Old fashioned, outdated information in manual handling training is at best redundant and at worst harmful
By Paul Bolger. Chartered Physiotherapist at Nano Physiotherapy, Kilkenny (www.nanophysio.ie).
Recently, my colleagues and I underwent a mandatory manual handling training session. Many thousands of Irish workers must undergo such training every three years. The contents of that training course were completely outdated and are in dire need of catching up to the latest science.
Here are some of my thoughts on what was covered, why it is a problem and what we might do to give people training that is useful and may help to reduce the burden of pain in this country.
Outdated
While the training session wasn’t all bad, there was a central message running through it that is completely out of touch with an up-to-date understanding of back health. That message was:
- There are structures in the spine that become damaged when you bend or turn your spine.
- This damage accumulates over time, resulting in injury.
- The best way to prevent this damage is to keep your spine in a ‘neutral’ position whenever you sit, stand, lie down, move or lift.
These ideas are not accurate, but we have probably all heard them before. What do you think when you read through them? Would they give you confidence in your back, or cause you to worry?
Dead Pig Spines
Some of these ideas stem from studies where researchers would take a section of a spine from a dead pig, clamp it into a machine that would then repeatedly bend and compress the spinal segment. The researchers wanted to see what this segment of spine could tolerate before some part of it would give in and become damaged.
Lo and behold, something would eventually give after many thousands of bends under load. Some people took this to mean that the tissues in our back have a limited number of bends. But there is a key difference between your back and these dead pig spines. The structures of your spine are living and capable of adapting over time.
A Better View
In reality, our spines are living and adapting throughout our entire lifetime. Movement, bending, twisting and lifting are all healthy things that our backs have adapted over hundreds of thousands of years to tolerate and to do well.
In fact, movement seems to be essential for maintaining a healthy back – it helps to bring nourishment to joints and discs, clears waste products from muscles, keeps ligaments strong and nerves lubricated and flexible.
Like all living things, our back gets good at what we expose it to regularly – so long as this is done in a gradual and regular manner with consistency. Instead of thinking about keeping your back ‘aligned’, perhaps it is better to think about keeping it healthy and keeping it in good condition for what your life demands of it.
Considering all of this, there are still certainly physical limits to what we can all tolerate. If somebody is unfit and not strong, it’s not a good idea to jump headfirst into lifting heavy furniture around the house or heavy weights in the gym. A gradual approach is important, under the guidance of a professional where possible.
It’s time we update manual handling training to move away from this outdated view and towards an approach that considers back health. We will all benefit.
