2019-10-27
Last week I wrote a blog post that questioned if the deadlift really helps low backs like everyone says. The moral of the story was….maybe! Sounds like a great post right?! The point was the deadlift that everyone knows and supposedly loves, the barbell conventional deadlift, may not be for everyone. However the movement pattern of the hip hinge IS! So, it isn’t about the deadlift, but the RIGHT version for you. With that in mind, I was excited to share this great post physical therapist, Scott Corso. It falls right in life with what I was JUST talking about. It isn’t about the exercise but the movement pattern. Even cooler, Scott goes the extra mile in teaching how we use load to become another coach in creating better results and movement. Without more to do, here is the great post by Scott!
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The deadlift is revered by some and maligned by others. Herman Goerner, one of the greatest strongmen, in a sentiment reiterated by strength coach, Dan John, believed that the true tests of strength are what you can lift off the ground, press overhead and carry. The deadlift is a fundamental standing exercise that helps train people to lift from the ground. Renowned physical therapist, Gray Cook says, “we find the deadlift to be a fundamental movement almost across the lifespan because it is more of a natural lifting pattern than even the squat.”
But what happens when the deadlift movement is painful or there is lingering fear that it will result in pain or injury? This was true for a recent patient of mine. She is an active 70 year old personal care nurse who injured her back in a motor vehicle accident. Lifting was still painful and she was concerned about going back to work because she might be required to help lift a patient.
So what do we do when it hurts to hinge? First, we need to remember that (as Josh Henkin says so often), the deadlift is a hinge but not all hinges need to be deadlifts. Keeping this in mind we can follow some of the principles of DVRT to help rebuild the deadlift from the ground up. By starting on the ground, in the most stable position for the spine, we can train the hinge pattern and progressively move through the developmental patterns of supine, quadruped, and tall kneeling to restore the deadlift.
Along the way it is helpful to let the sandbag do the coaching. What I mean is that the carefully programmed cues of the system allow us to tap into the sling systems of the body in order to create more activation through the chain. While all the sling systems are active, the hinge pattern really taps into the posterior oblique system. Physiotherapist Diane Lee, in her text, The Pelvic Girdle, discusses how this system is formed through the connection of the latissimus dorsi to the opposing gluteus maximus via the thoracodorsal fascia. This sling system helps with the transference of loads and results in improved stabilization across the lumbosacral region.
Rather than telling the patient or client to tighten the lats or squeeze the glutes, it is much more helpful to let the sandbag do the coaching. External cues have been shown to be more effective in producing the desired results with more complex motor tasks. Gabrielle Wulf, in an article documenting 15 years of research on the impact of where one focuses attention during physical activity concluded, “The enhancements in motor performance and learning through the adoption of an external relative to internal focus of attention are now well established. The breadth of this effect is reflected in its generalizability to different skills, levels of expertise, and populations, as well as its impact on both the effectiveness and efficiency of performance.”
In this case, the cues are to pull the Ultimate Sandbag apart and grab the ground with the feet. Pulling the Ultimate Sandbag apart activates the lats strongly, while grabbing the ground produces greater gluteal activation. These simple cues go a long way in creating greater stability through the lumbar region because of the sling system.
Let’s take a look at how we can build an exercise progression taking advantage to these DVRT concepts.
The Bridge
The bridge is a helpful position to start retraining the hinge because we are able to work from a position of stability, while reinforcing proper movement through the pattern. It is especially helpful for reinforcing the cue to pull the bag apart while engaging the ground with the feet. In this way, the client or patient understands that the hip drive starts from the feet pressing into the ground.
The Bird Dog
While technically not a hinge pattern, the quadruped position is a progression up the developmental sequence. The spine is still relatively unloaded and the position is very helpful in getting the client or patient to activate the latissimus dorsi/ gluteal connection while driving into hip extension. The bag is still coaching as we focus on pulling the lateral handle as we kick/ drive back with the foot, while the stationary foot drives the ground. Placing a XL mini band around the driving foot and the opposing thigh can help to provide additional feedback to the movement.
Tall Kneeling Press Out
Here we move from quadruped to tall kneeling. This allows us to start to load the spine while reinforcing the plank in the finish portion of the deadlift. Position the bag at belly button height with the elbows close to the body. The bag is still coaching us as we grab the outside of the bag and try to rip it apart while driving the balls of the feet into the ground.
Tall Kneeling Good Morning with Core Strap
For this exercise, we stay in the tall kneeling position and use the sandbag to help groove the hinge pattern. The sandbag is still training us to engage the lats as we cue the client to keep the elbows close to the ribs and pull the USB into the body by pulling it apart. The core strap provides additional feedback as we move back into the hinge. It is important that the balls of the feet continue to drive into the ground.
Deadlift
We are now on our feet, ready to retrain the hinge in standing. It is important to note that the progressions we have moved through are ones that I have found to be helpful with certain patients and clients. Within each of these exercises are variations and additional progressions and regressions that might be more helpful with the particular person being trained. As you can see, there is a consistency in the cues throughout each pattern. Pulling the bag apart and grabbing the ground are coached from the ground up to the standing position. As an experiment, get into the bottom of the deadlift, but just hold the handles but don’t crush them and pull the bag apart. Also keep your feet soft. DO NOT lift the bag, but just arch and then round the lumbar spine. Notice how easy it is to move through the lumbar spine. Now grab the handles and pull them apart. Is it more difficult to move the lumbar spine? Next, grab the ground with your feet and see how the lumbar spine becomes even more stable. NOW, you are ready to lift by driving through the feet and standing tall.
This is what my patient experienced. Letting the Ultimate Sandbag coach her, she was able to deadlift the sandbag without pain. She may not incorporate deadlifting into her exercise routine, but more importantly, she developed the confidence to lift again without pain. She has since returned to work and recently followed up to say she used the principles she learned from being coached by the sandbag to remove her air conditioner and carry it to storage without pain. This was, in Herman Goerner’s way of thinking, a true test of real world strength.
Find out more about how we teach to be successful faster and more effectively! Grab the last days of our Fall sale of 30% off with code “fall” HERE. Save big on our DVRT workouts, education, and of course, Ultimate Sandbags!
Works Cited:
Bento, Jessica. “Restoration Course Manual.” Restoration Course Manual, edited by Josh Henkin, Innovative Fitness Solutions, 2016.
Cook, Gray. “FMS Unplugged: Episode 2- Cook-ing the Deadlift”, 2013
Henkin, Josh. DVRT Level 1 Certification Manual. Innovative Fitness Solutions, 2014.
Lee, Diane. The Pelvic Girdle: an Approach to the Examination and Treatment of the Lumbo-Pelvic-Hip Region. Churchill Livingstone, 2004.
Wulf, Gabriele. “Attentional Focus and Motor Learning: a Review of 15 Years.” International Review of Sport and Exercise Psychology, vol. 6, no. 1, 2013, pp. 77–104., doi:10.1080/1750984x.2012.723728.
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