Deadlifts and Low Back Pain

With an increasing number of people remaining seated for long periods of time in office jobs, neglecting movement and exercise, and numerous other factors, most people experience some type of low back pain at some point in their lives. While the current evidence is unclear about the main cause of low back pain (Berglund, et al., 2015)., results from several research studies over time have indicated that deadlifts have improved lower back pain, even for those who performed the movement through moderate pain (Long, n.d.). While deadlifts were only prominent in powerlifting, athletes around the world perform the movement to build their hip, thigh, and back strength (Berglund, et al, 2015). A particular study in Sweden revealed an easy method with two conditions to determine whether people with low back pain should deadlift.  (Mandala, n.d.). Patients with a pain severity less than a score of 60 on a scale of 1-100, and people who are able to withstand more than 60 seconds on the Biering-Sorensen test were cleared to return to deadlifting (Mandala, n.d.). Another study that examined 35 patients with low back pain during and after an eight week training cycle reaffirmed validity of the test (Berglund, et al., 2015). In an attempt to gather accurate data, two physical therapists gathered subjects who sought care for experiencing back pain for at least three months. The results from the study indicated that people who had a low performance on the Biering-Sorensen test were less likely to benefit from deadlift training. The test was a reliable predictor because it challenged the ability to activate the stabilizing hip and back extensors for a long period of time which is required for performing deadlifts (Berglund, et al., 2015). A variation of the Biering-Soresen test can be performed if a glute ham raise machine is available, by climbing on and locking the feet, with the pads right under the hips. If 60 seconds can be endured in this position, people should feel safe performing the deadlift (Mandala, n.d.). 

There are many factors to consider in order to successfully deadlift without pain. Having proper form and ensuring that your body is in a strong position to lift the weight is one of the most important considerations. It is crucial to “maintain a neutral spine throughout the motion by keeping the lower back flat and avoiding excessive upper back rounding” (Mandala, n.d.). Maintaining such a position will “require extensibility of muscles around the hip and the activation of stabilizing muscles”(Berglund, et al., 2015). For most people, ensuring that the barbell is over the middle portion of their foot will result in a strong starting position. Rotating the elbows inward toward the body will help activate the upper back muscles. People should take a big breath of air before each repetition, bracing their core properly throughout the whole set. In addition, foot stance should be around hip width and hips and shoulders should rise together as the movement is performed (Long, n.d.). Lastly, externally rotate the hips (bring both knees away from the middle) to activate the glutes and ensure that hip height is not too low. 

There are many variables that can be adjusted in the deadlift in order to find a way to avoid pain. People should assess if they feel pain regardless of the weight on the bar or if the weight reaches a certain range. For example, someone who was used to deadlifting 300lbs may feel fine until they start to experience pain when the weight reaches 250lbs. People can deadlift with lighter weight by pausing the barbell at various points, such as on the middle shin, or right under the knee. The movement can also be slowed down so that pain can be avoided while still producing a training effect. 

There may be times when the only way to deadlift without pain would be to adjust the range of motion. Some individuals may feel pain at the beginning of the movement when lifting the bar off the floor or toward the end while locking out their knees. If pain is felt during the initial portion of the lift, people can place the barbell on blocks or inside of a squat rack on the pins, at the desired height. People can bring the bar back down as soon as it reaches their knees if the second portion of the lift causes discomfort. Utilizing other deadlift variations such as the trap bar deadlift, Romanian deadlift, or stiff-leg deadlift may be useful since the joints and ligaments can be relieved from the same overused movement pattern. If all of the mentioned methods above are unsuccessful, people can train the lower back directly and strengthen other muscles around the lower back.

Written by Jun Bae, student of Dr. Natasha Hastings