WHY NEARLY ALL LOW BACK PAIN PATIENTS SHOULD LEARN TO DEADLIFT 🏋️♂️
If you take away the ‘dead’, the word simply becomes ‘lift’; and that is essentially what it is. Hence, we should be more inclined to teach people with low back pain how to (dead)lift.
A study in 2015 by Bergland et al. demonstrated that barbell deadlift training can result in improvements in pain, reduction in fear of movement and increased activity levels. However, to benefit from deadlifting, individuals need a baseline of strength endurance in the lumbar extensor muscles (measured on the Biering- Sorensen test) and relatively low pain levels.
Alas, we also know there are more ways to deadlift than just the barbell deadlift - the trap bar deadlift promotes a more upright trunk and requires less of the back extensors and more of the quadriceps. The kettlebell RDL also allows the weight to stay closer or lateral to the centre of mass and might be appropriate regressions for those with less back extensor strength endurance or higher pain levels.
What about bending on the deadlift? There’s plenty of studies coming out demonstrating that even with a ‘neutral’ spine position we still get an element of lumbar flexion or reversal of the lumbar lordosis.
My opinion is - learn to hinge first (straight spine), then start exploring movements such as the Jefferson Curl. No point starting on an overly flexed spine without ever learning how to properly hinge. Don’t fear lumbar flexion, but don’t add heavy loads to lumbar flexion without learning how to use the ultimate leverage system of a hip hinge.