Preventing Gardener’s Trauma
After a long, snowy Michigan winter, the first warm and sunny day, we charge outside and clean up the yard. The months snow bound in the house have made the gardeners eager to start the spring clean up and prepare for the summer to come. Most of us will spend the winter in a fairly sedentary physical state and with no physical preparation to launch into hours of challenging outdoor work activity. Every year at our clinics, we treat patients with gardening and yard work induced injuries that could have been prevented with some modifications of activity and preventative exercise. These are my four hints to help safeguard my gardener friends from an unintended trip to the doctor’s office.
#1: Set a Time Limit.
Most of the patients we see with gardener trauma report that they worked “all afternoon” in the yard. It is not uncommon to hear patients report they were bending, pushing, or pulling for five or six hours. Use some caution and limit the duration of your weeding, raking, and shoveling. Set a time limit of two hours and then stop–the garden will be their tomorrow and you will be less likely to have to undergo a springtime MRI.
#2: Use Proper Ergonomics.
Many gardening tasks place your body in challenging positions. Ergonomic experts go to great lengths to eliminate forward trunk flexion and sustained knee flexion from industrial work settings. Pulling weeds and cleaning out flowerbeds combines both of these positions and can create mechanical back and knee pain. Avoid being in the “hands and knees” position for extended periods of time by changing positions frequently. Use knee pads to reduce compressive forces on the knee joints and purchase gardening tools with extended handles so that you need not bend as far or as often.
#3: Avoid Lifting Heavy Objects.
After a sedentary winter spent indoors watching television and knitting, the last thing you should attempt is to hoist the 40 lb. bag of fertilizer into the back of the wheelbarrow. Lifting injuries increase dramatically with loads greater than 25 pounds. Lifting any object from the floor to standing is risky, and carrying unstable loads that can shift around increases stress on the body. Divide heavy loads into smaller portions and avoid lifting directly off the floor. Get a bigger, stronger, and fitter neighbor or family member to help with heavy lifting tasks.
#4: Prepare For Battle.
Gardening and yard work are challenging tasks that should be met with a degree of preparation. If you want to work for five hours in the garden and remain pain free, you must train your body for that level of activity. I have selected three simple exercises you can do to get yourself ready for action in the yard. Simple modification of ergonomics, limitations on work duration, and preparatory exercise can prevent a summer of pain.
Getting Ready To Toil In The Soil.
These three exercises can help you avoid injury and make your spring gardening safer and more productive. Ideally you will perform these drills three times a week for two or three weeks before getting outside and working.
Hip Flexor Stretches
This stretch elongates the large muscle that runs across the front of the hip and attaches to the spine. This region tends to tighten with prolonged sitting and can restrict hip and spinal motion. Place one knee up on a cushioned chair and the other foot slightly forward on the floor. Keep the spine tall and bend the front knee to stretch the hip flexor muscles. Hold for five to ten seconds and repeat five times. Perform the stretch on the other side.
Four Point Fold Ups
If you are going to spend time on all fours, it is a good idea to train your body for this task. Assume a four-point position, knees under the hips and hands under the shoulders. Keep the hands stationary and drop the hips back toward the heels. Go back to the point you feel a stretch and hold–do not stretch into pain. You may feel this in your hips, shoulders, lower back, or upper back. Hold for five to ten seconds and repeat five times.
Gardening and yard work involves a lot of squatting. Being able to safely squat allows you to lift with better body mechanics. Simple bodyweight squats will strengthen the legs and trunk in preparation for these tasks. Place your feet at least shoulder width apart. Check the foot width with a full length mirror– most people squat with the feet too close together. Keep the heels flat on the floor and squat down by pushing the hips back. Work on maintaining balance and control during the motion. Practicing this movement pattern will also improve your flexibility. Perform a series of ten repetitions and then rest and perform another set of ten.
Michael O’Hara, PT, OCS, CSCS
Americans are far behind the rest of the world when it comes to the number of steps we take in a day. The body mass index numbers and mortality rates of our fellow citizens are rising in direct proportion to time spent seated. Human physiology operates optimally under the physical demands of a significant amount of standing and walking. Much of the now rampant obesity, heart disease, diabetes, and metabolic syndrome can be linked to our species sudden fall into sustained sitting. Standing for most of your workday and a daily habit of walking pays huge health and fitness benefits.
We are de-evolving into a nation of sitters. Between internet, television, driving, and computer work, it is not uncommon for many of my physical therapy patients and fitness clients to sit for ten hours a day. Unfortunately, you cannot train away the metabolic and physical damage created by prolonged sitting with a few 45 minute exercise sessions every week.
Seventy years ago, the London Transit Workers Study provided the initial scientific insights into the powerful health benefits of sitting less and standing more. Take the time to read the recent *article by Gretchen Reynolds in the March 23, 2017 edition of the New York Times. Ms. Reynolds’ provides some valuable information on the benefits of standing up and moving as much as possible. Now go for a walk and then Google Varidesk.
–Michael S. O’Hara, PT, OCS, CSCS
*Should 15,000 Steps a Day Be Our New Exercise Target?, Gretchen Reynolds, New York Times, March 23, 2017
The 2017 Australia Open Tennis tournament had an impressive finish. At the age of 36, Roger Federer became the men’s champion, and 35 year old Serena Williams defeated her 36 year old sister, Venus Williams to become the women’s champion. In the world of professional tennis, a mid-thirties champion is a rarity and to have it happen in both the men’s and women’s divisions is a sign of things to come. Rehabilitation and conditioning science have improved the results athletes can achieve in the gym. Athletes are staying healthier by eating better and training smarter. Take a look at some other recent examples:
Tom Brady, 39 years old. The quarterback for the New England Patriots will be leading his team in Superbowl LI. He is confident he can continue to compete for another five years.
Drew Brees, 38 years old. The starting quarterback for the New Orleans Saints feels he can play for several more years.
Kristin Armstrong, 43 years old. Won a gold medal in cycling at the Rio Olympics at the age of 42. This type of success is amazing in a competition that greatly favors youth.
Dara Torres, 49 years old. This twelve-time Olympic swimmer medallist competed at 41 years of age and won a silver medal in three events at the 2008 Summer Olympics.
Oksana Chusotivina, 41 years old. Oksana is gymnast from Uzbekistan that competed against teenage gymnasts at the Rio Olympics.
Meb Keflezighi, 40 years old. Competed in the Marathon at the Summer Olympics in Rio.
These performances illustrate how proper training and nutrition can produce a high level of performance in athletes thought to be too old to compete. We are all going to get older. It does not mean we are going to get weaker, slower, and more sedentary.
Michael S. O’Hara, PT, OCS, CSCS
Stand Up, Walk Around, And Read This Article
I have been ranting about how damaging hours and hours of sitting is for our fitness and overall health. More research is validating my belief that all the driving, computer time, and television watching is going to keep physical therapists, cardiologists, and surgeons working overtime for the next twenty years. It appears that going to the gym three times a week is not enough of a stimulus to counteract the bad that happens when you sit for eight hours a day. What we need is more general physical activity interspersed throughout our day and less sitting. Take the time to read this article, The Marathon Runner as Couch Potato written by Gretchen Reynolds from the New York Times, October 30, 2013.
Michael S. O’Hara, P.T., OCS, CSCS