Why I believe deadlifts to be of utmost importance for advanced spinal rehabilitation noting that “progressing the patient into more advanced physical training exercises is important in order to both improve the patients performance, as well as to gain higher levels of strength and muscular control in order to prevent future injury occurrences.” Further that “in the world of ‘manual therapists’, many would shy away from prescribing this particular lift as they feel that it is too stressful on the lower back. I disagree. When performed correctly, this lift is very effective for developing tremendous lower back and core strength which should be the goal of any lower back rehabilitation. In addition, it trains one of the most primal, and frequently performed movements….which is lifting objects off of the floor. This is a movement that our patients will have to perform for the rest of their lives…better to teach them how to do it right, and make them stronger at it than have them do it and re-injur their back in the process.”
Far too often I see that exercise perscription for the “core,” or for “spinal stability” in low back pain patients begins and ends with the classic McGill sets – cross crawl, side plank, safe curl. But as I have noted in blog posts in the past, there is a simple rule for rehabilitation that applies across the board for any condition and for any patient….and that is the rule of PROGRESSION. The entire topic/’world’ of ‘Rehabilitation’ can be summed up as follows….Provide the tissue with manageable, incremental insults (loads) allowing the body enough time in between progressions to adapt. That’s it. If the bodies tissues are progressively loaded, the body will adapt in a way that will ‘deal’ with said loads more effectively, and efficiently.
Thus for those with chronic low back pain, we can’t stop at a certain set of exercises and loads or the performance of these exercises will no longer trigger the bodies adaptation processes…. ie. the usefulness of the exercise/rehab program stops….but the goal of rehab should be not only to deal with a ‘condition’ or ‘symptom,’ it should be to better the persons mechanics thus preventing problems in the future.