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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