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    Barbell Medicine: Lumbar flexion doesn’t increase injury risk

    I don’t think there has been a thread on this yet, but forgive me if I missed it. Some people in the “evidence based” part of the fitness industry have recently been pushing the idea that lumbar flexion isn’t a risk factor for injuries in lifting:

    https://www.barbellmedicine.com/blog...and-deadlifts/

    “In summary, it does not appear that humans can avoid flexion-extension of the lumbar spine past the “neutral” zone during many exercises. Fortunately, this does not appear to increase the risk of low back pain or disc herniations, though admittedly disc herniations do not tend to correlate well with low back pain.”

    Thoughts? In my mind the way he is reading the data is very skewed and doesn’t support his conclusions.
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    So it was fake every time someone slipped a disk deadlifting?
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    Didn't read but while maintaining a neutral spine is good general approach, some people do lift fine with some rounding.
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    Originally Posted by air2fakie View Post
    Didn't read but while maintaining a neutral spine is good general approach, some people lift fine with some rounding.
    I agree.

    But that’s not the idea he is pushing. He is suggesting that substantial lumbar flexion - beyond the “neutral zone” - doesn’t even increase the risk of injury.
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    Originally Posted by EiFit91 View Post
    I agree.

    But that’s not the idea he is pushing. He is suggesting that substantial lumbar flexion - beyond the “neutral zone” - doesn’t even increase the risk of injury.
    So what accounts for actual injuries when they do happen, according to him?
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    Originally Posted by EliKoehn View Post
    So what accounts for actual injuries when they do happen, according to him?
    That is IMO the main missing link in that piece. As far as I can tell he doesn’t even mention that.
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    Originally Posted by EiFit91 View Post
    That is IMO the main missing link in that piece. As far as I can tell he doesn’t even mention that.
    Honestly I didn't read it, but I'd suspect he's possibly undergoing some delusional megalomania, because he's so accomplished he's intoxicated with his own success and failing to reason at a very basic level.
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    Yes.
    The article is very good..

    But a lot of misinterpretation of it in here (this thread) by the sounds of things.. And taking it far outside of what they are saying by not understanding their basic premises for injuries and pain.

    Which is echoed by the entire medical field..

    Its not megalomania, its end users not even being current with any of the current medical understanding.

    Originally Posted by EliKoehn View Post
    So what accounts for actual injuries when they do happen, according to him?
    The info is quite clear on this...

    Bad workload management and then doing lifts you are unaccustomed to and therefor have not adapted to the positions that are being stressed. Which runs akin to workload management.

    And ofc, accidents.

    Finally people are moving away from the athlenX and squatU bs.
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    Han shot first! TolerantLactose's Avatar
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    Watch some strongmen pick up Atlas stones. Rounding your back is pretty much required.
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    Originally Posted by MyEgoProblem View Post
    Yes.
    The article is very good..

    But a lot of misinterpretation of it in here (this thread) by the sounds of things.. And taking it far outside of what they are saying by not understanding their basic premises for injuries and pain.

    Which is echoed by the entire medical field..

    Its not megalomania, its end users not even being current with any of the current medical understanding.



    The info is quite clear on this...

    Bad workload management ������ and then doing lifts you are unaccustomed to and therefor have not adapted to the positions that are being stressed. Which runs akin to workload management.

    And ofc, accidents.

    Finally people are moving away from the athlenX and squatU bs.
    I find this way more nuanced and less skewed:

    https://www.strongerbyscience.com/lumbar-flexion/

    The following is a key point IMO:

    “As we get into lifting heavy objects or more grueling endeavors, “better” will likely shift more in favor of the neutral range. Currently, we have a number of papers that favor neutral while lifting; we do not have any favoring flexion”

    A lot of the points in Jordan’s article fails to discuss the issue of sample selection. He keeps comparing different populations as if they are directly comparable.
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    Originally Posted by TolerantLactose View Post
    Watch some strongmen pick up Atlas stones. Rounding your back is pretty much required.
    It's often the same for people with heavy DL maxes. I don't think people should go out of their way to round their spine, but sometimes it's just going to happen.
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    Originally Posted by TolerantLactose View Post
    Watch some strongmen pick up Atlas stones. Rounding your back is pretty much required.
    Especially when we look at even the flattest backs when deadlifting..

    That go thru 30+ degrees of movement 👌

    Soo much info on this available, but the bro lore is still prevailing cos movement gurus push the old agendas
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    Originally Posted by air2fakie View Post
    It's often the same for people with heavy DL maxes. I don't think people should go out of their way to round their spine, but sometimes it's just going to happen.
    Originally Posted by MyEgoProblem View Post
    Especially when we look at even the flattest backs when deadlifting..

    That go thru 30+ degrees of movement ������

    Soo much info on this available, but the bro lore is still prevailing cos movement gurus push the old agendas
    Wait, when I pulled 5 raw you all were telling me my back needed not to have a slight bend...? lol That was EC mostly and I think he was just concerned for the injury potential but it seems like the narrative's changing a little bit here.

    EDIT: Nevermind, went back and read it and it was just EC. No one else who said anything made any comment about that. Still seems to be the orthodoxy, but I won't speak to a straw man.
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    Originally Posted by EliKoehn View Post
    Wait, when I pulled 5 raw you all were telling me my back needed not to have a slight bend...? lol That was EC mostly and I think he was just concerned for the injury potential but it seems like the narrative's changing a little bit here.
    You where just in a ****ty inefficient position..

    Lumbar Flexion is not necessarily a vector for injury... Everything lifting related has a none zero chance to injure you. It's just far lower than ppl assume

    That requires excessive workload past your level, a freak incident or a high velocity stressor well outside... Your workload capabilities.

    You where adapted to that rounded position, ergo no Injury worries. But you where missing at the knee area, indicating your back was too out of position for its strength to take you to lockout..

    That's why I have the technical changes and advice did.
    Zero fear of you getting hurt.

    Edit..saw your edit /thumbs up
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    “Disc herniation rates for resistance training tend to be lower than what is seen in sedentary populations.“

    Yes, Jordan, but suppose the sedentary population started lifting. Is there any reason to expect disc herniation rates to be the same? People who lift and keep lifting are probably way less likely to herniate a disc (self-selected sample)

    “When it came to using free weights at least 10 times within the past 2 years, the RR was 0.90 indicating a mild protective effect. When we look a bit closer, this same data indicates that “lifting the heaviest weights, 2 or more repetitions” had a RR value of 0.72, or significantly reduced risk of disc herniation.”

    Again, sample selection problem. Those who keep lifting are probably at the outset less likely to suffer those injuries.
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    Originally Posted by EliKoehn View Post
    Wait, when I pulled 5 raw you all were telling me my back needed not to have a slight bend...? lol That was EC mostly and I think he was just concerned for the injury potential but it seems like the narrative's changing a little bit here.
    I don't recall telling you that if you were pulling 5 plates, but I could be wrong.

    But it's true that I generally encourage people esp noobs to keep a neutral spine if possible. Those types of threads usually have someone complaining about back pain, so there are usually a few things they can improve to try to resolve it.
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    I do wonder why people are soo scared of bending over tho? And use such fearful language around it.

    Ain't that fragile kids.


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    Originally Posted by MyEgoProblem View Post
    I do wonder why people are soo scared of bending over tho? And use such fearful language around it.

    Ain't that fragile kids.


    http://www.greglehman.ca/blog/2018/4...-doesnt-matter
    I am not necessarily against taking the position he takes, I just think his (not so nuanced) conclusion does not follow from his article.

    I think the Stronger by Science article is excellent and that also concludes that this topic is complicated, and that failing to stay within the neutral zone isn’t always a problem. But I think it’s an important point that there are studies favoring a neutral spine and none favoring flexion (particularly involving greater degrees of compression).
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    Originally Posted by MyEgoProblem View Post
    I do wonder why people are soo scared of bending over tho? And use such fearful language around it.

    Ain't that fragile kids.
    Some of it's what we've been told over the years like you say, but to be fair, some of it's experience - I've tweaked my own back at times over the years picking up awkward things like an old giant TV with "poor form" and it's not a lift I'm going to practice - I'm just careful with my back positioning, using legs etc. the next time I do it.

    I'm less in your camp in the sense that IMO if you can lift XXX weight efficiently with a neutral spine, then do it that way.

    And some people are pretty fragile. :P
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    To each their own interpretation xD
    Its good..

    I just hate the narrative that tugging round is inherently dangerous.. As it really just isn't, especially if your tight.

    Originally Posted by air2fakie View Post
    Some of it's what we've been told over the years like you say, but to be fair, some of it's experience - I've tweaked my own back at times over the years picking up awkward things like an old giant TV with "poor form" and it's not a lift I'm going to practice - I'm just careful with my back positioning, using legs etc. the next time I do it.

    I'm less in your camp in the sense that IMO if you can lift XXX weight efficiently with a neutral spine, then do it that way.

    And some people are pretty fragile. :P
    Be so you where in a position you where not adapted to which was My second point.

    'Neutral' is pretty relative as we all know. And isa very middle of the road technically, to no really leave glaring weakpoints.. Such as pulling round being easy to break as a hard to lock.

    People in general, arent as fragile as many think obviously some people are just built ****
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    Originally Posted by EliKoehn View Post
    Wait, when I pulled 5 raw you all were telling me my back needed not to have a slight bend...? lol That was EC mostly and I think he was just concerned for the injury potential but it seems like the narrative's changing a little bit here.

    EDIT: Nevermind, went back and read it and it was just EC. No one else who said anything made any comment about that. Still seems to be the orthodoxy, but I won't speak to a straw man.
    If I remember correctly I was advising you to pull with a straight back because it engages the glutes more from start to finish. I think you were missing at the top because of having to uncurl the spine at the top, and the erectors couldn't complete all that load. Don't remember you missing at knees, think it was 495 or 500 last year you missed at the top because the rounded spine couldn't uncurl. Then recently you got it and I suggested straighter back would be more efficient.

    I think the big thing here is not moving the spine under load. A static somewhat rounded spine isn't the cause of injury, but rather moving the spine under load is the cause.
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    Originally Posted by ECGordyn View Post
    If I remember correctly I was advising you to pull with a straight back because it engages the glutes more from start to finish. I think you were missing at the top because of having to uncurl the spine at the top, and the erectors couldn't complete all that load. Don't remember you missing at knees, think it was 495 or 500 last year you missed at the top because the rounded spine couldn't uncurl. Then recently you got it and I suggested straighter back would be more efficient.

    I think the big thing here is not moving the spine under load. A static somewhat rounded spine isn't the cause of injury, but rather moving the spine under load is the cause.
    Yeah, that's right - and it was good advice, but was curious this time since the claim made in the article referenced by EiFit in the OP seems at odds with it, but you're right, there is a big difference between a static rounding and a concentric use of the thoracic erectors. And that is pretty much exactly what appears to have happened last year with five plates - the bar moved easily up to the knees, then when I was out of glutes to use the erectors and traps weren't enough and I stalled. Exactly like the 4th rep of 465 a few months ago.

    Anyway, I don't want to derail the thread topic, but don't want to be on record putting words in anyone's mouth.
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    Originally Posted by TolerantLactose View Post
    Watch some strongmen pick up Atlas stones. Rounding your back is pretty much required.
    Well we aren't squatting while holding the bar out in front of us with our forearms now aren't we?
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    Originally Posted by MyEgoProblem View Post
    Yes.
    The article is very good..

    But a lot of misinterpretation of it in here (this thread) by the sounds of things.. And taking it far outside of what they are saying by not understanding their basic premises for injuries and pain.

    Which is echoed by the entire medical field..

    Its not megalomania, its end users not even being current with any of the current medical understanding.



    The info is quite clear on this...

    Bad workload management ������ and then doing lifts you are unaccustomed to and therefor have not adapted to the positions that are being stressed. Which runs akin to workload management.

    And ofc, accidents.

    Finally people are moving away from the athlenX and squatU bs.
    This.

    Go out in the world and lift some things and observe...you don't need a study to break this down.
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    Originally Posted by 401Delta View Post
    This.

    Go out in the world and lift some things and observe...you don't need a study to break this down.
    But comparably that will be very light loads, probably no problem rounding then. What’s the real world equivalent of pulling 5 plates?

    The Stronger by Science article I linked to suggests that the common saying that you should worry about rounding in everyday life (picking up light objects) is probably a myth - but as the compression increases (e.g. Eli pulling 5 plates vs pulling 2 plates) you should be increasingly concerned about trying to stay within the neutral zone.

    Of course you may still be fine, we are assessing risk in terms of statistics - whether on average there is a lower chance of injury lifting a large load with or without trying to maintain a neutral spine. Av average increase in risk doesn’t necessarily imply that the effect is the same for everyone. It could be that some have no increased risk with rounding, but others have a large increased risk.
    Last edited by EiFit91; 08-21-2021 at 10:43 PM.
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    Originally Posted by EiFit91 View Post
    But comparably that will be very light loads, probably no problem rounding then. What’s the real world equivalent of pulling 5 plates?
    There's no real world equivalent because a bb + plates can be lifted in specific ways and close to the body that many real world objects cannot. Once you start lifting a table, appliance, etc., moment arms, center of gravity, body dimensions, and your own bw all start factoring more into the equation. For ex, someone short & light but very strong who can DL heavy might have a harder time lifting a not-nearly-as-heavy crate than a tall, fat dude who barely works out because the first guy will literally tip back over and not be able to keep it off the ground.

    Originally Posted by EiFit91 View Post
    The Stronger by Science article I linked to suggests that the common saying that you should worry about rounding in everyday life (picking up light objects) is probably a myth - but as the compression increases (e.g. Eli pulling 5 plates vs pulling 2 plates) you should be increasingly concerned about trying to stay within the neutral zone.

    Of course you may still be fine, we are assessing risk in terms of statistics - whether on average there is a lower chance of injury lifting a large load with or without trying to maintain a neutral spine. Av average increase in risk doesn’t necessarily imply that the effect is the same for everyone. It could be that some have no increased risk with rounding, but others have a large increased risk.
    IMO a "neutral" spine should still be the goal if possible - esp since many people have other form issues, poor programming, try to lift too heavy at times, etc. But I think the point of some on this thread is that you don't need to freak out about the concept, and that there are plenty of people who've built up the capacity to lift heavy stuff with "rounded" backs without injuring themselves. To me that's doesn't mean that people still shouldn't still be encouraged to lift with a "neutral" spine if possible.
    Last edited by air2fakie; 08-22-2021 at 02:40 PM. Reason: typo
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    Didn't read through it all yet, but I would think it would depend on the exercise. When doing kneeling cable crunches, lumbar flexion is actually encouraged. Deadlifting.. I heard mixed ideas around that.

    EDIT: I see. Squats and deadlifts. Still think I'd rather play it safe and try to avoid it and keep my back as neutral as I can instead. I doubt that ever hurts.
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