Let's just cut to the chase here. Deadlifting is one of those exercises that gets a bad rap.
Many of us have probably known someone to injure their back deadlifting when they were young, dumb, and loading as much weight on the bar as possible without any regard for their body. But that right there should tell you everything you need to know. I would argue that nearly all back injuries from deadlifting can be boiled down to doing too much, doing it to quickly, or doing it with poor form.
Some people completely avoid the movement because they think it will injure their back and "blow out a disc". They see it as more risk compared to the "reward" they would get out of the movement. Fair enough, I understand that. But I find most of the people that have that mindset don't have much experience deadlifting, and don't understand the proper form and the insane benefits you can get from performing deadlifts in your exercise routine.
So while I admit there are some potential risks to deadlifting, most of those can be avoided by focusing on a few specific and simple pieces of advice.
I mean, how hard can picking a weight off the ground be right?
Surprisingly, the deadlift is a very technical movement. And if you're new to lifting weights, or you're tying to progress your weight lifting in any way, locking in your form is a great place to start.
That title is probably gonna trigger some people, because everyone will have variations of the same form and setup when deadlifting. And that's because most people have slight variations in their body and limb proportions.
Without going into TOO much detail, a 6 foot tall male with long femurs (leg bones) and short torso will have a much different setup and form than a 6 foot tall male with shorter femurs and a longer torso. It's all about the angles and the position your muscles and joints have to get into.
So anyway... where were we....
With any lifter of any skill level, we're gonna start from their setup, or how they approach the bar and get into a starting position. To keep it simple, we can break it down into 5 key points...
Those 5 points will get just about anyone into a great setup position. Now that is only half the equation, as you still need to lift the bar off the ground. And that is where many lifters will start to break down. Executing the lift while maintaining great form is hard, especially if you're lifting heavier and reaching the point of technical failure.
If you find yourself having a lot of difficulty finding and maintaining a neutral spine position and you're not sure if you're rounding your back, here is a drill I implement with many of my patients that have back injuries and are getting back into lifting again. This drill teaches neutral spine in regards to lifting weights off the ground, helping you develop the body awareness to know good from not as good.
There are hundreds of "cues" out there that are made to keep your setup and form strong and prevent the weight from folding you in half. These cues are made to help you focus on one body part or another to properly position yourself, brace your spine, push with "right areas", move where we want to and prevent movement where we don't want it. These are some that I have found most helpful for both myself, and the lifters that I help on a daily basis.
"Pressure through your arch" and "Tripod foot"
"Push the ground away"
"Wedge yourself into the bar"
"Pinch this piece of paper under your arms"
"Take the slack out of the bar"
Of course every person responds differently to different cues, so I always play around with different variations to see what sticks with my patients and clients.
I have found many people respond better to external cues, or ones that help them visualize the task without directly referencing the body part in question. Think something like "show me the logo on your shirt" vs. "keep your shoulders tight".
A huge part of being able to deadlift pain free is to ensure good strength in all the main muscle groups we are using. The deadlift is a magnificent exercise to train many large muscle groups as well a many other smaller muscle groups in a lesser, but still effective manner.
There are 4 prime movers in the deadlift- these are the muscle groups that do the lions share of the work. These are the:
The other muscle groups that play an important role in stabilizing and maintaining good form but don't play as direct of a role in lifting the weight are the:
Now if you're adding things up at this point, you're realizing how much of the muscles in our body deadlifts directly work. But for the sake of this article we are going to focus on the groups of muscles that I find keep people from deadlifting pain free the most often, and that's the spinal erectors.
As far as I am concerned, you can have some relative weakness in your glute, quads, and hamstrings, but if your spinal erectors are lacking?? Boy you better bring those back up to speed! So to be clear- for the sake of simplifying, we will be talking specifically about how the spinal erectors contribute to back pain and how we can get them stronger for a pain free deadlift!
These muscles are the main reason we can hold our spine in a straight and braced position when we are deadlifting. They take a LOT of stress off the actual joints and tissues of the spine, so you can see why lacking strength here can lead to back pain!
There are many ways to strengthen these muscles, but you have to be doing it the right way. Things like bird dogs, dead bugs, bridges, pallof presses, and supermen are way to easy for most people and won't cut it. We need to properly load these muscles to get actually them stronger and prepare your body for the actual demands of a deadlift. There are endless ways to strengthen up the thick hunks of tissue that are the spinal erectors to produce a strong and pain free deadlift, but here are some of my favorites!
Reverse Hyperextension: Perform 4 sets of 10-20 (pick a challenging number). If you can do more than 20, hold a dumbbell between your feet for added resistance.
Pin deadlift isometrics: Push hard into the ground for 10 seconds while maintaining a flat back. Perform 3 sets of 3-5 reps.
KB liftoff holds: Choose a heavy kettlebell, lift and hold for 10-15 seconds. Do 4 sets of 5
GHD back extension holds: Hold for at least 30 seconds, or close to point of failure, repeat for 4 total sets
To get an effective dose of strengthening, the exercise needs to be challenging enough, and done frequent enough. For these exercise I recommend 2 days a week, and if I were you I would pick 2 of them and perform each for 4 sets, with at least 60 seconds rest between each set.
You will definitely be noticing some low back soreness after these, WHICH IS TOTALLY NORMAL! What we don't want is any pain or stiffness that limits our range of motion and performance of normal movement and exercise. Which brings me to the next point!
Arguably the most important part of this whole process, is not pushing your body past its limit. We can have some muscle soreness, or DOMS (delayed onset muscle soreness) as you may know it. But we want to avoid provoking any pain during this process.
I would say that most peoples issues in the deadlift come from the loss of a braced and neutral spinal position, or not even getting there is the first place!
Knowing your bodies limit for activity just comes from years of training, knowing your bodies response to training, and having a great sense of proprioception(aka body awareness) to know when you are pushing it too hard and losing a braced core.
If after reading this article and implementing everything you've learned, you still have back pain when you deadlift, the problem is probably a little more nuanced than the info we can condense into an online article. Many pains and injuries are multifactorial and need to be considered from many angles, addressing a variety of factors such as mobility, strength, coordination, muscle endurance, nerve function, learned habits, and more.
With a proper and thorough assessment I am confident I can help nearly everyone's situation, helping them get out of pain, optimize their movement, and continue to show up in the gym and crush their fitness goals!
If you're dealing with back pain and are in the Columbus, Ohio area we would love the chance at helping you figure out your injury and get back to training at 100%. If you're living elsewhere, we also offer remote rehab and coaching options, which can be a perfect fit for the right person. Regardless, we would love to hear from you! Schedule a free 15 minute phone consultation with our doctor of physical therapy so we can learn more about your injury!