192. Neutral or Imprint? With Natalie Wilson and Raphael Bender

The age-old debate. We settle it once and for all. Resources mentioned in the episode: You can bias lower abs from upper abs by doing posterior pelvic tilt vs ab curl herePeople with LBP lift with LESS flexion in their lumbar spine hereThere was low-quality evidence that greater lumbar spine flexion during lifting was not a risk factor for LBP onset/persistence or a differentiator of people with and without LBP hereOnly 4% difference in total load on the vertebrae during stoop vs squat lifting hereLoad shifts posteriorly away from disk as you flex here at close to full flexion less than a quarter of extensor moment is from disk and deep ligamentsPeople lift more efficiently in spinal flexion (more efficiently = same force output with less muscle activity) hereThat’s probably why elite powerlifters increase spinal flexion automatically as they approach maximum loads hereSpine posture in general has not been shown to be a causal factor in LBP according to a systematic review of systematic reviews in 2020 hereEven lifting a box from knee height when instructed to keep the spine neutral, results in 22 degrees of lumbar flexion hereExperienced physical therapists can’t detect lumbar flexion of less than 34 degrees during a squat hereIn lab experiments compressive load - not flexion or extension - causes disk injury here“Bad technique” doesn’t cause injury - Crossfit injury incidence is 0.27 - 3.3 per 1000 hours of training hereInjury incidence in running is 2.5 - 33 which is almost exactly 10x higher hereInjury incidence in ballet is 3.9-4.4 per 1000 hours - which is higher than Crossfit even though ballet dancers practice in perfect alignment hereMost injuries in fitness centers result from people falling off equipment or dropping weights on themselves hereConnect with Natalie Wilson on Instagram Connect with me on Instagram: @the_raphaelbenderDownload a free course guide: