I hope it’s not only me that reads Aches and Pains by Louis Gifford and thinks “What have I been doing with my life?”. Yes it’s humbling, but I console myself with the thought that we all have our own paths in life, and part of his was clearly to write the classic, seminal text to guide manual therapists into the twenty-first century.
Usually when I share something on my blog, I try to make it more accessible, more understandable, more entertaining or just more concise for the benefit of my readers. However it is not really possible to improve upon Louis’s words as they already contain all of those qualities listed above. Whilst reading Aches and Pains I feel the need to share it with other osteopaths everywhere, but what bit of it? I feel like the nutty, religious relatives who sent Roseanne Barr a Bible with every single word highlighted in fluorescent pen.
I can’t reproduce every word, but I can urge you to buy the books here. (NB I don’t get a commission for this – it’s a genuine recommendation!)
If you still need encouragement, read this review.
But in the meantime, here is a taster. Philippa Tindle has kindly given me permission to reproduce Louis’s commonsense guidance on lifting. It is taken from page 781-2. (Yes, Aches and Pains is a lot of reading: over 1300 pages in total, but split into 3 volumes, then into bite-sized chapters. You can read it all at once, or as a long term project, or dip in and out, or even just keep it reassuringly on your shelf and open any page at random from time to time to find something useful.) A few weeks ago I was reading a study which kept referring to “postural education and advice on lifting” as an intervention, without specifying what that advice was. I was wondering what that advice might be, and where to find the best lifting advice, when I serenditipitously came across this.
So here we go, the words that follow are from the man himself:
“It seems to me that the best message regarding lifting is:
- Try not to lift too suddenly. Think about it before you do it and plan the most efficient way of doing it.
- Try a little test lift to get the “feel” of what you’re lifting.
- Keep your back straight or a little flexed when you lift as far as you can – not too flexed and not too lordotic either. You need the ‘Goldilocks’ position – that’s ‘just-right’ somewhere in between! This needs practice, most people haven’t a clue where this is, but some fall into it naturally.
- Try not to ‘sag’ on your ligaments – meaning lift with the spine at end range flexion. If you’re not strong enough to lift the object in question without doing this – then get training and get stronger by doing the posture plus a graded lifting programme.
- Try and be as smoothed and relaxed as you can, try not to over-tense your back and abdominal muscles.
- Keep the object as close to you as you can. If you have strong legs this is made easier to do if you bend your knees. I don’t think I’d ever tell anyone to lift a heavy weight with straight legs – using your legs enables you to get closer to the object.
- While carrying a heavy object stay relaxed, be smooth and don’t get alarmed! Apparently peak spinal compression during manual handling increases by between 30 and 70% when subjects are alarmed!
- If you can’t manage to maintain a lift and feel you’re going into a lot of flexion -drop it! If more than one of you are lifting a single object agree a ‘drop-it’ routine, so you don’t injure the others when you let go. Best is to get the right number of ‘lifters’ for the object.
- The figure 4kN equates to lifting a 14kg weight from the floor. Don’t do this day in and day out.”
Many thanks to Louis for sharing what he knew with us, and to Philippa for her permission to copy it to my blog, and please, if you use this advice in clinic, repay the favour by purchasing the books where you will find a treasure trove of similar wisdom, presented in a deceptively simple and straightforward way.