The Spine and Safe Moving and Handling
This month we take a look at the human body and, in particular, the spine. The spine is an important part of the human body and has several functions which we will look at through this blog and, as such, is a vital part of the body to be looked after by its owner!
Location of the spine
It is possible that everyone knows the location of the spine. Just for the avoidance of doubt, the spine is located in the centre of the back and reaches from the base of the skull right down the bum.
Main functions of the spine
The human spine has 3 distinct functions:
- Protect the spinal cord, nerve roots and several of the body’s vital organs.
- Provide structural support and balance to maintain an upright posture.
- Enable flexible movement.
Make-up of the spine
The spine is made of several sections as follows:
The cervical vertebrae are located in the neck area of the spine. There are 7 vertebrae in this area. They are abbreviated down to C1 through C7 from top to bottom. The role of the cervical vertebrae is to protect the brain stem, support the skull and allow for a wide range of head movements.
If we take a look at the individual vertebra we will see that they are all shaped slightly differently. Vertebra C1 is called the Atlas and is shaped like a ring, supporting the skull. Vertebra C2 is circular in shape, with a blunt tooth type structure which projects upwards to the Atlas, and is known as the Axis. Together the Atlas and Axis allow the skull the full range of movements. Vertebrae C3 through C7 are similar in design, box-shaped with small spinous processes extending from the back of the vertebrae. Spinous processes are finger-like projections; they provide the point of attachment for the ligaments and muscles of the spine.
Beneath vertebrae C7 there are 12 vertebrae collectively known as the thoracic vertebrae. When they are abbreviated by medical staff they are referred to as T1 through T12 from top of the section to the base. Vertebra T1 is the smallest of the thoracic vertebrae with the bottom vertebra T12 being the largest. The thoracic vertebrae are larger than the cervical vertebrae and have longer spinous processes protruding from the back of them.
The thoracic vertebrae are connected to the rib cage which provides strength and stability for the spine, also making this section of the spine one of the strongest and most protected. Not only that, but the rib cage joining on to the spine assists the spine in protecting many of the vital organs contained within this area. Movement in this section is limited due to its restrictions of the rib cage.
The lumber vertebrae are the largest of the spinal bones. In this section of the spine you will find 5 vertebrae known collectively as the lumber spine. They are abbreviated by medical staff to L1 through L5 from the top to the bottom. The lumber vertebrae carry most of the body’s weight. They allow a lot of movement but much less than that of the cervical spine. Lumber facet joints enable the lumber area to have significant flexion and extension movement but limit rotation.
What is Flexion and Extension Movements?
Flexion is the bending of a particular joint so that the bones forming the joint are pulled closer together. A visual example of this would be when the elbow bends, it reduces the angle of the ulna and radius bones in the arm.
Extension is the opposite movement to flexion in that it is a straightening movement that increases the angle between body parts.
This is the 4th section of the spine vertebrae which is located behind the pelvis. There are 5 bones in this section of the spine and are abbreviated to S1 through S5. The bones are fused together in a triangular shape forming the sacrum. The sacrum fits between the 2 hip bones, connecting the spine securely to the pelvis. The fifth lumber vertebra moves in line with the sacrum.
This is the final section of the spine, consisting of 4 bones which are fused together to form the Coccyx.
The spine in its entirety contains 33 of the 206 bones in a human body, that equates to almost 13% of the body’s bones. The other important thing to remember about the spine is that it holds the spinal cord through the middle of it, helping to send your nervous system around your body. Some people want to include the skull and the pelvis into the spine; this is however an incorrect thing to do. However these extra body parts do interrelate with the spinal cord and help to impact balance.
The spine is considered by many people to be straight, this is in fact not the case. The spine, if you look at it from the front, will indeed appear straight, however from the side the spine has 4 distinct curves in it. One of the curves in the spine, around the lumber vertebrae is an important curve as it helps to maintain a person’s centre of gravity. A person’s centre of gravity moves with each load and lift a person takes on before returning to normal. If this particular bend didn’t exist, we as human beings would simply fall over!
The curves in the spine are described as either kyphotic or lordotic. What do these words mean and which section of the spine will we find them in?
Found in: Thoracic and sacral sections of the spine.
Means: it is a convex curve in the spine. The convexity of the curve is towards the back of the spine.
Found in: Cervical and lumber sections of the spine.
Means: it is a concave curve in the spine, with the concavity towards the back of the spine.
In the diagram that we provided earlier the back of the spine is towards the labels of the spine sections. If you feel your own back, you are able to feel the spinous processes that are protruding from the back of the vertebrae.
Between each of the vertebrae there is a cushion, also known as a disc, spinal disc or intervertebral disc. The purpose of the discs is to absorb the stresses the body endures through movement and also to prevent the vertebrae from grinding against each other, therefore preventing the sound of crepitus (2 bones make this sound when grinding against each other!). These objects are the largest structures in the human body without a vascular supply going to them. Each disc will absorb the nutrients that it needs through the process of Osmosis. Each disc is made of 2 key parts:
- Annulus Fibrosus, and
- Nucleus Pulposus.
The Annulus Fibrosis is a tough tyre-like structure that encases a gel-like centre, the Nucleus Pulposus. The Annulus Fibrosus enhances the spine’s ability to rotate and also helps to resist the compressive stress. It has a layered structure which consists of water and sturdy elastic collagen fibres. The fibres are orientated at different angles horizontally similar to that of a tyre. Collagen consists of fibrous bundles made of protein that are held together by proteoglycan gel.
The Nucleus Pulposus is found in the centre of each of the Annulus Fibrosus, and is a gel-like elastic substance. Together with the Annulus Fibrosus, the Nucleus Pulposus distributes stress and weight from vertebra to vertebra. Structurally the Nucleus Pulposus is similar in make-up to that of the Annulus Fibrosus in that it contains, water, collagen and proteoglycans. However the concentration varies between the 2 things, especially as the Nucleus Pulposus has more water in it.
Why is it important to look after your spine?
Your spine, as we have looked at, already does an amazing job of looking after your organs, providing support and flexible movements as well as maintaining an upright posture. In life you are given just the one spine and that will see you through the entirety of your life, or at least that is the plan. The sad thing is however that poor manual handling and lifting practices can cause injury. In the workplace over 8.8 million working days are lost due to musculoskeletal disorders, over 40% of these account for back injury.
Safe moving and handling
Manual handling includes:
- Putting Down,
- Using Mechanical aids e.g. trucks and trolleys.
In the workplace, there is legislation in place. This piece of legislation is called The Manual Handling Operations Regulations 1992. Within this piece of legislation, it says that the employer should identify manual handling risks and, where practical, avoid manual handling risks. If avoidance is not possible the employer should take a risk assessment on the task needing to be done.
A good risk assessment that could be used is the TILE assessment, which we will look at now.
The TILE assessment stands for:
Let’s explore these areas:
You will need to look carefully at the task to be done, things that could be considered include:
- Does it involve handling away from the body?
- Are there movements such as bending, stretching, or twisting?
- Is the movement over a long distance or is it repetitive?
The employer will need to consider whether the task can:
- Be completed by using machinery, or handling aids,
- The task layout be improved,
- The movement of the body be modified,
- The work routine be improved,
- The task be completed in a team.
Once the task has been analysed the individual capability will need to be considered as follows:
- Is the person completing the lift fit and healthy?
- Have they been given training and information? Are they competent to do the task?
- Is suitable supervision provided?
- Are there any unusual circumstances that would cause a risk to certain employees e.g. is she pregnant?
The employer making the risk assessment could consider:
- Pre-employment medical,
- Provision for training and information,
- Ensuring the employee is competent in safe handling techniques,
- Providing supervision.
The load is a really important aspect of the assessment to be carried out. The person who is going to lift it should consider:
- How heavy is the load?
- Is it equally balanced?
- Is it stable?
- Does it have sharp edges?
- Will the contents shift?
If the load really does have to be lifted and moved, then control measures that could be considered are:
- Make the load lighter by splitting it,
- Make the load smaller,
- Provide handles to make it easier to grasp,
- Make the load more stable.
In everyday living we have to consider the environment, and in a moving safely lift this is no exception, you will have to consider the following:
- Is there enough space to carry out the task?
- Is the floor even or slippery?
- Is there good lighting?
In order to maintain safety, you could consider the following things:
- Can the workplace layout be improved?
- Can you improve the floor condition?
- Can we keep the lift to one level?
- Can you improve the environmental conditions?
- Do we have a good housekeeping process in place?
Of course, there are other things that should be taken into account as well the TILE assessment and these things include:
- Is movement hindered by work equipment?
- Is movement being hindered by any Personal Protection Equipment (PPE)?
- Issues that arise from employees identifying a lack of training or communication.
How to lift and move safely
There is a very easy, simple 6-step process to move safely this is:
- Stop and think.
- Position your feet.
- Bend your knees.
- Get a firm grip and keep the back slightly flexed.
- Raise with the legs.
- Keep the load close to your body.
Want to know more about looking after your spine and how to safely move and handle objects? Why not attend one of our courses? For more information visit the Moving and Handling section of our website by clicking here.