"I Can't Deadlift," Back-Too-Weak-Disease, Hip Adductor Stretch
The weekly recap is where we share some gems of information about some interesting, and sometimes common, things that we have seen in the clinic or training session throughout the week. We share these real-life treatment strategies, insights, and discussion on how to treat these ailments to get you or a loved one back in action!
1) "I Can't Deadlift"
Patient: High school football lineman
The Problem: Low back pain. He had previously hurt his back deadlifting, and has had pain when trying to attempt back squat and standard deadlift. The interesting thing is that he was lifting big weight in the front squat, sumo deadlift, and was even lifting 225 lbs on power cleans.
Insights: His motion and technique looked great for the front squat and sumo deadlift. Notice how he opted for the lifts that put him in a better upright posture. I.e. he was not handling the shear force very well in the standard deadlift and back squat.
The Fix: Actively bracing the core during the lift. "Tighten your core like you can take a punch to the gut" was the cue that I had him focus on throughout the back squat, and he said this was the first time he was able to back squat pain-free in 1 year. For the deadlift we focused on the same cue for the core and added a second cue: "tighten your lats by actively pulling the bar towards you."
Let's also take note of the different angle in which you pull a deadlift and a power clean. In the previous case the patient mentioned how the clean was not hurting him like the standard deadlift was. This is likely due to the more upright angle you position your spine in a clean. See below:
Bottom line: deadlift = butt higher, clean = butt lower.
2) Back-Too-Weak-Disease
Patient: 40s female, sedentary lifestyle
The Problem: Low back pain that had slight improvement initially with extension stretching, but then plateaued to 4 or 5/10 pain.
Insights: Sometimes the problem is simply that our core and back muscles are just too weak, and the spine ends up taking the brunt of our day to day activity. This is especially true when our patients don't know how to activate their core when lifting. I will credit ICE Physio for coming up with "back-too-weak-disease." It is quite a clever way to put it to patients who may have been told that they have "degenerative disc disease" or "arthritis" or whatever other healthcare providers may have told them.
The Fix: Actively bracing the core when lifting, and strengthen the back with DEADLIFTS. First we teach her proper lifting technique, how to brace the core, and drill it a few times with just a PVC pipe, and then we get to work on strengthening with dumbbells, kettlebells, and barbells. She had fantastic results as she was pain-free in a little over a week of doing this, and was shocked at how much she could actually do. Think about the contrast between this treatment approach and the message typically given from other healthcare professionals.
3) Hip Adductor Stretch
Patient: 30s female, active lifestyle
The Problem: Inner hip pain and hip adductor (inner hip muscle) tightness since childbirth 2 years ago.
Insights: In addition to weakness throughout the hip she showed tightness in the inner hip. We used our favorite hip stretching exercise, the hip airplane, but she was not getting as much rotation as I would like, so we added a bonus exercise for her.
The Fix: If an exercise is just not providing everything I want for a patient, we need to either choose an additional exercise, or a regressed (easier) version of the exercise we want to do. In this case we chose an additional exercise that was a little bit easier. We used a kneeling adductor stretch (there may be a better name for this) to really target the inner hip muscles. I also really like this stretch before a big squat day. Just like any mobility exercise, this is something that you would need to work on daily in order to make lasting improvements. However, you should feel immediate results after warming up with this exercise before squats. I would recommend 10-20 reps on each side with a little pause in the bottom of the exercise.
Check out the full rundown below!