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Say you love gardening, like Boston-based landscape designer Barbara Quartier in the video above. Say you, like her, find that your happy toil is tinged with dread, with the foreknowledge that one of these days, you’ll be pulling at a recalcitrant weed or hefting a heavy pot and boing: There goes your back. Or your knee. Or your neck. But you get carried away in the absorbing process of earthly beautification. You take chances you know you shouldn’t. What’s a gardener to do?
I asked Dr. Sharon Bassi of New England Baptist Hospital, which specializes in orthopedics and spine care, and she responded with evidence- and experience-based wisdom that diverges surprisingly from the usual folk wisdom. You know the usual maxims: Above all, bend your knees when you lift. Avoid prolonged repetitive movement without breaks. Know your weight limits.
All good pointers, Dr. Bassi says, but her central message, based on research and countless encounters with injured patients, is this: Strengthen your core, particularly your back muscles. Studies and experience suggest that matters more than specific postures.
Her advice, lightly edited:
“Many people feel that they have to lift a certain way or bend a certain way or not carry excess amounts of loads. But the reality is that it’s different for each individual, and a lot depends on how strong you are at baseline. One of the key pieces of our bodies that we fail to strengthen is the spine.
We talk about core strengthening a lot, about getting the abdominal muscles strong. But in parallel, the muscles that are less often talked about are the para-spinal muscles, and there are many of them: There are very tiny ones that hold the joints together, and there are larger ones that really help stabilize your back. And those are the muscles that we need to focus on a lot. In people who present with back strain or pain, we talk about core but we talk equally about getting the para-spinals in the back very, very strong, because that’s what helps holds you erect, that’s what helps to prevent sprain and strain injuries.
It’s especially important in people who are doing prolonged periods of gardening, or any type of prolonged activity — almost every activity involves your spine to a certain degree — that in parallel, those individuals strengthen those two key components. That will help prevent a lot of injuries and allow you to do almost anything in any comfortable posture and lift many pounds of weight without worrying about injuring your back.
So I think this whole notion of correct biomechanics — like bending from the knees — is really a little bit over-rated, and a little bit over-talked-about. We see plenty of people who have injuries having lifted in what is considered an ergonomically correct posture. And we don’t have great studies that show that by lifting in that manner you’re going to prevent an injury. We have more studies telling us that if we strengthen, that we can pretty much lift however we want, however it feels comfortable, because we will inherently be engaging the right muscles.”
(Here both Barbara Quartier — who goes by Barbara Peterson in her landscape design business — and I expressed some shock. We’d heard forever about bending our knees, but never a word about our para-spinals.)
“It really is a common misbelief,” Dr. Bassi responded. “We see patients who say, ‘I knew I lifted this wrong, and that’s why this happened,’ but that’s not necessarily true.”
So the question instantly arises, of course: How to strengthen those para-spinal muscles?
Dr. Bassi: “One of the things we do at the Baptist, one of our main protocols as part of our Physical Therapy program, is getting people on specific back-strengthening machines. You see these machines in a lot of gyms: One of them is the back extension machine. Incrementally, every time people come for their physical therapy session, we increase the weights, because we know that increasing repetition and increasing the weight is how you build muscle mass. So every time they come for their session, you build up their muscle mass to specific goals and weights.
We also have a rotatory torso machine, we do lat pulls, and we actually have our therapist filling up crates with weights, and we having people lift those crates — not necessarily in any type of posture, but just lifting the crates and putting them on shelves, in a repetitive manner and with incremental weights over time to build up all those key muscles. It’s a very deliberate method of actually building up those muscles.”
Thinking about setting up a crate-stacking workout at home? Better, perhaps, to check out these New England Baptist Hospital pointers on strengthening the spine:
And one additional note from Dr. Bassi: “A lot of what happens in your spine is genetically predetermined. A lot of the degeneration that we see, or arthritis, has a genetic component to it. Everyone’s substrate is a little bit different – genetic, as well as lifestyle and co-morbidities, like being diabetic, overweight, inactive, having high blood pressure, high cholesterol, smoking — all those things indirectly do affect your spine health. Those things are actually more significant risk factors than anything that you would probably be doing during your gardening.
Readers, thoughts? Personal note: I just hunted down the back extension machine at my gym and used it for the first time. Kind of pleasant…