This is an excerpt from Clinical Guide to Surface Palpation 2nd Edition With HKPropel Online Video, A by Michael Masaracchio & Chana Frommer.
The body mechanics of the practicing clinician is an extremely important concept. It not only protects the clinician from potential injury but also aides in proper positioning between the patient and clinician to improve structure identification and treatment. Proper body mechanics will not only help the clinician work more efficiently but also aid the clinician in applying the appropriate force during examination and treatment. It is important to be constantly mindful of the stresses being put on your body. Always strive to be as efficient as possible (e.g., using gravity, using larger muscle groups, aligning the forearm when applying force) when performing techniques, and minimize trying to “muscle through it.” The following are techniques to consider for manual assessment and intervention.
- It is important to make sure the height of the table is correct. This allows for appropriate application of desired forces. For example, a downwardly directed force is one of the most frequently used, and one needs to make sure that force is perpendicular to the tissue. Often, students and novice clinicians place the table too high, which leads to inefficient application of forces in addition to poor movement patterns on the part of the clinician (e.g., hiking the shoulder, too much elbow flexion). This often results in excessive firing of muscles, which will cause fatigue during treatment. Conversely, if the table is too low, there is a tendency to adopt a position of lumbar spine flexion (as opposed to neutral), putting the clinician at increased risk of developing low back pain.
- It is important to understand the concept of a hip hinge and its role in a healthy back. Proper hip flexion rather than thoracolumbar flexion should be maintained (figure 1.4). The lumbar spine should be in a natural lordotic position. Excessive or insufficient lordosis can create excessive forces through the lumbar spine, which may increase the likelihood of injury.