Drivers Beware:
Lumbar Support Can Be Harmful To Your Health!

 

25 TIPS FOR PAIN-FREE YOGABACK DRIVING
by Dennis Zacharkow, PT.

PART ONE:
TIPS ON DRIVING POSTURE

Driving a motor vehicle is a constant vigilance task in a very fixed sitting posture. Unlike sitting in an office chair, safety factors (such as avoiding an accident!) prohibit regular weight shifting while driving. Therefore, it is critical to drive in your healthiest, safest, and most alert sitting posture.

1. DO NOT SLUMP

Let’s first examine the driving posture with the greatest risk for back and neck pain - the typical slumped driving posture (Figure 1) without YogaBack’s multi-adjustable, dual back support system.

This slumped driving posture is characterized by a collapsed trunk with a round back, round shoulders, and a forward head posture (Figure 1-A & 1-B). The relaxation of the lower abdominal and back muscles in this posture increases the stress to the back ligaments and discs.

Also notice in Figure 1-C that the pelvis has slid forward on the car seat, away from the lower backrest. In this posture, the tail bone is bearing weight on the seat. In addition, the arms are elevated forward to reach the steering wheel. If there is one posture guaranteed to give you back and neck pain while driving, this is it!

2. SLUMPING IMPAIRS DRIVER SAFETY

Rotational head movements are restricted in a slumped posture. As a result, when driving in a slumped posture, you drastically reduce your field of vision!

Backward bending of the head is almost impossible when slumping. This severely restricted backward head movement with a slumped driving posture may explain why a whiplash injury can result from a slight rear-end impact!

3. SLUMPING INCREASES THE STRESS FROM VIBRATION AND ROAD SHOCK

With a slumped driving posture, the pelvis migrates forward on the seat, losing contact with the lower backrest. (See Figure 1.) This loss of pelvic stabilization results in relatively fast oscillatory movements of the pelvis rocking over the "sitting bones" (ischial tuberosities).

Vertical vibration on the driver’s seat, along with any road shock (from railroad crossings, chuck holes, etc.), intensify this rocking motion of the pelvis. The result is even greater bending stresses to the lower back. The harmful effect of road shock and vibration to the spine is also increased from the tail bone bearing weight on the seat in a slumped driving posture.

Prolonged exposure to vibration when driving results in fatigue of the trunk muscles, especially the lower back muscles. Over time, this fatigue impairs the driver’s position sense - the ability to sense unhealthy changes in the position of the pelvis and lower back. This is why it is critical to always keep the pelvis supported against the backrest of the car seat. As a result, the pelvis and lower back are properly stabilized with the least stress to the spine.

4. THE TRUNK MUST BE STABILIZED FOR HEALTHY, PAIN-FREE DRIVING

In a fixed task such as driving, optimal trunk stabilization is essential for the healthiest driving posture, with the least stress to the back and neck, and the most efficient operation of the controls (steering wheel, foot pedals). This trunk stabilization is due to spontaneous activation of four key muscle groups: the lower abdominals, the pelvic floor muscles, the diaphragm (the main breathing muscle), and the mid-back muscles.

However, several factors can break down the trunk stabilization required for healthy driving, resulting in increased stress to the back and neck, accelerating overall fatigue, and increasing the driver’s reaction time at the controls.

5. PREVENT THE PELVIS FROM SLIDING FORWARD ON THE CAR SEAT

There are three key reasons why the pelvis slides forward on the car seat when driving, leading to a slumped posture and a breakdown of proper trunk stabilization:

    1. Driving with extreme extension of the knees to reach the foot pedals increases the tension on the hamstring muscles in the back of the thighs. This hamstring tension pulls the pelvis forward on the seat.
    2. Movements of the lower extremity with braking and accelerating tend to pull the pelvis forward on the car seat.
    3. Vertical vibration on the seat has a similar effect, causing the pelvis to slide forward on the seat.

Suggestions to prevent the pelvis from sliding forward on the car seat, in order to maintain the essential trunk stabilization for healthy driving include:

5A. TRY MOVING THE CAR SEAT SLIGHTLY FORWARD
Moving the car seat slightly forward increases knee flexion (bending) and reduces the tension on the hamstrings. It is important to note, however, that excessive knee flexion, while beneficial in relaxing the hamstrings, can be disadvantageous for the application of force to the brake pedal.

5B. TRY A STATIONARY INCLINED FOOTREST FOR THE LEFT FOOT
A stationary inclined footrest, located to the left side of the brake pedal, enables the left lower extremity to exert effective counter-pressure for preventing the forward migration of the pelvis on the seat. This feature is available on several car models.

5C. TRY A WOVEN SEAT COVER
As opposed to slippery seat covers such as leather or vinyl, the beneficial friction from a woven fabric keeps the pelvis from sliding forward on the seat.

6. LOWER YOUR HANDS ON THE STEERING WHEEL

The least stressful and fatiguing position for the arms, neck, and back when driving is with the upper arms hanging vertically at the hip line. However, the commonly recommended ten o’clock - two o’clock hand positions on the steering wheel disturb this balanced vertical arm posture, resulting in a forward reaching of the upper arms.

This elevated arm posture increases the forward bending force on the spine via the rib cage. As a result, the optimal trunk stabilization for driving breaks down, leading to a round back and round shoulders, along with excessive tension in the neck and upper back.

The forward reaching of the upper arms when driving can be reduced with lowered hand positions on the steering wheel, such as nine o’clock - three o’clock or eight o’clock - four o’clock.

7. AVOID EXCESSIVE BACKREST INCLINATIONS WHEN DRIVING

A slight backrest inclination (approximately 10 degrees) when driving is important to stabilize the body with accelerating, braking, cornering, and other movements of the vehicle. As opposed to a fully vertical driving posture, shifting some body weight to the backrest helps reduce the spinal stress from road shock and vibration.

However, an excessive backrest inclination (20 degrees or greater) when driving distorts the proper upright relationship of the head, neck, and upper back due to the visual requirements of driving. In order to achieve the proper visibility out the windshield, the driver pulls his/her head, neck, and upper back forward. In addition, the greater the backrest recline, the more the upper arms are lifted forward to reach the steering wheel, adding further stress to the neck, shoulders, and upper back.

An excessive recline when driving relaxes the lower abdominal and back muscles to the extent that the driver has the same trunk muscle activity as an unconscious person! The result is a total breakdown of the optimal trunk stabilization for driving.

PART TWO:
TIPS ON IMPORTANT FEATURES OF THE DRIVER’S SEAT

8. USE A FIRM SEAT CUSHION

A firm seat cushion is recommended for better protection from road shock and vibration, and for preventing the tail bone from bearing weight on the seat. The lack of support provided by a soft cushion greatly increases the driver’s sitting instability. Increased muscle activity is then required to stabilize the body, resulting in greater stress to the spine and greater fatigue.

9. AVOID DEEP BUCKET SEATS

With excessive side to side contouring such as with deep bucket seats, the bony projections adjacent to the hip joints (the greater trochanters of the femurs) bear weight. Based on their structure and function, the trochanters are not designed for bearing weight in a seated position. Such weight bearing quickly leads to discomfort and fatigue when driving.

10. AVOID AN EXCESSIVE BACKWARD SLOPE TO THE DRIVER’S SEAT

A slight backward slope to the seat (approximately 5 degrees) is important for the following reasons:

    1. It helps prevent the driver’s pelvis from sliding forward on the seat, resulting in a slumped driving posture. Remember, the tendency for the pelvis to slide forward is always present when driving, due to the vertical vibration on the seat and the movement of the lower extremity with braking and accelerating!
    2. It helps retain the driver in the seat during a rapid deceleration or emergency stop.

An excessive backward slope to the seat requires greater hip flexion (bending) for sitting. This additional hip flexion is actually accomplished through rounding of the lower back. The result is a slumped driving posture with more stress to the back.

11. AVOID SLIPPERY SEAT COVERS

A breathable, woven fabric is preferred over leather or vinyl seat covers for two reasons:

  1. The increased friction from a woven fabric, as opposed to the slippery surface of leather and vinyl, keeps the pelvis from sliding forward or sideways on the seat.
  2. A breathable fabric aids surface ventilation, thereby preventing the accumulation of moisture under the buttocks and thighs.

12. AVOID SOFT BACKREST CUSHIONS

The softer the backrest cushion, the more the trunk sinks into the upholstery, fatiguing the back and leading to a round back posture. This is the most high-risk posture for back and neck pain.

13. AVOID EXCESSIVE SIDE TO SIDE CONTOURING OF THE BACKREST

A slight side to side contouring of the backrest helps keep the driver’s posture as symmetrical as possible. This lateral contouring is appreciated most by tall drivers.

Excessive side to side contouring of the backrest inhibits proper trunk stabilization by rounding the back and shoulders, and restricting diaphragmatic breathing.

PART THREE:
ADDITIONAL TIPS FOR REDUCING STRESS
TO THE BACK AND NECK

14. AVOID NON-ADJUSTABLE STEERING WHEELS

An adjustable height steering wheel facilitates a more vertical upper arm posture, the least stressful posture for the neck and upper back. If the steering wheel is too high, one is forced to elevate the upper arms.

15. TRY SEATS WITH ADJUSTABLE ARMRESTS

For chronic neck and upper back pain, try a driver’s seat with adjustable armrests, such as found in some vans. Adjustable armrests are especially important for individuals forced to elevate their arms to reach the steering wheel.

16. AVOID CARS WITH MANUAL TRANSMISSION

With a manual transmission, depression of the clutch pedal and gear shifting both increase the pressure in the discs of the lower back. Therefore, with chronic low back pain, an automatic transmission is recommended.

17. A STATIONERY INCLINED FOOTREST IS ONE OF THE MOST IMPORTANT CAR FEATURES!

When purchasing a car, always look for a stationary inclined footrest, located to the left of the brake pedal. This footrest allows the left lower extremity to exert effective counter-pressure for preventing the forward migration of the pelvis on the seat. This is one of the most important features to look for in a car!

18. DO NOT DRIVE WITH YOUR WALLET IN THE BACK POCKET

Driving with your wallet in the back pocket greatly increases the stress to your lower back by tilting your pelvis and spine to one side. In addition, the wallet can exert pressure directly on your sciatic nerve, leading to back and leg pain.

19. AVOID CARS SEATS WITH EXCESSIVE SEAT DEPTH

This is a common problem for many women of shorter stature. When the seat depth is too long, the driver will spontaneously move forward on the seat. This will relieve the uncomfortable pressure from the front edge of the seat pressing into the back of the knees, but it will prevent the pelvis from being stabilized by the lower backrest.

20. AVOID REACHING TO THE BACK SEAT

Do not reach to the back seat from the driver’s seat. The flexion and rotation of the spine required for this movement make it a very high-risk position for developing back and neck pain.

21.USE GOOD BODY MECHANICS GETTING INTO AND OUT OF THE CAR
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22. AVOID LOW CAR SEATS AND SMALL CAR DOORS

Always use good body mechanics getting into and out of the car. The lower the car seat and the smaller the door, the greater the risk for back and neck pain from flexing and rotating the spine.

When getting out of the car, pivot your whole body as a unit on the seat while you bring one leg out of the car at a time. For support, grasp the door frame or steering wheel. When both legs are out of the car, scoot forward on the seat. Move your feet back, under you as far as possible. Then, lean forward from your hips, keeping your back straight. Finally, stand up with assistance from the door frame or steering wheel.

When getting into the car, stand as close to the side of the driver’s seat as possible. Keeping your back straight, slowly bend your hips and knees like hinges while using the door frame or steering wheel for support. Then, pivot your whole body as a unit on the seat while bringing one leg at a time into the car.

For individuals with chronic back and neck pain, automobiles with high car seats and large doors are highly recommended.

23. THE DRIVER’S LINE OF SIGHT IS OPTIMAL IN VEHICLES HIGHER OFF THE GROUND. RESULT: LESS STRESS TO THE NECK AND EYES

With chronic neck and upper back pain, and headaches, avoid cars low to the ground. In these cars, you have to bend the vertebrae in the upper neck backwards for proper visibility out the windshield.

The driver’s line of sight is optimal in vehicles higher off the ground, such as vans and sports utility vehicles. With a higher vehicle, the driver can easily maintain the proper upright head posture with a slightly downward viewing angle out the windshield. This posture is the least stressful for both the neck muscles and eye muscles.

24. WALK DURING REST BREAKS FROM DRIVING

Prolonged passive sitting is considered a causative factor in venous thrombosis (blood clot) of the lower extremity. It is therefore important to walk during rest breaks from driving to restore the venous blood flow from the lower legs and reduce leg swelling.

Walking will also promote proper nutrition to the discs of the spine.

25.DO NOT LIFT ANY HEAVY OBJECTS IMMEDIATELY AFTER A LONG CAR RIDE

Since prolonged exposure to vibration leads to fatigue of the lower back muscles and an impaired position sense, one should not lift any heavy objects immediately after a long car ride. Individuals involved in lifting activities directly after driving are at a very high risk for developing low back pain.

 

SUMMARY
PROPER BODY ALIGNMENT FOR YOUR OPTIMAL HEALTHY AND STABLE
YOGABACK DRIVING POSTURE (FIGURE 2)

(A) Balanced, upright head posture
(B) Elevated rib cage from YogaBack's Lower Thoracic Support
(C) Upper arm hanging vertically
(D) Lowered hand positions on steering wheel
(E) Pelvis up against YogaBack's Sacral Support
(F) Knees bent - but not excessively.

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