Spinal flexion when lifting

The debate of spinal flexion when lifting seems a hot topic right now. Instagram arguments: camps for both sides, some saying – yeah do it, and others dead against it. Who is actually right though, should you or should you not have spinal flexion when you’re lifting? We are going to shed some light on this try and take out some confusion for people who just aren’t sure which way is right. We are going to break this down into 5 sections to get to the bottom of this. As with most things in life, this comes down to context. There are grey areas and really both sides of the argument are right in a way. We are going to try our best to explain why and help navigate all of this.

What actually causes back pain?

This seems the best place to start. We know this can be massively multi-factorial. Therefore, not just down to one thing such as lifting something in spinal flexion.  Other things to consider:

1. levels of adaptations to the movement and the load itself
2. how much have they slept
3. burnout
4. what’s their stress like
5. levels of fatigue from other training are they
6. your beliefs about your back at that current time
7. how vigilant of their back are they
8. is there any emotional trauma or any other life issues going on?

All of these can contribute to back pain. It normally isn’t just one that’s a single cause but a combination. Therefore, it’s a grey area and normally not as simple as, just because of a movement. If you have got back pain we generally know that movement is good. Contrary, bed rest is bad and fear of moving is also generally bad.  This is one reason why scans can be negative if creating this fear

Why spinal flexion is safe?

We know movement is good for backs. Therefore, it is better to get people away from the fear of movement. This is also known as a kinesiophobia. This can be a contributor or even the cause of back pain. The main goal is to give the idea that backs are strong and robust. They always have been. They can handle movements well, which in turn should get people moving more. Contrary to someone who believes that their back is fragile and likely to injure. These people are less likely to be moving and working on strengthening exercises due to fear of hurting their back and in turn be less adapted and less resilient. Obviously, all those health and safety videos with the “right lifting technique” don’t help to build confidence in people.

The lack of a link between spinal flexion and back injury is also now backed up by a lot of studies. In addition, we will also all have degrees of flexion and curves in our spine anyway when lifting things no matter how neutral we try to make it. Also, studies say when just looking at someone lifting we are very poor at saying how much flexion they’re in.

A problem from both sides is semantics. Someone may say lift with a neutral spine or keep your back straight. Someone will say well technically you’re back has a degree of flexion, kyphosis, and lordosis so neutral isn’t a thing. It’s definitely not straight as spines aren’t like that.

Why there is a belief that spinal flexion in lifting isn’t safe?

Now I spent many years teaching the form of a neutral spine as it was very much the understanding that any flexion especially with high loads is bad.  A big reason for saying lifting with flexion is bad comes down to the idea of it creating disc issues in the back. This makes sense, back flexing forward gives the idea that the discs are getting pushed backward. Therefore, a high enough load will herniate it, not good, and this is where the studies are coming in to say this isn’t correlating.

A lot of the main issue comes down to a case of overload.  If wanting to build muscle or get strong in the gym you need some progressive overload but you don’t want too much overload at one time.  

A good anagram would be if you would run a marathon. If you’re not used to running, your first day of training wouldn’t be ideal to run the distance of a marathon. Most likely this would cause an injury. However, if you would build your distance gradually and progressively over time, the chances of injury would be minimal to none.

The same can be said of deadlifting. For example, a lot of the time, mostly young guys tend to overload with ego lifts. When that happens with a deadlift and you’re trying to keep the back straight. You can’t because it’s too heavy which then forces you into excessive spinal flexion. Therefore, people are basically doing a heavy Jefferson curl (an exercise that is with a flexed spine which is covered in the video below). This is very likely to cause an injury because your body is not adapted to the load. SO, then yes spinal flexion isn’t good

People will use powerlifters as an example of spinal flexion when lifting heavy loads. However, these are seasoned professionals and extremely adapted to heavy lifting. Also, most likely with a lot and without spinal flexion. Therefore, it’s a really poor group to use as a comparison to the general population

So is the Jefferson curl bad?

So this exercise you’re going into a lot of spinal flexions, now this is very different from a deadlift.  And no, the Jefferson curl isn’t bad. But again something you need to gradually build into. If you’ve been deadlifting with heavy reliance on the erector spinae and keeping the back neutral you don’t then just want to do the same weight with a Jefferson curl. You want to gradually, progressively overload to increase the weight.  The discs just like any other area of the body can adapt to get more resilient. So, actually, if you’re more adapted to lifting heavier in flexion then, day-to-day things that involve spinal flexion would be less likely to cause injury.

So really they’re both right! if you build up slowly and have adapted well to spinal flexion that can keep being built up with weights.

Basically, whatever you’re doing, do it gradually and build into it.

Should you lift with spinal flexion? 

With this debate and as with most things in life it’s trying to avoid the extremes. If people are saying do zero spinal flexion ever on any exercise that’s just a bit excessive. I’ve seen some say don’t do sit-ups, cycling or the rowing machine. It’s bad for your back, because any flexion is bad. The research just doesn’t back this up! But also you don’t want to be going into spinal flexion lifting any old weights just because some research says it’s ok. Be sensible!

And to really answer this, it comes down to – what are you actually trying to achieve?

It will depend on your goal, if you’re just interested in getting the weight from A to B like a powerlifter and you’re gradually building strength, then a bit of spinal flexion is likely not a big deal and something you’ll probably really struggle to stop as pushing a lot higher on the 1 rep max percentages.

And just because spinal flexion might not be as big a deal as we have believed for decades in terms of overall injury rates, doesn’t mean it’s better.

If you want to work the erector spinae and get that strong, you’re not engaging that as well with a flexed spine, so you’ll be much better off contracting that which involves more of an anterior pelvic tilt and keeping the back straighter.  You’ll get a better stretch on hamstrings when doing RDLs like this and be able to get better glute contraction, so why wouldn’t you try to keep your back straight for them and then do a Jefferson curl separately and build that up with appropriate weights for each.  

Basically, try not to fear movements but build gradually into things as you start to increase volume, intensity, and frequency, regardless of what you’re doing.

Finally, if you already have back pain and would like some structured help with it, you could check our low back pain management blog