It’s spring cleaning season, which means many of you are cleaning out the clutter and working on your yards. We’re tackling our closets, moving heavy boxes out of storage, and laying down bag after bag of mulch in our flowerbeds, among other chores. All of this means lots of lifting. While it may not seem like a big deal in the moment, lots of lifting can lead to awkward movements and repetitive stress in the joints.

As a physical therapist, I have treated thousands of patients with low back pain. During my initial examinations, I ask them to squat down as if they had to pick up an object from the floor without giving them any visual or verbal cues to guide them. Almost every patient bends at their knees before hips or simply bends over at their waist first, and I point out that bending at their knees first causes the body to shift forward, increasing the load on the knees and lumbar joints.

“But I’ve always been told to bend at the knees,” is the usual response from my patients. We then have a conversation about how to flex at the hips first, like a hinge, and then flex at the knees to lift someone or something safely. Learning how to use the hip muscles to lift will help reduce forces over the back and knees.

The Five Ls of Lifting

Let’s discuss the five Ls of lifting for proper body mechanics applicable to any lifting situation.

1. LEVERAGE: Simply put, get close to the object or person you are about to lift. Your muscles work more efficiently when closer to the load being lifted.

2. LUNGS: Keep breathing and try not to hold your breath. The rule of thumb is to inhale when you pull an object, and to exhale when you push an object.

3. LUMBAR: Keep your back straight by flexing at your hips before your knees for a hip hinge. The hips unlock a split second before the knees to allow the lumbar spine to remain in a neutral position.

4. LEGS: By successfully flexing at the hips then knees for a hip hinge, it stretches the glutes and quadriceps, allowing them to contract forcefully if necessary. As the hips and knees extend to lift a patient or object, the lumbar spine is held in neutral.

5. LOAD: Find out how heavy the object or person is you are about to lift. This could be done with a scale or with an attempt to lift the object. If you know the patient or object is heavy, then it is time to ask for help with the lift.

Even if you develop perfect lift form, it is still important to ask for help when lifting heavy objects or when lifting light objects repetitively throughout the day. It is also important to keep your core and lower extremity musculature strong and flexible to deal with the rigors of lifting. If back pain develops 24 hours after a lift, and the pain doesn’t resolve within two weeks, then it is time to seek out a physical therapist for care and lift training to pre-vent a relapse.