach to the steering wheel a problem. This leads to excessive forward bending of the head and neck, resulting in a ‘slouched’ posture.
You may well scoff, dear readers, but have you ever gone through all this lot before a shift? Worth thinking about, especially at this time of year when cold and damp weather conditions are thrown into the equation.
Such weather is not a consideration is a place like Dubai, but taxi drivers in that country are current- ly being assisted by a group known as The Sameness Project, which has produced a series of exercises in a leaflet called “We’ve Got Your Back”.
After six years as a taxi driver, Rashid Muneer is all too familiar with the aches and pains of a day at the wheel; he routinely suffers discomfort in his shoulders and upper back. But now he knows some simple stretches and exercises that can eliminate his pain.
“Nobody has ever shown me this stuff before,” said Mr Muneer. “It’s very useful for us. It should be made compulsory to teach the taxi drivers this because when we are on duty, we all experience pain or discomfort.” He had been to a doctor about his pain before and was told to exercise to prevent the discomfort, which was not practical given his 12-hour shifts. “At least with these exer- cises I can do them during my duty,” he said.
The exercise leaflet setting out detailed stretches and exercises was put together by Fitnesslink, whose co-founders are group fitness instructors and whose classes in Dubai are held by Pilates and yoga teacher Emilie Mikulla. “The biggest problem is that the drivers are sitting too long without getting out of the car,” she explained. “Their hips, necks, backs, are all stiff.
They’re
always in the same position so it’s causing them a lot of discomfort.
“Even for those who are not in pain now, if they don’t take preventive measures, they won’t be able to do their job in years to come because once you hurt your back, you can’t drive. The fact that [these exercises] don’t take long is key too. They don’t need to dedicate more than a few min- utes, a couple of times a day for this, while they’re on a break or waiting for a fare. Even just getting out of the car can make a difference.”
Check out the Fitnesslink website
www.fitnesslink.me
and have a read, and see what you make of it all. This of course is one of many, many sources of beneficial points and exercises for back comfort. And as mentioned, personal health can affect one’s lumbar regions... we’ll look at the various physical/medical implications of overweight in the new year. How appropriate, following on from the festive season!
Meanwhile, we hope you enjoy this season of festivities - and the increased business we hope it brings you all! - free from back pain.
PHTM JANUARY 2014
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