A now remote client emailed me initially about some lower back problems they were having. Despite doing everything they possibly could think of, reading many articles on T-Nation, enlisting the help of a person or two very well known in the fitness world, they were still having issues deadlifting.
“I realized that I was fairly quad dominant and really need to work on my posterior chain and getting my glutes to activate. It’s an awesome program, but I ended up jacking up my low back a few times, mostly via bad form in conventional deadlifts. I kept trying to fix my [conventional deadlift] form (man, I was friggin determined to figure it out) and kept getting hurt before my husband banned deadlifts LOL…
…over the course of the last year or so, I kept hurting my lower back again and again by lifting things awkwardly by mistake, doing good mornings, and once tying my shoes. At first, I went to a massage therapist, then upgraded to a sports medicine chiro (does mostly Graston & ART) in August, then ultimately after a recent ER visit (2-3 weeks ago) I finally went to see my primary care doctor. My insurance got me X-rays and PT, which I just started. My PT thinks there may be a bulging disk, but is not really sure since they won’t give me an MRI, but I definitely have SI joint issues, as that is where all my pain is concentrated…
…I really don’t plan to ever do conventional deadlifts or good mornings ever again. Not only am I terrified of getting hurt, I feel like my body just does’t ‘like’ either one”
This probably sounds too familiar for many.
I asked the person to send over some information, including video of them deadlifting. I told them they could simulate the movement. No need for a barbell or anything, as I didn’t want them to tick their already sensitive back off more. Plus, they were currently having pain doing bodyweight exercises. It’s not as if we needed to think “Alright, maybe it’s only once the weight gets heavier.”
The person asked me to not share their videos due to privacy (no problem), so we’ll look at some photos of their technique.
This is a great set up. Notice how this person 1) owns a dowel 2) has the set up with pillows to simulate a barbell with plates. A deadlift doesn’t start on the floor, but a few inches off the floor. This person is serious about training.
We don’t have an iota worth complaining about above. That’s rare to say for a deadlift. The facial musculature could probably be more relaxed, but that’s nit picking. The spine is what we’re concerned with right now anyways. This is very good form. The load is nicely distributed over the spine. No segment is bending or extending too much.
But just because deadlifting is supposed to be a forward and back -lean over and stand up- motion, does not mean that’s how it always works. From behind:
That’s not so evenly distributed now is it!
That’s a significant amount of hip shifting to the right. No wonder this doesn’t feel good on this person’s spine. When they pull up and forcefully try to hold the spine in neutral, that force and subsequent compression on the spine isn’t going to be symmetrical. One side -the right in this case- is going to get squished together more than the other. Doing this chronically is a great way to piss off the spine, if not laterally herniate a disc (could happen in one acute instance). Compress one side too much, too often => greater likelihood the other side herniates. You can think of it like a sponge, when one side of the sponge gets squeezed, the other inflates:
Look at the white getting squished in the middle. (Made from this video: https://www.youtube.com/watch?v=XZn1BBhdWhM )
Ideally, the entire disc gets compressed evenly, to more uniformly distribute stress.
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This person is already doing this motion a lot to begin with. Like whenever they stand:
The spine tails off to the right some (middle red below), and the hips are shifted to the right:
Static posture can be indicative of how someone moves. This person is moving their spine / hips a lot during the day, in at least one specific manner. A manner that when they deadlift, also occurs.
We know when deadlifting you don’t want a mobile lumbar spine. You want that thing locked in neutral to the best of your ability. But neutral is not only flexion and extension. It’s not only forward and back motion. Side to side bending, as well as rotation, need to be accounted for when deadlifting too.
Lastly, no amount of active release technique, graston, manual therapy, massage, chiropractor, foam rolling, accupuncture, is going to solve this issue. The person needs to stop shifting their hips to the right during a multitude of activities. Including anytime they lean over. That requires active intervention on their part. Not passive. Yet nothing needs to get stronger in order for them to lean over and not shift their hips. (If this only happened at heavier weights in deadlifting, strength concerns would be more applicable. (Getting stronger with the hips not shifted right wouldn’t hurt though.).) But a new habit will need to be formed.
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Become a remote client yourself.
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kierfinnegan
December 2, 2016
Clinical eye, as ever 🙂
reddyb
December 4, 2016
Haha, thanks Kier. Hope you’ve been doing well!
Henrik P
December 5, 2016
Thanks for a great article and the great knowledge you share! Ever had thoughts of writing a book?
reddyb
December 6, 2016
Thanks Henrik!
Not sure a book is for me. Find it to be a daunting effort. I’ve written a few things around 10,000 words, and those were an exercise in perseverence enough, yet books are commonly three times or more than that. It’s a lot to keep sorted, where I can easily see how having something like an editor becomes highly advantageous, if not necessary.
I also prefer the online publishing approach I’ve done, mainly because for ability to 1) use animations and videos 2) edit things if needed. It’s not often I find a need to update something, but I like being able to. 2) Can be done with a book, but not as easily.
So far the manual approach has felt good.
Henrik P
December 5, 2016
Noticed that the right foot is more turned out as well. Looks like the person is over pronating with the right foot. Will this also be an possible contributor to the asymmetrical/curved spine and hip? My thoughts were so due to that if the foot on one side is over pronating the hips on that side will also get into a less optimal position and move in a unwanted way when walking, standing, running etc.
reddyb
December 6, 2016
They are overpronating with that right foot.
One way to think about whether this is a compensation is try it yourself. Do a deadlift / hip hinge, but shift the hips to the right. What you’ll likely feel is the weight of your body go on the outside of the right foot and inside of left foot. Meaning the right foot is *supinating* and left pronating.
So initially, we wouldn’t think the foot position is a compensation, or cause, of the hip positioning. In fact, my first assumption would be this person’s right foot rrrrreally pronates.
It’s true foot positioning can influence hip positioning, but I really haven’t seen this play out much for people. The opposite, hip dictating foot, is much more common.
Long way of saying I almost never find a benefit in addressing the hips by focusing on the feet, but the opposite I do. When you see a hip issue, like her shifting, it’s pretty much always from the hips. In this case, her right hip doesn’t bend like her left hip does. (Longterm, this is probably a person who should be sumo deadlifting, not conventional.)
The other way you could get this feel is both of her feet are pronating. It’s likely something she does during a lot of things (flat feet alarm goes off), where deadlifting is unlikely the main culprit.
Henrik P
December 9, 2016
Understand your thoughts around book writing and I can see the benefits with keeping the information to be handled and communicated digitally.
Thanks for a good answer regarding the foots position!
Really appreciating the knowledge you share and the time you give in to helping peoples different ways, like for example the well explained answer to the questions I asked.
reddyb
December 9, 2016
Sure thing. Thanks for saying thanks!