Since the dawn of time, we've been told to lift with our "back straight" and "use your legs" to avoid injury. Where did this advice even come from?
The advice is based on cadaver studies (i.e. laboratory experiments) showing your lower back will wear down with repeated bent postures when lifting heavy items. The problem with that is, well...people move differently in their daily lives and many factors play a role in back pain.
A recent literature review published by the JOSPT (J Orthop Sports Phys Ther 2020;50(3):121–130. Epub 28 Nov 2019. doi:10.2519/jospt.2020.9218) took a good look at all the current studies that have been done and concluded giving the advice of "lift with your legs" really is based on nothing. They did mention people with back pain do tend to lift with a more straight back but that was probably because they were told to do that and not because it actually prevented their back pain.
What does that mean for your daily life? Do you think you should just go on lifting things with your back?
Well if you think about it, and as I often see in my clinic, people tend to lift with their back on a routinely basis. I mean, heck, I even do it. It probably wasn't until I began carrying my baby girl around, strapped to my chest, that I realized how often I lift with my back and not my legs. With her strapped to me I definitely use my legs, so as to not have her tilting forward or slipping out of the sling.
Try this Self Experiment
Try doing this activity. if you have a little one, put him/her in a sling and pick something up off the ground. If you don't have little ones then try the activity with a gallon of water or liquid detergent close to your chest. Notice how you do it and you'll more than likely be using all legs with a straight back.
This activity really hit home in how often I lift with my back on a daily basis and, looking back on it, really isn't a big deal. In other words, I don't have back pain and I lift with my back on a daily basis...I'm sure you do the same.
Now you may be thinking, "Dr. Estrada! You're crazy! I've been told to never lift with my back!" And as is with all things in life, the answer to the question, "to lift with your back or your legs?" is it depends on what you're lifting. Notice I am talking about daily activity lifting. Meaning lifting something you may have dropped on the ground or just casually picking up.
What do I do?
I'm not talking about lifting heavy boxes or weight training here. That's a different story and there is published research demonstrating heavy loads, fatigue, and repeated lifting were all
associated with an increase risk for back pain. But it should be noted those are just risk factors and not causes of back pain, a huge difference. Typically what I find contributes most to low back pain is poor posture, poor endurance, poor conditioning, muscle imbalances, and poor motor control of deep perispinal muscles. All which can easily be fixed and managed with a proper conditioning routine.
What are your thoughts? Do you tend to lift with your back or legs when you drop something? Did try the experiment? What did you notice? Share your thoughts.