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Body Mechanics and Positioning

Range of Motion

     When someone cannot move their joints and muscles, potential complications can develop. Lack of movement not only causes pain from stiffness, but prolonged lack of action can cause the joints to freeze in the position they stay.  A contracture forms, and once formed, it usually stays permanently and reduces the use of that limb. 

 

     Range of Motion (ROM) helps prevent contractures, which is when the muscles and joints of the body shorten and freeze into a permanent position due to lack of use. When a contracture develops, it can become excruciating and debilitating because the limb can form into a very awkward position that does not allow for any genuine usefulness. Range-of-movement helps improve circulation and nutrition to all joints and tissues, thus preventing contractures. 

 

     What are range-of-motion exercises?  Just what they say.  You move each joint in all the directions it will go a few times.  It’s gentle movements that start small and gradually get bigger and bigger until the joint has fully expanded to its best potential. You do that 3 or 4 times for each joint arm, leg, foot, hand, finger, toe, knee, elbow, shoulder, hip, ankle, and wrist. The video below demonstrates how to do a full ROM run-through. 

 

Range of Motion Exercises

https://www.youtube.com/watch?v=iDUCgZK7ckE

 

 

BODY Mechanics

     Knowing and using proper body mechanics helps you avoid hurting yourself.  One wrong move could give you a lifetime of pain and suffering.

 

*BODY MECHANICS  ABC’s
A- Adjust Equipment Height

     Adjust the height of any equipment you are using to allow you to work at a comfortable level. If you are giving care to someone in a bed that raises, you want the bed at waist level.  If you get the person out of bed, you want to lower the bed to the hip level. 

 

B-Bend your Knees

     With your feet shoulder-distance apart, bend your knees and move in close to the object you want to lift.  Staying low and centered helps you to maintain a better balance and distribute weight evenly.

 

C – Center of Gravity

     Keep your base of support wide and stable. That means keeping your feet about shoulder-distance apart. To find your center of gravity, draw an imaginary line from your head through your body to the ground.  It should end up halfway between your two feet. That’s your center of gravity. 

 

S-Straight Line

     As you move, try to keep your body in a straight line rather than twisting.  Do this by moving your feet instead of twisting or bending at your waist. Learn to keep your back, neck, pelvis, and feet in alignment and focus on keeping what you are doing directly in front of you.

 

*Resource: Lippincott Nursing Procedures (2019) (Eighth Ed.) Philadelphia: Wolters Kluwer. 83

Sample videos

Proper Body Mechanics

https://www.youtube.com/watch?v=zYF5BZyD6nE

Body Mechanics

https://www.youtube.com/watch?v=4d4WeQvdxJg

Tips On Helping Someone Who Is Too Weak To Stand Up

  • Have them pull their feet back under their knees and lean forward as they attempt to stand. 
  • Stand to the person’s side. Have them lean forward from the waist as they start to rise. If they have a gait belt on, you can insert your hand underneath the belt as they lean forward and help lift them upward if they need assistance.
  • Encourage them to push against the chair’s arms as they attempt to stand rather than reach for their wheelchair or walker.  Have them come to a complete standing position before reaching for their walker.  Pushing downward gives them more stability than reaching out for something. 
Safe Body Mechanics for Resident Transfers

https://www.youtube.com/watch?v=H96dlMJllhI

Using Proper Positioning to Prevent Skin Breakdown and Help with Immobility

     The best rule of thumb when positioning to prevent skin breakdown to use pillows or towels wherever bones rub against each other or the bed.

 

     Your goal is to

  • allow air to flow freely around the body so that you don’t get moisture build-up from too much heat; 
  • you don’t want friction wear and tear on the skin that causes the skin to rub off,
  • and don’t cut off any areas of circulation.  

 

     Below are three videos that show good examples of how to position someone properly to prevent bedsores/pressure ulcers, as well as, provide them comfort.

 

Positioning Lateral & Supine  

https://www.youtube.com/watch?v=eJESfPA4NWM

How to Turn and Reposition an Immobile Individual in Bed

https://www.youtube.com/watch?v=3Z7gU9G5UVg

How to Position Someone on their Side

https://www.youtube.com/watch?v=JWPljgPSjrk

How to Perform Proper Body Mechanics

*How to Push and Pull Correctly

1. Stand close to the object and put one foot slightly ahead of the other. Tighten all your lower body muscles (legs, pelvis, abdomen, and butt)

2. To push, put your hands on the stable part of the object and bend your elbows, lean into it by shifting your weight from your back leg to your front leg, and apply steady pressure.

3. To pull, grasp the object as you bend your elbows and lean away from it, shifting your weight from your front leg to your back leg. Pull smoothly, avoiding sudden, jerky movements.

4. Once it starts moving, keep it going. Stopping and starting to use more energy.

 
Stooping Correctly

1. Stand with feet about 10-12 inches apart and one foot slightly ahead of the other given you a broad base of support.

2. Lower yourself by bending your knees, placing more weight on your front foot than your back foot. Keep your upper body straight by not bending at the waist.

3. Straighten your knees and keep your back straight as you stand back up.

 

Lifting and Carrying Correctly

1. Following the process for stopping in front of an object.

2. Grasp the object and tighten your stomach muscles.

3. Stand up by straightening your knees, using your leg and hip muscles. Keep your back straight. Keep the object close to your body.

4. Carry the object close to you at waist height to avoid straining your back muscles.

 

Additional Considerations

1. Wear low heels, flexible nonslip shoes, and closed backs to prevent accidents from slips and falls.

2. When possible, pull rather than push because the elbow flexors are stronger than the extensor muscles. Pulling an object allows the use of hip and leg muscles and avoids the use of lower back muscles.

3. When doing heavy lifting or moving, use assistive or mechanical devices when possible.

 

*Resource: Lippincott Nursing Procedures (2019) (Eighth Ed.) Philadelphia: Wolters Kluwer. 83

Caregiver Marketplace Check out links to products recommended to help caregivers cope with the challenges of caregiving at home. Ideas are available on everything from positioning to self-help booksmobility devices, to skincare.