Get Bent – safe lifting and other low back pain fallacies

By Jess Ackad

We’ve all seen the posters about safe lifting – use a good squat pattern; bend at the hips and knees NOT THE BACK! But let’s be honest here; when was the last time you lifted a bag, suitcase, shopping, toddler etc using that position? And the next question; did you injure yourself doing it? Most likely the answer to the second question is no (but if it was yes you know where to find us 😉 ). And chances are you have performed a similarly bent backed lift many many times over in your life without pain or injury.

Because guess what; our spines are designed to both flex and extend; and to be able to absorb loads while doing so! But isn’t lifting with a flexed spine dangerous or risky for disc injuries? The answer to that is well maybe. We know that there is a mechanism for disc injury with repeated lumbar flexion and that the compressive strength of the spine is greater in neutral positions. BUT we also know that both on in vitro modelling and epidemiologically (looking at who got injured and how) that disc injuries can and do occur in the absence of any lumbar flexion, although injury is more likely to occur in the presence of flexion.

So:

Our bodies are designed to bend

Avoiding flexion isn’t necessarily going to avoid injury

How do we protect from injury/pain then? And I use the term pain deliberately here as “injury” isn’t necessarily an accurate term for what happens in back pain scenarios; it is more of a sensitisation of the tissues to pain, there is often very little correlation between imaging findings and symptoms. This is where things start to get even more murky; there is much debate between treatment methodologies and research etc… At Peak we tend to use a two pronged approach. Mitigate overload; and train/strengthen tissues to be able to cope with the demands placed on them.

But my back is already injured; and IT HURTS! When I bend forward/sit for long periods/insert other flexion based activity here. Well firstly if this is you; come in and see us and we’ll help you get it right. Every situation is different, but most often the tissues (joints, ligaments muscles, and yes discs) have become sensitive to the movement and feedback pain when you do it. It’s important to note that the pain does not mean you are doing any damage or reinjuring anything. There are a few ways to treat this. Sometimes temporarily avoiding flexion is necessary, sometimes doing the movement itself is more appropriate; and sometimes something else entirely is needed.

So in conclusion – backs can and should bend! If yours can’t lets chat about how to fix that 🙂