Warning signs of acute injury

  • Pain

  • Swelling

  • Warmth

  • Redness

  • Numbness

  • Tingling


Four stages of tissue injury

(symptoms can be any of the above warning signs)

  • 1st stage: Symptom begins after activity

  • 2nd stage: Symptom begins during activity and goes away after

  • 3rd stage: Symptom begins while activity and does not go away for awhile afterward

  • 4th stage: Symptom occurs all the time


••• Modify position within one minute of symptom starting to minimize tissue damage

••• Change position, stretch, ice right away after, avoid other taxing activities

Techniques to Avoid Injury


• Change positions frequently and take frequent rest breaks to allow fatigued muscles to recover and to improve blood flow to all structures.

• Maintained contraction of a muscle fatigues the muscle and reduces the blood flow, making the muscle susceptible to injury.

• Even in an ideal posture, there will be some muscles contracting to maintain that posture, and therefore some muscles will have reduced blood flow.

• If sitting, stand up every 30 minutes for at least 30 seconds. If standing, sit down every 30 minutes.

• Do not remain in one position for longer than 30 minutes.

• Any change in position will help.


Risks with a Forward Head Position


• Increased cervical spine compressive forces for every inch the head moves forward.

• If our head weighs 12 lbs and our head is one inch forward, the lower neck feels 32 lbs of pressure from the head. 2 inches= 42 lbs pressure.

• The more weight the muscles have to exert holding the head up, the less strength available for outside loads.

• Structures are more likely to become injured when full muscle strength and control is not available.


The spine is balanced in this position which minimizes muscle contractions.

The muscles have to work harder to hold us up any time we are out of this alignment.

Ideal Sitting Alignment

As above except: Knees level or slightly lower than hips Feet resting flat on floor or foot rest Back supported by back rest

Ideal Standing Alignment


  • Ears over shoulders

  • Shoulders level

  • Shoulders over hips

  • Hips over ankles

  • Three normal curves in spine

  • Chin slightly tucked and level

wall/ pelvic tilt/ step away from wall

675 C South Jefferson Avenue

Cookeville, TN  38501

Phone:931-528-8822

Fax:931-528-8825

ttbc@therapyandbalance.com

Muscle Imbalance

Ergonomics: coming soon

Muscle Imbalance


• Just because our spine is in alignment, doesn’t mean the muscles are balanced.

• Most of our activities are in front of us which makes muscles shorten in front and lengthen in back.

• A muscle that is too long is also weak. Therefore muscles in our back tend to be overstretched and weak.

• Our bodies adjust to these new mechanical positions so we sense them as normal. For instance, we can’t tell that our head is forward.

• True way to know if we are standing straight is to stand at a wall:

  • Lean against the wall so your head, midback, and bottom rest on the wall with your feet a few inches away from the wall.
  • Assess how this position feels. For instance, does it feel as if you have to strain to get your head to the wall.
  • Once you have assessed your alignment, step away from the wall and try to maintain the same posture. For most people this will feel abnormal at first, but with practice it will improve.