Pain after deadlifting: lumbar spine

Pain after deadlifting: lumbar spine

July 12, 2022

Lumbar Spine Treating clinician: Dr. Rich Raigoza – Chiropractor

Case of the Month: Episode #1 – Lumbar Spine

On our first episode of “Case of the Month”, a young athletic male developed lower back pain after deadlifting. The pain was in the lower part of the lumbar spine (low back), and was typically aggravated after deadlifting. 

Immediately after meeting the client, I had a suspicion that this would be a mechanical problem as a result of a faulty movement. The reasoning behind this immediate impression was due to the following: 

  1. The client is a high level competitive athlete with many years of experience 
  2. He had well developed musculature as a result of his training
  3. What I consider essential abilities were perfectly demonstrated during our screen:
    • Great ability to hip hinge
    • Good ankle dorsiflexion 
    • Perfect knee tracking
    • Ability to brace and maintain while moving

I consider someone who demonstrates good performance on my ability screen to be someone that has been trained. These abilities aren’t perfected by accident and more often than not, individuals with a background in sports show more efficiency when performing them.

Situation specific testing 

Now that our screen has passed, the best way to assess pain during an activity is to recreate the task that reproduces the pain. In this case, we decided to deadlift. This is what we were able to capture:

Pain after deadlifting: Lumbar Spine

Did you notice the distance from the bar to the shin in both pictures? On the picture on the right, the distance is almost three times larger than the distance on the left side.

Let’s talk physics and torque

I’ve simplified a vector diagram to show the changes in the amount of torque when the bar is placed 10cm further from the shin.

Left diagram: The distance from the shin is 5cm

Right diagram: The distance from the shin is 15cm

By changing the distance from the shin by 10cm, the amount of torque that was placed on the spine went from 500 units to 1,500 units! That is three times the amount of stress.

** I’ve drawn the center of rotation in the middle of the spine for simplicity only.

What does this mean for the lumbar spine?

In order to fully comprehend what this means, we have to understand what torque is. Siri defines torque as a “twisting force that tends to cause rotation”. In this example, the weight is trying to bring our torso towards the ground while our muscles need to prevent that from happening. 

In order words, the picture on the left needs to fight against 500 units of torque while the picture on the right needs to fight against 1,500 units of torque. 

Which one do you think is more detrimental? 

Lumbar Spine Treatment

  1. Desensitize the tissues via manual therapy 
  2. Adjust deadlifting mechanics 
  3. Continue physical activity throughout, avoid inactivity!

Results?

Three sessions later and the client reports absolutely no pain!

Conclusion

The solution is often in the subtleties of movement. A good assessment with truly functional qualities can help identify these dysfunctions. The therapy is secondary to identifying the problem, and as a result of identifying the problem early on, the client was able to return to activity as quickly as possible.


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