BASIC BODY MECHANICS

CONTRIBUTING FACTORS

Most injuries are the result of:

• Months or years of poor body mechanics
• Life stresses
• Poor posture
• A loss of flexibility
• A general lack of physical fitness
 HOW CAN YOU PREVENT
INJURIES?
Most injuries can be avoided by using good
prevention methods.
• Use good body mechanics
• Stay physically fit and active
• Use mechanical assist devices when possible
(lifts, carts, dolly)
• Get help when necessary.
 TERMINOLOGIES
There are various terms used in relation to body
mechanics. Some of these terms are:

• Body Alignment- It refers to the positioning of joints,

tendons, ligaments and muscles while in standing,
sitting and lying positions.
• Body Balance- It refers to a state of the body
achieved when the center of gravity is balanced
over a wide, stable base of support and a vertical line
falls from the center of gravity through the base of
support.
 TERMINOLOGIES
• Posture- It refers to the position of the body in
relation to the surrounding space. It is the
relationship of various body parts at rest or any
phase of activity.
• Mobility- It is a person’s ability to move about
freely owing to his/her voluntary motor and
sensory control of the body’s regions.
• Immobility- Immobility occurs when the
individual is confined to a position and is unable
to move or change positions independently.
 TERMINOLOGIES
• Bed Rest- Bed rest is an intervention in which the
client is restricted to bed for therapeutic reasons.
• Weight- It is the force exerted on a body by gravity.
• Friction- It is a force that occurs in a direction to
oppose movement.
• Anatomical Position- It refers to a position wherein
the individual stands erect (upright position) facing
the observer, with feet on the floor and arms placed
at the sides, and the palms of the hands turned
forward.
• KYPHOSIS: It is an abnormal condition of the
vertebral column characterized by increased
convexity in the thoracic spine, the clients shoulder
are slouched & vertebral bones are prominent. It is
common in middle aged & older adult.
• LORDOSIS it is an abnormal condition of the
vertebral column characterized by an
exaggerated curvature of lumbar spine.
• SCOLIOSIS it is an abnormal condition of the
vertebral column characterized by lateral
deviation.
Body mechanics is a term that describes
the coordinated efforts of the
musculoskeletal and nervous systems. It is
the way the body moves and maintains
balance while making the most efficient
use of all its parts.
 REASONS FOR USING GOOD
BODY MECHANICS
1. Muscles work best when used properly.
2. Correct use of muscles makes lifting, pulling
and pushing easier.
3. Correct applications of body mechanics
prevents unnecessary fatigue and strain and
saves energy.
4. Correct applications of body mechanics
prevents injury to self and others.
 3 MAJOR CONCEPTS
1. Base of support: The portion of the body in
contact with the floor
2. Broad base = stability
3. Center of body weight. The point around which
body weight is balanced.
• Usually located in the midportion of the pelvis or
lower abdomen, depending on body build.
• Any object you hold adds to the weight on the
base of support affecting the location of your
center of gravity
Body is most stable when
the center of gravity is
nearest the center of the
base of support
 LINE OF GRAVITY
•Imaginary vertical line
passing through the
center of gravity.

•The body is most stable

when the line of gravity
bisects the base of
support
NOT GOOD GOOD
 8 BASIC RULES OF GOOD BODY
MECHANICS
1. Maintain a broad base of support.
- Feet 8 to 10 inches apart
- One foot slightly forward
- Balance weight on both feet
- Point toes in the direction of
movement
2. Bend from the hips
and knees to get
close to an object
and keep back
straight.
- Do not bend
from the waist
3. Use the strongest muscle to
do the job.
- Located in the shoulders,
upper arms, hips and thighs.

This is because the broad flat

muscles of the back are
weakest when stretched and
flattened and so are very
susceptible to injury when
heavy objects are lifted.
4. Use the weight of
your body to push or
pull an object.
- Push, Pull or Slide
instead of lift.
5. Carry heavy objects
close to your body.
6. Avoid twisting your
body. Turn your body and
feet to change direction.
7. Avoid bending for a
long period of time.
8. If a patient or
object is too
heavy, get help.
 SITTING AND
COMPUTER STATION WORK

• Sit close to your work

• Hips, knees and ankles are open to 90 degrees
• Elbows are open to 90-120 degrees
• Wrists are in relaxed and neutral position (not bent)
• Both feet are flat on the floor or use a foot rest
• Shoulders are low and relaxed
• Head and neck are aligned with spine
 SITTING AND
COMPUTER WORK STATION
• Do not slump or lean forward or
downward to reach for work.
• Do not sit for more than 60 minutes
without getting up or changing position.
• Raise the height of the computer screen
so screen is at or slightly below eye level.
 STANDING

• Bring your work close to you.

• Put one foot up, shift your weight and position
frequently.
• Keep your work at a comfortable height.
• Wear comfortable shoes and stand on an anti-
fatigue mat, if possible.
 STANDING

DO NOT:
• Stand in one place too long.
• Stand bent forward at your waist or neck.
• Lock your knees into a straight or over-
extended position.
 PUSHING

•Push whenever possible.

•Keep head up, knees bent, and back
straight.
•Keep the load in front and use both
hands.
•Remain close to the item being
pushed.
 PULLING OR TWISTING

DO NOT:
•Pull when you can push
•Twist your body
•Lean forward
 CARRYING OBJECTS OR
LIFTING ITEMS

When carrying objects:

• Test the load first
• Use a cart/transfer device whenever possible
• Pivot with your feet - don't twist at waist
• Use both hands
• Keep objects near your body and directly in front of you
• Ask for assistance with heavy items.
 LIFTING
When lifting objects, DO NOT:
• Lift in a bent-over, stooped position
• Twist at waist
• Lift with one hand
• Lift with outstretched arms
• Keep feet together
 REACHING

When reaching for an object, remember to:

• Keep back straight
• Reach with two hands
• Face the object
• Stand on a stable step-stool to reach high items
• Bend knees slightly.
 PATIENT MOVEMENT OR
TRANSFER

• Update yourself on the patient's physical

limitations or condition.
• Let the patient know what you are going to
do so they may assist.
• Position the patient for transfer.
 PREPARE YOURSELF/TEAM

• Keep feet apart, knees bent with back and head straight
• Be close to patient
• Use transfer device to assist in moving patient: transfer
belt, slide board
• Pivot feet, don't twist waist
• Have adequate number of persons to transfer patient
(based on patient's size and/or type of transfer required)
 PREPARE YOURSELF/TEAM

• Use mechanical lifts when possible.

• Lock wheels of bed, wheelchair or stretcher.
• Adjust position and height of bed, wheelchair or
stretcher.
• Do not attempt to move patients by yourself. This
may cause injury to yourself or the patient.
 COMPLICATIONS OF IMPROPER
BODY MECHANICS
If body mechanics principles are not observed, it may lead to
various complications like:
• Musculo-skeletal injuries
• Complications of immobility, e.g. pressure sores,
contractures, etc.
• Muscle fatigue
• Orthostatic hypotension
• Hypotension bronchopneumonia
• Decreased basal metabolic rate
 ERGONOMICS

The science of
designing
equipment and
devices that fit the
human body and its
movements
PROCEDURES FOR MOVING, LIFTING
AND POSITIONING OF PATIENTS
Good posture and body mechanics and
assistive devices are necessary when inactive
patients require positioning and moving. An
inactive patient’s position is changed to relieve
pressure on bony areas of the body, promote
functional mobility (alignment that maintains
the potential for movement and ambulation),
and provide for therapeutic needs
Transferring is a nursing skill that helps the
dependent client or client with restricted motility
attain positions needed or desired safely.
Mobilization plays important role in rehabilitation as
physical activity:
• maintains and improves joint motion
• Increases strength of the musculoskeletal system
• Promotes circulation
• Relieves pressure on skin (pressure points)
• Improves respiratory function
Equipment needed for transfers include:
• Transfer belt
• Slide board
• Wheelchair
• Stretcher
• Lifts e.g. hydraulic lift.
 GENERAL INSTRUCTIONS IN
MOVING AND LIFTING PATIENTS
• Maintaining a good anatomical position of the body.
• Use longest and strongest muscles extremities to provide energy
needed in strenuous activities.
• Keep the object or the patient close to the body to prevent
unnecessary strain on the muscles as this brings the centre of gravity of
the object/patient close to the centre of the gravity of the body.
• Place the feet apart to provide a wide base of support. This facilitates
better body balance.
• Flex knees to come closer to the object/ patient.
• Keep work close to the body.
• Maintain the four body curves of human body and work with their
proper alignment.
• Slide, roll, push or pull an object rather than lift in order to reduce the
energy needed to lift the weight against pull of gravity.
• Keep the body above the object and the use the weight of the body
to pull or push the object.
• Avoid disturbances/ interruptions in the path of movement of patients.
• Move obese patients by sliding them rather than lifting them.
• Seek assistance when lifting or moving heavy patients.
• The height of the bed should be adjusted to a height that allows the
nurse to keep her back as erect as possible while moving the patient in
the bed. This reduces the injury to the lower back.
• The patient is moved to the edge of the bed before he is lifted from
the bed. This helps the nurse to keep her trunk more erect.
• When moving a patient by more than one nurse, each nurse assumes
the responsibility for supporting one of the patient’s body sections. The
areas to be supported include head, shoulders, chest, hips, thighs and
ankles.
• In order to coordinate the movements of the nurses and to maintain the
patient’s body in correct alignment, the nurse gives the signal by counting
1,2,3 etc. with each activity of the procedure.
• Unless contra-indicated, encourage the patient to use his abilities as much
as possible.
• Observe the patient for symptoms of orthostatic hypotension e.g. fainting,
dizziness, sweating etc.
• Do not support the patient under his armpits, since injury to major nerves and
blood vessels may occur.
• Always lock the wheels of the bed, stretcher or wheel chair while transferring
the patient so as to increase the maximum static friction between the wheels
and floor.
 POSITIONING
• Positioning defined as placing the person in
such a way to perform therapeutic
interventions to promote the health of an
individual.
• Placing the person in a proper body
alignment for the purpose of preventive,
promotive ,curative and rehabilitative aspects
of health.
 PURPOSES
• To provide comfort to the patient
• To relieve pressure on various aspects
• To improve circulation
• To prevent formation of deformity
• To perform surgical and medical investigations
• To prevent pressure sores
• To provide proper body alignment
• To carryout nursing interventions
 TYPES OF POSITIONS
• Dorsal position/supine position
• Dorsal recumbent position
• Lithotomy position
• Lateral position
• Prone position
• Sims position
• Knee-chest position
• Trendelenburg’s position
• Fowler’s position
 PRELIMINARY ASSESSMENT
Check
• Patients general condition
• Physician order
Assess self care ability
Arrange the comfort devices near the bed side
Identify the deformed extremity (support the immobilize
area during positioning)
Identify the rationale before positioning
SUPINE
- Entire bed frame horizontally parallel with floor.
- Is used for client’s with vertebral injuries and in
cervical traction.
- Is generally preferred by clients for sleeping.
PRONE
- Patient lies flat on abdomen with head turned to
one side and hands held in comfortable position
- Used in the examination of posterior trunk, spines
and rectum and surgeries of back
- To relieve pressure on areas such as sacrum,
scapula and heel
LATERAL
- Side lying position
- Patient lies on left side
- Major portion of body weight on the dependent hip
and shoulders.
- Relieve pressure on bony prominences
- Used for enema, insertion of suppositories and for
checking rectal temperature
SIMS
- Differ from side lying position.
- The weight is placed in the anterior ilium, humorous and
clavicle.
- Patients lies on his left with left arm drawn behind the back.
- Right arm may be in any position .
- The right thigh is flexed against the abdomen.
- Used for Vaginal and rectal examination.
- To relive pressure in the buttocks, scapula and heels.
FOWLER’S
- Head of bed raised to angle of 45 degrees or more, semi-
sitting position; foot of bed may also be raised at knee.
- Is preferred while client eats
- Is used during nasogastric tube insertion and
nasotracheal suction
- Promotes lung expansion
SEMI-FOWLER’S
- Head of bed raised approximately 30 degrees;
inclination less than Fowler’s position; foot of bed
may also be raised at knee.
- Promotes lung expansion
- Used when clients receive gastric feedings to
reduce regurgitation and risk of aspiration.
TRENDELENBURG’S
- Entire bed frame tilted with head of bed down.
- Is used for postural drainage
- Facilitates venous return in clients with poor
peripheral perfusion
REVERSE TRENDELENBURG’S
- Entire bed frame tilted with foot of bed down.
- Is used infrequently
- Promotes gastric emptying
- Prevents esophageal reflux
KNEE CHEST POSITION
- Patient lies on the bed in such a way that the knees and the
chest rests on the bed
- The head is turned to one side
- A small pillow can be placed under the chest
- The knees are flexed and thighs are at right angle to legs
- Used for examination of rectum and vagina and for Post
partum exercise
DORSAL RECUMBENT POSITION
• Patient lies on back, knees fully flexed and legs
separated, thighs flexed and externally rotated and feet
flat on the bed.
• Pillow is placed under the head
• Used for examination of vagina and rectum,
catheterization and care and for doing procedures in the
rectum, vulva and vagina
LITHOTOMY
• The patient lies on her back the legs are separated and
thighs are flexed on the abdomen.
• The buttocks are kept in the edge of the table and legs
are supported by stirrups
• Provides maximal exposure of genitalia
• Uses
Vaginal examination and Pap smear
Position during delivery for many women
Surgical procedures of genitourinary system
 AFTER CARE OF THE PATIENT
• Ensure correct body alignment and comfort of the patient.
• Replace pillow and other comfort devices as needed.
• Raise the side rails if necessary for the safety of the patient.
• Check for any discomfort, pain, skin condition etc.
• Check vital signs of the patient after assessing the desired
posture for assessing orthostatic hypotension.
• Remain with the patient during change of position to
prevent his/her falling.
• Return to the supine position in case of any discomfort.
• Ensure that the patient is comfortable and safe.
• Record the following aspects:
Duration of the assumed position of the patient.
Amount of assistance/instruction needed.
Vital signs of the patient-temperature, pulse, respiration, blood
pressure.
Reaction of the patient to activity.
Observations, if any.
Recommendations for progressive activity and independence.