Prevention begins with good posture and body mechanics. Like our mothers told us all when we were children, "stand up straight," "don't slouch in that chair," you know the routine - and she was absolutely correct. Those of us who ignored mom should take her advice now. In addition to posture, mechanics while bending or lifting is crucial to a healthy back. When bending, the movement should be from the hips, with the buttocks projected rearward (i.e., stick your butt out), and keep your back flat. Actually "flat" means "neutral - that is, in the same orientation as when you are standing normally - erect, head up, eyes forward, palms toward each other, and maintain the normal curves in the spine. There is a backward curve to the thoracic spine (chest cavity), and a slight forward curve (also called "slight lordosis") to the lumbar spine (lower back). Do the best you can with these positions - your back will thank you. Two additional topics need to be addressed here that are important to back wellness: lifting and sitting. Constant body awareness is important. One small postural "mistake" can be the proverbial straw.

When lifting, it is important to use your legs. Keep your shoulders above your hips, lift heavy objects close to your body, and keep "squared up" - don't bend sideways to lift, if you can avoid it.

When sitting, pressure on spinal discs is greater than when either standing or lying down. This may seem contradictory, but when sitting, postural muscles, tendons, and ligaments are more relaxed, putting greater stress on the spinal discs. A sore back resulting from standing is typically from muscle fatigue and not spinal pressure. To help reduce spinal disc pressure from sitting, one should try the following:

1. Don't sit for more than 20 minutes; get up and move around periodically, or just stand up for a few seconds.

2. Sit on the front edge of your chair, feet flat on the floor, and with the normal lumbar curve maintained.

• Chairs should have lumbar support that maintains the slight lordosis of a normal, healthy back.

• Chairs with armrests also help reduce disc pressure.

• Keep your knees apart; a close knee position encourages slumping.

• Your chair/desk arrangement should allow your forearms to rest on the desk, elbows at a 90 degrees angle, and close to your sides - this position reduces stress on your upper back (trapezius muscle).

• If you work with a computer monitor, keep it at eye level - helps prevent rounded, slumped forward position.

• If you do have to look down, try to keep your neck erect and just rotate eyes downward whenever possible.

STRETCHING EXERCISES

1. Stretch the lumbar Erector Spinae muscles by lying on your back and pulling your knees toward your chest (your hands should be clasped behind the knees) until the tail bone is lifted off the mat. This may be done one leg at a time, or both together. The single leg movements may be done diagonally.

2. On your hands and knees, tuck in your stomach (suck it up) without rounding your back.

3. From a prone position (stomach down) with hands under the shoulders, extend your elbows and lift your chest up off the mat, but with the pelvis remaining on the mat. This stretch is called a Prone Pressup.

4. From a hands-and-knees position, alternate tilting the pelvis anteriorly (front) to posteriorly (back) - slowly back-and-forth. Keep the movement in the pelvis and lumbar spine - not the thoracic spine.

ABDOMINAL Muscle Exercises

• Front Crunch - From a supine (on your back) position with knees bent, curl your shoulders up off the mat, squeeze your abdominal muscles, hold momentarily, then slowly lower your shoulders (only your shoulders and upper back should clear the floor), but don't let them touch the mat before starting up again (keep some tension in the muscles throughout the set). Keep your eyes looking up at about 45 degrees, don't let your chin touch your chest. There are three optional arm positions that are applicable to all types of crunches and situps: 1) with straight arms, press your hands between your knees as your shoulders rise, 2) fold your arms across your chest as you rise, or 3) hold your arms straight overhead as you rise. These arm positions change your center-of-gravity, hence the difficulty of the exercise. Note that in the hands-behind-the-head position, the elbows should be pointed out to the sides. That position lets your hands support your head, but without letting you pull on it.

• Diagonal Crunch - From the same starting position as above, as you start your upward movement, one shoulder is moved toward the opposite knee. This movement works the Internal/External Oblique muscles on the sides of the abdominal cavity. You may alternate from side-to-side, or you can do a set on one side and then switch to the other. Do 10-50 repetitions (or 3, if that's all you can do).

• Reverse Crunch - From a supine position, with hands under your hips, thighs vertical, and knees bent, curl your pelvis until your tailbone comes up off the mat. Then return to the starting position. This movement focuses on the lower area of the abdominals (Rectus Abdominus muscle), as opposed to the front crunch which stresses the upper abdominal area. Do 10-50 repetitions, or ???

• Double Crunch - From a supine, bent knee position, simultaneously curl your shoulders/upper back off the mat, as you curl your tail bone off the mat. The movement is as if you were going to touch your chest to your knees. This works both the upper and lower areas of the Rectus Abdominus. Do 10-50, or ???

• Back Extension - From a prone position, hands at your sides, behind your head, or above your head; raise your head and chest off the mat and hold for about 10 seconds, then return to the mat. Repeat 5-10 times. This a fairly gentle exercise - can be good for someone with a bad back history. It will tone and strengthen weak back muscles (Erector Spinae group, in particular). This exercise can also be done by raising the legs, instead of or in- addition-to, the trunk. This exercise should be used to finish an abdominal exercise session - balance, remember.

• "Good Mornings" - This interestingly named exercise is typically done from a standing position with a light barbell across the meaty part of one's shoulders/upper back, behind the neck, obviously. The bar can be an unweighted bar, dumbbells, a broomstick, or nothing at all, or ??? depending on the state of your back and the availability of equipment. Bend from the hips until your trunk is parallel to the floor, then straighten up. Maintain a "neutral" back and neck. Try to do 10 repetitions, and keep the legs straight, but the knees "soft."

• Dumbbell Dead Lift - Standing erect with dumbbells held in the pronated hand position, bend forward from the hips, as for "Good Mornings," but bend as far as you can while still maintaining a neutral back position, and straight legs. Your arms should be hanging straight, toward the floor. Then slowly stand up. Do 10 repetitions.

• BREATHE - don't hold your breath while exercising. During weight training, exhale on exertion, inhale on return to starting position.

• CONTROL - don't allow momentum to take over any stretches or exercises. Control the movements.

• NEUTRAL POSITION - Be especially mindful of maintaining the slight lordotic position of your lumbar spine (start with and maintain a pelvic tilt), and keeping your neck in-line with your trunk (i.e., if you are bent over 90 degrees, you should be looking at the floor).

• "SOFT" KNEES - Even with straight legs, your knees should not be "locked." Keep them slightly relaxed - "soft."

• If You Feel Any PAIN, STOP!