Polio Place

 
I. INTRODUCTION

Please understand that consistently using the principles discussed below is important when performing ANY activity. In other words, do not wait to use these principles just when you are in pain, but rather, use the principles all of the time.

Why should you use these principles?

• To prevent pain and further malfunction.
   
• To maintain ease of movement during the performance of any activity.
   
• To reduce the energy needed to perform activities. This slows the onset of fatigue and reduces the severity of fatigue.
   
• To handle objects safely and efficiently.
   
• To avoid injury to yourself and objects.
   
• To end the day feeling as good as possible!
   

A. The first and most important principle is to move into a new position every 15 to 20 minutes to avoid strain, fatigue and joint stiffness. You should alternate positions as much as possible between sitting, standing and lying down. You should also alternate activities so that no one body part must be used for greater than 15 to 20 minutes at a time if possible. Alternate periods of worked with brief periods of rest and stretching.

To become accustomed to using this rule, you may find it helpful to make a list at the beginning of the day or the beginning of the week. On this list, write tasks that you wish to accomplish in the given time frame. Then attempt to alternate amongst the various activities on the list every 15 to 20 minutes until, by the end of that time frame, hopefully the tasks are completed.

Be aware than any task that you perform only rarely has the potential for creating pain. Therefore, whenever performing unusual tasks, make especially certain that you do no more than 15 minutes of that task before resting and moving on to another activity. Examples of how to use the 15-minute rule follow:

EXAMPLE I
Type for 15 minutes.
Get up to stretch.
File papers for 15 minutes.
Get up to stretch.
Make phone calls for 15 minutes.
Get up to stretch.
Repeat the above cycle of activities.

EXAMPLE II
Fold laundry for 15 minutes.
Vacuum for 15 minutes.
Rest for 10 minutes.
Wash the car for 15 minutes.
Rake leaves for 15 minutes.
Rest for 10 minutes.
Repeat the above cycle of activities.

If your job requires you to perform the same tasks over and over again without variation, pause at least every 10 minutes to stretch for 30 seconds. Try to alternate between sitting and standing if possible.

B. Always keep good posture and body alignment, whether you are sitting, standing or lying down.

1. Keep the arms/legs close to the trunk. When you do work with the arms/legs extended away from the trunk, you place extra stress on the neck, back, hips and shoulders.

2. Keep the head over the shoulders.

3. Keep the shoulders over the hips. Keeping the abdominal muscles tight helps to accomplish this.

4. Avoid twisting motions or side-bending motions of the trunk except for a few seconds at a time. Use these motions for movement only – never for doing work.

C. Use the largest and strongest muscles of the body to perform as much work as possible. Use the smallest and weakest muscles of the body to perform as little work as possible.

EXAMPLE I. To hold an object, hug it in towards the body and use the arms to hold it rather than gripping it with the fingers.

EXAMPLE II. Normally, the leg muscles are stronger than the back muscles. Therefore, to pick something up from the floor, you should squat to reach the object. Do not lean forward from the waist to reach it using the back muscles, because they are relatively weaker and less bio-mechanically useful muscles than the leg muscles.
 

II. SITTING

A. Keep in mind that you should alternate from the sitting position to other positions whenever possible. If you have the physical capability, stand up every 15 to 20 minutes to stretch when you are not riding in a car. (When riding in a car, if the trip is longer than 30 minutes, stop to stretch every 30 minutes.) Put your hands in the small of your back, tuck the chin in and lean back slightly over the hands.

If you use a wheelchair, it is important that you try to use alternate positions periodically through the day. If you have the capability of standing up periodically, try to do so. If you have the capability of lying down periodically, try to do so.

B. Remember to use good abdominal support instead of allowing the abdomen just to relax while sitting. This allows you to retain proper posture more easily and supports the back.

C. Always make sure that you are sitting on the buttocks and not your tailbone.

D. If possible, use a firm chair. Choose a chair with back height, leg height and seat depth that adapts well to your body frame.

Remember the "90°-90°" rule: When sitting, your chair height should allow your hips to be bent at 90° and your knees to be bent at 90°. If you are sitting at a work surface such as a desk or table, adapt the height of the work surface to your body height so that the angle at the elbows is 90° when your shoulders are relaxed.

If your feet do not touch the ground, or if the backs of your legs press too hard against the seat of the chair, this will tend to make your back arch. To solve this problem, put something under the feet so that the angle at the hips and knees is 90°.

Propping pillows under the armpits helps take further stress off the spine. Your shoulders remain relaxed, and your abdomen does not have to work as hard to keep your spine in a normal posture.

E. Many chairs are constructed in a way that makes it impossible to sit upright in them without leaning backwards. The only way that you will know this is to look at the chair from the side before you sit in it. Seat backs in cars are especially noted for being slanted backwards in this way. If the chair or car seat does not allow you to sit upright without leaning backwards, place a large pillow vertically between the entire back and the chair.

F. To maintain a very small curve in the lower back, use a small, rolled towel of 1" thickness behind the low back at waist level. To further avoid leaning backwards, also put a 1" towel at the level of the lower shoulder blades. If the seat back is high enough, you may wish to put a 1" or 2" thick towel roll behind the neck as well.

G. Always sit as close as possible to the work
at hand.

1. If seated a desk or table, sit so your chest and abdomen are close to the work surface and your forearms can rest comfortably on the work surface.
a. If the work surface is too high to allow this, consider using a clipboard in your lap propped against the work surface for writing purposes.
b. You may also use a lap board to hold objects that your are working on.

2. When driving, sit close enough to the steering wheel so that your legs are not fully extended when you work the pedals of the car.

H. When sitting for any length of time, try to sit so that you are directly facing the object that you are looking at. (Examples: Persons speaking, TV, a book, etc.) If you use a computer screen, adjust the screen so that you are able to look directly at it with your chin level so your gaze is nearly horizontal. You should never have to look up at the screen, and you should not have to tilt your head downwards more than 10° to look at the screen.

When in a car, do not constantly turn the head sideways to speak to your car mates. Look ahead when speaking. Having to turn the head or trunk repetitively or for long periods to one direction or another puts strain on the muscles that can easily create pain.

I. When sitting to read, it is helpful to use on of the following methods (see below for reading while lying down).

1.You may elect so sit with proper posture with your reading material propped on pillows in your lap.
a. Use enough pillows so that you can look at the reading material so it tilts toward you.
b. Use your eyes to look down to read. Do not bend your neck forward to look at the reading material.

2. You may elect to sit with proper posture with your reading material propped on a table or desk in front of you.
a. Sit close enough so that forearms can be supported on the work surface.
b. Put towel roll or other object under top of book to that book tilts towards you.
c. Remember to use eyes to read. Do not bend neck forward to look at the reading material.
d. Instead of propping your arms on the work surface, you may pull the reading material close to you and prop your arms on pillows piled in your lap.

J. If you work at a desk for any length of time, keep the following principles in mind.

1. Put all of the items you use constantly through the day close to you so that you are not extending your arms more than a couple of inches to reach the items that you must use frequently. For example, I put phone, calculator and appointment book are in constant use, these items should be arranged in a U-shape around your seat.

2. To reach items that are not within your immediate U-shape, either stand up and move the item to reach it, or move your chair in the direction needed to reach the object. Try to avoid bending, twisting and extending your arms out to reach objects not within your immediate vicinity.

3. Periodically through the day, alternate which side of the desk the phone, calculator, etc. are on. You can then alternate which side of your body you use at any given time for these tasks, lessening muscle fatigue.

4. If you use the telephone excessively during the day, consider using a headset to avoid neck and hand fatigue.

K. If your pain is so severe that you cannot sit comfortably on the toilet, try sitting backward on the toilet so that your arms can rest on the toilet tank. Sitting this way support the trunk, and significantly reduces pain while attempting to use the toilet and while getting up afterwards.

REMEMBER: If possible, stand up every 15 to 20 minutes to stretch. Put your hands in the small of your back, tuck the chin in and lean back slightly over the hands. If you are unable to stand up, shift your position in your chair and stretch whatever body parts you can. If possible, alternate periodically to a lying-down position. 

III. STANDING

A. Whenever possible, alternate from standing to sitting or lying down every 15 to 20 minutes. When standing for any length of time, you may wish to lessen abdominal and back fatigue by propping one foot upon an object. A small stool, box or book helps to lessen the curve in the low back while giving the abdominals a rest. If you elect to use this method, make sure that you still have your weight born evenly on two feet. Every 15 to 20 minutes remember to straighten up, put the hands behind the low back, and tuck the chin while leaning backwards slightly over the hands.

B. Note that proper footwear is important to any activity involving standing. A low-heeled, sturdy shoe is best for any activity requiring standing more than 15 minutes at a time. A tie shoe with a broad heel and sole is best. When "dressing up," ladies should seriously consider flat-heeled or very low-heeled dress shoes with a broad heel and sole.

C. Always remember to maintain good abdominal support and to retain good posture and alignment.

D. Pay attention to the CENTER OF GRAVITY. The center of gravity is the point at which the mass of weight is centered in an object. In normal anatomic standing position, the center of gravity is in the middle of the pelvis.

The taller the object, the higher from its supporting surface is the center of gravity. This makes it more difficult for the object to hold itself up against outside forces such as gravity, wind, etc.

Since an object is more stable when its center of gravity is closer to the ground, whenever possible you should lower your center of gravity while standing. To accomplish this, bend the hips and knees. Be sure to maintain proper posture with trunk erect, belly and buttocks tight, low back slightly curved and buttocks only slightly behind shoulders.

Each part of the body has its own center of gravity. The body's center of gravity changes when the body changes position.

1. In other words, if you bring your arms forward from the body, the center of gravity also moves forward. In order to keep the body from toppling forward, the back muscles must work very hard. Therefore you should use this position only for a few seconds at time if possible.

2. If you extend your arms out to the side, the muscles on the opposite side of the trunk and neck must work hard to keep the body from toppling to the side to which the arms are extended. Therefore, you should avoid such a position except for a few seconds at a time.

E. Pay attention to the BASE OF SUPPORT.

1. The base of support is the area of the body that is weight-bearing.

2. In activities involving standing, the base of support involves the position of the feet. When standing still, remember to bear weight evenly on both feet.

3. Generally, the wider the base of the support, the more stable you are. The base of support can be widened from side to side. It can also be widened from front to back. In general, the base of support should never be more narrow than the width of the hips.

4. There is a "point of no return." If the base of support is too wide, the body will topple over.

5. If performing an activity that requires your arms to be moving from side to side, the base of support should usually be widened in a side-to-side fashion.

EXAMPLES
a. Transferring dishes form sink to drying rack.
b. Moving tools from one side of a work bench to another.

6. If performing an activity in which your arms are required to move front to back, in general the base of support should be widened in a front-to-back fashion.

EXAMPLES
a. Dusting a table from the middle to the edge.
b. Drying the hood of a car from the front to the back.

F. Stand in such a way so that you can look directly at the object, person, etc., in front of you. Try hard not to rotate or bend sideways for more than a few seconds at a time.

G. Stand as close as possible to the work at hand. Standing close permits you to maintain proper body alignment and keeps the center of gravity in its normal position. Therefore you can work without twisting or stretching, and, as a result, you put less strain on the shoulders and spine.

H. If you need to lean forward while standing (as in washing dishes or working at a counter), always bend the knees slightly and round the entire back into a slight "C"-shape. This is harder on the back than erect standing, and you should remember to take a stretch every 5 minutes instead of every 20 minutes if performing activities that require this kind of positioning.

REMEMBER: The alternate to standing for prolonged periods is to sit to do the work required. Alternating between sitting and standing is often helpful. If necessary, periodically use the alternate position of lying down to rest.

IV. MOVING IN BED.

A. When moving from sitting down to lying down, put your arms in front of your body. Use your arms to lower your upper body down onto the supporting surface and simultaneously gently lift your legs onto the bed, couch, etc. Be careful not to twist or to bend the trunk, more than a few degrees when doing this. Once you are lying down, if you prefer to lie on your back, simply roll over.

B. When rising from lying down, turn on your side first. Put your arms in front of your body. Push with your arms to lift your trunk into a sitting position while simultaneously lowering the legs over the edge of the bed, couch, etc. Be careful not to twist or bend your trunk more than a few degrees while doing this.

C. At all costs, do not roll and scoot the body at the same time. This creates a terrible negative force on your spine.

D. When rolling to the right:

1. Bend the knees so feet are flat on the bed.

2. Take left arm across chest and roll to the right using arm and knees to people the body into the motion. (When rolling to the left, use the right arm to propel.)

E. When moving right to left on bed or up and down in bed:

1. Bend knees so feet are flat on the bed.

2. Lift buttocks up and gently move then in the direction you want to go.

3. Gently slide trunk to line up with buttocks.

4. If you have to move farther, reposition feet and repeat steps 2 & 3.
 

V. LYING DOWN

A. Follow these suggestions whenever you lie down, whether you are sleeping or not. These positions may be good to use simply for pain relief on and off during the day as well as for sleeping.

REMEMBER: If you are lying down to rest while performing some activity such as reading or watching TV, be sure you change position or get up to stretch every 15 to 20 minutes. Put your hands in the small of your back, tuck the chin in, and lean back slightly over your hands. If you are unable to do this, simply move about in the bed and stretch.

B. If you lie to read lying down, the suggested method is to read while on your back.

1. You should prop two pillows horizontally under two pillows vertically.

2. Place a towel rolled 1" to 3" in thickness at the top of the vertical pillow to support the neck.

3. Lie on the vertical pillows so that your neck is on the towel roll and your waist is at the lower edge of the vertical pillow.

4. Place two or more additional pillows under the knees.

5. Try to prop the reading material on the chest, abdomen or legs so you do not fatigue the arms by holding the reading material. If necessary, put additional pillows against the chest, abdomen or legs to support the reading material.

6. Remember to use your eyes to look at the reading material. Do not bend the head forward to look to the reading material.

C. Sleeping: Choose a mattress that is comfortable for you. Some people do well with soft mattresses; others do well with firm mattresses or waterbeds. If you are considering purchasing a new mattress, find a friend or relative who owns one of the type that you are considering and ask if you can take a nap in his/her bed. If you wake up feeling refreshed and relatively pain-free, this type of mattress might be helpful to you.

You should find that you become accustomed to using the techniques noted below. You will briefly wake enough when you change positions at night to reposition the pillows properly for good alignment during sleep.

1. If you sleep on your back:
a. Place a horizontal pillow underneath a vertical pillow. ("T-shape") If necessary, use two horizontal pillows and two vertical pillows.
b. Place a small rolled towel 1" to 3" in diameter at the top of the vertical pillow.
c. Lie on the vertical pillow so that your neck is supported on the towel and your waist is at the bottom of the vertical pillow.
d. Place one or more pillows under the knees. The goal is to minimize the curve in the low back.

2. If you sleep on your side:
a. Place one to two horizontal pillows for the head. Whether you choose one or two pillows depends on how broad your shoulders are and how level you can make your head with your spine when lying on your side.
b. Place a 1" to 3" towel roll on top of the horizontal pillow(s) to take up space between the head and shoulders.
c. Place one to two pillows vertically between the legs so that the top leg is supported all the way from the hip to the sole of the foot.
d. Bend hips and knees slightly.
e. An alternate method of placing pillows for the legs is to place one to two pillows in front of the legs and to bend the top leg at the hip/knees so it can rest comfortably on these pillows.
f. Position your arms comfortably. One suggestion is to fold your arms in front of your chest as though hugging yourself. Some people prefer to extend the top arm out along the body while keeping the bottom arm hugging the body. Other people prefer to hug a pillow.
g. Try not to curl the bottom arm up under the pillow. This leads to loss of adequate blood flow in the arm.

3. If you sleep on your stomach: (Note: This is the least preferred method.)
a. Place one to two pillows at the foot of the bed to rest the feet/ankles on.
b. Place one to two vertical pillows over a horizontal pillow.
c. Lie so that your chest and abdomen are well-supported on these pillows.
d. Place a towel roll under your forehead so that you can sleep face down without turning your neck.
e. Use towel rolls under the shoulders to prevent them from rolling forward.
f. Keep the arms either resting extended at the sides or bent so that the arms are at shoulder level and the hands are pointing towards head.

REMEMBER: If you are lying down just to rest while performing some activity such as reading or watching TV, make sure you change position or get up to stretch every 15 or 20 minutes. Put your hands in the small of your back, tuck the chin in, and lean back slightly over the hands. If you are unable to stand, at least move into a new position every 15 to 20 minutes.
 

VI. SPECIAL TASKS

A. CARRYING OBJECTS

1. Avoid carrying any object that weighs more than one pound for longer than one minute or for a distance farther than 25 feet whenever possible.
a. Use a waist carrier ("fanny pack") for light objects.
b. Use a dolly or a luggage carrier for heavier objects.

2. Maintain erect posture when carrying objects.
a. Keep good belly and buttock support.
b. Keep shoulders pulled back.
c. Keep chin tucked.
d. Don't twist or turn the trunk to change direction of the movement when carrying objects. Instead, simply move the entire body from the feet up into the new direction of movement.

3. Make sure you can see over the object that you are carrying.

4. Whenever possible, use your arms instead of your fingers to carry objects, because the hands and fingers fatigue easily.
a. Hug object in close, using two arms if necessary.
b. If using one arm, hug object to side of body like a football. This is especially effective for carrying purses or small packages.

B. MOVING OBJECTS FROM SIDE TO SIDE

1. Always make sure that you are squarely facing the object so you do not twist or bend to reach it.

2. Widen your base of support form side to side.

3. Keep back erect.

4. Keep belly tight and shoulders pulled back.

5. Keep buttocks tucked under, but maintain a small curve in the low back.

6. Squat to the level of the object.

7. Test the weight of the load. If it is too heavy, get help.

8. Shift your body weight (center of gravity) toward the foot closest to the object.

9. Pick up object partly by using arm power and partly by using a slight rise from the squat position.

10. Hold the object close to your body as you shift your body weight to the opposite foot and put object down.

C. PICKING UP OBJECTS FROM THE FLOOR

1. Always make sure that you are squarely facing the object so you do not twist or bend to reach it.

2. If you are unable to squat to the floor with good posture and then rise again without using hand-hold support, you will be prone to injury if you try to pick objects up from the floor (even if the object is a feather).

INSTEAD:
a. Use a "reacher" to pick up light objects.
b. Sometimes you can safely sit in a chair to reach a light object (2 pounds or less) on the floor.
c. Get help if you need to pick up a heavier object.

3. If you are able, square to the floor with good posture and then rise again without using hand-hold support, use this methods to pick objects up from the floor - even if the object is a feather.
a. Squat down close to the object on the floor.
b. Keep back erect.
c. Keep belly tight.
d. Keep buttocks tucked under, but maintain a small curve in the low back.
e. Widen your base of support, but keep your feet flat on the floor.
f. Test the weight of the load. If it is too heavy, get help.
g. Pick up the object and hug it in close to your body.
h. Rise to a standing position using leg power and maintaining good posture.
i. USE THIS SAME TECHNIQUE TO PICK UP ANY OBJECT AT WAIST LEVEL OR LOWER LEVEL.

D. REACHING OBJECTS FROM HIGH PLACES

1. Using a step stool or ladder, climb as close as possible to the height of the object. Make sure you are squarely facing the object so you do not twist or bend to reach it.

2. Test the weight of the object; get help if necessary.

3. Pull object in close to your body and hug it.

4. Keep good belly and buttock support, shoulders back and chin tucked.

5. Slowly climb down to the ground.

E. PUSHING OBJECTS

1. Maintain erect posture with good belly and buttock support, shoulders back and chin tucked.

2. Keep arms hugging sides as you grasp object. Make sure that you are squarely facing the object.

3. Widen the base of support from front to back.

4. Squat to the level of the object's center of gravity.

5. Shift weight onto rear foot, keeping your knees bent.

6. Keeping your knees bent and your arms hugging your body, shift your weight onto your forward foot in order to begin moving object.

7. As the object begins to move, retain erect posture and stay at its height as you walk along while pushing the object. DO NOT USE ARMS TO PUSH OBJECT!

8. SPECIAL EXAMPLES:
When using a vacuum cleaner, push broom or mop:
a. Hold object in one hand at the side of your body.
b. Keep your shoulders square with your hips are you walk along with the object.
c. Periodically switch tool to other hand.

When pushing open a heavy door:
a. Stand close to the other door so that your chest is near the door and retain good posture.
b. Hug your body with your arms and place your palms on the door.
c. While maintaining the position of the arms, begin walking into the door to open it.
d. Keep walking to push the door fully open. NEVER OPEN DOOR BY PUSHING WITH YOUR ARMS.

F. PULLING OBJECTS

1. Maintain erect posture with good belly and buttock support, shoulders back, and chin tucked.

2. Keep arms hugging sides as you grasp object. Make sure that you are squarely facing the object.

3. Widen base of support form front to back.

4. Squat to the level of the object's center of gravity.

5. Shift weight onto your forward foot, keeping your knees bent.

6. While keeping your knees bent and your arms hugging your body, shift your weight onto the rear foot to move the object.

7. As the object begins to move, retain an erect posture and stay at its height as you walk along to pull object. DO NOT USE ARMS TO PULL OBJECT!

8. SPECIAL EXAMPLES:
When raking:
a. Put the rake in front of you by shifting your weight from the rear foot to the forward foot.
b. Pull the rake toward you by squatting and shifting your weight from the forward foot to the rear foot.
c. Periodically switch which hand holds the rake.

When pulling open heavy doors:
a. Stand close to the door.
b. Bend elbows and grasp the handle of the door as you hug your body with your arms.
c. While maintaining the position of your arms, begin to walk away from the door to open it. NEVER OPEN THE DOOR BY PULLING ON IT WITH YOUR ARMS.

When sweeping with a dust broom:
a. Hug your arms into your body while you hold the broom in front of you and off to one side with both hands.
b. While maintaining the positions of the arms, begin to sweep by walking sideways.
c. Periodically switch broom to the other side of your body.

G. CLEANING HORIZONTAL SURFACES (Examples: Dusting, washing cars, washing tables/counters)

1. Maintain erect posture with good belly and buttock support, shoulders back and chin tucked.

2. Make sure that you are squarely facing the object so that you do not twist or bend.

3. Widen your base of support from side to side if cleaning from side to side around the edges of an object.

4. Alternately widen your base of support form front to back if attempting to reach the middle of an object.

5. Keep your arms hugging your body as you hold the cleaning cloth.

6. Squat to the level of the object and remain squatting as you clean.

7. Accomplish task by shifting your weight alternately from one foot to the other and walking around the object to be cleaned. DO NOT PUSH ARMS AWAY FROM BODY TO CLEAN THE OBJECT!

H. CLEANING VERTICAL SURFACES (Examples: Washing windows and walls)

1. Maintain erect posture with good belly and buttock support, shoulders back, and chin tucked.

2. Make sure that you are squarely facing the object so that you do not twist or bend.

3. Widen your base of support form side to side.

4. Hold the washing cloth with arms hugging your body and with your elbows bent so that your hands are at the level of your face.

5. Perform the task by alternately standing at full height and then by squatting low. DO NOT REACH WITH ARMS!

6. Climb on ladder, etc., in order to reach high area.

7.Sit on the floor or on a stool to reach low areas.

I. DOING THE LAUNDRY

1. TO LOAD THE WASHER
a. Maintain erect posture with good belly and buttock support, shoulders back and chin tucked.
b. Make sure that you are squarely facing the object so that you do not twist or bend.
c. If possible, place the dirty laundry on top of the dryer before loading it into the washer.
d. Widen your base of support from side to side.
e. Use two hands to grasp dirty laundry as you hug your body with your arms.
f. Load the dirty laundry into the washer as you walk from side to side, from dryer to washer.

2. TO UNLOAD CLEAN LAUNDRY
a. Maintain erect posture with good belly and buttock support, shoulders back and chin tucked.
b. Make sure that you are squarely facing the object so that you do not twist or bend.
c. Use two hands to grasp laundry.
d. Squat to the level of the laundry.
e. Rise to a standing position while hugging your body with your arms.
f. Place the clean laundry on top of the dryer.

3. TO LOAD DRYER
a. Maintain erect posture with good belly and buttock support, shoulders back and chin tucked.
b. Make sure that you are squarely facing the object so that you do not twist or bend.
c. Grasp the clean laundry with two hands as you keep your arms hugging your body.
d. Squat to the level of the dryer door and throw your clothes in.

4. TO UNLOAD DRYER
a. Maintain erect posture with good belly and buttock support, shoulders back and chin tucked.
b. Make sure that you are squarely facing the object so that you do not twist or bend.
c. Place laundry basket under the dryer door.
d. Have clothes hangers nearby.
e. Sit on a chair facing the dryer opening.
f. Remove items to be hung on hangers and hang them up.
g. Remove other items with two hands and put in basket.

5. TO FOLD CLOTHES
a. Maintain erect posture with good belly and buttock support, shoulders back and chin tucked.
b. Make sure that you are squarely facing the object so that you do not twist or bend.
c. Place clothes on table to fold.
d. DO NOT SHAKE THE CLOTHES IN THE AIR AND DO NOT HOLD THE CLOTHES IN THE AIR TO FOLD.
e. Keep your arms hugging your body.
f. Shift your weight from the front to the back or from side to side to accomplish the task of folding.

J. PREPARING FOOD

1. Maintain erect posture with good belly and buttock support, shoulders back and chin tucked.

2. Make sure that you are squarely facing the object so that you do not twist or bend.

3. Keep your arms hugging your body.

4. Sit to reach items on low shelves in the refrigerator or cupboard.

5. Move your feet from front to back or from side to side to perform tasks such as cutting and stirring.

6. Use two hands to carry any object from one surface to another.

7. A rolling cart is also useful to transport objects in the kitchen.

8. To pour liquids:
a. Place the container holding the liquid on the edge of the counter or table.
b. Hold an empty cup, bowl, etc. under the full container.
c. Keeping the full container on the counter, tip it so that the liquid pours into the empty container.
d. NEVER HOLD OBJECTS IN THE AIR TO POUR LIQUIDS.

9. You might perform some tasks in the kitchen more easily while standing, if you are able. However alternate standing with sitting whenever possible.