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Health and Safety legislation dictates that manual handling training should be provided. But, there is no evidence that one type of technique is superior to another. How should manual handling training programmes be designed, taught and ultimately implemented by organizations?

It is a myth that the spine is an inherently weak structure, resulting from a failure in the evolutionary process. The human spine is, in fact, a perfect example of how structure is defined by function; it is perfectly adapted to the upright posture and capable of coping with large stresses in its upright neutral, "S" shape posture

When exposed to the cumulative effect of poor postures, heavy loads and unnatural movements, the threshold of injury prevention is lowered, resulting in fatigue and ultimately, failure.

Effects of on going exposure to minor trauma and insidious injury are not often obvious. Cumulative 'micro-traumas' are far more wide reaching in terms of their effect on the injury threshold of the spine and development of painful symptoms.

The disc acts as a shock absorber, distributing loads to other tissues in the spine and its fibrous structure both facilitates and controls movement between vertebrae.

The disc can resist compressive loading by imbibing fluid. Its health is Dependant on the movement of nutrient fluids in and out of its structure which is achieved through cyclic loading.

Loads less than those produced in the standing posture allow fluid to be drawn in, whereas loads greater than those produced in the normal standing posture squeeze fluid out... For the disc to maintain its function, the exposure to loading that causes extrusion of fluid should be reduced throughout the day - not just when carrying out manual handling tasks.

For example, a manual worker will be fatiguing the discs in his/her spine whilst driving a vehicle to the location where manual handling tasks will start for the day. The seated journey would have caused extrusion of fluid from the disc making it already loaded to the point of reaching the threshold of injury.

This threshold is breached when the first manual handling task of the day is carried out and sudden pain is experienced. The symptoms of an injury were experienced during the manual handling task after getting out of the vehicle, yet the insidious damage was actually done whilst driving.

When considering the implementation of manual handling training, ensure that exposure of all risks to disc injury are addressed, ensuring that the individual's risk of being close to their exposure limit is reduced before and during manual handling tasks.