Dead lifts for rehabilitation

"Wait, don't dead lifts cause injury? Like, people get injured doing them?"

Yes. People absolutely hurt their lower back doing dead lifts. We'll get to that. But first is the claim that dead lifts are a critical component of rehabilitation. Please consider reading this as a prelude:

You'll hurt your back (not) doing dead lifts!

From that essay:

Dead lifts accomplish what no machine, training device, or supplement can. They teach the brain to dial in the correct movement pattern for functional lifting. Picking things up is a part of life, unless you can find a way to hamstring curl your suitcase through the airport or leg press a new TV up the stairs. 

As a physical therapist, I've never tried documenting dead lifts as medically necessary. Medical doctors, insurers, and other third party payers would understandably raise an eyebrow. So instead, many patients under my care have something like this listed as one of their long-term goals:

Patient will demonstrate a proper neutral spine hip hinge pattern [shhh...a deadlift!] as a means to return to their basic self care, household tasks, and fitness/wellness activities without exacerbation of pain.

Take Quay as a case study to illustrate the point.

Quay himself in a cool display of extension overload!

Quay was seventeen when he first came to the office for treatment of severe and chronic lower back pain, demonstrating signs and symptoms of both flexion (too much bending) and extension (too much arching) overload. The pain increased when he sat and especially worsened when he extended his spine as in serving and spiking a volleyball.

With poor hip, abdominal, and lower back strength, his discs and vertebrae were taking the brunt of it. How else do you explain the MRI which revealed various degenerative changes? In the words of a local orthopedist, "He has the back of a 50-year old."

The problem was that Quay was not 50. He had plans to play volleyball and work and do things. He was not content with the "sit around and do as little as possible" route to long-term spinal...health.

So we began with some light hands-on work and wimpy core stabilization exercises. The pain remained off and on for some time, I believe primarily due to the fact that he was playing volleyball through a fairly significant injury. But the frequency and intensity of his pain slowly improved.

Quay began with dead lift variations in the clinic before he even realized it. He acquired knowledge of his limits, and sufficient strength and stability to tolerate some decent resistance training. After discharge from formal physical therapy, I had him pulling up the barbell within a partial range of motion. Not long after that, he managed to dead lift 150 pounds off the ground with nary an issue.

As of today, Quay is playing volleyball, jumping higher than ever, hitting, sprinting and lifting with much less pain. His brain has learned to "turn on" the stabilizing muscles when he moves, and he has developed adequate strength levels to effectively decrease the wear and tear on his back.

Quay is working consistently and I do keep pushing him to get even stronger. I'm certain that getting to the point where he can easily lift his body weight (say, ~ 200 pound dead lift) off the ground would be a realistic and fruitful goal.

Given his history, I would not encourage Quay to be a power lifter. Besides, nobody ever claimed it was necessarily healthy to test the absolute most you can lift for one repetition, especially in the dead lift. But I know equally well that the process of building strength and stability through dead lifting variation holds tremendous value for individuals who expect to do more than take it easy for the rest of their life.


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personal records in the rain (and other nonsense)

What did the neighbors think upon seeing a few of us running down Grantham road today? We're crazy. That's what I think, in the comfort of my own home or vehicle, when judging some poor soul wearing shorts and running out in the November rain. 

Addicted.
Obsessed.
Slave.
Would it really hurt you to take a day off?

Maybe nobody else gives it nearly this much thought. Of course this lack of grace toward the fanatical exercise guild says more about my own issues (and my day job). How obvious it is when examining others.

Thirty minutes later it's still raining. Grey dusk and colder temperatures are also upon us. The crown of my head is buried into the exterior hatch of the old Subaru because my shoulders are made waste and my hands keep slipping off the bumper.

Inching down Bonny Lane at some pathetic fraction of one mile per hour, every step is a grinding effort of literal and figurative hardheadedness. Each foot placement is a gamble as to whether or not the coefficient of friction of wet shoes and macadam is sufficient to withstand the applied force.

I'm trying desperately not to fail in an effort to match the epic Car Push that occurred last week (completed by two of my proteges nonetheless). Another neighbor pulls behind me. From the corner of my eye I notice that it's Jack from down the street. Nice guy. Usually waves or says hello to the kids. So I put my head down and dig. Jack patiently waits for the Subaru to clear a few cars parked along the side of the road before pulling around us.

And so I made it, joined the Cul De Sac Car Push Club at (possible) further expense to my reputation as an upright neighbor and proper 37 year-old. At least my doctor is pleased with the top notch blood profiles.

But sprinting and car pushing in the rain is far from the end of the nonsense.

A few weeks ago my friend Matt walked down Bonny Lane with a weighted barbell sustained high over his head. I Farmer Walked two heavy dumbbells as our kids biked circles around us. There have been thousands of tuck jumps and a few Tony Little Gazelle carries on that road.

Neither is the ridiculousness limited to the outdoors. Just two days ago I noticed bloodshot eyes after doing heavy dead lifts with a lifting belt notched too tight. Breaking the blood vessels in your corneas, that can't be a good thing...

I want to tell my neighbors that we're...not as bad as it looks. I want to explain how this sprinting and car push nonsense truly happens less than once per week, and we only train three days per week. The conditioning must happen on Friday because of tight family and work schedules. Friday comes but once per week, and this is actually something that we enjoy. Yes it's miserable but also rewarding. Training day is like when a dog who sees his master move toward the door with a leash.

"Who wants to go for a walk!"

That's the rhythm your body feels when it's time. And if we don't get some decent conditioning done on Friday, we'll be set back for...  ...

'Doh...

...That sets us back in terms of recovery for a heavy lifting day. Dead lifts will suffer. And we simply can't have that.

So never mind. I will simply smile and wave and thank my kind neighbors for tolerating the crazies. And I'm thankful for the fellow obsessives (including a few of those very neighbors) who join me, follow me, lead me.

And that's why you see us sprinting and pushing the car on a wet dreary Friday.