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Watch Your Back!
By Lorna Taylor BSc (Hons) Physiotherapy, MCSP, HPC Registered
First Published in SEN Magazine (Special Educational Needs) on 22 July 2011
School staff, particularly those working in SEN, are at an increased risk of suffering back problems. Lorna Taylor looks at how to avoid work-related back pain
It is recognised that teaching is a mentally demanding profession. However, less well understood are the demands the role places on one’s body. In any day, when working at low heights with children, there is repetitive bending, twisting, stooping over and awkward lifting. Many teachers will be familiar with sitting on children’s chairs, bending over low tables, washing up in low sinks, and lifting and moving play and therapy equipment and often children.
The very nature of the teacher’s job puts him/her in a continuous at risk situation of developing work-related back pain. Damaging postures primarily affect the lower back with compensatory neck pain. Tense neck muscles also contribute to voice strain.
I recently carried out a survey of over 700 primary and early year education professionals (including those working in SEN) which found that 88 per cent experienced back pain and 80 per cent neck and shoulder pain. Alarmingly, 82 per cent experienced pain more than once a week and 74 per cent had received treatment to ease it, either through the NHS, self-financed or both.
Yet, despite these findings, discomfort is frequently accepted as an inevitable part of the job and often not reported. Such under-reporting masks a very serious problem affecting an incredibly valuable and important part of the education workforce. Awareness needs to be raised if this is to be addressed.
Why does my back ache?
The spine has a difficult job to do, so it is already vulnerable. It has to provide strength to keep us upright and also flexibility to allow movement. It really does need looking after, as it is susceptible to cumulative strain injury – occasional back ache which, if damaging postures continue, becomes more painful and frequent with time. Its incidence is also increased by anxiety and stress. Prevention is therefore very important.
Healthy spine posture
The spinal column is central to our skeleton. It is straight upright if viewed from behind and from the side has three curves, forming a healthy letter “S”. The most important curve is the lower, inward curve (the lumbar lordosis). This is maintained when sitting upright with your knees lower than your hips and when bending using your knees and not your back.
Low working heights and awkward flexed postures force the spine into a damaging crouched “C” shape. If poor postures are prolonged or repeated over time, muscle tension increases, and slipped/prolapsed discs and sciatica can occur.
Far reaching implications
Staff wellbeing, reduced staff absence and the prevention of ill health retirement are vital for the individuals concerned, their colleagues, the school, pupils and parents. Aside from the well recognised financial implications, it is important for pupils that teachers are fit and well at work, especially when working with pupils with SEN, who may rely more heavily on them for emotional support and physical assistance.
If staff are absent for any length of time, it can be unsettling for pupils, cause parental anxiety and put further pressure on colleagues.
Discomfort is frequently accepted as an inevitable part of the job and often not reported
Don’t suffer in silence!
Staff discussion should be encouraged – which activities contribute to or exacerbate back and neck pain within school? Discomfort is understandable but not acceptable long-term.
Workplace health and safety legislation is in place to protect employees. The head teacher and governing body are responsible for ensuring safe working practices, but they need to be alerted to ones which are not. Reporting is crucial; it is likely that if you are experiencing back pain, your colleagues will be too.
School heads should try setting aside INSET or staff meeting time to share experiences, and governors should also be involved. Injuries should be recorded in an accident book – even cumulative strain has an end point. Details should be provided of aggravating and causal factors, so that discomfort can be investigated, and either measures can be put in place to support the teacher’s role or activities can be altered. Discussion with occupational health professionals may also be needed.
Safer lifting and carrying
Many daily tasks involve manual handling, from furniture or equipment to pupils. Staff should receive regular training to ensure that current safe ways to lift, move and carry are understood and that risks can be assessed. Staff should be involved in pupil risk assessment where applicable. A manual handling policy can help reduce staff injury.
If a particular therapy or play activity is causing problems, teachers should speak to pupils and, where available, a school’s physiotherapist, to see if it can be adapted. Other simple rules to follow include, ensuring that storage sheds have portable or fixed ramps and, if carrying a single strap bag, the strap should be across the body and sides should be swapped regularly.
It is likely that if you are experiencing back pain, your colleagues will be too.
Whether sitting or standing, each workstation should be arranged to suit each teacher and task. This is often difficult when furniture is designed for children, therapy equipment is involved and space is limited, but it is possible.
Ergonomic equipment is available to promote good posture and simple adjustments can be made to existing workstations. Take time to get comfortable, take regular movement breaks and rest if aching. Ideally, stop before pain comes on.
Useful tips here include:
asking pupils or the school physiotherapist for class and dining room set-up ideas, as situations change throughout the year.
trying a high perching stool for prolonged standing, a specialist chair for low sitting (incorporating key features such as a wedged seat and height adjustable back support) and a wedge cushion for floor sitting
a height adjustable table can be used by pupils during the day and double up as a teacher’s desk and project table at other times.
We take our backs everywhere and healthy lifestyles help keep spines healthy. It is important to keep well hydrated and to exercise regularly to maintain or improve core strength and lower limb flexibility. The best practice tips for safer lifting and healthy workstations should also be employed at home.
Advice and guidance on maintaining healthy posture should be available from union’s health and safety representatives and, if back pain persists, medical attention should always be sought.
Lorna Taylor is a member of the Chartered Society of Physiotherapy, specialising in paediatrics, occupational health and ergonomics. She is also a professional member of BackCare, the charity for healthier backs, and a Director of Jolly Back Enterprises Ltd.