The Dreaded Deadlift: Should you do it if you have back pain?
YES! Okay now for the longer answer…
If I had a quarter for every patient or client I’ve ever had that told me they avoid deadlifting because he/she believes it is “bad” for his/her back, I’d be rolling in dough. The deadlift; really the ability to hinge at the hip, is one of the most important components of “bulletproofing” your body from back pain. If you have pain already, nailing this pattern down will help to rehab your injury/chronic pain and prevent future exacerbations. If you don’t have pain and you’re hinging correctly, you’re helping prevent injury.
Here’s why…
The hinge is your body separating out hip movement from lumbar spine movement. You are moving a stable spine on a mobile hip, which is what we want for so many functional movements, such as reaching into a crib to pick up a baby, reaching into a car trunk to lift a suitcase, loading the bottom rack of the dishwasher. These are activities where you can’t necessarily “bend at the knees” as the stereotypical lifting advice dictates. So why does it have such a bad rep? Because so many people don’t have the pattern mastered.
Here’s how I like to start, with a dowel hinge. The dowel gives you external feedback so you have a better understanding of where your spine is in space. With training this is something you will begin to FEEL without use of the dowel.
Once you master the movement without weight, you can add weight! I like the RDL to start, it’s more back-friendly so to speak. Here are some tips on alignment to get started:
Here is where we can start to add in modifications if this does not transition well and you have pain or feel your back with this movement despite mastering the pattern with the dowel.
Sometimes it’s just a matter of modifying your range by elevating the "bottom” of the movement:
Sometimes it LOOKS perfect, but you’re still feeling your back. This is where motor control comes in! The human body is very good at cheating when it’s used to using certain muscles more than others. In a person with back pain, especially chronic back pain, the body LOVES using it’s lumbar extensors a lot and the gluts and hamstrings very little. This puts you into a vicious cycle. Here’s one trick that might help you fix that:
Still not quite there? There’s still hope! Look for a local PT or strength coach with a strong corrective background and go see them! You got this!