The deadlift – through the eyes of a graduate sports therapist

Deadlift – through the eyes of a graduate sports therapist

The deadlift is an important exercise performed by a range of athletes to improve posterior chain strength (Glutes, hamstrings, erector spinae), develop midline stabilisation and increase flexibility (Mackenzie et al).

Set up: Good technique vs. Bad technique

Good technique:

Starting position…                                               End position…

Setup pointers:

1) Walk shins up to the bar and position feet underneath hips and squeeze that core

2) Bend over from hips, bend knees SLIGHTLY and grip the bar- remember keep that core squeezed

3) Load hamstrings (drive knees backwards) and elevate hips, keep your head in neutral

4) Shoulders should be over bar and then external rotate your arms- imagine trying to squeeze something like a newspaper underneath your arms pits

5) Keep your back flat and then drive weight through heels, extend hips, USE HAMSTRINGS to lift weight off ground

6) End position, continue to extend hips not BACK and stand up with weight. Then squeeze glutes to maintain that full extension

(Mackenzie et al).

Let’s expand on a couple of points…

Our head throughout the movement needs to stay in neutral. We should move like a unit. Imagine a piece of wood stuck to our back. Our head should be in line with our bum. In the picture above you can see how Tom is in perfect positioning and keeping alignment from start to full extension in a deadlift.

Full extension at the end of a deadlift doesn’t mean extending the lower back which you see in a lot of athletes when performing a heavy lift. We need to ensure in a deadlift that the hips are fully extended, avoiding that hyperextension of our back as our facet joints (part of our spine) do not like this, increasing our risk of injury. Remember keep that neutral spine throughout the movement.

Once we have hit full extension we then push our hips back and lower the weight to the floor. We don’t bend from our knees first, why? We want to keep our posterior chain activated by sending our hips back otherwise our quads then take over. Our knees are then at an increased risk of injury such as patellar tendinopathy due to the improper loading. Bending at our knees first also makes the movement inefficient, as the bar needs to then go round our knees. Keeping shins vertical and hips back means the bar can be as close as possible to our body ensuring best technique and efficiency can be used.

Poor technique

What can we see in these pictures?

Well picture no.1 looks like a camel trying to deadlift- therefore, using TOO much back.

Picture no.2 Tom’s legs are too straight

Picture no.3 Tom’s knees are too far over the bar

These are all pictures of poor technique. Lifting like this will be inefficient, energy wasting and also increase your risks of injury. Poor technique and set up means it is likely you will be overusing your quads and back muscles if you are rounding your back like the above picture shows.

If you are unable to set up correctly, maybe due to mobility issues, we can change how we perform the deadlift such as placing a bar on boxes so the correct set up can be performed to decrease risk of injury.

The neutral spine…

The spine should maintain a ‘neutral position’ throughout the deadlift- both the eccentric and concentric phase of the lift (Floyd, A). Losing this lumbar spine can put your spine and surrounding structures at high risk of injury. As we saw in one of the poor technique pictures this shows someone lifting from the floor with a lot of lumbar flexion (rounding off at the lower back). Structures of the spine such as the discs are a highly talked about area when it comes to deadlifting. You hear people saying “oh I felt something go in my back” and then they are normally in quite a bit of pain. Lifting wrong, such as not keeping a neutral spine, can increase your risk of disc injury. You’re probably wondering why is having too much lumbar flexion when lifting a problem? Bending forwards and touching your toes (lumbar flexion) increases disc pressure by 200% compared to standing normally, add some weight such as a barbell of 20kg this increases by 500% with a rounded back (Wilke et al). Not surprising why so many people injure their backs deadlifting with poor form.

Bracing before we lift…

On set up no.1, which we have previously addressed, we speak about squeezing our core. This is when we need to brace. Throughout the movement of a deadlift we need to maintain our brace position, so getting our core engaged. We do this to protect our back. Once our midline is lost our back musculature will take over. Bracing will allow us to keep that neutral spine.

Strength of upper back

Before we lift we need to get the upper back involved by pretending we are squeezing a newspaper under our armpits. We need to ensure that on set up our shoulders are in a stable position and our back remains neutral. By doing this our upper back needs to be strong to ensure our upper back doesn’t go into flexion. Therefore, it is important we get our upper body engaged as well as our lower body. Treat the spine as one joint- we see flexion of the upper back when our upper back is likely to be weaker than our lower back. This will affect the initial pull in a deadlift.

When is it too heavy?

It’s pretty obvious when the deadlift becomes too heavy for you. The neutral spine, we have just talked about, is lost so therefore rounding occurs. This means STOP and go lighter. You have basically reached your limit and you are now not efficiently working and increasing your chances of injury.

What are our primary muscles working in a deadlift?

Back muscles: erector spinae- helps extend our torso

Multifidus- supports the spine

Glute muscles: gluteus maximus- helps with hip extension as you stand up in a deadlift

Leg muscles: hamstrings and quadriceps

Core muscles: transverse abdominis- supports/stabilises spine

Safety of a deadlift:

A lot of people stress about their backs when its deadlift day. The deadlift is safe for your back just as long as it’s done correctly and under supervision by a trained professional. It’s the same as many lifts. All lifts have that injury risk element; all sports have injury risk. Just be intelligent about it.

Like a lot of sports, you feel discomfort the next day or day after. This is fine as this is part of the process of training. To develop as an athlete, you need adaptations to occur and this isn’t going to be pain free and easy. DOMS- delayed onset muscle soreness usually occurs after a new exercise or increased loading 24-48 hours post exercise. Muscle soreness is a side effect of the repair process that develops in response to microscopic muscle damage (ACSM and Cross Fit Journal). To repair this micro damage from all your hard work in training the body initiates an inflammatory response to initiate the healing response. With DOMS you will feel soreness, aching, tightness and muscle tenderness upon palpation (Petrofsky et al).

It is important to realise though, if pain doesn’t feel like just a bit of muscle soreness and doesn’t resolve after a couple of days, that you get yourself into see a Sports Therapist/ physiotherapist to ensure you haven’t injured yourself as there is a difference between good pain and bad pain.

Remember, train safely, have fun and we can avoid injury.

Thank you for reading.

Jessica Woodhouse

BSc Sports Therapy MSST