This article was inspired by conversations I held with several people over the last few months who came to see me for help with a chronic back problem that was hindering their job. During their assessment I could see in each case how poorly they would complete a bending action, also known as a Romanian Deadlift. This is not unusual and a very common problem to most back pain sufferers, especially those with a bulging disc. However, as I got to know these people I discovered this was not their natural way to move. They told me that they had spent considerable time learning how to lift a certain way at work where they use their knees and keep their back straight. It was this poor method that they had been taught that was to blame for their pain. Unfortunately, it was not a simple task to reset their movement to a more efficient and safer technique as their body had developed a lot of compensation and stiffness in the meantime. If they had been shown a better way in the beginning I believe they would have avoided a lot of pain and suffering.

Why Do We Have Manual Handling Instructions?

We all know how important it is to have correct technique for lifting weights in the gym, but somehow this mindset was often neglected for a long time in the workplace and many people suffered severe cases of back pain from lifting poorly. Research shows that 9 out of 10 adults now experience back pain at some point in their life. Only colds and flu beat low back problems for Doctor visits!

Some people were not even lifting anything and also suffered with severe back pain from poor repetitive movements or simply sitting behind a desk for long periods of time which is another thing altogether. For the sake of this article not going too long I want to focus more on lifting techniques, but you can read more about sitting postures in this article – How much compression does sitting place on the spine?

I remember working in a supermarket filling shelves 25 years ago and we were never taught how to lift correctly or had any training in place for staying safe. We would work solid for 4-5 hours lifting boxes, dragging heavy pallets of stock, climbing ladders and lifting loads onto the top of shelving. I remember lifting multiple stacks of incredibly heavy loads of dog food and boxes of soft drinks to save time that would have me instantly sacked if I was caught doing that today. However, I never hurt my back during those four years or so and there was only a few people I worked with that did have a sore back. Was it good luck that saved us or did we use a good lifting technique? More on this later.

Over the last 10-15 years we have seen a big shift in this mindset as workplaces spend a great deal of money and time into teaching their employees how to lift and move objects safely. Most governments around the world have also made it a law for companies to teach their workers safe handling techniques. By understanding the risks associated with lifting poorly and learning proper techniques, employees are less likely to suffer from strains, sprains, and other injuries.

However, it is not just about preventing injury as learning good manual handling techniques helps employees to work more efficiently, leading to increased productivity and reduced downtime due to injury or fatigue. This can greatly reduce the amount of time employees take off due to injury. This helps to build a better workplace culture of safety and value as employees are more likely to take their own safety seriously and be mindful of potential hazards in the workplace.

Unfortunately, some of the training in this area has not really helped as the method often taught and used to protect them is more likely to hurt them.

Let’s take a look at some examples.

What Are The Current Lifting Methods Taught In Most Workplaces?

The current method most often taught is to keep the object close to the body and use your knees. While there is good intention with these instructions anyone with half of an idea of how to lift correctly will instantly see some massive problems with this simplistic way of lifting. Keeping the object close to the body is a great instruction, but make sure you use your knees is not.

Before I go into more detail about and to prove to you just how dangerous some of these tips are here is a list of instructions I copied directly from the current Victorian Work-safe website. I have placed a comment in brackets next to the points where you need to pay attention.

The back is particularly vulnerable to manual handling injuries. Safety suggestions include controlling risk factors in the workplace, in addition to personal controls:

1. Lift and carry heavy loads correctly by keeping the load close to the body (this is good) and lifting with the thigh muscles (this is incorrect and dangerous).
2. Never attempt to lift or carry loads if you think they are too heavy. (Correct)
3. Pushing a load (using your body weight to assist) will be less stressful on your body than pulling a load. (Correct)
4. Use mechanical aids or get help to lift or carry a heavy load whenever possible. (Good)
5. Organise the work area to reduce the amount of bending, twisting and stretching required. (Good)
6. Take frequent breaks. (Good)
7. Cool down after heavy work with gentle, sustained stretches. (Good)
8. Improve your fitness – exercise regularly to strengthen muscles and ligaments, and reduce excess body fat. (Good idea as long as the exercise is performed well)
9. Warm up cold muscles with gentle stretches before engaging in any manual work. (This is incorrect and will weaken the working muscles. A warm-up is more beneficial than stretching)

As you can see there are some instructions that are good to follow and will save your back. Most of these I would say are common sense. However, the main ones I have a big problem are related to the lifting technique and these are not good instructions at all and will only set people up for future problems.

Why This Method Exposes Your Back & Knees To Injury

To help explain this method in more detail let’s take a look at some infographics and break down exactly where the main problems are so you can avoid them. The picture below is meant to be an example of good lifting technique (top picture) versus bad technique (bottom pictures).

As you can see I have changed this picture to represent bad lifting form in both cases for two different reasons.

Firstly, the lower pictures which is the original poor form is due to the excessive flexion of the lower back. This type of posture is the one most consistent with bulging discs and is not a good way to lift heavy objects. Sometimes occupations requiring constant bending contribute to this problem, but it is not the occupation, it is how you bend that is the problem. If it was the occupation then 100% of the people in this job would have a bulging disc. There is no problem with bending if you use your hips and maintain a neutral lumbar curve. Problems arise when you use your spine to do the bending.

While it is obvious this is not good for lifting heavy objects it is much closer to good form than the upper example.

The upper picture which is meant to demonstrate good form is terrible and has several massive problems that make this an unsafe lifting posture.

• Glute Weakness - When the heels leave the floor this means you can no longer generate force with your posterior chain muscles of the glutes and hamstrings. The glutes are the engine room for the legs and the main muscle groups you need fully firing. You will now be transferring force into your quadriceps and calf muscles which are nowhere near as capable.
• Knee strain – The massive forces placed into the quads and calf by adopting this poor position will inevitably end up putting severe strain into the knee joint.
• Unstable Body – Only having half of your feet planted on the floor makes it very difficult to maintain great balance and the chances of falling forward during the lift are very high. You must have your feet flat on the floor to be perfectly stable.
• Straight back – Most people think their back is safe if it is kept perfectly straight but this is not true at all. Watch any weight lifter or someone lifting a heavy deadlift in the gym and you will see their trunk in a bent over position. This is to place the glutes in the most advantageous position to fire during the lifting movement. Remember, the glutes are the engine room and where you maximal strength will be found. You will never be able to use the glutes to their full potential if you are trying to keep your back upright.

To illustrate this point even further I have put a table of various points below that I read in a book by highly regarded Physical Therapist Esther Gokhale called “8 Steps to a Pain Free Back”. This is quite a fascinating book for she observed how people in rural India and Africa could bend over for long hour’s day after day gathering chestnuts or rice paddies and present with no episodes of back pain at all!

She features many pictures of these people working and the way the bend over using a hip hinge method identical to a Romanian Deadlift. When you compare this method to the one above taught in many workplaces it is easy to see why many people still hurt their back.

What You Should Do Instead?

Before I go into great detail as to what you should do instead I think it is important to discuss the question I am always asked – Does a correct lifting technique even exist?

Some people like the guy in this article at Pain science will argue that lifting technique is not important and tell you there is no such thing as a good way to lift. There has also been some research into this question that would agree with this assumption as shown below.

The Cochrane Collaboration

The Cochrane Collaboration conducted a systematic review in 2011 to determine the effectiveness of manual handling advice and training and the use of assistive devices in preventing and treating back pain in workers.

Cochrane found moderate evidence to prove manual handling advice and training is no more effective at preventing back pain related disability than having no intervention.

Reference: Verbeek , J., Martimo , K., Karppinen, J., Kuijer , P., Viikari-Juntura, E., & Takala, E. (2011). Manual material handling advice and assistive devices for preventing and treating back pain in workers. Cochrane Database of Systematic Reviews, (6), Art. No.: CD005958. doi:10.1002/14651858.CD005958.pub3

Postal workers study

In this study, approximately 4000 US postal workers were involved in a randomised control trial* for more than five years from 1985 to 1990, to test the effectiveness of manual handling training.

The study included workers and supervisors being taught principles of back safety, core lifting and handling posture, exercises and pain management. A refresher training session occurred six months later and then on a yearly basis.

The study concluded that:

• The training program did not reduce the rate of lower back injury
• There was no significant difference in the median cost per injury
• There was no difference in the rate of musculoskeletal disorders or handling behaviours.

Half way through the study, a survey was conducted to measure knowledge gained and behaviour changes made by the group. The survey found significant increases in the knowledge of safe lifting behaviour among workers, but no significant improvement in actual lifting behaviour or reduction in reported discomfort.

Reference: Daltroy, L., Iversen, M., Larson, M., Lew, R., Wright, E., Ryan, J., … Liang, M. (1997). A controlled trial of an educational program to prevent low back injuries. The New England Journal of Medicine, 337(5), 322—328.

Having worked with hundreds of severe back pain cases over the past 18 years as a trainer I would disagree with these conclusions and say that lifting technique DOES matter. You can see several case studies and examples of this on our testimonials page.

The thing you need to understand is that just because you know how to lift correctly doesn’t mean you can. This is why I think these studies fail and do not show the results that you would expect to see, for they assume that everyone is the same and use a template model to teach people to lift exactly the same way.

The compensation each person who has back pain varies a lot, and the reasons they lift poorly are also very different, meaning that the ways to teach them how to lift correctly is not the same. Each person is unique and just showing them the correct technique is not enough to guarantee they can do it. If they cannot demonstrate good form you have to find out why they cannot do it correctly.

The obvious problems is a lack of coordination and knowledge but once you have explained the technique correctly this is usually resolved quickly. If the person still cannot get into the right position or it breaks down easily during it then you have to explore other reasons.

Some people will have mobility problems preventing them from adopting the right posture and position. Others may have instability or weakness with other joints preventing them from using the right muscles to lift correctly. This means you will need several exercises and methods to assist them in learning this process and making it strong enough to withstand the demands of the occupation.

Research from the world’s leading researcher into back pain Dr Stuart McGill has proven this over and over and to be true. You can read about this in great detail in his book “Lower Back Disorders”. Okay, so what is the correct technique?

Learning To Use Your Hips Correctly Is The Key

As mentioned previously the secret to learning bend correctly and safely lift objects is to use your hips and not your spine. However, this may not be very easy for many people to do and you need a lot of accessory exercises to assist you in becoming mobile enough to adopt the right position.

This is where I regularly have to spend a bit of time teaching people how to mobilize their hips and release stiffness in the glutes and hamstrings that prevent them from maintaining a neutral lumbar spine. Also do not disregard thoracic mobility as this is another part of the body that very easily accumulates stiffness that robs the lumbar spine of stability.

You will find some good ideas of how to improve these areas in the videos below.

For more information and other exercise examples make sure you check out the articles below.

• Top 10 hip mobility exercises
• Top 10 thoracic mobility exercises

You Must Learn How To Brace Your Core Correctly

Let’s say you have no mobility problems to set up in the right position easily and you have a good understanding of the technique, does this mean you are good to go? Not quite. This is where you still need to understand how to brace your core correctly.

Almost every movement in life requires the transfer of energy from the extremities (upper to lower, lower to upper, right to left, etc) with the energy being transmitted through the core. Having a strong core is the foundation of all efficient movement.

Without a good understanding of how to engage the core everything can fall apart, and very quickly lead to the onset of back pain.

A classic example I see every day in the gym every day is when someone knows exactly how to squat or deadlift correctly with their body-weight. At first everything is fine but once load is added and the strength demands increase, their spine buckles due to a poor stabilization technique. Their body alignment and posture is fine, the movement is great, and the strength in their prime movers is adequate too. Their problem is they lack the understanding of how to create good stiffness in their core to prevent their spine from buckling and execute the movement safely and efficiently.

Watch the video below to see how to do this.

Now that you appreciate all the factors that contribute to lifting correctly it is time to see how to do it. I will often break this into two parts. Part one being the Romanian Deadlift and part two being a heavier trap bar deadlift.

How To Learn The Hip-Hinge (Romanian Deadlift)

This first version of the deadlift is the best way to improve mobility and execute the movement with less risk. This type of deadlift we see you moving from the top downwards which is the opposite of lifting something, but is much easier to control. Once you have this mastered you can move onto the much more dangerous lifts with less risk due to good hip control from learning this movement first.

The knee will be flexed about 20 degrees at the bottom of the movement and the tibia must remain vertical during the lift. The objective of this movement is to sit back as far as possible with the hips and maintain a neutral lumbar curve and perfect stability with your body. The most important part here is to maintain the natural curve of the lumbar spine by keeping an anterior tilt of the pelvis. Again critical for anyone who has back pain.

Instructions:

1. Position the kettlebell on the floor between your legs so that you cannot see your shins in a mirror from the side.
2. Standing with feet a comfortable width apart. Reach down keeping the natural arch in your low back, and neck tucked and grab the kettlebell maintaining good posture.
3. Inhale and engage your core before you begin to stand to the top position, exhaling when at the top and gently rolling your shoulder down and scapula apart.
4. At the top repeat the inhaling process before lowering to the ground.

Now that you know the technique of the RDL, you are almost ready for the single leg version. Before we get to that, how does the RDL compare to the more traditional versions? And why does it work so well with injury?

You can read more about deadlift technique in this article – How to do the Romanian deadlift correctly

How To Do The Trap Bar Deadlift

We are now at the point where we are going to lift from the bottom up! This is where the legs will now be heavily involved and a key component of the lift. I will always start with a trap bar deadlift before a traditional bar deadlift and the reason is very simple. It provides the best leverage.

For a beginner it is all about perfecting the technique and movement and this version out of all the heavy lifts is the easiest.

Always remember the deadlift is all about minimizing any levers the weight can generate by keeping the load as close to you as possible. You only have to look at the shins of an Olympic weightlifter to see what I mean, as they constantly drag the bar up against their shins to keep the load close to them. Many actually wear shin guards for this reason. The trap bar is unique in that it allows you to stand effectively inside the bar! This is why it provides the best leverage and also why many can lift much bigger loads with this version.

Below are two versions of the trap bar deadlift so you can get a good visual of how relevant this is to lifting boxes.

Just Because Something Is Not Heavy Does Not Mean It Will Hurt You

So far we have looked at lifting heavy objects but what about lighter loads? Do you still need to adopt this technique? The answer is yes but not to the same degree.

Many people will tell you it is not important to worry about your bending technique when what you are lifting is light. To some degree this is true as our bodies are very capable of doing this movement, however this is a dangerous assumption for there are many people who have multiple muscle imbalances and postural deviations that only need a slight nudge to push them over the limit and damage joints.

Repetitive actions if performed poorly will eventually lead to problems if you do nothing to counter the repetitive action. This is how many people who play sports encounter problems if their posture is affected by a repetitive action that changes how they move or hold their posture. If you are using exercises to counter the repetitive stress and restore balance to muscles and joints you will be able to withstand the repetitive stress without problems. However, if you ignore it or complete other activities that further exacerbate the stress eventually light load movements will be enough to break you. It is just a matter of time.

Ask anyone who has severe back pain how hard it is to tie their shoelaces or vacuum the carpet in their home to see how difficult light load movements are. These are classic examples of where a repetitive action will now become problematic and spending time to bend correctly will save these people a lot of pain and suffering.

To see more about this you can read the article – Bulging disc treatment starts with how you move in daily activities

Do you Need More Help?

Before jumping straight into a corrective program make sure you have seen a qualified Health professional for an accurate diagnosis and assessment of your condition. I cannot stress this enough as self-diagnosing can potentially lead to more problems. We often refer out to Doctors, Chiropractors, and Physiotherapists before implementing our program to know exactly what we are dealing with. Being certain on where to start is crucial to the success of the program.

If you have seen a health professional and are now looking at implementing a series of exercises and stretches this article will provide you with many great ideas on how to do this. As many people struggle to implement this into a gradual progression I created a detailed step by step program called Back Pain Secrets that includes a 85 page Ebook and 90 minute video with exercises, stretches, mobilizations and in an easy to follow format. This can be done at home or in the gym and we cover everything about your condition in great detail from eliminating the cause to best strength exercises, even nutrition to speed up the healing process! For more information you can watch a quick trailer video of what is included. Click here or on the image below to get a copy.

Summary

I know many people reading this article will say that everything I have discussed in this article is a no-brainer and that everyone knows how to lift correctly. If you are that person I applaud you for you most likely adopt a deadlift posture to do this. However, you would be amazed at how many people I have to explain to on a regular basis that this lifting posture is not a good thing to use. Usually it is people not familiar with lifting weights in the gym or how to do a deadlift correctly. So many people still think lifting weights is dangerous, but I would say it is the other way around.

Using the gym to practice and perfect movements for daily life and building your strength to a level that is higher than you need when you leave is what protects you from harm. Plus you get the added benefits of looking and feeling great. Who wouldn’t want that?

For more ideas and information on specific topics I may not have covered in detail be sure to check out our INDEX PAGE on the website that has over 300 of our best articles. These are all sorted into categories for quick reference so you can find what you are after more easily. You can also subscribe to our FREE fortnightly newsletter to stay up to date with all of our latest tips and training methods by clicking here.

If you live in Melbourne and feel you need specific help with your exercise program please feel free to reach out to me for help and we can set you up with your individualised program.

About The Author

Nick Jack is owner of No Regrets Personal Training and has over 15 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specialises in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise.

References:

• 8 Steps To Pain Free Back - By Esther Gokhale
• The Vital Glutes - By John Gibbons
• Movement - By Gray Cook
• Corrective Exercise Solutions - by Evan Osar
• Back Pain Mechanic - by Dr Stuart McGill
• Diagnosis & Treatment Of Movement Impairment Syndromes - By Shirley Sahrman
• Low Back Disorders - by Dr Stuart McGill
• Ultimate Back Fitness & Performance - by Dr Stuart McGill
• Core Stability - by Peak Performance
• Athletic Body in Balance - by Gray Cook
• Anatomy Trains - by Thomas Meyers
• Motor Learning and Performance - By Richard A Schmidt and Timothy D Lee
• Assessment & Treatment Of Muscle Imbalance - By Vladimir Janda
• How To Eat, Move & Be Healthy by Paul Chek
• Scientific Core Conditioning Correspondence Course - By Paul Chek
• Advanced Program Design - By Paul Chek