Whether standing or sitting, bending is a function that you constantly use as a manual therapist. There is no way to avoid bending, primarily because manual therapy requires you to transfer your work from a vertical position to a horizontal one.
That is, you are standing or sitting vertically while working with a client who is lying down (horizontally). Given that many manual therapists work several hours a day, most days of the week, it is no wonder that working in a safe and comfortable bent position is the number one body mechanic challenge facing manual therapists.
How do you meet this challenge and find an ergonomically sound bending posture? First you identify the part of your back from which you habitually bend. You then learn a healthy bending alternative that uses your hip joints, knees, and ankles. Once learned, you can practice flexing from your lower body joints every time you bend over your massage table. In a short amount of time, you’ll be bending with ease and you’ll notice that the ache in your back is gone.
Self-Observation #1
Bending from the Back
Action. Stand next to your table. Reach your hands toward your table, bending forward using your neck, upper back, and shoulders.
Feel. Notice how the muscles in your neck, upper back, and shoulders feel as you make this movement.
Ask. Do you feel the effort in your neck? Upper back? Shoulders? Do you feel effort in other areas of your body?
Feel. Notice if bending in this manner feels familiar to you.
Ask. Would you consider your neck, upper back, and shoulders to be the place in your back from where you habitually bend ?
Action. Stand again as before, then reach your hands toward your table, this time bending from your mid-back. Your shoulders will also be involved in the movement, but try to initiate the bending from the middle of your back.
Notice. Sense how your mid-back and chest feel as you make this movement.
Ask. Do you feel effort in your mid-back? Do you feel effort or a collapsing in your chest? How does bending in this way affect your breathing?
Feel. Notice if bending in this manner feels familiar to you.
Ask. Would you say that you habitually bend from your mid-back?
Action. Finally, stand as before and reach your hands toward your table, bending from your low back. Your upper and mid-back will bend, too, but initiate the bending from your lower back.
Feel. Notice how your low back, abdomen, legs, and feet feel as you make this movement.
Ask. Do you feel effort in your low back? In your abdomen? In your legs or feet? Do you feel effort in other areas of your body?
Feel. Notice if bending in this manner feels familiar to you.
Ask. Would you say that you habitually bend from your low back?
Now that you have identified the area in your back from which you typically bend, you can be more aware of when you are bending from this place while working. The following Self-Observation will teach you how to bend more ergonomically, using your hip joints, knees, and ankles.
Give yourself some feedback. What part of your back did you identify as the place from which you habitually bend?
Self-Observation #2
Bending from the Hip Joints
Action. Stand next to your table, using a parallel stance. Bring your hands to your table and bend using your hip joints, knees, and ankles. As you bend your upper body forward, keep your spine in a neutral position.
Continue to reach toward your table several times, bending from your hip joints. If you find that you begin to bend from your spine, stop the bending, bringing your back into a neutral position again. Each time you bend, become clearer that you are bending from your hip joints and not your back.
Ask. Do you sense more ease of movement in your arms? In your shoulders and neck? Does your back feel more relaxed?
Action. Stand now in a one-foot-forward stance. Bring your hands to your table, bending from your hip joints. Even though you are using a different stance, continue to bend both knees and ankles.
Continue to reach toward your table, switching between this and a parallel stance. Take as much time as you need to become comfortable with bending from your hip joints.
Bending from your hip joints liberates your back. Instead of being recruited for bending, the muscles of the spine and back can support and facilitate the fine and skillful work of your therapy.This, in turn, leaves the hard work of bending to the capable hip flexors.
Give yourself some feedback.
Compare the differences between bending from your back and from your hip joints. How can bending from your hip joints improve the overall quality of your body mechanics?
Barbara Frye has been a massage educator and therapist since 1990. She coordinated IBM’s body mechanics program and authored Body Mechanics for Manual Therapists:
A Functional Approach to Self-Care,
3rd edition. She has a massage and
Feldenkrais practice at the Pluspunkt Center for Therapy and Advanced Studies near Zurich, Switzerland. Contact her at barbfrye@hotmail.com.