A central resource for individuals with congenital or aquired limb loss, their families, carers and healthcare professionals
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Posture

Posture is the position of your body at rest and during activities. Maintaining good posture and taking care of the back is important for everyone, but especially for amputees to prevent back problems. Arm amputees must have strong back muscles to help them support an artificial limb and to get the best use from it. For leg amputees, using an artificial leg places extra strain on the remaining weight-bearing leg and on the back.

Poor posture is something most of us find easy to achieve without trying. Modern day living and its activities such as carrying heavy laptops or bags over one shoulder, watching television and sitting as a desk all day, has led us into bad habits.

For both arm and leg amputees, back muscles work harder to enable the amputee to use an artificial limb or to compensate for a missing limb. Good posture is something we have to work hard at; more often than not it requires a conscious effort to stand tall, or sit without slouching in a chair.  Good posture is not only beneficial to our health, but has the added bonus of improving our physical appearance.

TIPS FOR GOOD POSTURE & BACK HEALTH

If you slump while sitting, your head (which actually weighs about 5.5 kilograms) exerts a weight of approximately 16 kilograms on your neck and back! This extra weight means that the muscles in your neck and back have to work much harder and tire more quickly.

Good posture does not mean standing to attention – you should instead hold your head high with your chin tucked in as far from your feet as possible. This will straighten your entire back including the neck area.

  • Swayback, a condition where the top of the pelvis leans forward, is an example of poor posture. It causes the muscles, ligaments and other back tissues to become shortened and tight. Good posture can be achieved by tilting the pelvis upward and backward, thus reducing, or flattening the curve in the lower back.
  • When seated, ensure that the lower back is flat or slightly rounded outward never with a forward curve. This position can be ensured by having the knees a little higher than the hips.
  • When lifting objects, bend your knees, going down as far as possible with the legs, not the back. Hold the object close to your body. Lift with your legs, using the large muscles of the thighs, rather than the small muscles of the back.
  • The best position for sleeping is on your side, both arms in front, with your body partially curled. Sleeping on your stomach should be avoided because it increases swayback and strains various tissues. Sleeping on your back should also be avoided unless your legs or knees are supported in a raised position. A firm mattress also greatly improves your back position while sleeping.

Standing

  • Maintain a neutral alignment to your spine
  • Avoid slouching forward or hyperextending
  • Keen chin up with your head centred over your shoulders
  • Keep your feet should width apart
  • Have your knee (knees) slightly bent, “soft knees”
  • Avoid standing for long periods of time

  • Change your standing position every 20-30 minutes, sit or move around

Standing Tips

  • Wear flat shoes, shoes set at the wrong heel height may cause back pain
  • Stand “tall”
  • Tuck your stomach in

  • Strong abdominal muscles and strong spinal muscles combine to support and strengthen the back

Sitting

  • Keep back straight, knees bent, with head centred over your shoulders
  • Ensure the seat has a back rest, which provides good lumber support
  • Keep a slight gap between the back of your bent knee and the edge of the seat
  • Position seat height so that feet are fairly grounded on the floor
  • Use a footrest if your feet do not reach the floor comfortably

  • Take a mini break every 20-30 minutes, get up and walk around
Sitting Tips

  • distribute your weight evenly over both hips. If you are not sure you can always ask to visit the gait lab at your rehab centre, if they have one
  • do not cross legs
  • adjust the chair height so your arms rest at right angles to your workstation
  • where possible use ergonomically designed equipment
Driving
  • adjust your seat until feet comfortably reach the pedals

  • ensure legs are supported by seat with a gap between the back of the knees and the edge of the seat
  • keep shoulders relaxed, with arms slightly bent and head upright
  • backrest angle should be comfortable, but not too reclined or too upright

  • ensure backrest supports your back
Driving Tips

  • position the bottom of headrest so that it is level with the base of the skull
  • break your journey 1-2 hours
  • use a lumber roll or rolled up towel at the base of your spine if you feel you need extra lumber support
  • don’t grip steering wheel too tightly
  • remove bulky restrictive clothing before driving

  • position your seat so that you have good all round visibility

Don’t:

  • attempt any manual handling task unless you feel that you are able to do it safely
  • handle loads above shoulder height, or in cramped working areas
  • bend, twist, or stoop unnecessarily
  • overload trolleys so that your vision is obscure
  • use equipment that is faulty or if you are unsure how to use it correctly
  • wear clothing/footwear that could limit your range of movement or compromise your balance when working or carrying out any moving or handling action
  • stand, sit, or maintain one position for too long, instead take a short break every 20 minutes
  • do not twist at the truck, use your feet to turn

Simple back exercises can improve an amputee’s comfort and ability to function, and prevent future problems. Again, you should consult your rehab consultant or GP before starting a new exercise program.