Does teaching proper lifting techniques work for injury prevention?
Teaching proper biomechanics for lifting at work. Does it make sense? Does it really prevent injuries?
Many companies are hiring professionals to teach their employees how to properly lift in order to prevent injuries. Most of the time, they focus on posture and biomechanics. Posture is an interesting topic that requires our attention…but not today. Today, we will be discussing proper lifting techniques to prevent pain or injuries.
So, once again, let’s dig into the science. Because without science, things become too debatable. And we want facts.
Annnnd the science say… that biomechanics of lifting RARELY matters, for pain.
Let’s travel back in time and briefly review a few studies on stoop lifting vs squat lifting.
In 1999…a group of researchers demonstrated no significant difference in spinal compression between both lifting techniques. Net moments and compressions forces were shockingly equal or even higher in squat lifting!
In 2002, another group of researchers reviewed lifting techniques and identified little evidence to support effectiveness of training programs to change workers lifting habits and attempts at change may increase risk of injuries due to not using their protective conditioned movement patterns.
In 2008, 6 randomised trials and five cohorts studies were studied. The conclusion? Still no evidence to support use of advice and training on working techniques with or without lifting equipment for the purpose of preventing back pain that involve heavy lifting.
Finally in 2012, they found no clear relationship between sustained flexed posture and Low Back Pain. Limited evidence was found for range of motion and duration of sustained kyphotic posture.
Time after time, we have proven that there is clearly no relationship between lifting posture and low back pain at work or in any other situation, in general.
Beneficiary attendant waking up with back pain after a tough day at work. Why? Overload.
SQUAT LIFTING IS NOT SUPERIOR TO STOOP LIFTING TO PREVENT BACK PAIN
Teaching “proper” lifting techniques have been highly popular in 90s up until... now. And it’s understandable. People still believe that there is such thing as a proper squat to prevent injuries and optimize force. Apparently, flexion of the lower back is bad! We all thought this. Flexion posture is bad. Bending movements are bad.
However, now we know that current evidence-based science does not support this idea.
THE BACK IS NOT FRAGILE
The science does not support the use of squat lifting over stoop lifting. And it makes sense.
Why? Because humans back are NOT fragile.
The back can be trained. If you are stoop lifting. You become good and strong specifically throughout the movement and you normally won’t get hurt.
Ideally, for lifting heavy objects, you still need to be careful.
Overload is an actual thing, definitely. In order to lift heavy, you need to train your robust back and make it even stronger. If you feel like stoop lifting isn’t sufficient enough to lift heavy, DON’T do it. Strengthen your legs and practice a stronger technique, like squat lifting. But this has nothing to do with whether stoop lifting is bad or not for the back. It has more to do with load management. The distinction is important.
Lumbar flexion isn’t bad. It’s safe to bend your back and it is definitely safe to bend your back while lifting (unless you have a herniated disc).
SO HOW CAN YOU PREVENT INJURIES AT WORK?
Practice spinal flexion and start working out. Make that back stronger! Bend that back and use a variety of angles. Challenge the back. Stoop at work. Stoop in real life, but don’t forget to extend. Too much of anything is bad.
Remember, if power lifters can lift 500 lbs without too much pain, the back is NOT that fragile.
The back is STRONG not weak as claimed. There is a reasonable amount of flexion in this position too.
Reference:
Nolan D, O’Sullivan K, Stephenson J, O’Sullivan P, Lucock M. What do physiotherapists and manual handling advisors consider the safest lifting posture, and do back beliefs influence their choice?Musculoskelet Sci Pract. 2017 Oct;33:35–40
Van Dieen JH, Hoozemans MJ, Toussaint HM. Stoop or squat: a review of biomechanical studies on lifting technique. 1999