How to Bend and Lift Pain and Strain Free

Bending and lifting is a hotly debated topic in the fitness and movement world, with a great deal of misinformation, should and should nots, and conflicting information. This is an incredibly important topic to be well-informed on, as bending and lifting are a common trigger for back injury and reinjury. Many people with back pain begin to avoid this activity in general for fear of pain flare ups. For the general public, improper bending and lifting can put excessive strain on the spine and other joints, and also limits performance during fitness activities and household chores. Many people are used to hearing flashy but shallow phrases such as, “Lift with your legs, not with your back!”, as well as seeing ergonomic posters and pamphlets about how to do it right without actually knowing how to internalize this movement pattern into daily life.

When bending and lifting, whether it is to pick up a 200 pound barbell or simply to bend down to tie your shoes, we want to move with efficiency.

This means our nervous system and musculoskeletal system working together with pristine responsiveness, precision, and organization to ensure an even distribution of load throughout the joints, making the movement as easy as possible. By moving the most efficiently, we are able to spread the work out over more of our body, utilize the force coming up from the ground, and lift more weight more often without being limited by pain or injury. It is not a matter of lifting with the legs and not with the back, but rather it is a matter of lifting with everything in the body, making particular use of the force couple that is formed between the contraction of the abdominals and the gluteal muscles. This force couple between the front and back of our bodies allows us to generate the most power, because the glutes and abs are the strongest muscles in our body. In order to utilize this muscular connection to our advantage, we must know how to lift and tuck the tailbone.

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Follow along with this lesson to practice your lifting and bending mechanics:

1. First, sit on a firm chair with your feet on the floor. Begin to visualize where your tailbone is, and visualize an imaginary “light” shining from the end of your tailbone (see the red arrow). Then, tuck and tilt your pelvis in order to LIFT the tailbone so the light shines more behind you, and then TUCK your tailbone so the light shines more down and forward towards your feet. You can imagine you have an actual tail, and you are trying to move this tail by rolling the pelvis forward and back. Practice alternating between these two positions several times. 

2. Next, practice bending forward in the chain until your hands start to lower towards the ground. If you have back pain, you don’t have to lean forward very far at all. The important part is to LIFT the tailbone as you lean forward, and TUCK the tailbone back under as you roll back up to sitting. Another helpful cue is to think about pushing the ground AWAY from you with your feet as you come back up to sitting. 

3. Now let’s apply this to standing. Stand very close to an object, starting with something light like a yoga block or a shoe. As you bend forward to reach your hands toward the object, allow your head to drop down, and allow your tailbone to LIFT. Let the knees bend. To come back up with the object, think about TUCKING the tailbone, pressing the hips forward, and rolling back up to standing. Notice that this is more of a horizontal movement (hip hinge) rather than a vertical movement in which the spine stays upright.

How did that feel? Practice applying the principle of lifting your tailbone to bend down and tucking your tailbone to come back up the next time you bend and lift in your daily life.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Unlearning Fear of Movement

Kinesiophobia, or fear of movement, is an issue that affects far too many of us. Often
times, people with chronic pain or a history of injury to a particular body area will develop a fear of movement. Kinesiophobia can exist on a macro or micro level, affecting both overall physical activity levels, as well as movement of specific joints and patterns of muscular activation. Kinesiophobia is often outside of our conscious control, as the fear circuits of our brain (e.g. the amygdala) are involuntary and affect our movement without us necessarily being aware.

How does this happen? Individuals with kinesiophobia may associate certain activities with pain, as this activity may have caused pain in the past. An activity that is a common trigger is bending down towards the ground, perhaps because this movement may have led to an injury in the past. The internalized association between movement and pain will contribute to fear-avoidant behavior, and the individual will continue to avoid this activity due to fear of pain or re-injury. Over time, even after the original injury heals, the individual will still have this same fear embedded in them and will avoid bending down. Now the motor pathways, muscles, and joints responsible for bending down will atrophy, and it will be far more likely to cause injury if the individual were to bend down in the future! The irony is that the fear is what contributes more so to the dysfunction, rather than an issue in the physical tissues of the body.

What can we do about this?

Because fear is a learned behavior, we must "unlearn" the fear, as well as create new neural pathways that teach us that movement can be safe, easy, and pleasurable. Your physical therapist at the Wellness Station will quickly identify what is contributing to your kinesiophobia. Along with providing education about anatomy, biomechanics, and pain neuroscience, your therapist will teach you how to gradually engage in safe movement patterns that will help you gently progress towards your functional goals. It is important that this process is done slowly and gently, as our brains will not be receptive to learning if fear is still present. The tissues of your body will slowly adapt, and your nervous system will gradually learn that previously feared movement patterns can be safe and even easy.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Moving in Three Dimensions

All movement occurs in some combination of the three dimensions. This includes the sagittal plane, frontal plane, and transverse plane.

Movement in the sagittal plane, which involves flexion and extension of the body, is the most common movement that is trained, and tends to be the most familiar in our daily lives. Sagittal plane movements include squatting, walking, climbing stairs, bicep curls, and interacting with objects that are in front of us.

Sagittal Plane

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Frontal plane movements relate to lateral, or side to side movements, and may include side stepping, side bending, and lateral arm or leg raises.

Frontal Plane

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The transverse plane is the third dimension of movement, and includes rotational movements such as turning the spine from left to right, or rotating the hips or shoulders in or out.

Traverse Plane

Movements in the sagittal plane tend to be overemphasized in people's lives, whereas the latter two planes of movements may be more unfamiliar.

We must be able to move with agility and efficiency in all three dimensions in order to respond to the unpredictable demands of daily life without strain. Limiting movement to only one dimensions can put more stress on particular tissues of the body, which can contribute to pain and pathology, particularly of our joints. For example, walking has the potential to be very beneficial for our whole bodies, but the way we walk can also contribute to excessive strain on certain joints. If we only ever walked on flat, invariable terrain (think concrete or a treadmill), and tend to keep our spines very rigid while we walk, this would limit our movement to primarily the sagittal plane. This may put extra stress on certain regions of our weight-bearing joints, particularly our hips and knees.

If we can vary the way we walk as well as the terrain we walk on, we can move in all three dimensions which will spread the movement over a greater area of our bodies. Imagine adding a little “dance” to your walk by allowing the pelvis to glide from side to side with each step, as well as allowing the arms to swing and the chest to turn. This will allow the body to move more fluidly by including side-bending and rotational movements in our gait. Combine this with regularly walking on different terrains (e.g. inclines/declines, twists and turns, grass, dirt, stones, etc.), and we will stimulate our bodies in constantly varying ways to minimize repetitive strain on isolated areas.

As part of a comprehensive treatment plan, your Wellness Station therapist will ensure your program includes balanced movements in all three dimensions. It is our mission to address the root of issues, rather than treating symptoms, an unfortunate tendency that is often found in more traditional therapeutic approaches. We strive to see the bigger picture, and will help you develop strategies to bring greater balance and ease into all dimensions of life.  

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team