who are in need of total care.

Home caregivers are usually so busy caring for others that they often fail to look after themselves. Indeed, low back pain, is often a common complaint for many of you in this position.

When caring for patients in the home, or doing other work that requires lifting, twisting, bending, or reaching, your back is vulnerable to injury.

If you use proper body mechanics you can help to protect your back against injuries. Knowing what it takes to keep your back healthy, helps to reduce the risk of injury.

Your back consists of a column of individual small bones called vertebrae, separated by cushions or discs, and held together by ligaments, muscles and joints.

A healthy back has three natural curves: the cervical curve of your neck, the thoracic curve of your middle back, and the lumba curve of your lower back.

When these natural curves are in normal alignment, your weight is evenly distributed throughout the vertebrae and discs. Your three curves are correctly aligned when your ears, shoulders and hips are in a straight line.

The muscles of your abdomen, back, buttocks and thighs support your three natural curves and permit you to move freely.

Keeping these important muscle groups strong and flexible helps you to reduce the risk of back injury.

Flexible joints in your vertebral column allow you a full range of motion with your back.

Flexible joints in your hips, knees and ankles provide you with the freedom of body movement as you work.

As we stand upright, the lower back bears the brunt of supporting the weight of our entire upper body and bears most of the load as we work. This is one reason why so many people develop low back pain.

Good body mechanics involves lifting the load close to your body and giving yourself leverage that reduces the strain on your lower back, whilst maintaining the three natural curves to keep your back in balance. Whether lifting, bending, pushing, pulling or twisting, good body mechanics is good back protection. So plan each manoeuvre with your back in mind when lifting or moving your patients.

For example: When transferring a patient from a bed to a wheelchair the patient usually can help. To accomplish this safely remember to: Lock the wheelchair and adjust the bed height if possible.

Support patient's weak knee (or knees if both are weak) between your legs.

Move the patient to the edge of the bed.

On signal, move the patient to standing position with a rocking motion; keep your knees slightly bent and your back balanced.

Pivot and lower the patient into the wheelchair by bending your knees.

If the patient must hold onto you, have him hold your waist or shoulders, not your neck.

If the patient is too heavy, get assistance if you can. Aids such as mechanical lifts help to safely move patients from beds to chairs, toilets and cars. The use of a transfer belt or board can also assist you in the safe transfer of your patient.

Pulling a patient up in bed, may be easy, but if you forget to use good body mechanics you can hurt your back. Avoid injury by doing the following: Adjusting the bed height below your waist.

Work from the side of the bed, feet point in the direction you will move the patient.

Reach under the patients shoulders and back and slide, don't lift.

Ask the patient to help by pushing against the mattress with their feet or elbows.

Keep your feet wide apart, knees bent and your back balanced.

Always try and maintain good posture when performing a task that requires prolonged standing.

Stand close to the patient so you don't have to lean forward.

Bend with your knees and maintain your back's three natural curves.

Poor posture can cause muscle tension, fatigue, neck ache and backache.

Sometimes patients may fall in the home and this may be due to many reasons.

They may be afraid or become dizzy or their knees may buckle. When a patient begins falling; Don't try to prevent the fall; guide the person easily and safely to the floor.

Stay close to them as they fall.

Mentally practice this manoeuvre before an accident actually happens.

Get help to lift the person from the floor. Looking after yourself and maintain total wellness will help you to look after your aged loved ones in the home. A programme of regular exercise will benefit your muscles and joints. Exercise will also encourage you to take charge of your overall wellness by encouraging you to eat better, control your weight, manage stress and reduce the risks of back injury. When you take care of your back you work more comfortably and efficiently and are able to provide better care for your elderly loved ones.

SANDRA THORNHILL Community Physiotherapist Health Department