Back Strong and Beltless
By Paul Chek
Article Excerpt, Full Aricle at CHEK Institute
When it comes to lifting heavy, a weight belt is more often a fashion accessory than an essential piece of workout gear. How many of you remember the only time anyone wore a weight belt was in the gym and only when they were performing heavy squats, heavy dead lifts, or heavy overhead presses? Now it seems virtually everyone is wearing a weight belt! Regardless of how heavy someone's lifting or what exercise they're performing men, women, Arnold wannabes, weekend warriors, and even the elite few who make the cover of Powerlifting USA are all wearing weight belts.
You've all heard the mentality. Squats? "You MUST wear a belt." Bench presses? "You should probably wear a belt." Biceps curls? "To be on the safe side, wearing a belt may be a good idea." Getting a drink of water from the drinking fountain? "Hell, you may as well leave it on since you'll be wearing it for your next set." This scenario does not pertain to everyone, but the point I'm making is that a trend we never used to see in a gym, is one we're seeing more and more everyday.
It's getting ridiculous and way out of hand.
To make matters worse, the trend to wear a weight belt has extended beyond the gym. Trash collectors, truck drivers, and construction workers often spend their entire workday wrapped in a weight belt. Some companies have gone so far as to make it a mandatory safety policy that all their employees wear a back harness. Visit any Home Depot, Office Club, or take a look at the waist of your local UPS driver. What do these employees all have in common? They're all wearing weight belts! Next thing you know, it will not only be against the law to drive without a seatbelt, it will be against the law to operate a vehicle without a weight belt!
What's going on here? Do weight belts really protect our back? Will they make us stronger? Can the estimated 35-40% of people reporting back pain each year, or the 70% of the population who will suffer from at least one episode of back pain in their lives (1) find relief, and possibly even avoid surgery, by making a weight belt a habit?
Before I answer these questions, try to dig up recent pictures of the world's best Olympic weightlifters in competition, but not the American weightlifters who are losing the struggle to achieve international respect. Look at photos of European weight lifters who are continuously breaking records and winning world and Olympic titles. Isn't it interesting that Europeans never use belts when they perform the snatch lift? They're rarely seen using one for the clean and jerk! Even during training, you'll find that many of these lifters prefer to train without any forms of artificial support. In fact, IronMind Enterprises (2) sells videos of these athletes squatting over 300kg (660lbs) without a belt! Either these athletes are asking for an injury, or they know something we don't.
When Did Belt Use Get Started?
A look through David Webster's book, The Iron Game, demonstrates that there is a long history of belt use in connection with heavy weight training.(3) Thomas Inch, publisher of Scientific Weight Training (1905), is shown pressing two adult females overhead with one hand, "while wearing a weight lifting belt." This guy was no slouch either. He could clean and jerk 92.5 kilograms (203.5 pounds), perform the "Right Hand Anyhow and Bent Press" lifts with 96.8 kg. (213 pounds), and he could snatch 67.3 kg. (148 pounds). Not impressed yet? Perhaps I should mention that he performed all these lifts using only one hand.
American Olympic lifter J. Terpak is pictured wearing a weight belt during his gold medal performance in the 1937 World Championships in Paris, France. Later during the 1958 World Championships held in Stockholm, Sweden, an American athlete named Berger is pictured on the Bantamweight winner's platform wearing his weight belt. It's interesting to note however, that even though there are numerous pictures showing winning and highly accomplished lifters wearing weight belts in David Webster's Iron Game, there are even more pictures that don't.
One has to wonder, what is it that leads a lifter to use a belt? Is it direction from coaches, did these particular lifters have back pain in their lifting history, did they only wear the belts when performing competition or "max" lifts, or was a belt simply looked upon as an insurance policy?
With a long history of corset use in the medical field, particularly for back injury, perhaps the lifters have been influenced by the medical approach to treating back pain. Corsets have been used since the early 1900's for the treatment of Scoliosis (4) and back pain (5) and quite possibly much longer. Therefore it is logical that a lifter, wanting to make the right decision, would choose to use a belt based on the medical establishment's use of belts, especially considering the history and treatment of back pain dates all the way back to 1500 BC!(1)
Did Developmental Man Wear Weight Belts?
Regardless of your opinion about the origin of man, if you believe in God, you have to wonder why he didn't provide weight belts as standard-issue equipment.(Figure 1) On second thought, maybe he did, and we just don't know how to use them correctly. Perhaps we abuse our bodies, which creates a dysfunction in our "natural weight belt" and causes us to be reliant on an artificial one.
A Look at The Belt God Gave You
Today, our understanding of the stabilizer system is at an all time high, thanks to the works of people like Richardson, Jull, Hodges, Hydes,(6) Vleeming, Snidjers (7) and Gracovetsky.(8) Because of them and others, we have been able to progress beyond the developmental knowledge of medical doctor Robert W. Lovett (4) and Anatomist Raymond Dart.(9) In 1912, Lovett created detailed diagrams indicating how the musculature of the torso worked together to stabilize the spine. Later, in 1946, Dart described the double spiral mechanism of the spinal musculature, expanding beyond the concepts described by Lovett.
What modern researchers have been able to do is more clearly define two major stabilizer systems of the body, the inner unit and the outer unit.(6,7,8) The stabilizer system considered as our "God-given weight belt" is the inner unit.
The Inner Unit serves to stiffen the axial skeleton in preparation for work. The Inner Unit muscles are
A) Transversus Abdominis and the posterior fibers of obliquus internus,
C) Deep Multifidus,
D) Pelvic floor musculature.
The inner unit is composed of the transversus abdominis (TVA), some fibers of the obliquus internus (IO), the musculature of the pelvic floor (PFM), the multifidus and the diaphragm.(6) Although there is a definite working relationship among the inner unit muscles, the TVA appears to be the key muscle of the inner unit system.
In studies of people without back pain, it was found that the TVA fired 30 milliseconds (ms) prior to shoulder movements and 110 ms before leg movements.(6) It should also be noted that though there are slight variations in timing relative to the motor pattern selected or direction of the postural perturbation, there is synergistic recruitment of all inner unit muscles. However, the TVA appears relatively consistent in its activation pattern, regardless of movement plane or pattern.(6,10,11,12) Researchers propose that the nondirectional, specific activation of the TVA relates to the dominant role played by the TVA in providing spinal stiffness. (6,10,11,12,13,14)
The TVA, in concert with other inner unit muscles,(Figure 2) activates to increase stiffness of spinal joints and the sacroiliac joints.(6,7,15) Activation of the inner unit provides the necessary stiffness to give the arms and legs a working foundation from which to operate. Failure of the TVA to activate 30-110 ms prior to arm or leg movements respectively has been correlated with back pain and dysfunction.(6, 16) The inner unit is part of a system of stabilizer mechanisms, all of which are dependent on the integrated function of all inner unit muscles. To better appreciate how the inner unit creates stability in the body, let's look at each of the proposed mechanisms of stabilization: Thoracolumbar Fascia Gain, Intra-Abdominal Pressure and the Hydraulic Amplifier Effect.
Thoracolumbar Fascia Gain
Studying the anatomy of the TVA makes it clear that contraction of this muscle can only produce one action, drawing in the abdominal wall. This is evidenced by movement of the umbilicus toward the spine.
When activated, the transversus abdominis and posterior fibers of the obliquus internus draw the umbilicus inward toward the spine (see arrow). This creates intra-abdominal pressure and hoop tension, which serve to stabilize the lumbar spine.
The synergistic action of the TVA and IO produce a characteristic hoop tension through the thoracolumbar fascia (TLF),(Figure 4) which has been shown to create an extension force on the lumbar spine.(8,17) This is referred to as thoracolumbar fascia gain. TLF gain is thought to be an important element, buffering the transfer of force between the muscular and ligamentous systems during forward bending or rising from a forward bent position. The point at which the force transfer occurs is called the critical point, occurring at approximately 90% lumbar flexion.(17)
Contraction of the transversus abdominis and obliquus internus generates lateral tension on the thoracolumbar fascia. The superficial lamina of the posterior layer of thoracolumbar fascia generates tension via its attachments at L2 and L3 (yellow), while the deep lamina generates tension upward through its attachments at L4 and L5 (blue). These mutually opposing vectors tend to approximate or oppose separation of the L2 and L4 vertebra and the L3 and L5 vertebra, creating what is referred to as "thoracolumbar fascia gain". (8,17,21)
As the TVA is activated, drawing the abdominal wall inward, the viscera are pushed upward into the diaphragm and downward into the pelvic floor, creating intra-abdominal pressure (IAP). The pressure of viscera upon the diaphragm and pelvic floor is referred to by Wirhed, as the piston effect. (18) When the viscera rise secondary to TVA contraction a lift pressure is created under the diaphragm. As you are likely aware, when lifting a heavy object or exerting yourself to throw or move an object such as in work or sports, it is natural to hold the breath. Holding the breath under load is associated with increased tension in the diaphragm. The concomitant elevation of the viscera against a tightening or tightened diaphragm from holding our breath produces a lift force through the cura of the diaphragm, which attach at the L2 and L3 level. Wirhed believes this to be a major contributing factor of spinal stabilization and joint/disk protection by reducing compression of the lower lumbar discs by as much as 40%.(18)
When lifting any heavy object, the load is transmitted downward through the spine to the legs (A). To stabilize the axial skeleton and minimize compressive loading of the lower lumbar segments, the transversus abdominis and posterior fibers of the obliquus internus should draw the umbilicus inward. The hoop tension created by activation of the deep abdominal wall pushes the viscera upward into the diaphragm and downward into the pelvic floor (B). Because of the innate tendency to hold one's breath while under load, there is increased tension in the diaphragm. Wirhed proposes this mechanism may decompress the L4 and L5 segments by as much as 40%. (18)
White and Panjabi (19) used an analogy of a football in the abdominal cavity, stating that IAP and thoracic cage pressures may be factors in providing mechanical stability to the spine.
It is theorized that intra-thoracic pressure created by filling the lungs and intra-abdominal pressure (demonstrated here as a football in the abdominal cavity) work against each other to support the torso when lifting an object. Practical experimentation in the gym will show that the trunk is stiffer when filling the lungs as opposed to not filling the lungs with inhalation.
More recently, it has been shown that IAP does provide a stiffening effect on the lumbar spine, but that IAP is most effective at stabilizing the spine when applied in concert with co-activation of the erector spinae muscles.(20)
It has also been suggested that IAP does not stabilize the spine. Standing firmly against the notion that IAP provides any significant stabilizing mechanism for the spine are Gracovetsky and Bogduk.(21 p.122) These experts have sited the following reasons for the ineffectiveness of IAP as a stabilizer of the spine, contrary to previous belief:
? To generate any significant resistance to the heavy loads being lifted by athletes and workers, the pressure required would exceed the maximum hoop tension of the abdominal muscles.
? Such pressures would be so high as to obstruct the abdominal aorta.
? When the abdominal muscles contract to produce IAP, they produce flexion of the trunk, which would negate any extension quality produced by IAP.
Therefore, it is likely that the stiffness of the abdominal muscles generating the IAP increase spinal stability. In other words, activation levels of all trunk muscles determine the stability of the spine, regardless of the magnitude of IAP.(20) Although, as suggested by Gracoskevetsky, we can not rely on muscles alone because mathematical modeling shows that Olympic athletes would not be strong enough to lift the loads they currently are lifting during competition.(8) We must look to the fascial system of the body for a missing link, the hydraulic amplifier effect.
Hydraulic Amplifier Effect
The hydraulic amplifier effect, originallytheorized by Gracovetsky (8) to increase the strength of the back muscles, was later proven mathematically to increase the strength of the back muscles by 30%.(21 p.124-125) The hydraulic amplifier mechanism is composed of the TLF surrounding the back muscles to create a relatively stable cylinder.(Figure 7) (22) As the back musculature contract within the cylinder created by the investing fascia, a hydraulic effect is created, aiding in the erection of the spine from a flexed position.
Gracovetsky (8) has demonstrated with mathematical modeling that the extension force produced by expansion of the erector spinae muscles within the compartment created by the thoracolumbar fascia and lamina groove of the spine is a significant contributor to one's ability to lift a load. The expansion of the muscles within the thoracolumbar fascia produces intra-compartmental pressure (ICP). The cylinder is stabilized by synergistic activation of the transversus abdominis (TVA) and posterior fibers of the internal oblique (IO).
To better understand how the hydraulic amplifier effect works, imagine taking a spine model and gluing a bicycle inner tube along each side of the spinous processes in the lamina groove. Once adhered, if you were to begin pumping up the tube (back muscles) inside a stable cylinder (TLF), it would begin to erect the previously flaccid spinal column This is the basic premise of the hydraulic amplifier.
As demonstrated by this junior scientist, a bicycle inner tube pumped up inside a cylinder representative of the thoracolumbar fascia will create an extension force.
The Outer Unit
The outer unit consists of many muscles such as the obliquus externus, obliquus internus, erector spinae, latissimus dorsi, gluteus maximus, adductors and hamstrings working in concert with the inner unit musculature and fascial systems.
While the inner unit muscles are responsible for developing and maintaining segmental stiffness, the bigger muscles….are responsible for creating movement.
As you can well imagine, if the inner unit were to fail or even suffer altered function under the load of outer unit functions, the mast (spine) could easily buckle, resulting in spinal injury. Judging by the statistics on spinal injury, and the authors of clinical experience, it is evident that the population at large commonly suffers from an imbalance between the inner and outer units.
When the inner and outer units are functioning synergistically, there is a characteristic look to the abdominal wall. There is a noticeable oblique line and the umbilicus moves toward the spine as the torso moves through the zone of the critical point.(23) Although an explanation of the outer unit is beyond the scope of this article, a reader interested in more information may review "The Outer Unit" (24) as well as references (7), (15) and (23) for a comprehensive understanding of the outer unit system.
A) If your outer unit is dominant over your inner unit, as you bend forward to pick up a load, a string placed around the waist will become tighter as you pass through the critical point (~90% lumbar flexion). If the load is significant enough to require activation of both inner and outer units, the string will have become loose as you bend forward and tight as you lift the load.
B) When the inner unit is strong enough to provide adequate stabilization, you will stay under the stabilization threshold as you pass through the sticking point. Staying under the stabilization threshold is indicated by the fact that the rectus abdominis and external oblique musculature have not shortened and thickened, pressing on the string.
Now that you have a better understanding of how our own internal weight belt works and how it functions to stabilize our spine, Part II of this article will analyze some commonly sited reasons and supposed benefits for using a belt. I will show that the reasons most people use belts may actually be providing a false sense of security and potentially setting the belt user up for injury.
1. Waddell, G. The Back Pain Revolution. New York: Churchill Livingstone, 1998.
2. Ironmind Enterprises (catalog)
3. Webster, D. The Iron Game. Scotland: John Geddes Printers Irvine, 1976.
4. Lovett, R. Lateral Curvature of the Spine and Round Shoulders Philadelphia: P. Blakiston's Son & Co., 1912.
5. Steindler, A. Post-Graduate Lectures on Orthopedic Diagnosis and Indications Charles C Thomas, 1951.
6. Richardson C., Jull G., Hodges P. and Hides J. Therapeutic Exercise For Spinal Segmental Stabilization In Low Back Pain ? Scientific Basis And Clinical Approach. London, New York, Philidelphia, Sydney, Toronto: Churchill Livingstone,1999.
7. Ed by: Vleeming A., Mooney V., Snijders C.J., Dorman T.A. and Stoeckart R. Movement, Stability & Low Back Pain ? The Essential Role of the Pelivs. New York, Edinburgh, London, Madrid, Melbourne, San Francisco and Tokyo: Churchill Livingstone, 1997.
8. Gracovetsky, S. The Spinal Engine. Wien, New York: Springer-Verlag, 1988.
9. Dart R.A. The Double-Spiral Arangement Of The Voluntary Musculature In The Human Body. Surgeons' Hall Journal Vol. 10, No. 2. Oct. 1946 ? March 1947.
10. Hodges P. W., Richardson C.A. Feedforward contraction of transversus abdominis is not influenced by the direction of arm movement. Exp Brain Res (1997) 114:362-370.
11. Aruin S.A., Latash M.L. Directional specificity of postural muscles in feed-forward postural reactions during fast voluntary arm movements. Exp Brain Res (1995) 103:323-332.
12. Cresswell A.G., Grundstrom H., Thorstensson A. Observations on intra-abdominal pressure and patterns of abdominal intra-muscular activity in man. Acta Physiol Scand 1992, 144, 409-418.
13. Hodges P.W., Richardson C.A. Contraction of the Abdominal Muscles Associated With Movement of the Lower Limb. Physical Therapy. Vol. 77 No. 2 February, 1997.
14. Norris C.M. Functional load abdominal training: part 1. Journal Of Bodywork And Movement Therapies July 1999
15. Lee D. The Pelvic Girdle (2nd. Ed.) ? An Approach to the Examination and Treatment of the Lumbo-Pelvic-Hip Region. Edinburgh, London, New York, Philadelphia, Sydney, Toronto: Churchill Livingstone, 1999.
16. Richardson C.A., Jull G.A. Muscle control ? pain control. What exercises would you prescribe? Manual Therapy(1995) 1, 2-10.
17. Bogduk N., Towmey L.T. Clinical Anatomy of the Lumbar Spine (2nd. Ed.).Melbourne, Edinburgh, London, New York and Tokyo: Churchill Livingstone, 1991.
18. Wirhed, R. Athletic Ability & the Anatomy of Motion. Wolfe Medical Publications Ltd., 1984.
19. White, A. and Panjabi, M. Clinical Biomechanics of the Spine 2nd. ED. J.B. Lippincott Co., 1990.
20. Cholewicki, J., Juluru, K., McGill, S. Intra-abdominal Pressure Mechanism for Stabilizing the Lumbar Spine. Journal of Biomechanics 32 (1999) 13-17.
21. Bogkuk, N. Clinical Anatomy of the Lumbar Spine and Sacrum 3rd. ED. Churchill Livingstone, 1999.
22. Chek P. Scientific Back Training. (correspondence course) Encinitas, CA: Chek Institute, 1995.
23. Chek P. Scientific Core Conditioning. (correspondence course) Encinitas, CA: Chek Institute, 1993,1999.
24. Chek P. The Outer Unit. Published at www.personaltraining.com.au.
EricT on 05-09-2006, 07:42 PM
Back Strong & Beltless - Part II
HOW TO BE BACK STRONG AND BELTLESS!
The worst thing someone could do is discontinue the use of a belt cold turkey! If you have been using a back belt or weight lifting belt for more than a month, chances are very good that your abdominal recruitment patterns have been altered. Your TVA and posterior IO are now likely sitting on the couch, relaxing, while allowing your rectus abdominis and external obliques to act as the primary stabilizers of the trunk in concert with the erector spinae muscles.
If you have been using a belt for several months or even years, particularly if you have had or currently experience any low back pain, chances are very good that you have sensory-motor amnesia of the deep abdominal wall. If you remove your belt and go back to your normal Herculean performances in the gym or start packing power tools around the construction site, chances are very good you will be purchasing a new Mercedes for your doctor or orthopedic surgeon, real soon!
When you take the belt off and begin working or lifting, your brain will sequence the muscles as though you were lifting with the belt. When your nervous system recruits the rectus abdominis and erector spinae at the greater intensity as learned when wearing the belt (40,44), you are likely to have increased compression, torsion and/or sheer in one or more segments of your lumbar spine, but without the hoop tension provided by the belt (42,43).
Additionally, a correlation of my clinical findings among athletes that wear belts and have experienced hamstring injury is supported by research. Lander et al. found that while using weight-belts, there was increased EMG activity of the vastus lateralis and biceps femoris (55). This is logical when considering the intimate relationship that exists between the biceps femoris and the TVA via the thoracolumbar fascia system as an integral part of what is called the "deep longitudinal system" by Gracovetsky (7 p. 243-251, 15 p. 58)
Adopted from Gracovetsky (7 p. 243-251, 8) and Lee (15 p. 58) the Deep Longitudinal System illustrates the working relationship between the TVA as a stabilizer of the pelvis (A), the sacrotuberous ligament (B), the peroneus longus and biceps femoris (C) and the erector spinae musculature (D). In the late swing phase of gait, dorsiflexion of the foot in preparation for heel strike generates tension in the peroneus longus. Vleeming (7) indicates that approximately 18 percent of that force is transferred into the biceps femoris, which works to tension the sacrotuberous ligament, stabilizing the sacrum and ilium at heel strike. The erector spine musculature serve to dissipate kinetic energy through rotary action on the spinal column prior to reaching the cranium. This mechanism may explain the high correlation between biceps femoris injury in lifters using belts and sprinters with TVA dysfunction; theoretically, the biceps may be working to tension the thoracolumbar fascia system to compensate for inadequate action of the TVA.
If the belt user has developed the habit of responding to the exteroception provided by the belt by pushing the abdominal wall outward (which will inhibit the TVA), then it is very likely the brain may up-regulate the recruitment of the biceps femoris in an attempt to stabilize the thoracolumbar fascia.
This can be done by the biceps femoris because of its intimate relationship with the thoracolumbar fascia via the sacrotuberous ligament. Having treated numerous biceps femoris injuries in weight lifters and athletes performing in sports requiring explosive movement, I have witnessed a strong correlation between sensory-motor dysfunction of the deep abdominal wall, an inability to stabilize the lumbopelvic region, and biceps femoris injury.
Additionally, a study titled, "The effect of industrial back belts and breathing technique on trunk and pelvic coordination during a lifting task," found that "phase angles" (relationships) between the pelvis and lumbar spine during the initial phase of lifting tasks were altered among belt users (56). The researchers concluded "the change in segmental kinematics was similar to that previously reported for patients with a history of low back pain" (56). What this means is that if you stop belt use cold turkey, or even forget your belt one day, not only will your motor sequencing be aberrant, but the relative timing of joint movements will also be faulty. This is a formula for disaster!
Belt use has been shown to alter the natural recruitment patterns of the abdominal wall, favoring the rectus abdominis (40), erector spinae (44) and potentially disrupting recruitment sequences in the legs (39). It is therefore no surprise that belt users frequently present with aberrant coordination in the abdominal wall when assessed clinically.
It is very common for belt users to have reduced ability to control sacral base inclination, or pelvic tilt. This is another common challenge I must work through with back pain patients. Inability to control sacral base inclination can cause instability of the sacroiliac joints, particularly during forward bending activities (58). Clinically, I have found inability to control sacral base inclination is also commonly related to such spinal pathology as spondylolistheses, spondylolysis, spinal instability and disc herniation.
It is well documented that coordinative patterns of the abdominal wall are task specific (6,12,14,23). For example, one may have normal abdominal wall function during a squat pattern, but not a push pattern. Additionally, loss of abdominal wall coordination is easier to prevent than to restore (61). This should give those of you considering use of a weight belt adequate reason NOT TO!
I recommend trying what I call "the worlds greatest weight belt". It is simply a piece of kite string. Place the kite string around your waist at the belly button level. Exhale and draw your belly button in slightly, just enough to notice that it has moved toward your spine and that you now have more definition along the oblique line. With the string snug around your belly now, tie the string in a knot.
As you perform your exercises in the gym, you should always inhale and draw your umbilicus off the string prior to exerting any force. This teaches the brain to activate the TVA first. If you are lifting any significant load, you will cross the stabilization threshold (23), at which time you will go from segmental to gross stabilization. This will be identified as visually observable activation of the external oblique and rectus abdominis.
When the load is heavy enough, you will notice that no matter how hard you try, you cannot keep the string loose around your torso. If you progressively reduce the weight, you will eventually cross back under the stabilization threshold, which will be identified by your ability to perform the lift and keep the string loose.
It is very important to perform enough low intensity lifting to train the brain to always recruit the deep abdominal wall before recruiting the outer unit, or outer muscles, which function as gross stabilizers.
To best condition your body, it is important to focus first on learning to activate the abdominal wall while performing what I call "Primal PatternsTM". Primal Patterns' are the movement patterns most likely to have been necessary for our developmental survival as dictated by the selective pressures of nature (62). The Primal Patterns are:
Gait (walk, run and sprint)
All these patterns, to be true Primal Patterns, must be performed from a standing position. If this is not possible, then you will need the help of an exercise or rehabilitation professional, preferably a C.H.E.K Intern, to assist you in learning how to correctly perform the sequencing and development of the movements.
For those interested in an educational resource that teaches integration of the deep abdominal wall while performing many functional exercises, I recommend "The Gym Instructor Series" (60). This program covers many pushing, pulling and abdominal exercises as well as showing how to restore normal coordination and strength to the inner and outer unit muscles of the abdominal wall and back.
Once you have implemented the training techniques described here, you will be free from training with the belt and have full confidence that your body now works correctly. If you have any orthopedic problems at all, it would be wise to consult a C.H.E.K Practitioner or a skilled rehabilitation professional that understands the science of corrective exercise to aid you in your quest to be "BACK STRONG AND BELTLESS!"
In this article I discussed several legitimate considerations regarding chronic use of corsets, back belts, and weight lifting belts. Available research clearly demonstrates that belts are unable to stabilize the spine at a segmental level, therefore only stabilizing the torso. Gross stabilization, as provided by belts, may allow you to lift more weight than you could without the belt, indicating a stabilizer dysfunction within your body. The increased weight being lifted as afforded to the lifter by the belt will likely serve to traumatize the spine due to increased levels of compression, torsion and sheer, increasing the potential for a serious injury.
Caution should be exercised by those using belts to increase "proprioception," as a belt is clearly a form of "exteroceptive stimuli". When the belt is removed, it is likely to have accomplished little in improving proprioception, leaving the lifter with an increased risk of injury secondary to belt usage. My clinical treatment of workers and athletes with spine injuries has shown that chronic use of weight lifting belts and back belts is highly correlated with sensory-motor amnesia of the deep abdominal. Finally, weaning yourself off a belt must be done carefully and in concert with evaluation and treatment of any stabilizer deficit found in the torso.
Waddell, G. The Back Pain Revolution. New York: Churchill Livingstone, 1998.
Ironmind Enterprises (catalog)
Webster, D. The Iron Game. Scotland: John Geddes Printers Irvine, 1976.
Lovett, R. Lateral Curvature of the Spine and Round Shoulders Philadelphia: P. Blakiston's Son & Co., 1912.
Steindler, A. Post-Graduate Lectures on Orthopedic Diagnosis and Indications Charles C Thomas, 1951.
Richardson C., Jull G., Hodges P. and Hides J. Therapeutic Exercise For Spinal Segmental Stabilization In Low Back Pain - Scientific Basis And Clinical Approach. London, New York, Philidelphia, Sydney, Toronto: Churchill Livingstone,1999.
Ed by: Vleeming A., Mooney V., Snijders C.J., Dorman T.A. and Stoeckart R. Movement, Stability & Low Back Pain - The Essential Role of the Pelivs. New York, Edinburgh, London, Madrid, Melbourne, San Francisco and Tokyo: Churchill Livingstone, 1997.
Gracovetsky, S. The Spinal Engine. Wien, New York: Springer-Verlag, 1988.
Dart R.A. The Double-Spiral Arangement Of The Voluntary Musculature In The Human Body. Surgeons' Hall Journal Vol. 10, No. 2. Oct. 1946 - March 1947.
Hodges P. W., Richardson C.A. Feedforward contraction of transversus abdominis is not influenced by the direction of arm movement. Exp Brain Res (1997) 114:362-370.
Aruin S.A., Latash M.L. Directional specificity of postural muscles in feed-forward postural reactions during fast voluntary arm movements. Exp Brain Res (1995) 103:323-332.
Cresswell A.G., Grundstrom H., Thorstensson A. Observations on intra-abdominal pressure and patterns of abdominal intra-muscular activity in man. Acta Physiol Scand 1992, 144, 409-418.
Hodges P.W., Richardson C.A. Contraction of the Abdominal Muscles Associated With Movement of the Lower Limb. Physical Therapy. Vol. 77 No. 2 February, 1997.
Norris C.M. Functional load abdominal training: part 1. Journal Of Bodywork And Movement Therapies July 1999
Lee D. The Pelvic Girdle (2nd. Ed.) - An Approach to the Examination and Treatment of the Lumbo-Pelvic-Hip Region. Edinburgh, London, New York, Philadelphia, Sydney, Toronto: Churchill Livingstone, 1999.
Richardson C.A., Jull G.A. Muscle control - pain control. What exercises would you prescribe? Manual Therapy(1995) 1, 2-10.
Bogduk N., Towmey L.T. Clinical Anatomy of the Lumbar Spine (2nd. Ed.).Melbourne, Edinburgh, London, New York and Tokyo: Churchill Livingstone, 1991.
Wirhed, R. Athletic Ability & the Anatomy of Motion. Wolfe Medical Publications Ltd., 1984.
White, A. and Panjabi, M. Clinical Biomechanics of the Spine 2nd. ED. J.B. Lippincott Co., 1990.
Cholewicki, J., Juluru, K., McGill, S. Intra-abdominal Pressure Mechanism for Stabilizing the Lumbar Spine. Journal of Biomechanics 32 (1999) 13-17.
Bogkuk, N. Clinical Anatomy of the Lumbar Spine and Sacrum 3rd. ED. Churchill Livingstone, 1999.
Chek P. Scientific Back Training. (correspondence course) Encinitas, CA: Chek Institute, 1995.
Chek P. Scientific Core Conditioning. (correspondence course) Encinitas, CA: Chek Institute, 1993,1999.
Chek P. The Outer Unit. Published at www.personaltraining.com.au.
Ziglar Z. How To Stay Motivated. (tape series) . Carrollton, TX: The Zig Ziglar Corp.
Lahad A., Malter A.D., Berg A.O., Deyo R.A. The effectiveness of four interventions for the prevention of low back pain. JAMA 1994;272:1286-91.
Majkowski G.R., Jovag B.W., Taylor B.T., Taylor M.S., Allison S.C., Stetts D.M., Clayton R.L. The Effect of Back Belt Use on Isometric Lifting Force and Fatigue of the Lumbar Paraspinal Muscles. Spine Vol. 23, No. 19, pp 2104-2109, 1998.
National Institute for Occupational Safety and Health. Workplace use of back belts: Review and recommendations. Rockville, MD: Department of Health and Human Services (National Institute of Occupational Safety and Health) Publication No. 94-122, 1994
Mitchell L.V., Lawler F.H., Bowen D., Mote W., Asundi P., Purswell J. Effectiveness and cost-effectiveness of employer-issued back belts in areas of high risk for back injury. J Occup Med 1994 Jan;36(1):90-94.
Thomas J.S., Lavender S.A., Corcos D.M., Andersson G.B. Effect of lifting belts on trunk muscle activation during a suddenly applied load. Hum Factors 1999 Dec;41(4): 670-6.
Reyna J.R., Leggett S.H., Kenny K., Holmes B. and Mooney V. The Effect of Lumbar Belts on Isolated Lumbar Muscle Strength and Dynamic Capacity. Spine Vol. 20 No. 1 pp 68-73, 1995.
McGill S.M., Norman R.w., Sharratt M.T. The effect of an abdominal belt on trunk muscle activity and intra-abdominal pressure during squat lifts. Ergonomics 1990 Feb;33(2):147-60.
Hodgson E.A. Occupational back belt use: a literature review. AAOHN J 1996 Sep;44(9): 438-43.
Ciriello V.M., Snook S.H. The effect of back belts on lumbar muscle fatigue. Spine 1995 Jun 1;20(11):1271-8; discussion 1278.
Cholewicki J., Juluru K., Radebold A., Panjabi M.M., Magill S.M. Lumbar spine stability can be augmented with an abdominal belt and/or increased intra-abdominal pressure. Eur Spine J 1999;8(5): 388-95.
Smith E.B., Rasmussen A.A., Lechner D.E., Gossman M.R., Quintana J.B. The effects of lumbosacral support belts and abdominal muscle strength on functional lifting ability in healthy women. Spine 1996 Feb 1;21(3):356-66.
Zatsiorskii V.M., Sazanov V.P. A Waist-Corset For Decreasing The Risk Of Injury To The Spine When Lifting Weights And Doing Strength Exercises. Teoriya I Praktika Fizicheskii Kultury 3:15-17, 1987.
Bourne N.D., Reilly T. Effect of a weightlifting belt on spinal shrinkage. Br J Sports Med 1991 Dec;25(4): 209-12.
Lander J.E., Simonton R.L., Giacobbe J.K.F. The effectiveness of weight-belts during the squat exercise. Medicine and Science In Sports And Exercise Vol. 22, No. 1 Feb. 1990 pp 117-26.
Miyamoto K., Iinuma N., Maeda M., Wada E., Shimizu K. Effects of abdominal belts on intra-abdominal pressure, intra-muscular pressure in the erector spinae muscles and myoelectrical activities of trunk muscles. Clinical Biomechanics, Feb. 1999 14(2): 79-87.
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Axelsson P., Johnsson R., Stromqvist B. Effect of lumbar orthosis on intervertebral mobioity. A roentgen sterophotogrammetric analysis. Spine 1992 Jun;17(6): 678-81.
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Bauer J.A., Fry A., Carter C. The Use of Lumbar Supporting Weight Belts While Performing Squats: Erector Spinae Electromyographic Activity.
Hodges P. Richardson C., Jull G. Evaluation of the relationship between laboratory and clinical tests of transversus abdominis function. Physiother Res Int 1996;1(1):30-40.
Cholewicki J., Juluru K., McGill S. Intra-abdominal pressure mechanism for stabilizing the lumbar spine. Journal of Biomechanics 32 (1999) 13-17.
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EricT on 05-10-2006, 06:53 AM
A BRIEF ON BELTS
A B E LT MAY NOT BE AS “ S U P P O R T I V E ” A S Y O U T H I N K
By James Krieger
Before we talk about belts, injury risk, and performance, we need to delve into how a belt supposed to work. During heavy lifting, the transverse abdominus, a hooplike muscle that surrounds your waist and lies deep in your abdomen, “squeezes” your torso. This increases the pressure in your stomach, which is known as intra-abdominal pressure IAP). This action provides support to your trunk by essentially making your torso stiffer, adding strength and support to your spine, and can even prevent your spine from buckling with a heavy load on your back.10 Now, wearing a belt creates even more IAP,4, 7, 8, 11 which, theoretically, would provide even more support to your spine.
NO BELTS ALLOWED
Though I dug deep, I couldn’t find any studies that directly examined if belts can decrease injury risk in athletes. However, that doesn’t mean we can’t put our brains to use and derive some logical conclusions. If a weight belt truly adds extra spinal support, then it makes sense that the erectors, the primary muscles involved in extending your back and keeping you upright, would be relieved of some of their duty. Since a muscle’s degree of work can be measured via electrical activity, it would also follow that such activity would decrease with the use of a belt, since the muscles wouldn’t need to work as hard.
However, in five out of six studies that looked at the electrical activity of the erectors with belt use, there was no decrease in erector activity.1, 7, 8, 11-13 And the lone study that did show a decrease has been criticized for its statistical analysis.3 So the next deduction is that a belt doesn’t add extra spinal support and that therefore the concept of injury prevention may be flawed.
Actually, if you dig deep enough, you would learn that a belt might actually cause problems, rather than prevent them. You see, your spine comprises 24 little joints that are constructed to allow for a certain range of motion. By wearing a belt, you might immobilize certain portions of your back when they’re supposed to be moving, thereby increasing stress to other parts of the spine and making those parts more vulnerable.5
Wearing a belt can also increase blood pressure and cardiovascular strain.6 Finally, although there’s no decrease in surface abdominal muscle activity when a belt is used,11, 12 it’s possible that a belt might decrease the activity of the deep abdominal muscles. This is because the belt may relieve some of the need of the deep abdominals to supply IAP.
This, in turn, would reduce the training stimulus to these muscles. Eric Burkhardt, MA, CSCS, the strength and conditioning coach for the University of California, Irvine, agrees. “I have not worn a belt during any exercise for about 15 years of relatively heavy training,” says Burkhardt. “In doing so, I feel that I have developed my abdominals’ ability to create sufficient IAP, eliminating the need for a belt. I’m quite certain that had I used a belt on a regular basis, my trunk musculature wouldn’t be as strong as it is today.”
A BELT, PLEASE
The value of using a belt is clearly in question, at this point. But let’s shift gears and take a look at a study that favors the belt.2 Eight males performed six weight-training xercises for 3 sets of 10: a deadlift, high pull, squat, clean, bent-over row, and bicep curl. Four subjects wore a belt, while four didn’t. After the training session, the subjects who wore a belt reported less discomfort while lifting.
Their height decreased by an average of 2.87 mm, while for the subjects who didn’t wear a belt height decreased by 3.59 mm. This indicates less “spinal shrinkage” in the subjects who wore a belt, implying that the spine experienced less compression. This might be important to injury prevention. Why? In yourspine there are soft disks made out of cartilage, called intervertebral disks, which act as cushions. More compression on your spine means more compression on these disks. Relieving some of the compression might be beneficial, since these disks can be relatively easily injured.
While this looks like evidence in favor of the belt, you need to be cautious in interpreting the results. The difference in spinal shrinkage between the groups was not statistically significant, meaning it might have been due to random chance. Also, the subjects were experienced weightlifters who may have been accustomed to wearing a belt. This might explain why they felt discomfort when they didn’t wear one.
With all this talk of injury prevention, we still haven’t addressed the effect of a belt on performance. Probably the one type of athlete that would derive the greatest performance boost from a belt is the powerlifter. Most powerlifters that we talked to agreed that they could add at least 30 pounds to their squat and deadlift by wearing a belt. Also, two studies found that the subjects could squat faster with a belt,7, 13 indicating that they’re generating more power. This in and of itself could contribute to why powerlifters feel that they can lift more with a belt, though you can’t dismiss the fact that feeling more secure with a belt also has a positive effect.7
So after yanking you back and forth, how can we make sense of the data? Here are some major pointers to bear in mind:
Constant reliance on a belt for every lift, even max attempts, probably isn’t a good idea and could result in belt dependence. While there’s no solid evidence for belt use, there’s also no indication that occasional use is harmful. If you decide to use a belt, make sure you get a fair amount of beltless training also. Limit your belt use to some of your maxes and definitely consider using one in competition for some added power.If you’ve been consistently wearing a belt in training, it’s probably time to get your body accustomed to lifting without one. Start at around 60% of your max and slowly progress by 2 to 5% per week or as tolerated.
Proper lifting technique and appropriate progression are probably much more important to injury prevention than wearing a belt. “The athletes I train aren’t using lifting belts and never have,” says Burkhardt. “I haven’t had any serious back injuries in my weight room and strongly feel that this is due to being a stickler about proper technique.” Maintaining neutral spine is an important part of proper technique. Neutral spine means keeping the natural curvature of your back when you lift. Don’t round it, and don’t hyperextend it either. This keeps the pressure on those intervertebral disks even on all sides, reducing the risk of injury.
Belt or no belt, a brief Valsalva maneuver (holding your breath) may help protect your back. This increases IAP and tends to reduce erector activity, suggesting a reduced spinal load.11 However, avoid excessive breath holding because it can result in a dramatic ncrease in blood pressure and, if prolonged, could cause blackouts.9 The best way to avoid these problems is to start breathing out once you’ve passed the sticking region of a lift.
1. Bauer, J.A., A. Fry, and C. Carter. The use of lumbar-supporting weight belts while
performing squats: Erector spinae electromyographic activity. Journal of Strength and
Conditioning Research 13:384-388, 1999.
2. Bourne, N.D., and T. Reilly. Effect of a weightlifting belt on spinal shrinkage. British Journal
of Sports Medicine 25:209-212, 1991.
3. Group, National Institute for Occupational Safety and Health Back Belt Working. Workplace
Use of Back Belts: Review and Recommendations. Cincinnati: National Institute for
Occupational Safety and Health, 1994.
4. Harman, E.A., R.M. Rosenstein, P.N. Frykman, and G.A. Nigro. Effects of a belt on intraabdominal
pressure during weight lifting. Medicine and Science in Sports and Exercise
5. Howard, R.L. Back pain, intra-abdominal pressure, and belt use. Strength and Conditioning
Journal 21:42-43, 1999.
6. Hunter, G.R., J. McGuirk, N. Mitrano, P. Pearman, B. Thomas, and R. Arrington. The effects
of a weight training belt on blood pressure during exercise. Journal of Applied Sport
Science Research 3:13-18, 1989.
7. Lander, J.E., J.R. Hundley, and R.L. Simonton. The effectiveness of weight-belts during
multiple repetitions of the squat exercise. Medicine and Science in Sports and Exercise
8. Lander, J.E., R.L. Simonton, and J.K.F. Giacobbe. The effectiveness of weight-belts during
the squat exercise. Medicine and Science in Sports and Exercise 22:117-126, 1990.
9. MacDougall, J.D., D. Tuxen, D.G. Sale, J.R. Moroz, and J.R. Sutton. Arterial blood pressure
response to heavy resistance exercise. Journal of Applied Physiology 58:785-790, 1985.
10. McGill, S.M., and R.W. Norman. Low back biomechanics in industry: The prevention of
injury through safer lifting. In: Current Issues in Biomechanics. M. Grabiner (Ed.).
Champaign, IL: Human Kinetics, 1992, pp. 69-120.
11. McGill, S.M., R.W. Norman, and M.T. Sharratt. The effect of an abdominal belt on trunk
muscle activity and intra-abdominal pressure during squat lifts. Ergonomics 33:147-160,
12. Miyamoto, K., N. Iinuma, M. Maeda, E. Wada, and K. Shimizu. Effects of abdominal belts
on intra-abdominal pressure, intra-muscular pressure in the erector spinae muscles and
myoelectrical activities of trunk muscles. Clinical Biomechanics 14:79-87, 1999.
13. Zink, A.J., W.C. Whiting, W.J. Vincent, and A.J. Mclaine. The effects of a weight belt on
trunk and leg muscle activity and joint kinematics during the squat exercise. Journal of
Strength and Conditioning Research 15:235-240, 2001.
EricT on 03-28-2008, 11:35 AM
I've been looking to see if I could luck out and find some online article from Dr. Stuart Mcgill on this subject. For those of you who don't know he is THE man when it comes to back health. Most of his stuff is in his research or his books but here is a page linking some PDF articles...the second and third being the most pertinent.
Notice that he mentions this notion of sucking in the gut like Chek recommends. I think most of us realize that is pretty assinine and he reiterates that.
EricT on 01-23-2010, 09:12 AM
I'm still embarrassed that I put the back strong and beltless article here. The more I've learned and the more I've seen of CHECK, the more I've realized that he is a whack job with virtually no scientific or analytical ability.
Now I have the pleasure of linking this thing where Mell Siff rips him a new one and critiques this thing by CHECK. Must read.
The issue here is not about whether to wear a belt or not, it's CHEK's analysis, or lack of it, and his insistence on the all powerful ability of the TVA to stabilize the spine.