The importance we put on exercise technique or “form” as it is often referred to in order to maximise safety and minimise potential risk for pain in injury is over-emphasised, outdated and in many cases, unsupported – often conclusively. That is to say if we were to look at the scientific literature surrounding injury prevalence and exercise – of which there is quite literally thousands, we find that exercise technique (how we move the weight) is nearly always at the bottom of the list of factors that increase the risk and number of injuries. As it turns out, load management (how heavy the object we are lifting and/or how much training we are doing), age, previous injury, sleep, psychosocial stressors and many more are far greater indicators of potential injury or pain than how we move is. Thinking we can have everybody perform any exercise the same way and that this is the most important factor when trying to avoid injury oversimplifies the complexities and individualistic nuances of human movement – and pain for that matter.
Efficiency by its very definition is to maximise the output with the least amount of energy expenditure. In terms of exercise, you might say being efficient is to move the heaviest weight possible with the least amount of effort. This is going to vastly differ from person to person. If we can concede the fact that individual factors like; height, weight, joint angles, bone lengths, experience with the particular exercise can be very different amongst the population and will affect how this person moves – then how could we possibly think there could be one “right” or even “safe” way to perform an exercise?
One of the biggest shortcomings of trying to critique someone’s technique to reduce their risk of injury is that it relies – in almost all cases -solely on visually identifying these so-called “imperfections” and as it turns out, we just aren’t as good as doing this as we think we are. Even though we think we can, we can not accurately and reliably see the things we are trying to. What about getting hands on and physically palpating the muscles or bones we are looking at – turns out we’re not very good at this either (1). Let’s say we are trying to see if someone’s back is “flat” or “neutral” while they pick up a weight, when explicitly instructed to do so and closely watched by a professional, one group of scientists found the spine bent up to 45 degrees going entirely unnoticed (2). So even when someone is instructed to keep their back flat, believes that they are doing so and is closely watched by a highly qualified clinician in a laboratory experiment who also believes their spine to be flat… it still bent – quite a bit actually. Knowing that spinal flexion is not only completely safe so therefore unrelated to injury risk (3, 4, 5, 6) but that professionals can’t even reliably see or feel the spine or pelvis like we think we can – the notion that we can see if your technique is wrong and therefore going to put you at risk of injury is null and void. To obsess over technique with the intention of reducing the risk of someone hurting themselves is of course coming from a place of care and best intentions but our efforts to do so are wasted and in almost every case, unnecessary.
Exercise Efficiency
As it has been mentioned, to optimise movement efficiency is to minimise the amount of energy required to complete the task – for the sake of this conversation, moving a weight. By way of analogy, let us imagine we were completing a barbell deadlift of 100kg (lift the bar of the floor from a stationary position). If there were two different ways to perform this exercise and one of them required far less energy to do so, this would be the more efficient way and likely everyone’s first choice… or would it be?
Often we have preconceived ideas of how an exercise like the deadlift should be completed, how it should look and feel – hips down, arms compressed to the side of the body, eyes forward and down, head and spine in a neutral or flat position. What if, however there was a more effective way that would allow you to lift this 100kg barbell with less effort (energy) and perhaps even lift more weight, would you do it? What if it didn’t fit the above constraints or ideals of safety or correctness.
The brains pre-motor cortex is an incredibly intuitive and adaptive part of our brain that pre-plans all human movement with our motor cortex carrying out and executing these movements – down to what muscles work, when they work and how much they work. Our brain is an evolutionary masterpiece that has advanced over billions of years, we don’t need to try and override it when we exercise yet many feel the need to consciously activate or switch on more muscles or more of the muscles already working – or tell others to. If efficiency is based around trying to minimise energy expenditure then doing this will only increase energy output therefore making an exercise less efficient or quite simply put, harder than it needs to be.
Let people find the most comfortable way of completing the task – lift the bar off the floor, push the weight overhead, pull the weight into the body – whatever it is. The human body is incredible at self-organising itself and doesn’t need us to try and convince it we know better. Progressively expose yourself to more load and fearless experiment different “techniques” to find the most comfortable way to move and this will likely be the most efficient.
1. Alexander, N., Rastelli, A., Webb, T., & Rajendran, D. (2021). The validity of lumbo-pelvic landmark palpation by manual practitioners: A systematic review. International Journal of Osteopathic Medicine, 39, 10-20.
2. Kingma, I., Faber, G. S., & Van Dieën, J. H. (2010). How to lift a box that is too large to fit between the knees. Ergonomics, 53(10), 1228-1238.
3. Suri, P., Hunter, D. J., Jouve, C., Hartigan, C., Limke, J., Pena, E., … & Rainville, J. (2010). Inciting events associated with lumbar disc herniation. The Spine Journal, 10(5), 388-395.
4. Nolan, D., O’Sullivan, K., Newton, C., Singh, G., & Smith, B. E. (2020). Are there differences in lifting technique between those with and without low back pain? A systematic review. Scandinavian journal of pain, 20(2), 215-227.
5. Saraceni, N., Kent, P., Ng, L., Campbell, A., Straker, L., & O’Sullivan, P. (2020). To flex or not to flex? Is there a relationship between lumbar spine flexion during lifting and low back pain? A systematic review with meta-analysis. journal of orthopaedic & sports physical therapy, 50(3), 121-130.
6. Mawston, G., Holder, L., O’Sullivan, P., & Boocock, M. (2021). Flexed lumbar spine postures are associated with greater strength and efficiency than lordotic postures during a maximal lift in pain-free individuals. Gait & posture, 86, 245-250.