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NUESTRA ESPALDA

Las causas del dolor de espalda son múltiples y sabemos que ésta es una patología muy frecuente, es fácil comprender la importancia de adoptar unos hábitos posturales correctos, y adecuar el estilo de vida para prevenir el mencionado dolor. Es fundamental, por tanto, conocer los hábitos posturales dañinos para nuestra columna, a fin de ser evitados; así como aprender y practicar aquellos otros que actúan de forma protectora.

En general, LA COLUMNA SUFRE PRINCIPALMENTE:

  • Cuando nos mantenemos mucho tiempo en la misma posición, ya sea de pie, sentado o acostado.
  • Cuando adoptamos determinadas posturas que aumentan sus curvas fisiológicas.
  • Cuando realizamos grandes esfuerzos, o pequeños, pero muy repetidos.
  • Cuando realizamos movimientos bruscos o adoptamos posturas muy forzadas.

Comentaremos a continuación, las Medidas Básicas de Higiene Postural recomendadas para evitar estos factores mecánicos de sobrecarga de la columna vertebral.

MEDIDAS GENERALES

A.- Organizar nuestras actividades de forma que:

No estemos sentados, de pie, acostados, fregando, etc. durante largos períodos de tiempo, procurando alternar las tareas que requieran posiciones estáticas de pie, sentado o en movimiento; repartir la tarea en varios días (p.e. la plancha).

Intercalar períodos de pequeños descansos entre tareas, nos servirán para estirarnos, relajarnos, etc.

Modificar de nuestro entorno, sí es necesario, el mobiliario, especialmente mesas y sillas, recordando que lo blando es perjudicial (sofá, sillón, cama), adecuar la altura de los objetos, la iluminación, etc.


B.- De pie o al caminar:

Al estar de pie, poner siempre un pie más adelantado que el otro y cambiar a menudo de posición, no estar de pie parado si se puede estar andando. Caminar con buena postura, con la cabeza y el tórax erguidos. Usar zapatos cómodos de tacón bajo (2-5 cm, Figura 1). Para recoger algún objeto del suelo flexionar las rodillas y mantener las curvaturas de la espalda (Figura 2).

calzado flexionar rodillas

Para realizar actividades con los brazos, hacerlo a una altura adecuada, evitando tanto los estiramientos si elevamos demasiado los brazos, como encorvamientos silo hacemos con los brazos demasiado bajos.

Evitar las posturas demasiado erguidas (militar) o relajadas de la columna.


C.- Sentado:

sentado

Mantener la espalda erguida y alineada, repartiendo el peso entre las dos tuberosidades isquiáticas, con los talones y las puntas de los pies apoyados en el suelo, las rodillas en ángulo recto con las caderas (Fig. 3), pudiendo cruzar los pies alternativamente. Si los pies no llegan al suelo, colocar un taburete para posarlos. Apoyar la espalda firmemente contra el respaldo de la silla, si es necesario utilizar un cojín o una toalla enrollada para la parte inferior de la espalda.

Sentarse lo más atrás posible, apoyando la columna firmemente contra el respaldo, que ha de sujetar fundamentalmente la zona dorso-lumbar.

Si vamos a estar sentados con una mesa de trabajo delante, hemos de procurar que ésta esté próxima a la silla, de esta forma evitaremos tener que inclinarnos hacia adelante. También es importante que el tamaño sea adecuado a la estatura, evitando especialmente las mesas bajas que obligan a permanecer encorvado. En general se considera un tamaño adecuado si el tablero de la mesa nos llega, una vez sentados, a la altura del esternón.

Evitar los asientos blandos, los que no tengan respaldo y aquéllos que nos quedan demasiado grandes o pequeños. Igualmente, se evitará sentarse en el borde del asiento, ya que deja la espalda sin apoyo, o sentarse inclinando y desplazando el peso del cuerpo hacia un lado. Si estamos sentados para trabajar o estudiar con una mesa delante, se debe evitar que ésta sea demasiado baja o alta, y que esté retirada del asiento.

 D.- Conducir:

Adelantar el asiento del automóvil hasta alcanzar los pedales (freno, acelerador y embrague) con laespalda completamente apoyada en el respaldo, las rodillas en línea con las caderas (ángulo de 90º).Sentarse derecho, coger el volante con las dos manos, quedando los brazos semiflexionados.

Se debe evitar conducir con los brazos demasiado alejados del volante, con brazos y piernas extendidos y sin apoyo dorso-lumbar.

E.- Inclinarse:

Para recoger algo del suelo, se recomienda no curvar la columna hacia delante, sino más bienagacharse flexionando las rodillas, y manteniendo la espalda recta. Podemos ayudarnos con las manos si hay algún mueble o pared cerca.

F.- Levantar y transportar pesos:

Doblar las rodillas, no la espalda, y tener un apoyo de pies firme. Levantarse con las piernas y sostener los objetos junto al cuerpo (fig. 4).

levantar objetos

 


Levantar los objetos sólo hasta la altura del pecho, no hacerlo por encima de los hombros. Si hay que colocarlos en alto, subirse a un taburete. Cuando la carga es muy pesada buscar ayuda. No hacer cambios de peso repentinos.

 

Para transportar pesos, lo ideal es llevarlos pegados al cuerpo, y si los transportamos con las manos, repartirlos por igual entre ambos brazos, procurando llevar éstos semiflexionados.

 

Se evitará flexionar la columna con las piernas extendidas, llevar los objetos muy retirados del cuerpo, echar todo el peso en un mismo lado del cuerpo y girar la columna cuando sostenemos un peso.

Empujar y tirar de objetos puede ser fácil si sabemos emplear la fuerza creada por la transferencia de todo el peso del cuerpo de uno a otro pie. La forma correcta de empujar es con un pie delante del otroy es la transferencia del peso del cuerpo del pie posterior al anterior la que empuja el objeto. Se realiza con los brazos flexionados, la barbilla retraída, los abdominales contraídos y expulsando aire durante el proceso. Para tirar de un objeto se procede de la forma siguiente: una vez cogido éste, hay que dejarse caer como sí fuéramos a sentarnos en una silla, y es esto lo que nos permite utilizar todo el peso del cuerpo para tirar del objeto. Es más recomendable empujar los objetos que tirar.

 G.- Acostado:

Las posturas ideales para estar acostado o dormir, son aquellas que permiten apoyar toda la columna en la postura que adopta ésta al estar de pieBuena postura es la "posición fetal", de lado, con el costado apoyado, con las caderas y rodillas flexionadas y con el cuello y cabeza alineados con el resto de la columnaBuena postura también es en "decúbito supino" (boca arriba), con las rodillas flexionadas y una almohada debajo de éstas (Figuras 5 y 6). Dormir en "decúbito prono" (boca abajo) no es recomendable, ya que se suele modificar la curvatura de la columna lumbar y obliga a mantener el cuello girado para poder respirar.


cama 

  


 

El colchón y somier han de ser firmes y rectos, ni demasiado duros, ni demasiado blandos, que permitan adaptarse a las curvas de la columna, la almohada baja, la ropa de la cama debe ser manejable y de poco peso (ej. sábana y edredón). Las camas grandes, en general, son más recomendables, en especial si se duerme acompañado, ya que permiten mantener posturas relajadas y cambiar de postura con mayor frecuencia y facilidad.

Se debe evitar dormir siempre en la misma posición, en camas pequeñas, con el somier o el colchón excesivamente duros o blandos, con almohada alta , o en la posición de decúbito prono (boca abajo).

 

H.- Vestirse:

Se procurará estar sentado para ponerse los calcetines y zapatos, elevando la pierna a la altura de la cadera o cruzándola sobre la contraria, pero manteniendo la espalda recta. Para atarnos los cordones de los zapatos, o nos agachamos con las rodillas flexionadas o elevamos el pie y lo apoyamos en un taburete o silla.

 

I.- Levantarse o sentarse de una silla o sillón:

levantar silla


Para levantarnos, primero apoyar las manos en el reposa brazos
, borde del asiento, muslos o rodillas; luego, desplazarse hacia el borde anterior del asiento, retrasando ligeramente uno de los pies, que sirve para apoyarnos e impulsarnos para levantarnos (Fig. 7). Debemos evitar levantarnos de un salto, sin apoyo alguno.

Para sentarnos, debemos usar también los apoyos, y dejarnos caer suavemente. No debemos desplomarnos sobre el asiento.




levantarse de la cama


J.- Levantarse de la  cama:

 

Lo ideal es flexionar primero las rodillas, girar para apoyarnos en un costado, e incorporarnos de lado hasta sentarnos, ayudándonos del apoyo en los brazos. Una vez sentados al borde de la cama, nos ponemos de pie apoyándonos en las manos (Fig. 8).






 

K.- Asearse:

Hay que tener en cuenta la altura del lavabo, porque la excesiva flexión del tronco para asearnos, no provoque dolores lumbares. La postura correcta será agacharnos con la espalda recta y las piernas flexionadas(Fig. 9).


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