DEADLIFTING AND LOW BACK PAIN
The deadlift is an extremely popular exercise for athletes and the general population in those looking to build strength. However its influence and safety for people with lower back pain is often debated, particularly due to high compressive and shear forces it places on the spine (Eltoukhy et al., 2016).
There is now solid evidence to support the use of the deadlift in the rehabilitation of people with mechanical lower back pain. A recent trial found that two-thirds of participants who undertook deadlift training for lower back rehabilitation achieved significant improvements in pain, activity levels and trunk muscle strength/endurance (Assa et al., 2015).
So how do we know who will and who won’t benefit from deadlifting? And when is it safe to do so after an episode of lower back pain?
Another study (analysing the individual factors in people with low back pain) found those with lower reported pain intensities at baseline and those with higher endurance of the back and hip extensor muscles would benefit the most from deadlifting (Berglund et al., 2015).
Pain intensity was measured on a 0-10 scale, and scores of below a 6/10 at baseline were predictive of successful outcomes from deadlifting.
Back and hip extensor endurance was measured with the Biering-Sorensen test. This test is performed with the subject face down on a bench, with the lower half of the body strapped/held down, and the upper body unsupported in the air. The ability to hold this position for > 60 seconds was predictive of successful outcomes from deadlifting.
The current research evidence tells us that we should not hesitate to use the deadlift as both a strength and conditioning exercise, and as a rehabilitation tool for low back pain. Although if pain intensity is high and back/hip extensor endurance is low, then other interventions should be considered first.
Above all, the proper coaching and achievement of proficient skill in execution of the lift should always be the most important consideration – there is no such thing as a bad exercise, only a poorly executed one!
Chris Bryceson
B. Health Sciences (Physio), APAM
CB Physiotherapy