I chose the title of this article to emphasize how important the back musculature and glutes are when effectively and holistically training the core. The more you read and research core training, the more you are exposed to the significant bias toward isolated abdominal training, which commonly falls under the broad umbrella of core training. It is imperative you first understand that in a normal functioning system, the core is used in every activity to stabilize, balance and protect the body as well as to transfer energy from one body segment to another. It is only when the system breaks down and mobility and stability problems are evident that we need to isolate a part and break it down during core training.

One of the most fundamental movements and core exercise techniques I have seen is the deadlift. However, many individuals shy away from the deadlift because they perceive it will place a higher degree of stress on the back, which may increase the potential for injury. As a board-certified orthopedist specialist in physical therapy, I do not see how a complete core training or back rehabilitation protocol could not involve this most fundamental movement. I think the biggest problem with the deadlift is individuals do not realize the many options they have to evoke this primitive stabilization pattern.

Dead lifting is not about a straight bar, large plates and chalk on your hands. Dead lifting is about holding the segments of the spine stable in a neutral position and allowing the hips to exert their force through the spine to move the upper torso without changing the position of the vertebrae, which make up the spine. This move is described by concentrically contracting the hips during extension, with an isometric contraction of the spinal stabilizers. Having said that, a deadlift is actually any hip hinge move – either single or double leg – that fits the definition. I primarily use the deadlift as a corrective maneuver to help demonstrate left and right side asymmetries in my core training programs. I use this both in rehabilitation and performance training, first to help patients recover from an injury that has involved the spine or core and second when consulting with high school, collegiate and professional athletes who are having performance issues and recurrent problems associated with their training.

Let me review a few pearls on dead lifting that have become apparent to me since I have researched and dissected core training over the last few years.

1. For the purposes of training the core, it is necessary to at least have 20 degrees of flexion at the knee. This reduces compensation that can be caused by muscles attaching to the IT band. Flexing the knee renders the IT band as more of a stabilizer and not a prime mover. It also increases proprioceptive awareness at the foot, knee and hip, which allows the core to have more control over the situation of dead lifting. It should also be stated that maintaining a slight bend in the knee simulates the universal ready position used in most sports and allows the pelvic stabilizers to work more effectively. The slightly flexed knee position also allows for more effective foot positioning, decreasing pronation for individuals who may have increased tightness in the gastroc/soleus complex and in the hamstrings.

2. It is not about the straight bar. Although I think that straight bar dead lifting large amounts of weight is one of the most fundamental maneuvers in weight training, I do not feel it is necessary for all individuals to use a straight bar. Only those individuals going into high-stress situations need to incorporate straight bar dead lifting large amounts of weight into their weight training. A deadlift can be executed with a single arm either on a dumbbell or a kettlebell. We have even demonstrated in our recent published information how a deadlift can be done with tubing or a cable column for those populations not yet ready for free weights. The single arm deadlift turns the move into a three-dimensional stabilization drill. This technique evokes a rotational component by the single arm pull, which effectively strengthens the shoulder girdle while receiving all of the benefits of a straight bar deadlift. This rotation is countered by the rotators of the torso, the internal rotators of one hip and the external rotators of the opposite hip. When splitting the deadlift in half and executing a single arm deadlift, it is important to take the uninvolved arm and place the back of the hand in the lordotic curve (inward curve of the low back) of the spine. We have even instructed first timers to hold a stick or a dowel in this position and maintain constant contact between the stick, head, thoracic spine and buttocks. This gives increased proprioceptive feedback for spine stability. Since the deadlift is being executed with each arm independently, the trainer and strength coach have an excellent opportunity to look for mechanical differences between the left and right pull movements. These differences may not be a result of a slightly weaker shoulder; it could be an entire pattern problem with reduced core stabilization on one side. These types of asymmetries can be addressed by placing more emphasis on the weaker side. You can increase the sets and/or reps on the weaker side until technique improves and left/right symmetry is noted.

3. The movement is more important than the motion. This statement could be confusing, without definition, but my point is that a good stable spine and a good hip drive is more important than pulling the weight completely from the floor. Range of motion is not the most important thing when teaching dead lifting. It may be important for some individuals to elevate the bar, dumbbell or kettlebell off of the floor so that appropriate neutral spine and a 20 degree knee bend can be performed. I will use a small step or platform, in order to place the weight six to eight inches off of the floor. This allows for good strong pulls and excellent mechanics without the added stress of excessive range of motion while initially teaching the maneuver. There are two options for progression once the individuals can perform it with the weight elevated. The first is to maintain the same weight and move it closer to the floor with a two or four inch elevation. Secondly, you could increase the weight and choose to stay above the level of the floor if you feel that range of motion may be a problem.

4. One of the best examples of total core stabilization is the single arm, single leg deadlift. This should always be done as a cross-body maneuver, meaning if you are dead lifting while standing on the left leg, you will be lifting weight with the right arm. This places the right leg off the ground, and although I have seen it demonstrated with a slightly bent knee, I encourage my clients and patients to extend the hip and the knee as much as possible as the leg leaves the ground and goes into extension. This total extension of the non-weight bearing leg helps evoke core stabilization. Standing on one leg and lifting the weight with the opposite arm places an extreme amount of three-dimensional force through the core. To execute the move appropriately, the core must stabilize three-dimensions of stress while the hip drives itself into extension. The internal and external rotators of the hip as well as the adductors and abductors of the hip must continuously monitor motion and stabilize the way they were designed to do. These muscles are not prime movers. They perform a stabilizing role in order for the prime movers to work and change position during the movement. Foot position is extremely important in both the single and double leg deadlift. The foot position should be monitored at all times, relative to the knee. Ideally, you would like to set the knee as far outside the foot as possible without changing foot position. The foot needs to remain flat on the floor, and the individual is instructed to push and drive with the big toe. This movement will cause the foot to have a tendency to pronate or supinate. If this occurs, it will reduce the effectiveness of core stabilization. Keeping the knee abducted as much as possible on top of a stable foot will allow the best possible biomechanical alignment as well as neuromuscular horsepower for the hip.

5. Never try to teach hip hinge and deadlift mechanics to an individual who cannot perform a full and comfortable toe touch. In my book, "Athletic Body in Balance," I demonstrate how to quickly clear up this movement pattern limitation. The inability to touch your toes signifies more than just hamstring tightness. It demonstrates a serious disconnect between core stability and hip mobility. These are the two fundamental aspects that need to be reinforced with the deadlift. As a matter of fact, effective dead lifting for those individuals who have demonstrated life-long stiffness in the forward bend will actually reduce the limitation quicker than daily hamstring stretching. Remember, for every degree of mobility you gain, you must gain the same degree of stability to help control the increased range of motion.

6. One last bit of advice. I have found the single arm, single leg deadlift to be extremely effective in reducing stride problems and stride asymmetry in running. Many field and court athletes as well as runners may never go to a double leg straight bar deadlift; however, they can benefit significantly by keeping the hips symmetrical in a single arm single leg deadlift. It is an effective form of hip mobility and core stabilization that is unlike any other exercise maneuver most running and field and court athletes will experience. For this reason, I think it is an excellent balance of both mobility and stability, while giving the trainer and coach an excellent opportunity to address symmetry on a weekly basis. Individuals will always have tendencies to be more proficient with movement on one side of the body as opposed to the other; however, these differences should never exceed 10 percent. If you notice a greater than 10 percent difference between a left and right single arm, single leg deadlift, train the weaker side and watch the stride problems correct themselves as core strength and hip symmetry increase.