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ACTIVITIES OF DAILY LIFE

A very important aspect of treatment is to improve functional activities of your daily life. Some of the recommendations below are general guidelines. Please consult with your treating clinician for individualized recommendations and precautions.

Activities of Daily Life (ADLs)
The following guidelines have been developed to give you specific suggestions when you are in different positions or performing selected activities. These guidelines will help if you experience discomfort, but will be most effective if followed routinely to minimize strain on your back.

Standing:
Always maintain lordosis in the standing position.  Keep knees relaxed, not stiff.  Avoid prolonged one legged standing.  Try to vary position.  For example, propping one foot on a low stool

  • Don’t stand in a forward bent position when performing daily activities such as brushing teeth, shaving, washing hair, cooking.
  • Options: bending at hips and knees
    • Support upper body with hand on sink or counter
    • When working in a standing position, take a 2 minute break every 30 minutes to do range of motion exercises:  standing pulling one knee to chest, standing extension, side bending with hands on hips.

Sitting:

  • Sitting in a proper height chair is essential to maintain proper posture and avoid strains on the lumbar disc and other structures. A chair is the proper height when the hips and knees are at right angles, with the feet flat on the floor. The back of the chair should provide some sort of lumbar support. Some newer chairs are designed with the base of the chair tilted forward so the knees are slightly lower than the hips. This is also an excellent position for maintenance of proper posture.

Working In The Seated Position:

  • Don’t lean forward to reach work.  Work surface should be close and high enough so you do not have to lean forward.
  • Avoid prolonged work with head bent forward.
  • Give yourself a 2 minute break every 30 minutes to do the following exercises:  Sitting:  Chin tucks, neck side bending, shoulder rolls, and shoulder pinches; Standing: standing extension, side bending with hands on hips.

Driving/Riding In A Car: 

  • Use the pivot principles to get in and out of your car.  Seat should be back all the way.  Back into the seat then turn & bring your legs in one at a time. Reverse order to get out of the car.
  • While driving, knees should be level with hips.
  • Avoid reaching and twisting to retrieve items from the back seat.  Instead, kneel on the seat facing the back seat to reach forward, or get out of the car to reach the back seat.

Dressing:

  • Avoid bending over at the waist while sitting or standing.
  • Options:
    • Lean against wall, bring knee up within reach of arms.
    • Socks, shoes, nylons, or underwear may be put on while on your back, bringing knee up to chest.
    • Put foot on a chair to pull on socks or tie shoes.

Lifting:  
If you are unsure of objects’ weight, move it with your foot to estimate its weight.  Clear a path where the object will be placed. Get help if there is any question in your mind whether you can handle the object.

  • Technique:  keeping feet apart, one foot slightly in front of the other
    • keep back straight when lifting
    • bend at your hips and knees
    • keep weight close to your body
    • Never Twist at the waist when picking up or putting down a load.

Pushing/Pulling:

  • Heavy loads:  use body weight to push rather than pull heavy objects.

Vacuuming/Sweeping/Mopping/Raking:

  • Maintain a wide base of support with one foot behind the other and allow the front leg to bend slightly at the knee, shifting your body weight from front to back.
  • Body rhythm and movements should be the same speed as the cleaning utensil (like a fencer’s lunge).
  • Walk forward and backward holding the cleaning utensil using both hands.  Avoid extreme reaching by keeping the utensil close to you.

Bending: 

  • Do not forward bend at the waist when you have to work or reach below your waist level.  Instead, maintain a lordosis and bend hips and knees or kneel on one knee or both knees.

Cleaning The Tub/Shower:

  • Kneel outside the tub supporting your weight on one hand while scrubbing
  • Maintain lordosis
  • Avoid twisting at the waist

Bed Making:

  • Kneel on one knee to tuck in sheets
  • Walk around the bed while making it instead of leaning across

Laundry:

  • Avoid heavy baskets by splitting loads in half
  • Squat to pick up laundry basket, keeping it close to your body
  • Bend knees and maintain lordosis to retrieve clothes from washer
  • Kneel to level of dryer to load and unload clothes

Loading Dishwasher:

  • Rinse all dishes at one time before loading, to avoid repetitive movement
  • Pivot and face dishwasher rather than twist at the waist
  • Squat or kick one leg back to load/unload dishes and dispense detergent
  • When unloading, stack all dishes counter until loaded, then put dishes away

Yard & Garden Work: 

  • Keep mower close to you, move with it
  • Avoid leaning forward to push, pull, or reach to water, plant, or trim shrubs
  • Pace yourself to avoid fatique; divide chores and perform on separate days
  • Use long handled tools to avoid forward bending

Loading/Unloading Trunk of Car: 

  • Maintain lordosis
  • Squat or kick one leg behind you
  • Use arms to push load away from you to allow further loading

Unloading:

  • Maintain lordosis
  • Squat or kick one leg \behind you and pull loads to edge of trunk
  • Pick up load and keep it close to you

Reaching: 

  • use a steady stool when reaching higher than shoulder level
  • Never Twist while reaching
  • Lift in increments: lift first to chest, then to shoulder, then into compartment or shelf
  • Reverse increment procedure to lower items higher than your shoulders.

Please note: this brochure is to assist the patient in understanding. It does not replace nor take the place of a good clinical evaluation by a medical doctor. If any of the exercises result in pain or increased symptoms please avoid those activities.

Contact Us

13710 Olive Boulevard (Primary Office)
Chesterfield, MO 63017
Telephone: 314-469-PAIN (7246)

Fax: 314-469-7251
Exchange: 314-441-6965 (for after-hour Emergencies Only)

Hours:
Monday thru Friday
8:30 AM – 4:30 PM