Techniques and tips to avoid back pain and injury

The reality of working in early childhood education and care means increased rates of lifting, bending and carrying, and these daily demands can pose a significant risk of injury especially to the back, shoulders or neck. It can be a physically demanding job so reducing the risk of harm through a combination of awareness and safe behaviours is important to the health and wellbeing of all staff members.

Ever wondered how much cumulative weight an early childhood educator may be lifting throughout the day? According to a recent Australian study, an educator working with children in nappies is lifting a cumulative load of 193kg in a typical three and a half hour time span. Educators involved in preparation tasks – setting up outdoor environments and moving furniture – were lifting about 187kg in the same time frame.

The study identified changing nappies as the most demanding task on educators’ backs followed by injuries caused by lifting, carrying and moving children and objects. Consider the amount of daily bending and stretching, reaching up and down, to the left and to the right, and it becomes evident that a ‘typical day’ could easily cause a work-related musculoskeletal disorder in the longer term.

A persons’ musculoskeletal system provides form, support, stability, and movement to the body. But spinal alignment problems can occur from repeated movements involving poor posture and repeated strain, which can affect areas such as the back, shoulders or neck.

Early childhood staff are at risk of injury from lifting and carrying particularly when:

• lifting children in or out of cots or high chairs, or on and off change tables – bending, twisting and reaching to lift children due to the design, placement or characteristics of cots, high chairs or change tables.
• moving equipment – lifting, moving, carrying, pushing or pulling heavy or awkward indoor and outdoor play equipment.

Injuries and conditions can include:

• muscle sprains and strains
• injuries to muscles, ligaments, intervertebral discs and other structures in the back
• injuries to soft tissues such as nerves, ligaments and tendons in the wrists, arms, shoulders, neck or legs
• abdominal hernias
• chronic pain.

Recommendations for reducing the likelihood of staff sustaining a back injury may include:

• Developing and implementing policies and procedures for lifting and moving children and equipment.
• Eliminating risks where you’re reasonably able to or if this isn’t possible, take steps to minimise the risk
• Redesigning facilities to ensure an ergonomically appropriate environment to minimise the occurrence of movements that place strain on educators’ bodies and have the potential to cause injuries to the musculoskeletal system
• Running ongoing education and training programs covering the correct procedures for daily tasks and the correct use of any aids and equipment. Consider posture exercise classes and staff health promotion programs.

Paediatric physiotherapist, Lorna Taylor provides these ‘trade tips’ for addressing some of the most common back health challenges experienced by staff in early childhood settings:

Comfortable interactions

• All staff should have access to a height adjustable chair designed to fulfil the ergonomic needs of educators when sitting and working at a low children’s tables. The discs of the spine are extremely vulnerable to the twisting and shearing forces that can occur when sitting on low static chairs or children’s furniture.
• If an educator needs to spend a period of time on a table, try a slightly higher table where the children can work while standing for part of their day.
• Ask children to access and help tidy away their own resources, especially if they are low down, to reduce staff stooping and bending over. It’s okay to stand upright when talking with young children at points throughout the day, rather than bending to their height every time.

Equipment & resources

• Take care when lifting and carrying children, resources and equipment. A wheeled trolley case or crate may ease the manoeuvre of books and equipment if there are limited stairs. Use ramps to wheel equipment where available, and ensure storage sheds have ramped access, it will only take a few extra minutes and can really help your back.
• A cost-effective removable manoeuvring option is to use a portable wheelchair ramp. It’s also more beneficial to push trolleys, rather than pull them.
• Look for equipment that is easily mobile and has lockable castors – for example, sand and water trays, cots with adjustable sides that can easily be operated by an adult, or beds and mats that enable children to climb in and out of with minimum assistance.
• Reduce the need to lift children whenever possible. Adding steps or stools that allow the children to get to water fountains, sinks or changing tables will eliminate the need to lift many of them. Lowering furniture heights on cribs, beds and changing tables will also make it easier on your back and shoulders. If the child is old enough, always ask them to participate in the activity and reduce the need to lift them.

Don’t suffer in silence

• Back pain and emotional wellbeing are interlinked. It’s essential that you feel supported at work and feel able to voice concerns if you’re feeling cumulative strain injury (aches and pain increasing over time). If you’re finding an activity difficult, it’s highly likely colleagues will be too. Prevention is key and rest and movement breaks are important for wellbeing.  It’s helpful to develop a supportive leadership team and workplace culture.

References and further reading

Aussie Childcare Network: Back Pain Prevention In Childcare  

WorkSafe Victoria