For the past 25 years, I have had an interest in the field of ergonomics. During most of that time, I have felt that there is a great deal of similarity between ergonomics and chiropractic.Both disciplines are based on some common themes:
- The whole is no better than the sum of its parts.
- Health problems have a multicausal nature.
- In order to solve problems, you have to identify the cause, not just eradicate the symptoms.
In other words, both disciplines are holistic in their approach to health problems. In addition, my experience tells me that most folks don't clearly understand what either profession has to offer. Both are clearly misunderstood.
I recently ran across another interesting connection - ergonomics and spinal stabilization. I am currently working my way through a book that I just acquired, Therapeutic Exercise for Lumbopelvic Stabilization, by Carolyn Richardson, Paul Hodges and Julie Hides. This is the second edition of this very interesting text. It expands on some of the thoughts, ideas and techniques that were presented in the first edition, published only five years earlier. It's amazing how much research has been done in such a short period of time. The work that these authors and others have done in the area of neuromuscular contributions to spinal stability has revolutionized the way that we look at low back pain. It seems that these days, almost everyone is utilizing some form of spinal stabilization approach in their management of patients with low back pain.
While the spinal stabilization movement is not a magic wand, and is not likely to eliminate back pain from our modern world, it does provide us with a very interesting approach that we can add to our treatment methods. As an aside, it's probably worth noting that while the research database supporting spinal stabilization procedures is new, many of the exercises used in the spinal stabilization protocols have been around for many years. One only has to look at the work of Joseph Pilates to appreciate that strengthening the core muscles is a technique that has been popular for a long time.
At any rate, in their new text, Richardson and her fellow authors discuss the important role of the muscles in providing protection to the spine. They state that there are two broad approaches for improving this spinal protection role. The first involves reducing forces that may be applied to the lumbar spine during various functional activities. The second involves ensuring that the muscle system is coordinated appropriately to optimize control of all of the elements involved in lumbopelvic control. This involves paying attention not only to the muscles, but also to the neural control elements.
With regard to the first method (i.e., reducing forces on the lumbar spine), the authors point to several ways that this may be accomplished during everyday and work-related activities. As you might have guessed, one of these involves ergonomics. In fact, the authors state, "The study and practice of ergonomics has increased knowledge and helped to establish suitable working postures, lifting techniques, and furniture design, which are essential in decreasing joint forces potentially harmful to spinal structures." With this in mind, it would seem that at least a basic working knowledge of ergonomic principles should be a vital part of the tools of any practitioner who is interested in promoting spinal health.
I'm curious to know what you think ergonomics is. Also, what training, if any, should chiropractors have in order to provide ergonomic advice?
Paul Hooper, DC, MPH
Diamond Bar, California
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