Is Deadlifting Good for your Back?
The deadlift is an excellent exercise to develop full body strength that is commonly seen in the gym, but not so often in physical therapy clinics. The deadlift gets a bad rap for stressing the lower back and spine. Some people avoid the exercise their whole life while others throw it in the can after experiencing their first episode of low back pain.
Various comments I hear from people who do not deadlift or are afraid of deadlifting…
“It puts too much stress on the spine”
“I’m afraid I’ll hurt myself”
“Your back shouldn’t take that much load”
The goal of this blog post is to discuss the benefits of deadlifting and how it can be used for patients with low back pain.
What is a Deadlift?
The deadlift is a hip hinge movement pattern created by flexing your hips with a flat back and mild to moderate knee bend. The movement is primarily powered by the glutes with the assistance of hamstrings, quads, and low back. The deadlift also activates spinal stabilizing muscles to a greater extent than low load core stability exercises on the floor.
Benefits of deadlifting:
- Increase strength and load capacity
- Increase bone mineral density
- Improve functional movement
INCREASE STRENGTH AND LOAD CAPACITY
Our bodies need load in order to withstand load. Most injuries occur when external load exceeds the internal capacity of the tissue. High load resistance training increases the capacity of our tissues building strong resilient bodies. Deadlifting is a safe and effective way to increase load capacity of the hips and lower back. For more about load capacity, visit our blog post “rest will not heal your tendinopathy.”
Deadlifting strengthens the following muscles groups: glutes, hamstrings, quads, lower back/ erector spinae, latissimus dorsi, trapezius, forearm/ grip strength, abdominals, and deep spinal stabilizers. Deadlifting also improves function and ability to perform daily activity.
Welch, et al conducted a study in which 30 participants underwent a 16 week free-weight progressive resistance training program including deadlifts, squats, lunges, planks, and step-ups. Intensity parameters were set between 6-10 one rep max.
The following MRI findings were found between L3-S1 among the participants: 33 disc herniations without nerve compression, 11 disc herniations with nerve compression, 20 facet joint degeneration.
At the end of 16 week program they found significant improvement in fatty infiltration of the lumbar muscles, 72% decrease in pain scoring, 76% improvement in disability, and increased quality of life.
INCREASE BONE DENSITY
Wolff’s law states that bone will adapt to loads under which it is placed. Deadlifting is an excellent exercise to promote strong healthy bones particularly in the lumbar spine and upper leg bones. This holds true even for individuals with osteoporosis and osteopenia.
A study done by Watson included 101 women greater than 58 years of age with low bone density (t-score less than -0.1) in their hips and spine. The participants were divided into two groups: low load resistance training and high intensity resistance training (HIRT). The HIRT program included deadlifts, overhead press, and back squat. Once fundamental movement patterns were established, the lifts were loaded to 80-85% of one rep max for 5 sets of 5 reps.
At the end of an 8-month training program, the HIRT group showed superior results in bone density, strength, and physical performance compared to the low resistance training group. It is important to note that zero occurrences of fractures or major adverse events occurred in any woman with low bone density lifting at 80-85% intensity.
IMPROVE FUNCTIONAL MOVEMENT
Deadlift training can improve strength and performance of functional daily activity such as lifting laundry, groceries, children, pets, and other household chores.
It is common for individuals to avoid positions or no longer intentionally perform movements they were doing when an injury occurred. Although this may sound like a bullet proof way to avoid another back injury, you are doing yourself a big disservice both physically and psychologically. After experiencing an episode of back pain while bending over or lifting, it is unreasonable to think you are never going to pick up anything heavy from the floor again. Avoiding this movement for prolonged periods decreases your load capacity in the movement further increasing your risk of injury. Fear and apprehension in the brain can lead to premature protection responses when this movement finally is performed. Additionally, pain-related fear has been shown to be a valid predictor of chronic pain and disability.
There is something empowering about repeatedly picking up heavy weight, especially when the mere act of getting out of bed once seemed impossible. Consistently deadlifting with moderate to heavy loads trains our bodies to be strong and confident in lifting objects from the floor, which occurs more frequently in our daily lives than one might consider. Learning proper mechanics followed by progressive resistance training can build your overall capacity to perform the movement with increased confidence and decreased risk of re-injury. The more you expose yourself to a movement, the less likely you are to get hurt by that movement.
DEADLIFTING AND REHABILITATION
There is research to support the use of deadlifting to treat lower back pain. However, it should be used selectively, coached appropriately, and prescribed based on individual clinical presentation.
A study by Berglund included thirty-five participants with chronic mechanical low back pain. The participants performed deadlift training under the supervision of a physical therapist with powerlifting experience. Results showed that participants with less disability, less pain intensity, and higher performance on the Biering-Sørensen test, which tests the endurance of hip and back extensor muscles, at baseline benefit more from deadlift training.
Deadlifting probably isn’t the first thing that should be added to your plan of care if you walk into a clinic with 8/10 pain and need to use your arms to climb back up your legs after picking a tissue up from the floor. This does not mean you should never deadlift. After appropriate techniques are used to manage pain levels, restore mobility, and increase isolated lower back strength and endurance, there are many benefits to deadlift training.
It is important for your physical therapist to be trained in strength and conditioning in order to properly instruct the movement, monitor your performance, and progress your resistance.
Deadlifting is a safe and effective exercise to increase full body strength and load capacity. With appropriate mechanics and load progression, deadlifting can safely strengthen the low back and deep spinal muscles. Deadlift training can improve strength with functional daily activity such as lifting laundry, groceries, children, pets, and other household chores. Deadlifting with chronic back pain or after an acute episode of back pain is most effective with manageable pain levels and baseline spinal extension endurance.
Look out for our next blog post highlighting deadlift progressions used in rehab programs following episodes of back pain.
Written by Hannah Sweitzer, DPT, OCS, CSCS
1. Welch N, Moran K, Antony J, Et al. The Effects of a free-wight-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 Exerc Med 2015;1:000050. doi:10.1136/ bmjsem-2015-000050.
2. Watson SL, Weeks BK, Weis LJ. High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. Journal of Bone and Mineral Research. Feb 2018. Volume 33 issue 2 pages 211-220. https://doi.org/10.1002/jbmr.3284
3. Berglund L, Aasa B, Hellqvist J, Michaelson P, Aasa U. Which Patients With Low Back Pain Benefit From Deadlift Training? J Strength Cond Res. 2015 Jul;29(7):1803-11. doi: 10.1519/JSC.0000000000000837. PMID: 25559899