Robert Hayden, DC, PhD, FICC
One of the very frequent reasons for the onset of low back pain in adults is lifting children. I see it over and over again, particularly among new grandparents. The adorable tiny people who look vaguely like their own children or themselves are irresistible. They make the cutest noises (well, sometimes)! The urge to lean over and pick them up for cuddling is overwhelming.
There are multiple scenarios for injury. The mechanism is simple: leaning forward at the waist, and adoring grandparent extends arms and forearms to pick up a bundle that may weigh anywhere from 6 to 25 pounds. The low back muscles that are used to lean backward are abused to lift both the grandchild and the grandparent at an awkward angle.
Think about how this looks from the side. Imagine a grandparent’s body bent at the waist at maybe a 45° angle. Imagine this body being a lever with the fulcrum at the hips. The length of the lever goes from the hips to the outstretched hands. The load being lifted is a child. All of the power and leverage for lifting comes from low back muscles.
Do you remember the seesaw at the playground? If you had a big kid and a little kid on a seesaw, you had to move the plank on the fulcrum of that lever so that the big kid was on the short side of the lever. It takes a big kid on the short side of lever to balance even a small kid on the long side.
Now return to the grandparent. The “little kid” on the seesaw is in grandma’s hands. The “big kid” is the muscle power in grandma’s aging back. Can you see how simple physics comes to play here? The stress on grandma’s back is multiplied by the length of the lever created by her extended arms.
The usual scenario is a strain of grandma’s extensor muscles in the back. There are other possibilities for injury if grandma has other structural issues in her skeleton, such as osteoporosis, scoliosis, old disc injuries, congenital anomalies, etc.
This suggests a very simple preventive measure: make the lever shorter. It is as simple as stepping closer to what you lift, bend the arms at the elbow, toward your body, then left. Try this experimentally and you will see it makes a big difference.
This goes for everything you lift. We see the same kinds of injuries when people cook on a stove and try to lift a heavy pot from the back burner or pull something from the back of the oven instead of pulling a pot to the front burner before lifting, or toward the oven door before lifting. Groceries in the trunk are a similar problem.
Sometimes our grandparents, or even our parents, have back conditions in which they should not be lifting any weight at all. This creates some angst among those who cannot resist playing with the grandchildren. The solution for this is also very simple: sit down (preferably in a comfortable rocker) and let the grandchild crawl into your lap. If the grandchild is not crawling yet, let someone who is able-bodied hand you the blessed bundle while you are already sitting down. You can still bond with this tiny source of joy without the stress of lifting. This will be good for the baby and even better for you.
For you grandparents, most of these injuries can be easily and successfully addressed by conservative means. Gentle chiropractic care, massage therapy, and ultrasound can get you back into the front line of grandparenting quickly.
Nonsteroidal anti-inflammatory drug (NSAID) use for acute injuries has dropped off by about one third in the last few years, which is good, as the drugs are potentially harmful, especially for seniors. Unfortunately, the use of narcotics for acute back pain has increased about 50% during the same period, while there is no evidence that they will help at all with your back pain. Indeed, there is now an epidemic of narcotic addictions with chronic pain. The overwhelming majority of these injuries are nonsurgical, so conservative care should always be pursued first.
Grandparents are important. They are the part of the family who can be loving and accepting, usually without any of the negative aspects of discipline that are left to parents. At grandparents’ houses, kids can do no wrong. They can lift their heads and feel special. We certainly want to foster that process, and besides, those grandchildren may be or caretakers someday, guarding their backs as they lift us.