Transferring, lifting, moving, and positioning care recipients can be a major safety problem unless you learn how to use good body mechanics. ‘Body mechanics’ involves how you stand, move, and position your body to prevent injury, avoid fatigue, and make the best use of your strength. Understanding the principles of good body mechanics and applying them to your everyday routine, whether at home or at work, enables you to feel better and less tired at the end of the day.

What are the principles of body mechanics?

        Body mechanics involves using good posture, balance, and the strongest and largest muscles of the body to perform the work. You can lift and move easier, no matter what your size is. You need to be concerned with both your own body mechanics and that of the care recipient. The major movable parts of the body are the head, trunk, arms, and legs. The way in which they are aligned with each other is known as posture or body alignment. Proper body alignment allows us to move and function efficiently and with strength whether we are standing, sitting, or lying down. Base of support is the area upon which an object rests. In humans, this is the feet. We need a good base of support in order to maintain balance. Standing with one’s feet apart gives a wider base of support and, therefore, more balance and stability. The strongest and largest muscle groups of the body are located in the shoulders, upper arms, hips, and thighs (NOT in the back.) By using smaller and weaker muscles to move heavy objects, you strain them, causing fatigue and injury. Use the strong muscles of your thighs and hips by bending your knees and squatting to lift a heavy object. Avoid bending from the waist when lifting, as this involves the small muscles of the back. Holding objects close to the body and base of support involves using upper arm and shoulder muscles. Holding an object away from the body exerts strain on the smaller muscles of the lower arms.

Follow these guidelines when lifting, moving, and transferring care recipients:

• Stand close to the care recipient.
• Create a base of support by placing your feet wide apart.
• Make sure the area is safe for a move or a lift.
• Bend at your hips and knees with your back straight.
• Push up with your leg muscles to a standing position. Back injuries are not usually the result of one incident but of the constant use of smaller back muscles.

DON’T Lift With Your Back, Lift With Your Head!!!!!!

TRANSFERS AND ASSISTIVE DEVICES

Lifting and Back Protection

        Every effort is made to protect employees from injury, but they must also use good judgment to avoid injuries. The most common injury to health care workers is a back injury. Employees are encouraged to strengthen their backs through daily exercise in order to prevent injuries.

Employees are prohibited from moving heavy objects in clients’ homes that may result in injury. For example, employees must not move refrigerators, televisions, heavy furniture, heavy boxes, etc. If a client requests this, the employee should refuse and report the request to the Supervisor.

If a client or employee is injured during a home visit, or if there is evidence of a safety or fire hazard, the employee must report the situation to a supervisor immediately.

Back Protection and Good Body Mechanics Guidelines

        “Body Mechanics” is using the body in an efficient and careful way to save energy and prevent injury. It includes good posture, balance, and using the strongest and largest muscles to do the work. “Body Mechanics” is the way a body moves and keeps its balance through the use of all its parts.

“Posture” is another word for “body alignment”. Good posture means keeping major body parts, including head, trunk, arms, and legs in a straight line to allow the body to move and function with strength and efficiency.

“Base of support” is the foundation for an object or individual. A human being’s feet are the person’s base, their source of support and balance. When the feet are wide apart, the person’s “base of support” is at its most stable foundation.

Our strongest and largest muscles are in the shoulders, upper arms, hips, and thighs. These muscles should be used to lift and move heavy objects and clients. If small and weaker muscles (lower back, neck, lower arms) are used for lifting, they could be injured. Objects being held or carried should be kept close to the navel (“center of gravity”) where the strong muscles will best support them. Holding them away or at an angle places unnecessary strain on the lower arms and back, causing fatigue and injury.

Basic Rules for Back Protection

1. Plan ahead. Know what you will be moving and where.
2. Know your limits. Evaluate the risks to you and the client.
3. Keep your back steady and body parts in good alignment.
4. Keep your feet apart to provide a broad base of support.
5. Bend from the knees, NOT from the waist.
6. Squat to lift objects from the floor.
7. Lift with your legs, NOT with your back.
8. Pivot your whole body to turn. Do not twist or reach.
9. Keep objects and clients close to your body when moving or lifting them.
10. Use the strongest muscles to do the job; shoulders, hips, legs, and upper arms.
11. Instead of lifting, push, slide, or pull heavy objects whenever possible.
12. Synchronize movements with client. Count “l , 2, 3″and work together.
13. Work with smooth and even movements. Avoid sudden or jerky motions.
14. Practice until you feel confident.

Helping a Reclining Client Sit on the Side of the Bed

1. Explain the procedure and ask the client to do as much as possible for themselves.
2. Wash your hands. Provide for privacy. Gather robe and non-skid shoes.
3. Determine which side of the bed to use. Always move toward the client’s strong side.
4. Ask the client to move toward the side of the bed. Assist as necessary.
5. Keep your knees flexed and back steady. It may help to put one knee on the bed toward the client’s head. Slide one arm under the client’s neck and shoulders.
6. Grasp the far shoulder. Place your other hand under the client’s far knee.
7. Guide the client’s legs over the edge of the bed while supporting the shoulders toward an upright position. Move the client in a fluid, smooth manner. .
8. Ask the client to put their hands or fists on the mattress to support themselves in a sitting position.
9. Be sure the client’s feet are flat on the floor and you are preventing their feet from sliding.
   1. Provide continued support as necessary.
   2. Allow time for the client to become balanced and steady in the sitting position.
   3. Do not move away until the client is sitting independently.
   4. Do not leave the client i f there is any chance they will fall forward or backward.

Stand-By Assistance (“Contact-Guard”)

        Some clients with weakness, mobility, or balance problems will need a help to accomplish the activities of daily living. The Personal Care Provider will assist these clients by “standing by” or “guarding with contact” as they change positions, while the client steps into the shower, or walks about the home. A stand-by assist is accomplished with the PCP/PCW at the client’s weaker side or back, with a guiding hand on the person’s elbow, around the waist, or with fingers in the belt loops, or under the transfer belt. Sometimes a verbal reminder is useful to cue the   client regarding which foot to move, which direction to move toward, or where to hold on for support. The PCP/PCW, who pays close attention to the client’s movements and is ready to lend a hand whenever necessary, provides “stand-by” assist.