1. Squats, Dead Lifts and Low Back Pain Why are low back injuries so common and how can we stop them from happening?

2. Take Home Messages Neutral spine is the key Poor flexibility of the hips, knees and ankles is often to blame Mobility before stability Effective exercise modifications Injury prevention and performance optimisation are the same thing

3. Overview Anatomy and function Key features of the squat and the dead lift Limiting factors Screening tests Exercise modifications

4. Anatomy & Function Lumbar Spine Disc structure: liquid nucleus, fibrous outer wall Migration of fluid during normal movement The spine is great at bearing loads when neutral Flexion + Load = Injury

5. Anatomy & Function Hip Huge ball and socket joint with large muscles Most people can produce more flexion ROM with some degree of ER Hip ROM is largely genetic and based on the shape of your bones

6. Anatomy & Function Knee Large joint with big muscles Modified hinge – 2 planes of motion Full squat asks for full knee ROM Be aware of the implications of intra-articular damage

7. Anatomy & Function Ankles Dorsiflexion range is important It can be difficult to change Often exercises can be easily modified to accommodate poor range

8. What’s the Difference? If a squat and a dead lift were the same movement pattern, surely we could delete one of them?

9. What’s the Difference?

10. The Dead Lift Hips move backwards Heavy utilisation of hip range of motion and core control Knees and ankles stay relatively fixed It is worth considering teaching a “top to bottom” approach for inexperienced lifters

11. The Squat Hips move downwards The effective depth of a squat is a function of the available range of the hips, knees and ankles combined Loss of range in any of these joints usually results in a loss of neutral lordosis when we push depth

12. The Squat

13. Key Features SquatDead Lift Bar TrackVertical Lumbar SpineNeutral Direction of hipsBackwardsDownwards Do shins and torso remain parallel? YesNo Knees in front of toes?YesNo RhythmHips break first then H, K, A together Full hip flexion before K, A

14. Examples of Good Form

17. Examples of Poor Form

23. Modifications: Blair

26. Modifications: Kate

29. Screening Tests Mobility before stability! Lumbar Spine (F, E) Hip Flexion Knee Flexion Ankle Dorsiflexion And only then can you look at motor control.

30. Now Have a Try!