Low Back Pain: Is it bad to bend over at the waist?
For many years, the prevailing notion has been that the safest way to lift objects off the floor is to bend the knees and keep the back straight, as shown in the icon below.
However, this general guideline, which does not deal with each case separately, does not seem to have reduce the incidence of low back pain. On the contrary, its indiscriminate implementation has created a subgroup of people who have now lost the ability to bend, with harmful consequences.
The prophylactic avoidance of bending at the waist results in stiffness and muscle weakness in the trunk, which are indeed factors predisposing to recurrent episodes of back pain and chronicity of the problem. Imagine that a chalk breaks much easier than bamboo, precisely because it is tough and rigid, with no elasticity.
Finally, the question remains. Is it OK to bend over at the waist or not? The answer is that each case is separate and no general instruction can be given.
Following are some questions and answers to clarify the issue as much as possible. However, because each case is separate, your evaluation by a physiotherapist is essential to have a personalized plan of treatment.
Is it OK to bend over at the waist?
We should be aware that bending at the waist when standing upright is one of the basic and necessary movements of the lumbar spine (i.e. the lower back). The functional anatomy of the vertebrae, intervertebral discs, muscles and ligaments is to serve the function of bending, what we scientifically call lumbar flexion. Therefore, bending is a normal function, such as flexing and straightening our elbow or knee.
“Yes, but since I have a problem in my lower back, is it still OK to bend over at the waist?”
Although, as mentioned above, the normal function of the lumbar spine includes bending, however if there is an acute condition, then we may have to stop bending for a while until the condition stabilizes. The same happens after an ankle sprain. We temporarily immobilize it on the splint until it heals and then we gradually move it to all directions and strengthen it, in order to regain full function.
“When the acute episode subsides, can I bend my back immediately?”
When the acute episode has subsided, then in collaboration with a physiotherapist, you should begin an exercise program aimed at restoring the range of lumbar flexion. This procedure should be gentle and gradual to give your body the necessary time to adapt. In our opinion, it is necessary to restore the range of flexion. We need to emphasize that this adaptive process is neither difficult nor dangerous. Anyway, there is no hurry. A program of gentle exercises that respect the natural rhythm of each body, will provoke the necessary adjustments.
When the range of motion in my back is restored, will I be able to lift weight too? “
When we need to lift a light object from the ground, something we can handle easily, such as a pen, our shoes, a child’s toy, etc. then we can generally bend the back without fear. This will enhance the normal flexibility in our lower back, allowing it to absorb greater load.
When we need to lift a significant amount of weight, which is not in our usual routine, then we should bend our knees and hold a straight back, as weightlifters do, because this way puts less strain on the spine.
However, it should be emphasized that if we need to lift more weight, due to occupational or any other reason, then this is possible with adherence to a strengthening program. However, the effort must be systematic and not occasional.
- Bending our back at the waist is a normal and useful movement that in the long run strengthens our back and therefore should not be avoided.
- When we have an acute episode in the lower back, we should limit our movements temporarily, until the condition has stabilized.
- The physiotherapist can evaluate our condition and provide the appropriate instructions and the appropriate exercise program to restore normal function to our spine, but also to increase its potential through systematic exercise.
- Our clinical experience is that people who avoid bending in order to protect their backs, usually end up with more pain. The best way is to strengthen our back through progressive exercise and perform all the movements naturally.
Alex Karagiannidis, MSc., Dip.MDT., BSc(Hons) Physiotherapy
Active Physiotherapy Solutions