Tips for good posture and a healthy back.

Resource PackIn the drivers seat – set up for good posture and healthy tips when you are in your car • 2 Travel health – DVT information guide for long haul flying or driving • 4 Extended travel activity/exercise guidelines • 5 Smart snacking: energy boosting - not weight boosting - tips • 6 Your take-away workout • 7 Working on the move – health tips & space set up guide • 8 Practical lifting – help yourself look after your back • 9

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Driving posture and ergonomics Good posture plays a key role in the prevention of back pain. However, any posture, no matter how good it is, could ultimately lead to discomfort. Therefore, it is important to adopt a range of comfortable driving positions and to make frequent changes to help delay the onset of discomfort.Ergonomics and key aspects of the vehicle are covered below. It is important to remember that the greater the number of adjustable features within a car, the greater the likelihood of achieving a good and comfortable posture.Look for certain features in a car, for example:

Seating: Generally a comfortable and supportive seat with:• An independent height and tilt adjustment• Electronic adjustment controls. Ensure that all adjustment mechanisms are

easy to use and positioned such that poor posture is not encouraged.• Ensure the seat material does not create discomfort and that all parts

of the seat provide adequate support. Seat Base: • Adequate leg length - ensure thighs are adequately supported

and that the seat base is not too short or too long• Adequate base width - ensure seat base is wider than hips and thighs• Adequate height adjustment of seat base to ensure:• Feet can operate pedals without stretching• All controls are easily reached• All display instruments can be seen• Good all round vision Back Rest: • Back rest height - ensure height of back rest reaches the shoulders

and does not obstruct ‘rearward vision’• Back rest width - ensure wide enough to support shoulders

Lumbar Support• The back rest should provide continuous, gentle support along the length

of the back and an adjustable lumbar support may help to achieve this, but be careful - many do not offer full adjustment resulting in pressure points or gaps

• An adjustable lumbar support with ideally up/down and in/out adjustment• Always ensure the lumbar support ‘fits’ your shape and is comfortable• If your seat lacks support, try using a lumbar roll

Seat Belt Ensure the seat belt is adjustable and comfortable.

Steering Wheel: • An adjustable steering wheel (in/out, up/down and tilt)• Power steering• Ensure steering wheel is centrally positioned and not ‘off-set’ to prevent

rotation of the spine• Ensure steering wheel does not obstruct the display panel

Pedals & Gearbox • An automatic gearbox can be helpful• Centrally positioned pedals that have adequate spacing and are not ‘offset’

as they can create torsion on the spine

Mobile Phone • If a ‘hands-free’ mobile phone kit is to be fitted, ensure the cradle, microphone

and speaker are appropriately positioned to encourage good posture• As demonstrated in the picture, the driver needs to stretch to reach the

mobile cradle Boot • A boot with an appropriate sill height, easy access and adequate space Car Environment • Comfortable leg Adopt a positive posture Think about your posture as you drive – if you practice the tips below they will soon become a habit:• Keep your chin in• Avoid gripping the wheel too tightly as this tenses your muscles

and adds to stress• Relax your shoulders• Keep you head upright Red light and traffic jam exercises that relieve tension • Pull in your stomach muscles and breathe out forcefully, relax and repeat• Raise your shoulders towards your ears, push the shoulders backwards

against the seat, relax and repeat Assess your general lifestyle A ‘pain free’ back is dependent on many factors including good posture and regular exercise. Exercises help keep muscles toned and joints mobile. It is important to maintain a basic level of fitness and to seek qualified medical advice on which exercises you should personally undertake. It is always wise to check with your GP before embarking on an exercise regime or carrying out any exercises.

In the drivers seat.

What is Travel Related DVT? First recognised back in 1946, travel related DVT is a potential health risk for travellers who are immobile for extended periods of time. While the problem is often associated with air travel, the risk is equally reported among those travelling by car, coach and train.Deep Vein Thrombosis (DVT) is a clotting of the blood in any of the deep veins but usually occurs in the calf. If a clot develops, it often makes its presence known by an intense pain in the affected calf. Medical attention should be sought immediately if this occurs, especially after a long journey. If the clot breaks off and makes its way to the lungs it can then affect oxygen uptake and in some cases this can be fatal. A DVT can occur some days or even weeks after a trip. In most cases ‘sufferers’ have more than one of the predisposing risk factors listed below. You are at higher risk if you are:

Studies have shown that up to 25% of all people who develop DVT have been on a long haul flight in the previous month. It has been shown that during a transatlantic flight, as much as 4kgs of fluid can shift from the circulation into the legs. A DVT can strike without warning so it is important to follow the health and exercise guidelines below when undertaking long haul flights, train or road trips. Alarm signals If you develop any acute pain, swelling or redness of your legs either during or post-flight seek medical advice as soon as possible.

Health guidelines that may help prevent DVT Hydration It is vital to keep yourself properly hydrated, otherwise your blood can thicken and make a blood clot more likely. During the trip you should try and drink a pint of water every three hours. It is sensible to avoid excess coffee, tea, coca cola and other caffeinated drinks because these are all diuretics (i.e. deplete the body of fluid). Your sitting position Try to avoid crossing your legs as this restricts the blood flow to your lower limbs and do not put luggage under your feet, which will restrict your leg room.

Avoid alcohol Alcohol is a diuretic and if you fall into the “higher risk” group already mentioned you should avoid it completely. Try to avoid any intake of alcoholic beverages during flights or train trips

Sleeping position If you have the opportunity to sleep during your long haul travel, try to ensure that you are not lying on one of your limbs and therefore putting it under pressure. Aspirin It is suggested that one 75mg aspirin tablet taken before a long haul trip followed by one per day for the following two days can lower the risk of a DVT, because it thins the blood. If you have not previously taken aspirin or have any stomach problems such as ulcers or any other medical condition, you must consult your doctor beforehand. Clothing It is advisable not to wear tight clothes, which can restrict the blood flow to the legs. Wear comfortable, loose clothing and avoid socks with a tight elastic top. During your trip, loosen any restrictive clothing like belts or shoelaces. If you have varicose veins, support tights can improve the blood circulation. Long haul trip exercise guidelines Keep moving - Even on short trips, you should get up and walk along the aisle every 20-30 minutes. This is probably one of the most important things you can do to prevent a DVT. This gets the circulation moving and ensures good blood flow around your body.

Exercises for when you are on the move The Cardiac Patients Association has recommended exercises, which should be done every quarter of an hour for just a couple of minutes even on short flights /trips. It is especially important to run through this quick routine if you are unable to walk about the aircraft/train or are blocked into a middle seat:• Pressing the balls of your feet down hard against the floor

or foot-rest hold for three or four seconds release and repeat five times.

• Put your heels firmly on the floor and bring your toes up towards your knees and hold for three or four seconds, then point your toes downwards and hold this position once again. You should feel your lower-leg muscles contracting.

• Performing neck, shoulder and ankle rolls will get the muscles moving and relieve travel tension. Try doing three to four rolls, slow and controlled in each direction.

• Stretch the upper back by sitting up straight, bring your arms out in front of you, locking you fingers and push your shoulders forward.

• Relax arms by your side, squeeze your shoulder blades together while pulling your elbows back, pushing your chest up and out to stretch across your chest.

• Exercise the calf muscles by moving your feet in the formation of each shape of the letters of the alphabet. To increase blood flow through your core and thighs, tighten your stomach (pull your navel towards your spine) and lift your legs an inch or two off the floor and hold up to one minute – be careful NOT to hold your breath.

• When you do get a chance to move about try to do some standing stretches. Focus on the sides, hamstrings, calves and quads.

Take advantage of re-fuelling stops if possible, get off the plane/train and walk about.

Travel health and DVT information.

• pregnant or two months post-partum• a smoker• dehydrated• taking oral contraceptives• suffering a blood disorder or clotting

abnormality

• prone to varicose veins• recently recovering from surgery• obese• suffering from a chronic illness• someone with a history of cardiac problems

Smart Snacking Modern living’s hectic pace might leave you feeling like there’s no time for healthy eating. And when you do stop to eat, it’s probably tempting to go the quick and easy route by grabbing some fast foods loaded with calories, saturated fats and sugars. Even if you take time to eat three meals a day, you may still feel hungry at times. Healthy snacks are the answer. Snacking on nutritious food can maintain your energy levels and your mind alert without taking up a lot of your time.To keep energy levels going — and avoid weight gain — steer clear of foods with lots of simple carbohydrates (sugars) like chocolate bars or soft drinks. Look for foods that contain complex carbohydrates like whole-grain breads and cereals and combine them with protein-rich snacks such as peanut butter or low-fat yogurt or cheese.

Judging whether snacks are healthy Choosing healthy snacks means shopping smart. Be cautious of the health claims on food packages. Here are some things to watch out for:• Just because something is “all natural” or “pure” doesn’t necessarily mean that it’s nutritious.

For example, “all natural” juice drinks can be filled with sugar which means they’ll be high in calories and give you little nutrition.

• Cereal bars are a good example of a snack that people think are healthy. Although they can be a good source of vitamins and nutrients, many also contain a great deal of fat, including a particularly harmful type of fat called trans fat. On average, about 35% of the calories in a regular cereal bar come from fat, there can also be a lot of sugar in cereals and bars. Check the Nutrition Facts label on the package to be sure.

• Be sceptical of low-fat food claims. If the fat has been eliminated or cut back, the amount of sugar in the food may have increased to keep that food tasting good. Many low-fat foods have nearly as many calories as their full-fat versions.

Smart snacking strategies Make healthy snacking part of your everyday routine:• Prepare healthy snacks in advance. Try making your own healthy grab bag. Small bags of nuts &

raisins, carrot sticks, string cheese sticks, rice cakes and crackers. Keep plenty of fresh fruit and veggies around so you can grab them on the go.

• Make it interesting. Healthy snacking doesn’t have to be boring as long as you give yourself a variety of choices. Keep them close by in the car, on your desk or in your suitcase.

• Satisfy cravings with healthier approaches. If you’re craving savoury munchies, snack on low fat/salt crisps instead of regular varieties and pair them with salsa instead of high fat dips.

• Don’t slip up after dinner. Evenings can be a tempting time to indulge in sugary, fatty snacks. If you’re really feeling hungry, pick the right snacks to fill the hunger gap. Rice cakes, air-popped popcorn, fruit paired with cheese or yogurt can tide you over till breakfast.

Take-away workout Before you begin this or any exercise program, consult with a Proactive Advisor or your GP regarding your readiness to participate in an activity programme. This workout has been devised to enable you to continue exercising whilst away from home. Ensure that you are well hydrated before commencing the programme. Do not exercise if you feel unwell.

Equipment needed • A chair• Two bottles full of water• A towel.

Warm-up 5 minutes of exercise to raise your heart rate. Walking on the spot, up and down stairs or around the hotel. Stretch Quads, Calves and Hamstrings. Hold each stretch for 10-15 seconds. Cardio Workout 15-20 mins of steady activity that elevated your heart rate. Choose from swimming, brisk walking, stair climbing or even a combination jogging on the spot, jumping jacks or spotty dogs.

Resistance Complete each exercise for 30 seconds. Repeat the circuit three times. • Squats • Bicep Curls

(use the water bottles)• Tricep Dips (on chair) • Shoulder Press

(use the water bottles)• Lat Raises

(use water bottles) • Static Lunge (left Leg)• Static Lunge (right leg) • Door Handle Towel Pull• Press Ups on floor • Calf Raises

Abdominal Exercises Complete 2 x 15 repetitions of each exercise. Keep your lower abdominals pulled in tight. Basic Crunch Oblique Crunch Reverse Crunch Plank (3/4 or Full - hold for 10 seconds) Cool-down Spend five minutes stretching upper and lower body, if you have been driving or traveling for a number of hours in the day, be sure to add some back, shoulder and neck stretches. Note: If you are unsure of your suitability to exercise, please consult your GP.

Healthy snacking.

Take-away workout.

As with everything, moderation is the key to smart snacking. People who eat regular meals and healthy snacks are less likely to overeat and gain weight than people who skip meals. It’s natural to feel hungrier at certain times. Knowing how much food your body needs to satisfy this hunger is critical. A handful of walnuts make great brain booster before sitting down to do a project, but a whole bag won’t boost anything — except pounds!

Healthy tips for home and mobile working• Start out with something easy, fun or interesting to help build momentum throughout

the day.• Stick to a schedule. Treat your days like a “regular” work day.• Separate your “work” area from your “living” area. This includes your phone and computer• Limit distractions. Keep your work area clear from things that might get you off track• Take breaks. Get away from the computer and don’t work through lunch. Have a 5 minute

break every hour; go for a brisk walk, go outside and breath some fresh air• Structure your work day and keep distractions at bay. Conversely, don’t be in work mode

all the time i.e. don’t just check your email when you’re off duty Setting up your Home OfficeFurniture Choosing the right furniture is an important part of establishing your own work space at home. Your work performance and your health can be affected by what you choose to sit in all day, how often you take a break from your computer screen and whether your work station is set up to enable you to minimise the problems associated with long hours at the computer.Think about seating, desk, lighting, telecoms, computer hardware, software & accessories. However tempting and practical it may seem to set yourself up initially at the kitchen table, do bear in mind that sitting in an awkward position and ‘making do’ for the time being may put your body under stress and out of action in the longer term. At home workstation layout In addition you may want to look carefully at how your workstation is set up. Home office work is now almost entirely dependent on computer use and people spend more and more time in front of a computer adopting a static pose:• Try not to slouch, keep your chair unlocked most of the time and make full use of the chair

movement (especially when reaching behind you or for the phone)• Try to alter your position when using the keyboard for long periods of time, adjust your

feet position forwards and backwards. Changing your posture and taking frequent breaks from your desk will help keep your muscles working

• Operate your keyboard when it is directly in front of you and have your monitor square on so you don’t have to turn your head to look at it. Tops of computer terminals should be at eye level, keyboards angled and movable

• Use a document holder so that your work can be closer to you and try to minimise glare on the screen. Document holders should be at eye level to avoid eye muscle fatigue

• Re-arrange the items on your desk according to the frequency that you use them - things used often kept closest, least often furthest away

• Your telephone should be positioned within reach of your non-dominant hand. This allows your dominant hand to perform activities while holding the phone in your non-dominant hand. If available, the use of telephone headsets (earphones) is preferred because they allow both hands to be free and bad neck postures are avoided

Working from home – top tipsWorking On the Move If travel is part of your job do you regularly use a laptop to catch up on some emails, finalise that report or prepare yourself for your next meeting, you need to be aware that however practical the laptop may be, from an ergonomic point of view it is not desirable for extended periods of use.Due to the low positioning of the laptop screen and the fixed keyboard, most laptop users maintain a hunched body posture while working. Intensive laptop use can therefore cause serious musculo-skeletal pain and injuries, particularly for users on the move.In general, think about moving away from the typical stance of crouching over your laptop on your knees placing pressure on your upper and lower back, neck and lower arms and wrists. Think about using a laptop holder on a nearby table if available which can re-position your keyboard and screen just right for health - and comfort.The following image can be a useful guide to help you set up both your at home work-station and your adhoc on the move work spaces.

The following is general guidance which will assist you in reducing the risks associated with lap-tops and other DSE’s.• Ensure lap-top work station is set up as a regular workstation.• Ensure that your forearms are roughly horizontal and supported when you hands

are on the keyboard. Work with your wrists in a neutral position when typing.• Position the screen on your desk/work surface in front of you at the correct height

so that you can see the screen without bending your neck forward.• Vary your activities regularly to avoid static posture and take regular breaks.

Stand up and move around frequently• Perform stretch exercises to increase circulation to your back, neck, arms and hands• Whenever practical use a separate full size keyboard and input device if you are

using the lap-top for prolonged periods. This is best achieved through a docking station. If not practical a mobile lap-top solution may provide a reasonable alternative, where a docking station cannot be provided.

• You should use the trackball or glide pad on your lap-top for short periods only, prolonged use is not advisable. Keep hands as relaxed as possible.

• Position your screen to avoid glare from windows and lights.• Regularly clean your screen.• Use approved workstations.• When transporting your lap-top, try to minimize weight and utilise the most

suitable method. Consider a rucksack.

Working out of the office – health tips.

Lifting Safety: Tips to Help Prevent Back Injuries

Have you checked the object before you try to lift it? Test every load before you lift by pushing the object lightly with your hands or feet to see how easily it moves. This tells you about how heavy it is. Remember, a small size does not always mean a light load.

Is the load you want to lift packed correctly? Make sure the weight is balanced and packed so it won’t move around. Loose pieces inside a box can cause accidents if the box becomes unbalanced. Is it easy to grip this load? Be sure you have a tight grip on the object before you lift it. Handles applied to the object may help you lift it safely. Is it easy to reach this load? You can be injured if you arch your back when lifting a load over your head. To avoid hurting your back, use a ladder when you’re lifting something over your head. What’s the best way to pick up an object? • Use slow and smooth movements. Hurried, jerky movements can strain the muscles

in your back• Keep your body facing the object while you lift it. Twisting while lifting can hurt your back• Keep the load close to your body. Having to reach out to lift and carry an object may

hurt your back• “Lifting with your legs” should be done only when you can straddle the load. To lift with

your legs, bend your knees, not your back, to pick up the load. Keep your back straight• Try to carry the load in the space between your shoulder and your waist. This puts less

strain on your back muscles• Think before you lift, plan the lift, make sure the load is safe to handle• Adopt a stable base with your feet apart, ideally hip width apart• Relax your knees as you bend forwards (moderate bending with your back,

hips and knees like a puppet)• Make sure you have a good grip• Lift the head to look in the direction of the lift as you start the lifting action,

this will realign your spine• Avoid twisting your back or leaning sideways, especially when the back is bent• Turn by moving your feet rather than twisting your back• Move smoothly when lifting or handling

Practical lifting tips.

How can I avoid back injuries? • Pace yourself. Take many small breaks between lifts if you are lifting a number of things• Don’t overdo it-don’t try to lift something too heavy for you. If you have to strain to carry

the load, it’s too heavy• Make sure you have enough room to lift safely. Clear space around the object before

lifting it• Look around before you lift, and look around as you carry. Make sure you can see where

you are walking. Know where you are going to put down the load• Avoid walking on slippery, uneven surfaces while carrying something• Don’t rely on a back belt to protect you. It hasn’t been proven that back belts can protect

you from back injury• Get help before you try to lift a heavy load. Use a dolly or a forklift if one is available