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Writer's Block Nov 30 | Rebuild Your Back

30 Nov 2008 06:55 pm

Writer’s Block Nov 30

Nov. 26, 2008

Back Pain and Lifting Belts

Once upon a time it was commonly believed that wearing a lifting belt would prevent back injury. You couldn’t go to a gym or health club and not see dozens of weightlifters and bodybuilders wearing them. I even have one around here somewhere.

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All that has changed now. The last time I was at the gym, I don’t recall seeing a single belt anywhere in sight.

So, does that mean they don’t work? Or that wearing one is a bad idea if you’re dealing with back problems?

That’s a good question. I stopped wearing mine because I had a hunch that it was more a liability than an asset — and it appears that most of the other lifters are of the same opinion.

But hunches and opinions are just hunches and opinions. Everybody has one and they aren’t worth much.

The only way to actually separate the facts from the folklore is to turn to those guys with the white lab coats (and way too much time on their hands) and see what they’ve been up to lately.

Here is a rundown of the latest findings:

First up, is a study published just this year (2008) by the Musculoskeletal Disorders Group at the Finnish Institute of Occupational Health in Helsinki, Finland. They concluded:

“There is no evidence to support use of … lifting equipment for preventing back pain or consequent disability.” [1]

Notice that they didn’t say that wearing a lifting belt was bad for you, only that there was no evidence to suggest that you need to wear one.

Next, we have a study conducted by the Institute for Work and Health, Toronto, Ontario, Canada. Their findings…

“Currently, because of conflicting evidence and the absence of high-quality trials, there is no conclusive evidence to support back belt use… ” [2]

Sort of reminds me of an old Herman’s Hermits song… “Second verse, same as the first.”

Herman's Hermits

Undaunted we move back over the pond to Amsterdam and the folks at the Institute for Research in Extramural Medicine who had this to say…

“There was moderate evidence that lumbar supports are not effective for primary prevention. No evidence was found on the effectiveness of lumbar supports for secondary prevention… There continues to be a need for high quality randomized trials on the effectiveness of lumbar supports.” [3]

Wait a minute…

“There continues to be a need for high quality randomized trials?”

So what exactly is it we’re paying you guys to do? Sorry, just kidding. I know you’ve been tied up lately, what with the kids and everything…

(I swear. You ever get the feeling some of these guys are just phoning it in?)

Speaking of which, here’s a summarization of the prevailing literature by the hardworking crew at the National Institute for Occupational Safety and Health (NIOSH) that further echoes the above opinions…

“They (back belts) appear to have little effect on most back injury risk factors, but may have a limited effect on improving muscle strength and supporting the back during lifting and twisting activities… Based on insufficient objective scientific data, NIOSH recommended against back belt use by healthy people.” [4]

Anyone else starting to notice a pattern here?

Anyway, moving right along, the Program in Physical Therapy at Washington University School of Medicine reports.

“The epidemiological data concerning the efficacy of back belts in the prevention of occupational low back injuries are not sufficient to warrant general use of back belts in the occupational setting for uninjured workers.” [5]

They then go on to add…

“There is actually a potential for increasing the degree of low back injury with general application of back belts in occupational settings.” [5]

Finally, we have at least some indication that wearing a back belt may actually weaken the spine and set you up for injury at a latter date. Nothing conclusive, mind you, but they seem to be thinking along the same lines as the rest of us.

Arbys

“In sum, there are insufficient data in the scientific literature to indicate that general use of back belts in occupational settings is appropriate for uninjured workers.” [5]

At this point, I’m thinking Arby’s, but let’s look at one more, then we’ll wrap this up.

“In the largest prospective cohort study of back belt use, adjusted for multiple individual risk factors, neither frequent back belt use nor a store policy that required belt use was associated with reduced incidence of back injury claims or low back pain.” [6]

My Conclusion

While it may seem — judging from popular opinion — that the verdict is in on back belts, the truth of the matter is, it’s not. We don’t really know if back belts help or not. (Maybe if those guys in Amsterdam would get off the pot…)

TeaTime

Anyway, what we do know is this:

  1. There is little evidence to suggest that they prevent back injuries, and
  2. There is the possibility that wearing them can lead to weak core muscles.

So, should you wear one or not? I guess it comes down to personal choice.

Until there is a truly definitive study, all we can do is speculate.

If you feel that wearing a belt helps support your back when lifting heavy objects, there seems to be no harm in doing so. However, you should probably only wear it when absolutely necessary.

My personal opinion (which is worthless, by the way) is that if you have a healthy back, you shouldn’t really need one. World-class athletes are able to lift safely without them.

Addendum:

By the way, if you’ve been wearing a lifting belt at the gym or at work, you shouldn’t just quit cold turkey. Instead, gradually wean yourself off of the belt as you condition your core muscles to take over that task.

The best way to do that would be to start out performing your preliminary (lighter) lifts without the belt while still using it for the heavy stuff. Then over the next few weeks progressively increase the weight you lift au natural, until you no longer need the belt for support.

Take care,
Dean

References:

1. Martimo KP, Verbeek J, Karppinen J, Furlan AD, Takala EP, Kuijer PP, Jauhiainen M, Viikari-Juntura E. Effect of training and lifting equipment for preventing back pain in lifting and handling: systematic review. BMJ. 2008 Feb 23;336(7641):429-31.

2. Ammendolia C, Kerr MS, Bombardier C. Back belt use for prevention of occupational low back pain: a systematic review. J Manipulative Physiol Ther. 2005 Feb;28(2):128-34.

3. Jellema P, van Tulder MW, van Poppel MN, Nachemson AL, Bouter LM. Lumbar supports for prevention and treatment of low back pain: a systematic review within the framework of the Cochrane Back Review Group. Spine. 2001 Feb 15;26(4):377-86.

4. Hodgson EA. Occupational back belt use: a literature review. AAOHN J. 1996 Sep;44(9):438-43.

5. Minor SD. Use of back belts in occupational settings. Phys Ther. 1996 Apr;76(4):403-8.

6. Wassell JT, Gardner LI, Landsittel DP, Johnston JJ, Johnston JM. A prospective study of back belts for prevention of back pain and injury. JAMA. 2000 Dec 6;284(21):2727-32.

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