By Susanne Michaud, DPT, OCS
Sunshine, birds singing and buds poking through is Spring’s call to all gardeners to go outside and play. We heed the call, pick up our gloves and tools and head outside to find our bliss in dirt and seeds and bugs and plants. As gardeners, we “Just Do It” – good news, bad news… This early spring exuberance to dirty our hands, however, should come with a warning: BEWARE OF OVER DOING IT! Many of us gardeners know the joy of those first weekend days in the yard only to wake up on Monday morning stiff and stooped and aching.
As a physical therapist, I regularly see clients in early spring with “gardener’s backs”, “weeder’s wrists” and “pruner’s necks”; in other words, doing too much too soon without proper warm-up or conditioning for the long hours in the yard. Gardeners are athletes, whose sport it is to prune, weed, dig, sow, plow, plant, mulch, water, thin, fertilize, spread, haul, propagate, etc. Gardening requires strength, flexibility, endurance, agility and pacing. As such, we are NOT exempt from training and conditioning to counterbalance the demands of the job.
The benefits of gardening are tremendous, including, but not limited to, relaxation, a feeling of purpose and creativity, mental stimulation, physical activity, community engagement and a deep connection to the earth and seasons. This article will provide some tips to reduce injuries and overuse that playing in the dirt can cause.
Just as you prepare the soil for planting, prepare your body by doing warm-up movements and stretches before digging in the dirt.
- Get inspired by taking a 15 minute walk in your neighborhood, checking out your neighbors yards and plantings.
- Grease your joints and muscles with a few dynamic movements. Examples include: repeated marching arm swings with high knees; sit to stand squats with downward reaches; forward, side and backward lunges; standing trunk rotations; neck circles; wrist circles; arm circles, etc. (see dynamic exercises below).
- Stretch the shoulders, back, and legs after active movements (see stretches below).
Pace & Plan
Injury risk increases when we go too far too fast. Appropriate planning and pacing, regular practice, and mindfulness around types of gardening tasks will reduce this risk.
- Consciously spend less time in the garden early in the season. 1.5 hours should be the maximum time spent in the garden for the first 3-5 days of gardening.
- Create an overall garden plan and execute that plan by dividing the tasks into smaller bouts, parsed out over the week. For example:
- Saturday weed for 20 minutes, dig for 20 min., transfer plants for 20 min.;
- Sunday mow for 20 min., weed-whack 20 min., sweep 20 min.;
- Monday water 30 min.
- Vary the tasks frequently to avoid muscle fatigue. Set a timer on your phone to ring every 20 minutes and change gardening tasks. Think 3 activities in the yard per hour.
- Avoid prolonged repetitive motions. If this can’t be avoided, then take 5 minute rest breaks every 15-20 minutes while doing the task. Injury risk to tendons and nerves is highest with repetitive motions.
- Listen to when you feel tired and/or sore and take a break.
- Stay nourished and hydrated throughout the day.
- Alternate lighter tasks with heavier tasks.
- Time your gardening at the cooler time of day to prevent heat related issues.
- Prevent falls by being aware of holes and divots in the ground, having a wider base of support on uneven ground and being mindful of slippery surfaces like mud, rocks and wet decking.
Form & Function
Proper form and alignment, coupled with efficient, functional movements serve to keep you gardening longer and stronger.
- Check your posture before using tools – keep back straight, knees slightly bent (not locked or overly bent), hands in “handshake” position whenever possible, and keep wrists neutral when holding tools (can lose up to 25% strength when wrist is bent).
- Avoid prolonged stooping, twisting or leaning.
- Strongly exhale before heavy lifting.
- Engage abdominal muscles before pushing, pulling, reaching and lifting activities.
- Hold heavy objects close to your center.
- When lifting objects from lower to higher surfaces, bend at hips and knees and keep hips higher than knees (for more details see lifting blog by Coral Lewis & Laurie Gribschaw).
- Square hips and shoulders with most tasks to avoid twisting especially with forward bending and lifting activities.
- Keep back straight with squatting and kneeling activities.
- Whenever possible, use a long handled tool, such as a shovel, hoe or fork, to minimize getting up and down off the ground.
- For low to the ground activities, try ½ kneeling (one foot on ground in front, 1 knee on ground), sitting on heels kneeling, 4 point kneeling with back straight or using a low to the ground stool. Consider using knee pads, a kneeling pad or a garden kneeler (https://www.gardeners.com/buy/deep-seat-garden-kneeler/40-009+++PR.html) to protect the knees.
- If sitting on the ground, keep the spine straight and avoid twisting. Hinge at the hips to reach.
- If possible, create elevated/raised gardening beds to avoid prolonged stooping. Ideal garden beds are 4’ wide and 3’ high: that way you can reach the center of the bed easily and can avoid stooping over.
- Gloves: these provide protection against thorns, scrapes, blisters, splinters, microbes and chemicals found in fertilizers and pesticides. Cuts, dry and irritated skin and infections can occur when hands are not protected. Gloves should fit well to prevent blisters and grip injuries with tools.
- Boots with good traction to protect against slipping and tool impact.
- Long pants to protect legs from scrapes and flying objects.
- Hat with a brim for sun protection.
- Eyewear to protect from sun and flying objects.
- Ear protection for power tools.
- Suntan lotion: protect exposed skin with a full spectrum product.
- These include trowels, weeding forks, hand rakes, hand hoes and pruners.
- Always better to use tools instead of using your hands.
- Use tools that fit your hand, but be cautious when buying “form fitting” tools – they tend to fit only 1 size hand.
- Good to have tools with safety locks for safe storage.
- Keep tools sharp to minimize amount of force needed to use.
- These include shears, shovels, hoes, rakes, spades.
- Check that the handle feels good in your grip.
- Use these tools to avoid prolonged stooping or kneeling.
- If tall, look for longer handles.
- When not in use, set tool face down on the ground to avoid a “cartoon” moment of stepping on a rake and having the handle knock you in the forehead.
- These include lawn mowers, weed-whackers, chain saws, blowers, and edgers.
- Maintain well: tune up machines 1x/year, keep blades sharp, fresh gas and clean oil, weed-whacker spools of string filled.
- When not in use, disconnect power tools and disconnect spark plug wires on gasoline tools.
- Wear protective gear for ears, eyes, feet and limbs.
- Prior to using, clear area of debris (stones, sticks, wires & other debris) that could fly and put you in danger.
- Start engine on firm ground to get good footing.
- Pay attention to what is going on around you and stop engine if someone is within 30-60 feet.
- Keep the weed eating at or below knee level.
- Allow engine to cool before refueling.
- Traditional style has 1 wheel in front and requires more strength and stability to lift and lower.
- 2 wheel options exist and provide more stability and ease in maneuvering – these are recommended for those with back issues or older gardeners who have difficulties with the single wheel.
- If the tire is pneumatic, keep it inflated. Pneumatic tires are generally smoother and easier to push when the tire air pressure is maintained.
- Keep loads light and make more frequent trips.
- Operating technique: keep elbows relatively straight, lift with feet separated and ½ step length apart, bend knees and hips and push through feet to lift up. Unload the barrel by tilting the front forward while in a split stance position, and pushing off the back leg to empty the load.
Watering hoses and buckets
- Appreciate that a 3 gallon bucket filled with water weighs 24 lbs.
- Use a nozzle on a longer wand to reach higher hanging plants and plants at the back of garden beds.
- Use the nozzle’s trigger locking mechanism to minimize prolonged squeezing.
- Hoses can be heavy and unwieldy – clear the area when pulling hose to intended site.
According to the American Hand Surgeons Association, garden tools and gardening account for over 400,000 emergency department visits per year. A 2006 study by the British Society on the Prevention of Accidents reported 87,000 gardening tool related injuries, including lawn mowers (6,500), flower pots (5,300), pruners (4,400), spades (3,600), electric hedge trimmers (3,100), plant tubs and troughs (2,800), shears (2,100), garden forks (2000), and hoses and sprinklers (1,800). Another British report by the Daily Telegraph found that 1 in 10 Britons have been injured in gardening, which is 4 times as many injured on the ski slopes
Gardening employs a multitude of movements that can lead to overuse and overload injuries. Usual gardening movements include lifting, pulling, reaching, pushing, cutting, kicking, gripping, picking, kneeling, bending/stooping, squatting, lunging, twisting and pivoting. No wonder we get hurt… The most common orthopedic injuries from gardening include
- low back pain/strain
- shoulder tendinitis/tendinopathy
- neck pain/strain
- elbow strain (medial and lateral epicondylitis)
- carpal tunnel syndrome
- thumb strain (De Quarvain’s tenosynovitis)
- knee pain/strain
Should any of these injuries occur, it’s best to “nip them in the bud” before they become a bigger problem and so you can continue to enjoy your yard. Physical therapy is a great first choice for treatment of any of these problems.
Cuts, scrapes and bruises are par for the course when working with thorns, branches, and sharp tools. Clean a cut immediately with mild soap and lots of clean water. Dress the wound with a sterile bandage, then apply pressure and elevate to stop the bleeding. An emergency room visit may be needed for a bad cut if:
- bleeding continues despite 15 minutes of continuous pressure on the wound
- Persistent numbness or tingling in the finger tips
- Trouble moving finger tips
- Unsure about tetanus immunization status
- Unable to thoroughly clean the wound
In conclusion, gardening is a fantastic way to stay active, to beautify your neighborhood, to stimulate your brain and to feed your soul. With good awareness, good tools and good form you can minimize your risk of injuries in the garden. But even with all these precautions, injures can still happen. Should you find yourself with a gardening injury, or have a pre-existing orthopedic issue that limits your participation, then schedule an appointment with a physical therapist at Stride Physio to get back outside and enjoying the fruits of your labor.
I. Pre-Gardening Warm-up
- Walk in neighborhood 15-30 minutes
- Dynamic warm-ups
- Standing awareness
- Posture check: soft knees, feel feet, weight shift (for/back & side/side)
- Shoulder rolls x 5 each direction
- Neck roll semi-circles x 6
- Wrist rolls x 5 each way
- Inhale reach arms up, exhale arms down x 5
- High knee marching with alternating arm swings x 10 total
- Forward lunge and alternating arm swings x 10 total
- Side lunge with same side arm reach x 10 total
- Sit back squats to standing heel raises x 10
- 4 point kneeling:
- happy dog/sad dog (a.k.a. cat/cow) x 10
- tail wag x 10 total
- bird dog x 6 total
- rock back hips to heels x 5
- arm reach rotations (a.k.a. thread the needle to open chest) x 10
- Prayer stretch – kneel on heels, arms reaching forward x 5 deep breaths
- Trunk side send in kneeling or standing x 3 deep breaths
- Crossed arm stretch x 30 seconds each side
- ½ kneeling hip flexor stretch x 60 seconds each side
II. Post Gardening Cool Down
- Supine (lying on back)
- Knees hugged to chest – hold 30-60 seconds and breath deeply
- Bent knee rocking side to side (feet on ground) – 10x
- Single knee hug with active knee straighten/bend – 10x each side
- Hip flexion isometric: bend hips & knees 90 degrees; put hands on thighs and push as thighs resist; keep back down and feel abs engage. Hold 10-20 seconds. Rest 3 breaths. Repeat 3-5x.
III. General conditioning for Gardeners
- Regular aerobic exercise: 30 minutes minimum per day of HR elevation of 40-60% max. If rate is 60-80% can do 3x per week
- General strengthening exercises
- Stair step ups to high knee – 10x each side, 2-3 sets
- Long lunges, up down – 10x each side, 2-3 sets
- Squats with arm reaches – 10x, 2-3 sets
- Partial planks with arm lifts – 10 second holds, alternate arms 5x
- Bridges with marching – 10x, 2-3 sets
- Leaning over “lawn mowers” for triceps with weight (3-10#) – 10x, 2-3 sets
- Standing “scaption” (straight arm lifts from sides to above shoulders, use 2-10# weights) – 10x, 2-3 sets
 “Gardening Riskier Than Skiing”. Daily Telegraph, April 30, 2010.