February 25, 2020
Within the last week, 2 different people and I discussed lifting as it relates to back health. One described a physician cautioning against the deadlift, suggesting axial loading (like squats) was healthier. Yet, I cannot remember any classes or education we had on weightlifting in medical school. The second coach was discussing how deadlift was the most common scapegoat for any lower back discomfort. The fact is, any movement can cause injury or harm if performed improperly but avoidance or abstinence can increase injuries as well. What makes the deadlift more ominous (than even axially loaded squat) is the sight of heavy lifting. The visual of big weighted plates and large men conjures up an irrational fear of a movement which could save an athlete’s life…or at least their back.
Most if not all low back (lumbar) injuries occur due to insufficient stabilization. No research has monitored quality of deadlift performance and its negative effects on back health. In fact, lower back pain is actually caused by excess mobility, particular excessive mobility at the lumbar spine. More importantly, a deadlift has the opportunity to heal the spine by restoring core stability through its unlimited resistance level. So to reinforce this stabilization, the tempo of the deadlift must be emphasized as the weight is lowered to the floor. Instead of counting (for tempo), a more objective goal is for the weights to “kiss the ground,” quietly changing direction from the floor. For maximal strength exercises (like deadlift) we increase weight as a specified percentage of body weight, before increasing range of motion. For example, beginners should use a deficit (plates on the ground or trap bar) to practice getting in the correct positions under load before adding range of motion by eliminating the raised surface.
Deadlifts are one of the first exercises we use following surgery because it emphasizes stability, unlike squat which does involve more mobility inherently deemphasizing mobility and range of motion. We always look to longitudinal studies with exercise so in 2015, a study looked at the effects of a 16-week free-weight resistance training routine on patients with lower back pain for greater than 3 months in duration. Significant improvements in fatty infiltrate of the lumbar muscles, a 72% decrease in pain scoring, 76% improves in disability measurements, and increases in quality of life assessments.
References
Mayberry, John K et al. “Improving Vertical Jump Profiles Through Prescribed Movement Plans.” Journal of strength and conditioning research vol. 32,6 (2018): 1619-1626. doi:10.1519/JSC.0000000000002248
Welch, Neil et al. “The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back.” BMJ open sport & exercise medicine vol. 1,1 e000050. 9 Nov. 2015, doi:10.1136/bmjsem-2015-000050