Across the globe, COVID-19 put frontline health-care workers at the centre of response and care around the clock. These included nurses who have been particularly impacted by the pandemic by working longer hours and being deployed to different units where they may not have previous experience. As result of being in a new environment and working under strenuous conditions, nurses are one population at risk for increased Musculoskeletal pain that could cause pain and injury and interfere with their capacity to care for patients.
“I’m a registered nurse working in the operating room at Cambridge Memorial Hospital. My usual shift is about eight hours, but ever since COVID-19 I’ve been deployed to the rehab and medical floors and my shifts have increased to 12 hours,” says Monica Huci, a registered nurse at Cambridge Memorial Hospital. “The kinds of patients that I now provide care for require more lifting and bending. As a result, I experienced severe back pain. My muscles became tight as a rock and I could not go back to work.”
In fact, there has been a major shift in how people go about their daily lives and fulfill their duties on the job across all industries. Dr. Amy Brown, a chiropractor at Coronation Chiropractic, Massage, & Physiotherapy in Cambridge, Ontario, who has been treating nurses throughout her 19 years of practice, has noticed an increase in nurses seeking chiropractic care over the last several months. To help nurses get through this challenging time, she shares helpful tips and tools that nurses can use at work and at home to keep their back safe and prevent pain from interfering with their capacity to care for patients.
Common and subtle ways to get injured
“There are many things during a nursing shift that can put strain on the body,” says Dr. Brown. “Being on your feet for eight to 12 hours is challenging enough on its own, and that doesn’t even consider patient care.”
Some of the most common ways that Dr. Brown sees nurses injure their back is bending over patients, reaching in awkward ways around equipment, and twisting their body to move patients. Some of the more subtle causes of injuries include time spent behind computers, charting patient files and even sitting during break times.
“One surprising issue that I have also seen in my practice is tight back muscles in nurses who are testing for COVID-19 as they are bending forward to seated patients all day.” All of this can lead to low back pain – the most common injury seen in nurses – but neck and shoulder injuries are also frequent. “Ideally, we want to prevent these injuries before they happen,” says Dr. Brown.
Think about your day ahead of time
“One of the best ways to prevent injuries is to take a look at what you need to do in a day and think about how you are going to do it,” says Dr. Brown. “We often go wrong when we dive into our tasks without taking the time to think them through. It’s important – at least after a shift – to think about the things that caused you discomfort and then consider the ways that you could modify them to be more body-friendly.”
For example, consider:
- Ensuring that you are square to your patient wherever possible
- Avoiding twisting to address a patient
- Using your legs to bring yourself down to your patient’s level rather than bending over
- Avoiding slouching or standing with one hip out to the side
If possible, seek out props to ease strain on your body. For example, look for something like a step stool to put your foot up on while standing for longer periods of time. And, of course, good shoes are critical.
“I encourage nurses to go out and try on as many shoes as possible to find the ones that feel best for them,” says Dr. Brown. “They should have a good cushion and provide support in the right places. Good shoes should also come up underneath the arch and provide enough support without too much pressure to last throughout the day.”
Top stretches at home and work
Performing quick stretches during a shift or break can make a big difference. Simple neck and leg stretches can help to offset muscle tightness that may cause issues later. If done first thing in the morning or the last thing before bed, these stretches can help to loosen low back muscles and gently mobilize the joints.
Here are a series of exercises for the low back that nurses can practice at work and at home:
Hamstring stretch
- Begin by standing and prop the foot of the leg you are going to stretch on a chair or step
- Slowly lean forward until a stretch is felt in the back of your thigh but is not painful
- Hold for 30 seconds, then return to starting position
- Repeat on both sides
Quadricep stretch
- Grasp the top of your foot and pull your heel up toward your buttocks
- Keep your thighs parallel and your knees together
- Pull to the point where you feel a stretch in the front of your thigh that is uncomfortable but not painful
- Hold for 30 seconds
- If this stretch is difficult, you can loop a towel or yoga strap over your foot to make reaching the top of your foot easier
“Practicing these simple exercises on a daily basis can really help address low back pain and tightness before it becomes a significant issue,” says Dr. Brown. “Nurses can also use a yoga strap if some parts of their body are particularly tight, or foam roller to help work out tight leg and back muscles.”
For more helpful stretches, download Dr. Brown’s Home Exercise Program.