The image below showcases a personal record of a 500-pound deadlift, a feat that required immense strength to achieve, despite its less-than-perfect form.

Did I sustain any injuries? No.

Do I recommend pushing yourself to the limit with deadlifts or any other lifts? Absolutely not. The position of your back isn't the main issue here.

This discussion is not intended as medical guidance. As a certified orthopedic physical therapy specialist, I aim to share insights from current research along with my personal and professional experiences. If you have medical concerns regarding exercise and lifting, please consult a healthcare professional.

Lifting with Knees or Back? How many times have you heard the advice to lift with your knees rather than your back? The notion of avoiding a rounded back aligns with traditional posture advice that lacks solid research backing.

A systematic review and meta-analysis from 2020 titled “To Flex or Not to Flex? Is There a Relationship Between Lumbar Spine Flexion During Lifting and Low Back Pain?” reached a significant conclusion:

> "There was no prospective association between lumbar spine flexion while lifting and the onset of severely disabling low back pain. Peak lumbar flexion during lifting showed no significant difference between individuals with and without low back pain. Current recommendations to avoid lumbar flexion during lifting to mitigate low back pain risk are not evidence-based."

This indicates that lifting with a rounded back does not necessarily correlate with future pain or injury.

Although this review included only five studies, the initial search yielded 4500 results, suggesting limited research specifically examining the effects of rounded back lifting.

It's important to note that the onus of proof lies with those making claims. If someone argues that lifting with a rounded back is hazardous, they must provide evidence to substantiate that assertion.

Research cannot test every conceivable variable.

Let’s delve deeper into the data that claims lifting with a rounded back poses risks.

Misapplication of Research Findings When trainers, physiotherapists, and doctors refer to research to argue that rounded back lifting is risky, they often cite studies involving cadaver models.

Whether using human or animal (often porcine) specimens, the research designs are flawed, and the findings have limited applicability to living individuals.

Researchers subject spines to protocols involving mechanical strain, such as bending and compressing them repeatedly in a pneumatic device. They assess the resulting damage and conclude that shear, bending, and compressive forces are harmful.

This design presents numerous issues.

Firstly, cadavers do not adapt to stress, but living humans do.

Our bones adapt and strengthen in response to repeated stress. Ligaments and tendons thicken, and muscles grow stronger. While overuse injuries and degeneration can occur if the load exceeds limits, this is not exclusive to the back.

If you suddenly decide to run 20 miles without prior training, you may suffer pain and potentially develop Achilles tendinitis. This doesn't mean running is inherently dangerous; it signifies exposure to a stimulus your body wasn't prepared for.

Consistently lifting heavy weights, whether with a straight back or a rounded one, can lead to muscle strains if it's a new experience.

However, you won’t develop degeneration or herniations due to your lifting style; such adaptations take years to manifest. Our intervertebral discs are resilient. Instead of the outdated analogy of jelly donuts, envision them as tires filled with a durable substance.

Returning to cadaver studies, repeated strain on cadaver models does not account for the complexities of muscles, ligaments, blood supply, or the nervous system's regulation. Compressing two decades of lifting into a few hours does not mimic real-life stimuli.

Thus, cadaver studies offer minimal useful insights and fail to predict low back injuries or optimal lifting positions.

Potential Benefits of Rounded Back Lifting Research has indicated that the spine may exhibit greater 'stability' when flexed.

Exaggerating to keep your back as straight as possible could increase segmental axial compression and shear forces at the L5–S1 level compared to a rounded back position. While I’m not claiming this is inherently safer, it challenges conventional wisdom.

A study examined different techniques for lifting a box and found that traditional “correct” lifting methods might induce greater shear stress in the spine than a rounded back. Importantly, the force was not sufficient to cause injury.

There are potential advantages to lifting with a rounded back, especially with heavy loads like in deadlifts.

The study involved twenty-six healthy participants performing maximum effort lifts in three postures: flexed, neutral, and lordotic (arched). Researchers evaluated trunk extensor and oblique muscle activity.

Findings revealed that adopting a flexed posture improved neuromuscular recruitment and efficiency compared to the other two positions, potentially enhancing strength and overall lifting capacity.

Many powerlifters and strongman athletes utilize a flexed posture, especially in the thoracic region, to ease the demands on hip and knee mobility.

Flexing your back minimizes the distance needed to bend at the hips and knees, optimizing the length-tension relationship of the hamstrings and glutes. This may enable a lifter to lift heavier weights with similar effort as when using a neutral spine.

Even Attempts to Maintain a Straight Back Result in Flexion Here are four studies where participants were instructed to lift while keeping a straight back:

• Coached to maintain a neutral low back during deadlifts: an average of 22 degrees of flexion
• Coached to maintain a neutral low back during kettlebell swings: an average of 26 degrees of flexion
• Coached to 'brace as hard as possible' during good mornings: 25–28 degrees of flexion
• Strongman competitors lifting extremely heavy weights: up to 45 degrees of flexion

Your back may appear straight in the mirror, but your spine is likely flexing as soon as you squat halfway.

This data does not indicate whether lifting with a rounded back is safer or riskier.

Injuries are Complex You can sustain injuries while lifting with a rounded back.

Conversely, you can also hurt yourself while lifting with the straightest back possible.

I have experienced both scenarios.

Carrying objects awkwardly poses a risk for low back pain, as does frequently lifting heavy items. However, body positioning is just one factor contributing to injury risk, and it is often not the primary one to target.

Research assessing workplace ergonomics training often yields lackluster results. Understanding mechanics is less crucial than implementing appropriate exercise and recovery strategies. Pain and injuries stem from multiple factors, and focusing on a single cause rarely resolves the issue.

Studies show that work-related pain is influenced by low job satisfaction, inadequate exercise tolerance, inactivity, and health issues. Elevated activity levels combined with poor recovery practices (diet, sleep, stress management) contribute to pain and injury, particularly when the activity is work-related rather than recreational exercise.

The most effective injury prevention strategy is to gradually acclimatize your body to specific activities while incorporating proper recovery. The key drivers of injury include overload—whether acute, like an ACL tear, or chronic, such as tendinitis—and inadequate recovery.

If you have experience lifting weights, you will develop strength in those positions, making tasks easier. Rapidly increasing the load or exercise volume, regardless of form, raises injury risk.

You must also consider your sleep and dietary habits, stress levels, and contextual factors that affect training intensity.

Training at high intensity for competition while pushing through fatigue increases risk. Conversely, incorporating a new movement into your routine while keeping the weight light—well below maximum effort—ensures safety.

Research indicates that strength sports have some of the lowest injury rates in athletics, comparable to non-contact sports and lower than contact sports. Bodybuilding exhibits some of the lowest injury rates (0.12–0.7 injuries per lifter annually; 0.24–1 injury per 1000 hours), with strongman (4.5–6.1 injuries per 1000 hours) and Highland Games (7.5 injuries per 1000 hours) still relatively low compared to team sports and running.

Does Form Matter? Form can be both beneficial and detrimental. Let's specifically examine posture.

Advising individuals to avoid flexion may do more harm than good.

One study assessed whether fear-avoidance beliefs affected spinal movement during lifting.

Fifty-seven pain-free participants were asked to perform various movements without specific instructions to promote natural movements:

• Standing upright and sitting down
• Bending forward and backward from an upright position without bending their knees
• Standing up from a chair and sitting down with arms hanging freely
• Lifting and placing a 5 kg box positioned 15 cm in front of their feet
• Walking and running on flat terrain

Results indicated that people's lifting actions correlate with their beliefs about body position. Specifically, increased back flexion correlated with greater expectations and fears of pain.

This pattern is evident every time I enter a clinic, influencing my educational approach and exercise recommendations.

From a young age, people are advised to lift with their legs instead of their backs. As I have demonstrated, research does not support this belief. Our backs are robust, and our bodies are adaptable and resilient.

To counteract this belief and alleviate fear of movement, strategies such as graded exposure and graded activity can be employed.

Graded exposure involves gradually facing activities or movements previously avoided due to fear or discomfort. The approach starts with manageable steps and gradually increases difficulty as your body adapts and becomes more comfortable.

The aim of graded exposure is to help your brain and body recognize that an activity or movement is not as perilous or painful as once believed. Incrementally increasing the challenge builds confidence and trust in your body’s capabilities, ultimately reducing pain.

If you fear lifting with a rounded back, begin small. You might lift light items from low surfaces, like your purse or groceries, without consciously controlling your spine position.

You could practice exercises in a rounded position, but with limited range of motion and light weights, such as dumbbell deadlifts starting from a box or bench.

Alternatively, start with minimal back bending during exercises or daily activities, gradually increasing the range of motion.

You can adjust the duration, degree of bend, frequency, and resistance. As fear diminishes, progressively increase the demands of these activities (graded activity). This will help you build strength and resilience while alleviating fear of the task.

Thus, to reduce fear and pain, explore various lifting forms purposefully. Is there ever a time for specific and traditional techniques?

Form is more relevant for performance than for injury risk. Even regarding performance, various methods can achieve athletic goals. Observe any golf swing or baseball pitch to see a diversity of mechanics.

In CrossFit and Powerlifting competitions, you’ll notice differences in form based on body type. Add fatigue to the equation, and form may deteriorate. While it’s not always advisable to train with variable mechanics, to excel during competition, occasional training at maximum effort while learning to perform despite form breakdown is essential.

Building Resilience Two effective strategies for fostering resilience through exercise exist.

The first, and most critical, is sound programming and recovery. When your training is well-structured, your recovery chances improve.

The second involves exposing your body to diverse postures and loads. This is why I appreciate integrating strongman exercises and multiplanar lifts. Below are a few examples from my routine.

For all exercises, start slowly and progressively increase the load and volume over months.

Challenge Your Lumbar Flexion

The image features Zercher deadlifts on the left, Jefferson curls in the center, and full-depth squats on the right. I could enhance the range of hip and knee flexion by widening my stance during squats, but a narrow stance places more demand on my ankles. I engage hip and lumbar mobility with Zercher deadlifts.

I recommend starting with Zercher squats before progressing to Zercher deadlifts. The Zercher technique involves holding the barbell in your elbows.

Rotate Under Load

This image illustrates a twisting or rotating deadlift, showing the sequence moving from left to right. You will become aware of which hip has greater stiffness in terms of internal and external rotation.

Incorporate Strongman Lifts

Here, you see the Jefferson lift on the left, the suitcase lift in the center, and the barbell hack lift on the right. Each lift presents unique mobility and stability challenges. For the Jefferson lift, switch grip orientation midway through the set.

As you grow more comfortable, you can explore additional lifts such as the Arthur lift, Steinborn squats, one-arm deadlifts (between the legs but with one hand), and the Reeves lift. For an extensive account of numerous strongman lifts and philosophies, refer to Super Strength by Alan Calvert.

All these exercises can be performed safely with gradual buildup. They will introduce variety into your routine and promote resilience. While I prefer using a barbell, you can effectively build resilience with dumbbells and kettlebells.

If someone claims these exercises are dangerous or ineffective, kindly inform them that evidence does not support their assertion.

Maintaining an exercise routine can be challenging. Let’s not complicate matters further by adopting a pessimistic view on movement.

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