As the name implies, spinal loading refers to the weight placed on the spine, such as a barbell, during a squat. Many people associate spinal loading with back pain, often linked to specific postures, repetitive loading, or lifting heavy objects. (1)
However, does new research render spinal loading dangerous? Dr. Layne Norton explores this question and addresses the myths surrounding the topic. On Oct. 23, 2024, he provided insights on spinal loading:
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New Study Findings
Dr. Norton broke down a comprehensive scoping review of 20 studies published in The Journal of Orthopaedic and Sports Physical Therapy, which examines the following key questions regarding spinal loading:
- Can spinal loading predict back pain?
- Does it have anything to do with back pain recovery?
- Does spinal loading reduce the risk of back injury?
- Does reducing spinal loading help with recovery from back injury?
- Does reducing it help reduce back pain?
- Does increasing spinal loading increase the risk of injury? Does it increase back pain?
- If one has a spinal injury, does it delay the recovery of back pain?
The study found spinal loading doesn’t predict injury or back pain. Furthermore, reducing spinal loading didn’t decrease the risk of back pain or injury or enhance recovery from these issues. (2)
Debunking Back Pain Myths
Since embracing the biopsychosocial model of pain, Dr. Notron has challenged conventional perceptions of the spine and the body’s reactions to it, emphasizing that the body’s tissues are remarkably adaptable; as they’re progressively loaded, they become better at managing that load.
A study from the Journal of Geriatric Physical Therapy demonstrates that lifting can alleviate lower back pain through the use of the spine. (3) “If you stress those tissues progressively over time, then your body gets better at handling it,” Dr. Norton explained. “That’s why resistance training actually tends to reduce lower back pain.”
What Causes Back Pain During & After Training?
Stress, sleep quality, and the intensity of back exercises can significantly impact back pain. To illustrate further, Norton explained how he’s training to be the strongest person in the world, drug-free, in his weight class and age — he recently won the 2024 IPF Masters Classic World Championships in the 93KG class.
“I have to train at a level of intensity and volume that is always right up next to what I can maximally recover from,” Dr. Norton identified. If he exceeds that, back pain will onset.
Various factors contribute to injuries, with recovery status being the most significant predictor overall. Allowing adequate time for recovery not only prepares individuals for their next session but also minimizes the risk of injury. This depends on several key factors, including:
- Sleep Time
- Stress Management
- Appropriate Progressive Overload (Adding Load Slowly)
Progressive overload means gradually increasing weight. Dr. Norton prioritizes a slow and steady approach to ensure he doesn’t exceed his recovery capacity. “If I continue to progressively load, eventually in a couple of weeks, I’m going to be at that load anyway, only now my tissues will have had more time to adapt and prepare for it,” Norton said.
If Dr. Norton had made a mistake, he would have only slightly exceeded his limits rather than surpassing his recovery capacity, ensuring safety throughout the process. Some of the world’s top athletes perform deadlifts with a rounded back and experience few injuries. Conversely, others who lift with straight or neutral backs can suffer from back injuries. Placing the body in positions it has never encountered under heavy loads, and fatigue increases the risk of acute injuries.
Overloading the spine isn’t the sole cause of back pain. Some individuals who lead entirely sedentary lifestyles can also experience severe back pain. As we age, experiencing pain becomes an inevitable part of life. “You can be strong and have pain, or you can be weak and have pain,” Dr. Norton explained. “I choose to be strong and have pain. But the research suggests you might have a bit less if you lift.”
References
- Marras, W. S., Davis, K. G., Ferguson, S. A., Lucas, B. R., & Gupta, P. (2001). Spine loading characteristics of patients with low back pain compared with asymptomatic individuals. Spine, 26(23), 2566–2574. https://doi.org/10.1097/00007632-200112010-00009
- de Bruin, L. J. E., Hoegh, M., Greve, C., & Reneman, M. F. (2024). Insufficient Evidence for Load as the Primary Cause of Nonspecific (Chronic) Low Back Pain. A Scoping Review. The Journal of orthopaedic and sports physical therapy, 54(3), 176–189. https://doi.org/10.2519/jospt.2024.11314
- Syroyid Syroyid, I., Cavero-Redondo, I., & Syroyid Syroyid, B. (2022). Effects of Resistance Training on Pain Control and Physical Function in Older Adults With Low Back Pain: A Systematic Review With Meta-analysis. Journal of geriatric physical therapy (2001), 46(3), E113–E126. https://doi.org/10.1519/JPT.0000000000000374
