Should you Deadlift or Deadbug?

Introduction 

The Biering-Sorensen Test is an assessment looking at an individual’s potential tolerance for deadlifting if they have non-specific lower back pain. People often question when they should add deadlifting back into their routine following a lower back injury.  Although this test is not the end-all-be-all when I am assessing an athlete with lower back pain, it is a good place to start.   

What is the test? 

Using a glute-ham developer, set yourself up for lumbar extensions — facing down, ankles locked in, with your hips in line with the pad.   

From this position, the test is simply an isometric hold at neutral. Extend from the hanging position and hold in neutral until you cannot maintain the position.  I usually will give the athlete/patient verbal cues when they unintentionally begin to drop in order to allow them to correct once prior to stopping the test.   

How do I use the test? 

If you’re non-symptomatic during the test, we would, ideally, want to see a hold of 132 seconds.  For those having some lower back pain during the test, you are striving for a hold of 92 seconds.  Any individual who may fall under the time in their respective category would likely benefit from some additional core strengthening before adding deadlifts into their program.  Patients who are able to maintain the prolonged hold for beyond the instructed times would benefit from deadlifts in their program. 

Usually, by “additional core strengthening”, I am referring to a combination of deadbug, birddog, pallof press, plank and carry variations.  I will continue to make use of these exercises until the athlete can progress their extension isometric hold to the desired time.  

Differences in Patient Population 

Please use this test as a guide, not an absolute.  Obviously if I am working with an older patient population, not everyone will be able to complete/pass this test.  However, I may still add deadlifts based on their progression throughout my treatment program. Also, variations of deadlifts (elevated surface, kettlebell, etc.) might be appropriate to add earlier if you are having trouble with the endurance aspect of the Biering –Sorensen Test.   

If you do not have a glute-ham developer, there are variations to perform this test.  In the clinic we use a bench and mobility bands at a squat rack.  

In a rehab setting, using a gait belt to strap down the legs while hanging off a table.  For additional challenge in stability, you can use a Swiss ball with your feet against the wall to give you an idea of where you are. Be creative! Come up with your own ways of putting the test into practice. 

Hope this is a helpful guide for programming if your back flares up.  Let me know if you have any additional questions!