Abdominal exercise 

Here are a few exercises for a firm abdomen. 

Abdominal Exercises for a Strong Back
Stand with feet wide apart, holding a long stick behind the neck. Twist the upper body from side-to-side slowly keeping lower part of body still. Continue for one to three minutes. 
Stand ( as shown) with your hands behind your neck, and lower your left elbow towards your right knee as you bring the knee up to meet it. After returning to the starting position repeat with right elbow and left knee and keep repeating alternately moving as smoothly as possible. 

Lie on back with knees bent and feet flat on the floor. Now, sit up slowly first raising your head then your neck, then each vertebra slowly as if peeling them one by one off the floor and move the arms forward past the shins. Now, slowly lie down again at the original position. Keep repeating smoothly 10-15 times. 

Lie on back with knees and feet flat on the floor and place hands behind head elbows outwards pressing lower back on floor. Now bend legs at knees, lift shoulders about thee inches from the floor keep looking towards the ceiling and slowly lower them back. Repeat 10-15 times. 

Lie on stomach with legs and arms extended, raise your right leg and left arm, off the floor at the same time and slowly lower. Repeat 10-15 times, then do the same with the left leg and right arm. 
Kneel so that your neck is in line with your spine and simultaneously rise your left hand and right leg tighten your stomach and hold till a count of three. After returning to kneeling position, repeat on opposite side alternating 10-15 times. 
Sit comfortably on the floor with torso erect and hands extended behind you on either side. Raise legs as high as you can while keeping body on floor. Repeat the action 10-15 times. 

Stress Reduction : Mind plays a big role in perception and tolerance to pain. Therefore, stress reduction and relaxation techniques like meditation, reiki, yoga and asanas like shavasana help in backache. 

How Can We Prevent Backache?

It is extremely important to take preventive measures for backache since we know that most back problems do recur. We must, therefore, learn the correct way to use our backs so that problems do not occur. 
This can be achieved by adopting the following:
· Sitting with a bolster or ‘load’ as it is commonly known against the lower back, helps to prevent a ‘slump’ in the posture and thus strain on the lower spine. This can also be achieved by using a good orthopaedic chair. 
· Intermittent neck and foot exercises should be done during working hours prevent stiffness of joints. 
· A good exercise programme must be adhered to. 
· A balanced diet with plenty of greens, dairy products, fish and fruits ensures adequate supply of calcium and other minerals, which are essential for a healthy spine. Also, a regular exposure to sunlight is essential because it helps in converting Vitamin D to its active form. 

· Treatment of any of the known causes of backache must be aggressively pursued to prevent the occurrence backache.

Learning from Patients
A lady patient with backache discovered that moving on all four limbs ( crawling) like an animal whenever her backache ‘acted up’ and helped in quicker recovery. She was taking the load off her spine! There are many such things we doctors can learn from the practical experiences of patients. 

How Can We prevent Backache at Work?


Correct chair and sitting posture

Correct Chair
Chairs should be ideally firm, uncushioned, or have a layer of coir in the cushion to give them the desired firmness. Straight-backed chairs are the best, and if possible there should a support for the lower back and a foot-rest or a small stool in front of the chair so that feet can be rested on it intermittently. Rest one foot at a time on the stool. The arms of the chair should be at waist height. If your chair does not have a support fro your lower back, use a small firm bolster or ‘load’ to achieve the same result. 

Correct Method of Sitting
Sit straight without a ‘slump’ to avoid strain on back. Feet should not dangle in the air but rest comfortably, preferably on the foot rest. 
An ideal work station ( if you are going to stand and work) should be at a height that is midway between the wrist and the waist. If you are sitting, follow the guidelines listed above in ‘correct chair and correct method of sitting’. Also, see that the computer is placed such that it does not force you to bend down or sideways while using it. 

Driving 
Two-wheeler: One should look for a two-wheeler with a good suspension. Motorcycle is a better choice in this aspect. Choose a vehicle with a handle height that does not require bending forwards. Drive slowly, especially on speed breakers and try to avoid potholes. 

Four – wheeler: Following corrective measures can be taken to avoid backaches induced by incorrect driving habits:
· There should be no gap between your back and the back-rest of your car seat. If it exists, place a firm pillow behind your back to bridge this gap. 
· Place a thin pillow below your knees to raise it above the thighs. This helps to take the load off your back especially in case of long distance driving. 
· Break your journey, at least, once in two to three hours. 

Correct Method of Picking up an Object
While lifting a weight, or picking up an object, jerky movements should be avoided, and one must get up with the object, and not bend and lift it. This can be achieved by keeping the knees bent. When the knees are bent while picking up an object, the thigh muscles absorb most of the strain instead of the muscles in the back. Thigh muscles are the strongest muscles in the body, and should, therefore, be utilized more. While picking up an object first keep one foot slightly ahead f the other, gently bend the knees and come almost to sitting position, pick up the object, and then slowly and smoothly rise with the object. 


Correct Wrong
Picking up an object

How can We Prevent Backache at Home?

Correct Bed
An ideal bed should be firm. Mattress should never be soft, and should be made of cotton. If made of sponge, it should be reinforced with coir. The mattress should be pliant enough to adapt itself your spine, but with a rigid base to provide good support,. Pillow should also be like the mattress. 

Correct Method of Getting up from a Lying Down Position
When getting up from a lying down position the correct method is to turn to one side before rising. 

Correct Wrong
Getting up from a lying down position. 


Stairs and Floors
Stairs should be made safe by avoiding highly polished granite or marble. They should be preferably carpeted, and never left wet (this includes floors), and a good support should be provided in the form of side-railings. Care should be taken, while wearing rubber slippers on wet floors and running down stairs with rubber slippers or socks. It may be an invitation to a fall or injury. 
Rough floor (provided with non-skid tiles) should be preferred especially in bathrooms. Bathrooms should also have plenty of hand supports that one can hold on to if one slips. 

Correct Method of Sweeping Floor
The correct way to sweep floors is either sitting down on the floor or, by performing the task standing as shown in picture – by pushing the body forward with minimum bending of the back. 

Correct Method of Washing Clothes
Correct way to wash clothes is to sit on a low stool with the height of the bucket being such that there is no need to bend the back while doing the washing. The position should be such that one can sit for a length of time without straining the back. If our servants are doing the washing we should encourage them to adopt this method in order to prevent backache. 


Correct Washbasin Height for Washing Vessels.
It is very important to keep the height of the washbasin at the correct level, to prevent strain on the back. In case fittings have already been fixed, you can raise the working height or reduce the working distance by adding appropriate attachments to the top (see illustrations below).

Correct Wrong distance Wrong depth

The kitchen platform should be midway between wrist and waist when you stand erect. 

Tap Attachments
The tap attachments should be such as to : (a) reduce distance and (b) to increase height.

A B
Illustration showing how to use tap attachment for 
Reducing distance. 

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