posture

Doing Dishes With Back Pain: Strategies for Success

For most of us, doing the dishes is not exactly the highlight of our day. For those of us with back pain, this chore can be daunting, uncomfortable, or even seem impossible. There are many strategies that can help this task become possible, manageable, or even easy. A lot of this comes down to our posture and movement patterns, our attitudes, and our willingness to break down the task into chunks.

Posture and Movement Patterns

How we hold ourselves can make a big difference in how our bodies feel. Being in a forward bent position for a long time puts extra strain on the back. Because the dishes are down and forward, it is easy to find yourself in this slumped position, but it is possible to do it differently!

  1. Position yourself for readiness:

The closer you place your body to the sink, the shorter the lever arm is that your body has to hold. In other words, if you’re holding a heavy pan far away from your body, this is a lot more work on your back than holding the pan close to yourself. Just wear an apron so your clothes don’t get wet! 

You could also bring the dishes closer to you by using two dish pans. One on the bottom, and the other one upside down which would bring everything up closer to you. This will allow you to wash the dishes a little higher, and not have to bend down as far to scrub dishes at the bottom of the sink. A long handled scrubber may also be helpful.

2. What’s under your feet?

Think about your feet, as you are holding your weight through your legs as you stand. Try standing on a soft cushy pad to help spread the forces coming up from the ground.

Another strategy is to have one foot placed on something, such as on a stool, or inside the cabinet that is in front of you. Every so often, switch which foot is elevated. This will both keep you more upright, and allow your legs to alternate sharing the load. However, the downside of using a stool is that it brings you further away from the sink. This makes it all the more important to elevate the dishes by using two dish pans, as described in #1 above. 

Notice that this individual in the left-hand picture does not need to be bending from the waist in order to see the dishes. This position causes the back to work harder than it needs to. This person should instead be looking down at the dishes by tipping just their head, not their whole back. 

3. Dishwasher strategy:

Use the automatic dishwasher as much as you can. Believe it or not, this actually saves water! However, loading and unloading the washer can be troublesome for many with back pain. At the Wellness Station, we can teach you how to optimize your body mechanics for success based on your individual characteristics.

Generally speaking, try to position yourself as close to where you are putting the dish as possible. In other words, don’t try to reach and crane to the far corner of the bottom rack holding a heavy plate! Walk around to the side, send your bottom back, and place each dish with ease. In other words, keep your center of mass (your pelvis) over your base of support (your feet) so that when you reach forward, you can counterbalance by sending your bottom back. This is something we can teach you to do effortlessly at the Wellness Station.

Attitude and Mindset

If we see dishes as a cumbersome chore, it will continue to be so. How can we change our attitude and mindset relative to this task to make the most out of it?

  1. Mindfulness:

Don’t have time to meditate? Make doing dishes your meditation. Pay full attention to your experience. Notice the sensory information coming from the splashing water. Notice your fine dexterity skills required to grasp and scrub. Relish in the small dopamine hit from each completed dish, and the sense of accomplishment from finishing the task. Feel gratitude for having food to eat, dishes to use, and modern technology to support the ability to feed yourself and your loved ones.

2. Bring the joy to the experience:

If mindfulness isn’t cutting it, what else can you bring to the experience? How about playing your favorite music and making it into a dance? Listening to your favorite podcast to educate yourself while you work? Or perhaps rewarding yourself upon completion with a tasty snack or self care routine. 

Breaking it down

Many of us can’t tolerate dishes because of the amount of time spent standing. If the above strategies are not helping as much as you would like, consider breaking down the task into chunks and taking movement breaks.

  1. Break into chunks:

Rather than trying to push through and finish dishes as quickly as possible at the expense of a sore back, how about breaking it into chunks? Unload the dishwasher, sit down. Load the top rack, sit down. Load the bottom rack, sit down. Wash the pots and pans, sit down. Remember the lesson of the tortoise and the hare! If sitting down is not necessary, or even preferable, consider moving about with other household responsibilities and coming back to washing dishes later. 

2. Movement breaks:

Try incorporating some gentle movement breaks into your dishwashing routine. It might be helpful to do movements that incorporate the opposite movement of your body. As doing the dishes involves some bending forward with your arms in front of you, how about some bending back with your arms behind you? Here is a movement break that are great for incorporating into your dishes routine: Hip and Shoulder Extension

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Posture Part I: Does It Matter?

Posture is an extremely complex and nuanced subject that often gets oversimplified into “good” and “bad” posture. What is posture, and is there such a thing as good or bad posture? How much does posture matter when it comes to comfort, function, and overall well-being? 

Posture vs Acture

There is no one “correct” posture, as our bodies are dynamic, and it is literally impossible to stay in the exact same position if we are alive and breathing. The position that we are in depends largely on our environment and situation in real time. Moshe Feldenkrais encourages paying attention to dynamic posture rather than static posture. Feldenkrais uses the word “acture” as an alternative to posture, which he defines as the “ability to move equally easily in all directions without additional preparation for action”. This action-oriented word is perhaps a better description of human function compared to considering static posture. Our nervous system should allow us to be adaptable, changing our position quickly and easily depending on the demands of our environment. To achieve this, we need efficiency. It is not efficient for us to hold unnecessary tension in our backs to achieve an arbitrary “correct” posture, as this tension uses energy, is uncomfortable, and does not allow movement in any direction at any time. It places excessive and unnecessary forces across joints causing joint and tissue stress. Living in the other extreme of a slumped, folded-in posture is also inefficient, as this limits our readiness for action and can decrease spinal mobility over time. A sign that the posture (aka acture) that you are in might be inefficient would be the development of discomfort after sitting, standing or moving about for a while, indicative of musculoskeletal strain.

“Good” vs “Bad” Posture

A lot of our ideas about posture come from society, our parents, even teachers at school. “Stand up straight, shoulders back.” “Don’t slouch.” Beliefs like this cause us to work hard to try to keep an artificially straight spine, which we associate with “good” posture, and as soon as we stop paying attention to it we will slip right back to where we were. Our spine is not meant to stay in one effortful position for a long time, as this requires certain muscles to be working hard to maintain the position, thereby limiting our acture. Rather than muscles having to tense to maintain our posture, our spines should be able to “stack”, like a column of blocks with minimal muscular effort. When that is the case, each of our bones can receive support from the bone from below, rather than relying on muscles to maintain posture. (It should be noted that the spine is not exactly like a straight column of blocks, as we have a natural curvature inwards at the low back and neck, and outwards at the mid/upper back). Unfortunately, many people begin to lose this effortless stacking, and more effort becomes required to find an upright carriage. 

As we age, many of us begin to adopt a forward flexed posture known as kyphosis, characterized by an exaggerated rounding particularly of the thoracic spine. This condition and associated loss of spinal and rib cage mobility, contributing to increased strain on the musculoskeletal system and thereby impairing functional mobility (e.g. balance and agility, reaching overhead, turning with ease, lying prone). Kyphotic posture can even compromise our respiration, making it difficult to breathe deeply and effortlessly. This forward flexion is what many people consider to be “bad” posture. These changes happen very slowly over time, and sometimes we don’t realize it until we see a photo of ourselves perhaps at a wedding, or someone we haven’t seen in a while makes a comment about our posture. The posture in the moment is not what is “good” or “bad”, but the issue lies much deeper than surface level in how we developed habitual postures over time, and if we have lost the ability to effortlessly achieve different postural options.

Posture and Pain

Many people associate their pain with their posture, or their posture with their pain. The chicken or the egg relationship may be unclear in many cases- are we adopting a posture because we are in pain, or are we in pain because of our posture? The relationship between posture and pain is extremely nuanced and depends on many individual factors. However, the relation is clearly present and worth investigating for those of us with pain influenced by prolonged sitting and standing. Check out this research study to learn more about how postural awareness and pain are related. The researchers found a clear association between self-reported postural awareness and clinical symptoms in people with chronic spinal and shoulder pain. In conclusion, they found that improvements in postural awareness facilitated by participation in activities including mindfulness training, yoga, and qi-gong were longitudinally associated with reduced pain.

Inefficient Postural Tendencies: How did we get there?

It is not the posture itself that is good or bad, but rather how we got there. A person who spends some time slouching is probably not harming themselves in the moment, unless pain is present. However, is slouching the new normal, with spinal stacking no longer feeling easy and natural? Does slouching become the only option as time goes on and the joints and tissues become habituated to this set point? Is posture a source of frustration and having a negative impact on confidence and self-image? Is the habitual posture associated with pain, discomfort, impaired breathing, and a decline in functional mobility? If so, the posture has become a problem. 

Dysfunctional postural tendencies can happen over time, and can be influenced by many factors. Some people tend to gravitate towards certain postures more on a subconscious level, based on their own personalities, confidence in their bodies, insecurities, histories of trauma, lack of body awareness, and internalized societal norms. Other factors that can contribute are our society’s lack of celebration of embodiment, comfort, and regular mindful movement, and tendency towards encouraging productivity above all, disconnection from our bodies, and sedentary behavior. Additionally, our life is becoming increasingly lived within the context of an extracorporeal two-dimensional world that is situated below and in front of us, thereby facilitating a forward-flexed posture (smart phones and computers). Over time, our physical structures and nervous systems become very much habituated to our go-to postures, creating a negative feedback loop that makes it increasingly more difficult to achieve a variety of efficient postural options.

Where To Go From Here?

To answer the question of Does posture matter?, the answer is certainly yes. However, posture can not be simplified to good vs bad, as such a complex subject requires multifactorial considerations. Becoming more cognizant of your habitual postures and implementing strategies to improve your body awareness, movement hygiene, joint mobility, and sitting strategies can all be very helpful in improving posture or preventing postural decline. Tune in to the next blog to learn some practical strategies to bring into the rhythms of your life.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team