Christmas is busy enough without having to worry about back or shoulder pain. And yet every year I get a number of calls from patients saying they’ve hurt themselves carrying the Christmas tree, or heavy parcels, or even taking the turkey out of the oven. If I had to advise Santa on carrying a large number of heavy loads in one night here are the things I would want him to know:
At what point do people injure themselves during lifting and carrying?
In clinic most of the stories I hear are about people hurting themselves putting something down, rather than lifting it up. As we shuffle along, with fingers straining to keep hold of a heavy load, we may be desperate to just get it down. But putting something down involves muscles lengthening under load, and this is harder to control than simply contracting. Putting something down should be done with as much care and control as lifting it up.
So one of the first principles of lifting is:
1. Think it through first. 
- Plan out how you’re going to lift something.
- Think about how you’re going to put it down. Ideally, aim for a table or somewhere higher than the ground.
- Visualise yourself doing it: this causes the brain to fire signals to the appropriate muscles. As far as the brain is concerned thinking about an action is almost the same as doing it. This is a nifty way of priming your muscles for an important task and it’s a technique used in elite sports all the time.
In terms of actually lifting:
2. Bend your knees, not your back.
We’ve all been told to lift with our legs but the important point is to keep the back straight at the same time. To avoid hunching around the thing you’re carrying, try to stick your chest forward while lifting. Sticking your chest forward will fire up your back muscles and help protect your spine.
3. Turn with your feet, not your spine.
One of the most common forms of spinal injury occurs when bending down to pick something up while twisting at the same time. The spinal discs are made of concentric circles with strong fibres running in alternate directions. When you twist, half of these layers become tight and half of them are slack, so you only have half the support. Twisting is important for movement and we are designed for it, but when you twist while bending over and carrying a heavy load it can place a lot of strain on too few fibres and this may lead to injury. So if your oven is low down, and you have to drag a heavy turkey out of it, break the movement down into its component parts. First squat down facing the bird, then draw it out and stand up. Then turn and place it on the counter.
4. Keep it close to your body.
Holding an object close to your chest places less strain on your back. But bulky objects like a large parcel or a Christmas tree act like a long lever, placing higher forces on the spine even if the object isn’t particularly heavy. Holding some things close to your body can lead to a face full of pine needles, so this brings us to the final point:
5. Don’t be a hero
If it seems awkward, don’t be afraid to ask for assistance, even if it’s just from a little elf. Although this can be tricky if it’s a secret present for someone else in the house!
Have a great Christmas! I hope I don’t hear from you, but you know where I am if you need me.
Daniel
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