Lifting analysis

Lifting
An activity essential part of every day life
A contributing factor in the development of variety of
musculoskeletal injuries
Particularly of lumber spine
Lifting analysis
One of the first and most easily applied administrative
controls to prevent the high incidence of low back injuries
at the work site is training the workers to lift in a
biomechanically safe manner. There has been, however,
considerable controversy as to which of the most
commonly used lifts (stoop, squat, or semi-squat) is most
effective in protecting the worker.
 Lifting Safely
Ultimate Objective
To Relieve Fatigue & Strain

Use correct handling techniques

Ensure good vision
Change position regularly
Avoid over reaching or stretching
Adjust work surface heights
Relax where possible
Use mechanical aids
Stoop lifting
It is a maneuver that typically requires maximum flexion of the
trunk and as near to terminal extension of the knees without
locking as possible
Squat lift
The squat lift requires knee flexion >90 degrees and
trunk flexion <30 degrees.
 Semi-squat lift
It shares the characteristics of stoop
and squat
Knee flexion >45 degrees and trunk
flexion at apporx same angulation
It comprises greater anterior tilt of
pelvis in comparison with other lifts
promoting lumbar lordosis
Freestyle lift
This lift resembles in most respects the semi-squat but can
differ from person to person
Trunk kinetic lift
Characterized by a sudden extensor moment of the knees
before the lift
Load kinetic lift
The load kinetic lift requires a closer approximation of the load
to the body just before the initial acceleration moments
CRITIQUE OF LIFTING
TECHNIQUES
BIOMECHANICAL ANALYSIS
 It is generally accepted that the closer the load is placed to
the body the more significantly diminished the resultant
compressive forces to the lumber spine
 This strategy is employed more effectively in the semi-squat
lift(load between the feet and knees) then with the stoop or
squat lift
Increased compression appears to be present with the
stoop vs squat lift the shear forces are significantly
higher during the squat lift .
Low back loading was significantly higher during
squat lifting than with stoop lift when lifting from floor
This is the result of the longer moment arm created by
the more posterior fulcrum of L5/S1 in relation to the
load being lifted during the squat lift
These stressors can be bettered by decreasing the
moment arm with placement of load between the feet
As in semi squat lift rather than pure squat or stoop lift
Foot placement is depend upon the size of the load, if
the container is too wide (large) to allow for proper foot
placement (greater than shoulder width Approx 30
cm)then the ideal lift would be stoop as it would result
in less compressive forces
Soft tissue compliance (lumbothoracic paraspinals &
spinal ligaments) follows standard length-tension
relationship during various lifts.
Supraspinous & interspinous ligamnets more
effectively countered the lumbar moment during the
stoop rather than squat and semi squat
PHYSIOLOGIC RESPONSE
O2 uptake consumption , %VO2 max, the gold
standard of energy expenditure was found to be
greater with the squat lift than with stoop lift
Stability of the load
 Comparison of a response to lifting a stable load with one
that has been manipulated to shift both anterior to posterior
and vice versa, it has been found that the unstable loads
carried significantly higher risks for poor mechanics and low
back injury.

Postural data demonstrated that the lumbar spine flexes

more during the unstable situation than when one is
maneuvering a load that does not shift. The tendency was to
preserve a stable center of gravity (COG) by flexing the
trunk and lowering the load and body as a unit. This
resulted in a more kyphotic lumbar spine and exposed the
intervertebral disc to even greater hydrostatic pressure.
The other added feature was efficacy of
hand couple
This was classified using the following three criteria:
(1) good—fingers wrapped completely
around the object or handle;
(2) fair—not all but a few of the fingers could grasp the
object or handle; and
(3) poor—partial or fingertip grasp of the object or
handle.
Correct Grip Kinetic Lifting
Take a firm grip by using
the palms of the hands
and roots of fingers
Taking weight on finger
tips will create pressure at
the end of fingers and
could strain muscles and
tendons in the arms
A full palm grip will reduce muscle
stress to the arms and decrease the
possibility of the load slipping
Keep the load close.
 Evidence overwhelmingly identifies the benefit of
maintaining the load close to the body while lifting
from a variety of work surface heights.
 The reduction in lumbar stress has been
documented,and the behavior can be easily
addressed in injury-prevention protocols
Ensure the placement of a secure hand couple.
Maintain a degree of lumbar lordosis at the initiation
and during the lift.
Use the lifting technique that is most applicable to the
situation
When lifting on an uneven-sloped surface, face down
the slope to negotiate the lift.
When lifting, do so as much as is possible in the
sagittal plane
 Use the lifting technique that is most applicable
to the situation .
Semi-squat. Frequently seen as the safest lift in terms of resultant
forces to the intervertebral disc, but it does carry a high energy
cost, which will limit applicability during highly repetitive
efforts. Convention would dictate that this would be the ideal lift
for heavy loads performed on an occasional basis (10% to 33%
of the work day).

Squat lift. To be used as an alternative to the semi-squat when

space is limited and load size does not allow for foot placement
to the side of the object to be lifted. This also is the lift preferred
by individuals experiencing acute and chronic low back pain.
Use the lifting technique that is most
applicable to the situation
Stoop lift. Although this lift is the direct opposite of what
is usually perceived by the therapist as being the ideal lift,
it apparently has an application. Lifting scenarios
requiring light loads (20 pounds and below)on a frequent
basis (defined as 33% to 66% of the workday) are more
efficiently managed using this technique.
Correct & Incorrect Techniques
 Conclusion
Maintain the load as close to the body as possible
Ensure adequate hand couple
Maintain the lumbar spine in as much of a lordotic curve as possible
Maintain a degree of lumbar lordosis at the initiation and during the lift.
Lift in the sagittal plane, and avoid extraneous multiplanar movement patterns
Ensure proper footing
Lift slowly
Use the lifting technique (stoop, squat, semi-squat) best suited for the situation

These principles can easily be applied to any number of occupational scenarios

that require moderate or heavy lifting.
Occupational and physical therapists possess a breadth of knowledge relative
to the factors that influence human performance. It is our responsibility as
therapists to incorporate this knowledge into common processes to prevent the
maladies associated with aberrant lifting practices through education, early
intervention once an injury has occurred.