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NEWS | March 15, 2017

Preventing deadlift back pain

By U.S. Air Force Capt. Dennis Shay, PT, DPT, OCS, CSCS and Ryan Moore, PT, DPT 628th Medical Operations Squadron

Some of the most common causes of back pain seen in the physical therapy clinic include poor posture, job specific and exercise induced injuries.  As a sports medicine team, with physical exercise, it is our objective to give appropriate guidance and feedback so everyone maintains mission ready capability.

Recreational use of the deadlift, among other Olympic lifts, is an exercise, if done incorrectly, can have devastating consequences. Improper form with deadlifting applies to both high load/low repetitions and low load/high repetitions. The posture which creates the greatest pressure on the intervertebral discs is bending forward when lifting weights from a seated position, which is similar to performing the deadlift.

The intervertebral disc is a fluid filled structure between each vertebrae of the spine, with a hard outer layer and soft core. With increased pressure, the soft core can push on the outer layers and can cause bulges or herniation which can compress the nerve roots behind the discs, causing pain and/or lower extremity weakness. Disc herniation ranges in severity, some requiring medical treatment; up to and potentially including surgery.

The Deadlift  

The deadlift is a multi-joint exercise and works several muscle groups simultaneously but deadlifts will not help improve your AF Fit test significantly. We recommend a solid stability and core strengthening program before initiating lifts such as the deadlift. As with all Olympic lifts, correct form and proper preparation are essential to prevent injury. Form should be reviewed prior to attempts at deadlifting, especially max efforts. A good, free site to use is the National Strength and Conditioning Association (NSCA) for Olympic lift instructions/videos. A video posted to the site, https://www.nsca.com/Videos/Conference_Hands-On/Simplifying_Olympic_Lifts/  by Tyler Christiansen, CSCS*D, highlights the importance of form for tactical and Olympic lifts. It is always good to have a spotter watch your form and make corrections prior to initiating a lift.

Corrections to Prevent Pain with Dead Lifting

  • Avoid rounding your back forward as you lower the bar.  Don’t lean backwards at the top of the lift.  The lift ends when your knees are straight.

  • Relax your shoulders; don’t try to shrug the bar at the top.

  • Don’t bounce the bar to build momentum.  Let the plates touch the ground and rest for a second before lifting.

  • Keep the bar close.  The bar should be aligned over your mid foot and should scrape your shins as you lift up. Wear pants or tall socks to prevent injury to the skin on your shin. 

Alternate Lifts

Below are identified some appropriate alternatives to higher risk lifts such as the deadlift. These exercises are multi muscle group exercises that decrease load on the back while also incorporating balance and recruitment of accessory muscles.

Single Leg Dead Lift  

The lift is performed by standing on one leg with a kettle bell in your hand and bending forward to touch the ground with the kettle bell while lifting the other leg so it stays parallel with your torso.  This lift helps improves core strength, hamstring flexibility and balance.  If you have any pain performing single leg dead lifts, start by just performing to chair height rather than all the way to the ground for several weeks to build tolerance. A good beginning workout design is three sets of 10-15 repetitions.

The single leg deadlift is not the only large muscle group exercise providing a great workout with less intradiscal pressure. Other exercise options include but are not limited to: single leg squats, single leg stance on the BOSU ball, lunges and step ups.

Summary

The clinic recognizes the dead lifting is not for everyone. If you have back pain you should not be dead lifting.  If you don’t have back pain, deadlifting can be incorporated into a routine, though the identified guidelines and recommendations should be followed. Maintaining correct posture and avoiding excessive fatigue certainly can help with injury prevention. Even with perfect form, appropriate training and exercise progressions, back pain still happens. Over our lifetimes, most all of us will have back pain from time to time. However, if a specific activity persistently causes back pain; modification or intervention may be warranted.