Risk-Benefit Ratios and SLDL

[Guest guest]

Greetings List Readership,

I feel that I have had this discussion on the Supertraining list before

(many moons ago) but maybe it is time to do that again. The Risk-Benefit

Ratio, as it implies, is the risk of something measured against the

perceived benefit there might be. As applied to a particular exercise the

benefit of the exercise needs to be measured against the risk of injury. In

this case stiff legged DLs.

The BENEFIT - if done with an ABSOLUTE lordotic lock-in of the back - will

indeed isolate the hip extensors (glutes and hamstrings). However, the

RISK - if rounding occurs (which it often does especially towards the end of

a hard set) tremendous wedging-type pressure is placed on front (anterior)

aspect of the lower thoracic and upper lumbar vertebral bodies. And, if

this continues, it WILL cause wedge-shaped compression fractures of these

bodies over time.

I presented two such cases in Hawaii back in the mid 80s of two gentlemen

who loved SLDLs - one a past-his-prime bodybuilder (#s of titles) and a

power lifter turned orthopaedic surgeon. Lateral spine x-rays revealed

beautifully identical compression fractures at T11, T12 and L1. And, both

gentlemen recognised that these were a result of doing SLDLs as there had

been nothing in their histories to argue otherwise. In a similar situation

I had the opportunity to care for 3 veteran rowers (60+) in New Zealand.

And, they too demonstrated the same on x-rays which, in these cases,

resulted from many years of hyperflexing the thoracolumbar portion of the

spine while rowing. Guess there is another message here for the similar

exercise performed in every gym.

The key in these examples is basically - KEEP THE BACK LOCKED-IN. And in

regards to SLDL why risk it when one can get exactly the same benefit from

performing hyperextensions (aka back raises aka glut-hamstring exercise) as

a non-weight bearing exercise (therefore non-compressive) while keeping the

back locked-in to isolate the movement at the hip joint. But if you REALLY,

really, really want to do SLDL do it with spotless technique.

So if folks continue doing these, IMHO, silly things with the poor

risk-benefit ratio, that's fine - it keeps me in business.

Cheers -

Dr J , MSc, DC

Whangarei Chiropractic Centre

20 Kensington Avenue

(64-9)-437-7345

Whangarei

NEW ZEALAND

" Nothing is forever except for Heaven & hell - CHOOSE CAREFULLY " (unknown)

Re: Re: Alternate to SL-DB deadlift

> Ted,

>

> Are your athletes rounding their upper back while performing the SL-DB

> deadlifts? I see many athletes that can touch the bar or DB's to their feet

on an

> elevated platform using that technique (which I don't recommend), however,

when

> I have them retract their scapulae and set their hips back, and keep a

flat

> back many of them cannot travel past mid shin.

>

> Even if your athletes have great flexibility, they will still have to

> contract their hamstrings to overcome the weight of the bar, therefore

they will

> still get the benefit from the exercise minus the increase in dynamic ROM

that

> most athletes will also get from the lift.

>

> Respectfully,

>

> Bryce Teager, CSCS

> FAST FORWARD

> Omaha NE

[Guest guest]

Seems like a narrow and distorted view of risk and benefit to me.

What you forgot to add to the benefit column is strengthening of the

lower back musculature such that the possibility of flexing the low

back inappropriately outside the training scenario is reduced. This

possibility is reduced even further by the fact that learning to do

SLDL's correctly ingrains the proper skill/movement pattern for

lifting an object by bending the hip and holding the back

correctly. It is movement-specific training of the most essential

kind for proper back health.

The hyperextension confers less benefit in the first case, as the

loads cannot be safely increased to comparable levels, and very

little benefit in the second case, as the hyperextension movement

skill is less functionally specific to actually picking things up,

which all of us must do.

As far as the negative effects or risks, you have mentioned none.

Any exercise carries risks when done incorrectly. Arguments against

doing an exercise incorrectly simply do not apply to doing an

exercise correctly. In the case of myself or anyone else I might

train, correct form is a given. When you come up with a risk

inherent to the RDL/SLDL, let us know.

Wilbanks

ville, FL

> Greetings List Readership,

>

> I feel that I have had this discussion on the Supertraining list

before

> (many moons ago) but maybe it is time to do that again. The Risk-

Benefit

> Ratio, as it implies, is the risk of something measured against the

> perceived benefit there might be. As applied to a particular

exercise the

> benefit of the exercise needs to be measured against the risk of

injury. In

> this case stiff legged DLs.

>

> The BENEFIT - if done with an ABSOLUTE lordotic lock-in of the

back - will

> indeed isolate the hip extensors (glutes and hamstrings).

However, the

> RISK - if rounding occurs (which it often does especially towards

the end of

> a hard set) tremendous wedging-type pressure is placed on front

(anterior)

> aspect of the lower thoracic and upper lumbar vertebral bodies.

And, if

> this continues, it WILL cause wedge-shaped compression fractures

of these

> bodies over time.

>

> I presented two such cases in Hawaii back in the mid 80s of two

gentlemen

> who loved SLDLs - one a past-his-prime bodybuilder (#s of titles)

and a

> power lifter turned orthopaedic surgeon. Lateral spine x-rays

revealed

> beautifully identical compression fractures at T11, T12 and L1.

And, both

> gentlemen recognised that these were a result of doing SLDLs as

there had

> been nothing in their histories to argue otherwise. In a similar

situation

> I had the opportunity to care for 3 veteran rowers (60+) in New

Zealand.

> And, they too demonstrated the same on x-rays which, in these

cases,

> resulted from many years of hyperflexing the thoracolumbar

portion of the

> spine while rowing. Guess there is another message here for the

similar

> exercise performed in every gym.

>

> The key in these examples is basically - KEEP THE BACK LOCKED-IN.

And in

> regards to SLDL why risk it when one can get exactly the same

benefit from

> performing hyperextensions (aka back raises aka glut-hamstring

exercise) as

> a non-weight bearing exercise (therefore non-compressive) while

keeping the

> back locked-in to isolate the movement at the hip joint. But if

you REALLY,

> really, really want to do SLDL do it with spotless technique.

>

> So if folks continue doing these, IMHO, silly things with the poor

> risk-benefit ratio, that's fine - it keeps me in business.

>

> Cheers -

>

> Dr J , MSc, DC

> Whangarei Chiropractic Centre

> 20 Kensington Avenue

> (64-9)-437-7345

> Whangarei

> NEW ZEALAND

> " Nothing is forever except for Heaven & hell - CHOOSE CAREFULLY "

(unknown)

>

> Re: Re: Alternate to SL-DB deadlift

>

>

> > Ted,

> >

> > Are your athletes rounding their upper back while performing the

SL-DB

> > deadlifts? I see many athletes that can touch the bar or DB's

to their feet on an

> > elevated platform using that technique (which I don't

recommend), however, when

> > I have them retract their scapulae and set their hips back, and

keep a

> flat

> > back many of them cannot travel past mid shin.

> >

> > Even if your athletes have great flexibility, they will still

have to

> > contract their hamstrings to overcome the weight of the bar,

therefore

> they will

> > still get the benefit from the exercise minus the increase in

dynamic ROM

> that

> > most athletes will also get from the lift.

> >

> > Respectfully,

> >

> > Bryce Teager, CSCS

> > FAST FORWARD

> > Omaha NE

[Guest guest]

In regards to the letter posted by Dr. , I would

have to agree with him. I too have always frowned

upon the use of the Stiff-legged deadlift when used in

the manner he states. I have seen athletes occur

similar injuries in which he discussed due to the

extreme pressures on the spine during this movement.

The alternative to avoiding this that I have taken in

the past has been the following:

Using the Stiff-legged deadlift as a " stretch

deadlift " - the loads are always kept light, rarely

exceeding 95lbs. The focus of this movement is then

to aid in flexibility of the hamstrings, glutes and

low back, improving in their co-ordinated movements.

To then strengthen the low back in conjuction with the

glutes and hammies, various combinations of hypers,

both glute and reverse, as well as a staple of RDL's

for the influence and transfer to Olympic lifts as

well as Squatting.

Athletes are always encouraged and made aware that the

hammies and glutes must fire in conjuction with and at

times before the low back to reduce any isolation and

negatives affects of specifically targeting the low

back. They are typically used in combination with

each other in sport, and thus are trained together to

minimize the over use of one or the other.

(Excessivley strong and tight hammies with lack of

strength in low back leads to over rotation of the

hips and the inability to successfully sit in a squat

without placing undue stress in the low back.)

Ebel, M.Ed.,CSCS

Director of Strength and Conditioning

Performance One Athletic Development

Columbus, OH

--- " J. , DC "

wrote:

> Greetings List Readership,

>

> I feel that I have had this discussion on the

> Supertraining list before

> (many moons ago) but maybe it is time to do that

> again. The Risk-Benefit

> Ratio, as it implies, is the risk of something

> measured against the

> perceived benefit there might be. As applied to a

> particular exercise the

> benefit of the exercise needs to be measured against

> the risk of injury. In

> this case stiff legged DLs.

>

> The BENEFIT - if done with an ABSOLUTE lordotic

> lock-in of the back - will

> indeed isolate the hip extensors (glutes and

> hamstrings). However, the

> RISK - if rounding occurs (which it often does

> especially towards the end of

> a hard set) tremendous wedging-type pressure is

> placed on front (anterior)

> aspect of the lower thoracic and upper lumbar

> vertebral bodies. And, if

> this continues, it WILL cause wedge-shaped

> compression fractures of these

> bodies over time.

>

> I presented two such cases in Hawaii back in the mid

> 80s of two gentlemen

> who loved SLDLs - one a past-his-prime bodybuilder

> (#s of titles) and a

> power lifter turned orthopaedic surgeon. Lateral

> spine x-rays revealed

> beautifully identical compression fractures at T11,

> T12 and L1. And, both

> gentlemen recognised that these were a result of

> doing SLDLs as there had

> been nothing in their histories to argue otherwise.

> In a similar situation

> I had the opportunity to care for 3 veteran rowers

> (60+) in New Zealand.

> And, they too demonstrated the same on x-rays which,

> in these cases,

> resulted from many years of hyperflexing the

> thoracolumbar portion of the

> spine while rowing. Guess there is another message

> here for the similar

> exercise performed in every gym.

>

> The key in these examples is basically - KEEP THE

> BACK LOCKED-IN. And in

> regards to SLDL why risk it when one can get exactly

> the same benefit from

> performing hyperextensions (aka back raises aka

> glut-hamstring exercise) as

> a non-weight bearing exercise (therefore

> non-compressive) while keeping the

> back locked-in to isolate the movement at the hip

> joint. But if you REALLY,

> really, really want to do SLDL do it with spotless

> technique.

>

> So if folks continue doing these, IMHO, silly things

> with the poor

> risk-benefit ratio, that's fine - it keeps me in

> business.

>

> Cheers -

>

> Dr J , MSc, DC

> Whangarei Chiropractic Centre

> 20 Kensington Avenue

> (64-9)-437-7345

> Whangarei

> NEW ZEALAND

> " Nothing is forever except for Heaven & hell -

> CHOOSE CAREFULLY " (unknown)

>

> Re: Re: Alternate to SL-DB

> deadlift

>

>

> > Ted,

> >

> > Are your athletes rounding their upper back while

> performing the SL-DB

> > deadlifts? I see many athletes that can touch the

> bar or DB's to their feet on an

> > elevated platform using that technique (which I

> don't recommend), however, when

> > I have them retract their scapulae and set their

> hips back, and keep a

> flat

> > back many of them cannot travel past mid shin.

> >

> > Even if your athletes have great flexibility, they

> will still have to

> > contract their hamstrings to overcome the weight

> of the bar, therefore

> they will

> > still get the benefit from the exercise minus the

> increase in dynamic ROM

> that

> > most athletes will also get from the lift.

> >

> > Respectfully,

> >

> > Bryce Teager, CSCS

> > FAST FORWARD

> > Omaha NE

[Guest guest]

wrote:

> Seems like a narrow and distorted view of risk and benefit to me.

>

> What you forgot to add to the benefit column is strengthening of the

> lower back musculature such that the possibility of flexing the low

> back inappropriately outside the training scenario is reduced. This

> possibility is reduced even further by the fact that learning to do

> SLDL's correctly ingrains the proper skill/movement pattern for

> lifting an object by bending the hip and holding the back

> correctly. It is movement-specific training of the most essential

> kind for proper back health.

******

The key term here is " correctly. " I am soley agree most exercises are

" safe, " if & only if, proper technique is utilised. Unfortunately, that is

often a big if. I have stopped going to gyms because of the sloppy

technique I too frequently observe - it is like the fingernails across the

blackboard feeling - I train in a home gym. Even in the best of gyms by the

best PTs it still occurs. I have very rarely seen SLDL performed correctly

thus shifting the risk benefit ratio the wrong way.

> The hyperextension confers less benefit in the first case, as the

> loads cannot be safely increased to comparable levels, and very

> little benefit in the second case, as the hyperextension movement

> skill is less functionally specific to actually picking things up,

> which all of us must do.

******

In my rehab approach I teach the U & C hyperextension type of exercise

as well as with the lumbar lordotic lock-in to isolate the gluts and

hamstrings. These exercises are performed over the range of near horizontal

to about 45 degrees of hip angle in order to strengthen a larger range of

functional movement. Performing the exercise with the lordotic lock-in

(Back Locked-In or BLI) thus aids in training individuals the functionally

specifics of lifting. The key to the exercise is hip-hinge pivot which can

be adapted to back mechanics in general.

> As far as the negative effects or risks, you have mentioned none.

*******

What about the mentioned anterior wedging of thoracolumbar

vertebrae??? Additionally (but not mentioned in my post) is the dangerous

loading on the involved discs. The anterior loading pushes the nucleus

pulposus posterior onto the already maximumly stretched anular fibers of the

disc and posterior longitudinal ligament setting up the perfect situation

for a disc herniation. I also did not mention in the prior post that the

bodybuilder of the two examples had a herniated upper lumbar disc which

occured while he was performing SLDL. The risk suddenly became apparent to

him.

> Any exercise carries risks when done incorrectly. Arguments against

> doing an exercise incorrectly simply do not apply to doing an

> exercise correctly. In the case of myself or anyone else I might

> train, correct form is a given. When you come up with a risk

> inherent to the RDL/SLDL, let us know.

*******

COMPLACENCY.... And not matter how close you watch clients they get

sloppy. I have found over nearly 30 years of coaching and teaching exercise

in gyms and in the rehab setting it takes 6-10 one-on-one to establish

proper technique and you still have to watch them for 6 months. So why take

the risk in the first place and perform safer exercises which provide the

same benefit - a no-brainer to me... I love RDL and use it with most of

back patients as a behaviour modification exercise through the

repeatitiveness. However they first are trained doing the BLI -

glut-hamstring execise as noted aboveBLI-hypers which enforces hip-hinge

pivot. Teaching RDL then becomes a simple transferance to weight bearing

doing the same thing. No problems and very little risk.

Cheers -

Dr J , MSc, DC

Whangarei Chiropractic Centre

20 Kensington Avenue

(64-9)-437-7345

Whangarei

NEW ZEALAND

" Nothing is forever except for Heaven & hell - CHOOSE CAREFULLY " (unknown)