Caregiver’s Corner: Not in the Manual—The Real Mechanics of Safe Transfers (with videos)

The most dangerous thing that caregivers do is transferring people. Caregivers are far more likely to hurt themselves this way—helping someone stand, sit, walk, etc.—than in any other way they help someone who relies on them.

This doesn’t just apply to home and family caregivers. You might think that the pros have the information, the help, and the devices they need to be safe, but they don’t.

Last week, I gave a talk on the subject of the danger of transfers and some simple fixes that no one else is talking about. I’m including some short videos from the talk below that will give you information on the dangers you face and how you can stay safer.

My insider knowledge didn’t come from anything or anyone in the industry. If the “experts” in the industry knew proper ergonomics, we wouldn’t be in such a crisis. Instead, I learned ergonomics over the course of 40 years of studying traditional martial arts with truly exceptional instructors.

One of my best “teachers” was actually a student of mine and the first person I ever promoted to black belt. Kris was 6’4”, 260 pounds, and an engineer with a need to test everything to make sure it worked.

He wasn’t an athlete: in fact, he was a little awkward. That actually made him even harder to work with: he would move in strange, unintuitive directions that were difficult to predict. His strength, however, was massive. His favorite words? “That won’t work!” When I proved him wrong, I saw his eyes light up with fascination and curiosity in a way that every teacher longs to see from a student.

These deep dives with teachers and students into mechanics, over decades of training, practice, failure, and occasional triumphs gave me an understanding of the body that can’t be gotten from a 30-minute in-service that treats picking up a person in the same way as picking up a box.

Here’s the thing: it’s difficult to move someone who is fighting you. That takes a lot of study, because they are trying to “beat” you. However, when you’re on the same side, working toward the same goal, you can take a couple of these principles and make your transfers safer and easier today.

Here’s how.

1. Start with Your Posture

Miss Manners was right all along: posture is critical. But it isn’t just about manners or appearance; it’s about safety too. When our bodies are aligned, they function more efficiently. Throw your posture just a little bit out of whack and you destabilize the whole structure.

That means that if your head tilts forward—a condition that has exponentially increased in the modern era because of looking down at cell phones and tablets—you are at risk not just in transfers but in general.

Before you even start a transfer, fix your posture to get your body in the correct alignment. The video below has my favorite tip on how to do that.

Triangles hold the key to balance

There is one super-simple rule to understanding balance that will help you stay steady and stable while you’re helping someone to transfer positions: treat your feet as the base of an equilateral triangle. The third point of the triangle, in front of you and again behind you, is your weakest point of balance.

Despite this, I see lots of YouTube “experts” teaching people to square up when they perform a transfer, overlapping the weakest points of both the caregiver and the patient like this:

The Wrong Tools for the Job

Our brains and bodies are wired to use certain muscles for certain jobs. It’s a good thing, too. If we had to consciously think about every muscle movement, we’d never move!

However, that also means that unless we consider the job we’re doing very carefully, then we’re going to be stuck with the movement we default to. That’s ok when we’re raising a glass of water to our lips, but when we’re doing something much more dangerous—transferring a loved one—it’s worth looking at our movement and considering how to maximize efficiency.

When we pull something to us, our instinct is to use our biceps and deltoids. In this case, our instincts are kinda dumb. Those are weak muscles that are injured easily. We’re going to replace this pulling movement with a martial arts principle: hands always push.

“Wait,” you might ask, “how can I push something toward me? Doesn’t pushing move a thing away from me?” Not necessarily. Push your elbows backward rather than pulling your hands (and what’s in them) toward you. You’ll feel your triceps and trapezius muscles activate: these are bigger, stronger (and safer!) muscles. (This is a lot easier to understand by watching the video. Even if you skip the rest, this is the one to watch.)

Lebron James plays basketball differently, perhaps even better, than I can. 🤣 (I couldn’t sink a shot even if the hoop were 4’ off the ground! Don’t pick me for your team!) Why are the pros in any physical endeavor better than the amateurs? They don’t just default to the first thing their brains and bodies pick.

Instead, they study, train, and ask for help. They don’t assume that they’re doing things right because they “feel” right. I haven’t studied basketball. I just do whatever seems to sort of work, and I leave it at that. This is how most people—even purported experts—approach transfers. This is destroying our backs, shortening our span for being caregivers and ruining our health.

Good martial arts are effective for the same reason that Lebron will always wipe the floor with me on the court. We study our craft carefully. Smaller martial artists can overcome larger people because we understand the mind and body better in this context, and we generally know what the other person is going to do before they do it. We understand how the average “computer” is wired, and we’ve hacked our own “CPUs” to perform at a higher level.

That’s what we have to start doing with transfers. Despite all of the education out there and all of the money you could spend, sky high injury rates indicate that what we’re doing isn’t working. I’ve given you better tips today than most caregivers get in their entire careers. Give these tips a shot and reply to this email to let me know how it goes!

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P.S. If you need deeper, step‑by‑step help, our parent company, elumenEd, offers short, accessible online courses for family caregivers. Explore the library: elumenEd Online Training