Deadlift: Part of the PRoblem or Part of the solution

When most people hear the word deadlift they get a nervous look on their face and often times tell you that they have been told by their doctor, physical therapist, chiropractor, etc that they should not perform deadlifts due to their back problems.  Well I am here to tell you that avoiding this movement pattern is not the answer, and honestly almost impossible to avoid. So, instead of avoiding maybe we should start prescribing this movement.

Every time you bend down and pick up an object from the floor you are performing a deadlift movement, and most of us are doing it wrong.  A majority of the population will just bend forward rounding their back and shoulders to pick something up off the ground placing unnecessary stress throughout their spine putting themselves at an increased risk of injury.  
Here are some statistics about low back pain: 

• 31 million people in America experience low-back pain at any given time.1
• A majority of back pain is mechanical in nature, meaning that it is not caused by a serious medical condition such as cancer or inflammatory arthritis.
• 80% of people will experience some type of back pain in their lives.2  
• Low-back pain is the third highest reason that people go to the doctor. 
• Americans spend at least $50 billion each year on back pain.3

Those are some daunting numbers to digest.  When I look at those numbers it tells me that the typical treatments currently being offered in our healthcare system are not as effective as they could be.  So what is missing? I believe part of the answer is truly teaching people the proper mechanics of lifting. As I said earlier the deadlift is one of the most common movement patterns utilized by humans while just performing everyday tasks.  

Most people will tell you that they know they are supposed to lift with their legs and keep their back straight, but that is the extent of the common person’s movement training.  Let me tell you from my experience as a doctor of physical therapy, that instruction leads to a wide variety of movement strategies that people are adopting with a vast majority of these movements being inappropriate and likely to lead to injury.  It is my belief that there is a significant disconnect in what it truly means to maintain a proper position of the spine and lift with the legs. So today, I want to give some basic instructions on how to safely and efficiently lift something from the floor, utilizing the principles of a deadlift. 

Here are simple cues that I give my clients when teaching them to perform a deadlift:

• Begin standing with feet hip-width apart, and be sure to not lock your knees
• Pull your shoulder blades together, and tighten your abdomen (this keeps the back/spine in a braced neutral position during the movement)
• Initiate the movement by thinking about pushing your butt backward and hands should go straight down by the sides of your knees
• It is important that you do not actively bend the knees, but instead allow them to bend on their own as you focus on pushing the butt backward
• As you stand up, think about keeping the shoulder blades squeezed together and squeeze your butt tight to pull you back up to a standing position.

Here is a photo of what the finish position should look like:

This movement strategy allows you to maintain a proper neutral position of the spine reducing the injury-producing shear forces to the spine, as well as reducing the amount of stress placed on the knees when compared to squatting all the way down.  With this information, let us start to fight the epidemic that is low-back pain, and get people back to being able to lift heavy objects from the floor.
  

References

1. Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.

2. Ibid.

3. In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD.