Anna Risius Physio

Anna Risius Physio ACPAT Chartered Physiotherapist

18/03/2026
I was talking about this research with a patient the other day!I feel itโ€™s not how you lift, itโ€™s how much and how frequ...
14/03/2026

I was talking about this research with a patient the other day!

I feel itโ€™s not how you lift, itโ€™s how much and how frequently you lift, and making sure your body is fit for whatever tasks you are doing ๐Ÿ’ช๐Ÿ‘Š๐Ÿ‘

๐—ง๐—ผ ๐—™๐—น๐—ฒ๐˜… ๐—ผ๐—ฟ ๐—ก๐—ผ๐˜ ๐˜๐—ผ ๐—™๐—น๐—ฒ๐˜…? ๐——๐—ฒ๐—ฏ๐˜‚๐—ป๐—ธ๐—ถ๐—ป๐—ด ๐˜๐—ต๐—ฒ "๐—ฆ๐˜๐—ฟ๐—ฎ๐—ถ๐—ด๐—ต๐˜ ๐—•๐—ฎ๐—ฐ๐—ธ" ๐—Ÿ๐—ถ๐—ณ๐˜๐—ถ๐—ป๐—ด ๐— ๐˜†๐˜๐—ต

โ—ผ๏ธ Low back pain (LBP) is the leading cause of disability worldwide, and lifting objects is commonly blamed as a primary risk factor.
โ—ผ๏ธ For decades, workplace safety guidelines and healthcare professionals have preached a universal rule: avoid bending your spine and lift with a "straight back" to prevent injury.
โ—ผ๏ธ But what if this deeply ingrained public health dogma isn't actually supported by science?
โ—ผ๏ธ A fascinating systematic review and meta-analysis by Saraceni et al. (2020) set out to investigate the core idea behind this rule.
โ—ผ๏ธ The researchers asked two fundamental questions: Is lifting with a flexed lumbar spine actually a risk factor for developing or worsening LBP? And do people with LBP actually bend their spines more during lifting than people without pain?
โ—ผ๏ธ Here is a deep dive into the idea behind the review, what the researchers found, and why it might change how we think about lifting.

๐Ÿง  ๐—ง๐—ต๐—ฒ ๐—ข๐—ฟ๐—ถ๐—ด๐—ถ๐—ป ๐—ผ๐—ณ ๐˜๐—ต๐—ฒ "๐—ฆ๐˜๐—ฟ๐—ฎ๐—ถ๐—ด๐—ต๐˜ ๐—•๐—ฎ๐—ฐ๐—ธ" ๐——๐—ผ๐—ด๐—บ๐—ฎ

โ—ผ๏ธ The advice to maintain a straight back or neutral spine while lifting didn't come from nowhere.
โ—ผ๏ธ It was largely based on early cadaveric studies, which demonstrated that a dead spine is more susceptible to structural failure when it is repeatedly flexed and compressed at the same time.
โ—ผ๏ธ However, dead tissues do not accurately represent living, breathing human bodies.
โ—ผ๏ธ The researchers noted that we do not fully understand how applicable these cadaver studies are to real-life, in vivo (living) lifting situations.
โ—ผ๏ธ In fact, recent biomechanical studies on living humans show that spinal loads (disc pressure, compression, and shear strain) are actually very similar whether you lift with a flexed spine or a straight spine.

๐Ÿ“Š ๐—ช๐—ต๐—ฎ๐˜ ๐˜๐—ต๐—ฒ ๐——๐—ฎ๐˜๐—ฎ ๐—”๐—ฐ๐˜๐˜‚๐—ฎ๐—น๐—น๐˜† ๐—ฆ๐—ต๐—ผ๐˜„๐˜€

โ—ผ๏ธ To test the idea that spinal flexion is dangerous, the researchers analyzed 12 independent studies involving nearly 700 participants.
โ—ผ๏ธ They compared the lumbar spine kinematics (movement) of people with LBP to those without it during natural, unconstrained lifting tasks.
โ—ผ๏ธ The findings were highly consistent and directly challenge conventional wisdom.
๐Ÿ”น No increased risk:
โ—ผ๏ธ There is no credible longitudinal or cross-sectional evidence showing that greater lumbar spine flexion during lifting is a risk factor for the onset or persistence of LBP.
๐Ÿ”น No significant difference:
โ—ผ๏ธ Most studies found absolutely no difference in peak lumbar spine flexion between people who have LBP and people who are pain-free.
๐Ÿ”น Less flexion, not more:
โ—ผ๏ธ When differences were observed, the data actually trended in the opposite direction.
โ—ผ๏ธ Several cross-sectional studies revealed that people with LBP often lifted with less lumbar flexion than healthy controlsโ€”likely as a protective adaptation to pain or because they were previously advised to keep their backs straight.
โ—ผ๏ธ In short, out of 43 different lifting comparisons analyzed in the review, only two suggested that people with LBP used more spinal flexion, while the vast majority showed no difference or less flexion.

โš ๏ธ ๐—ช๐—ต๐˜† ๐—ง๐—ต๐—ถ๐˜€ ๐— ๐—ฎ๐˜๐˜๐—ฒ๐—ฟ๐˜€: ๐—ง๐—ต๐—ฒ ๐——๐—ฎ๐—ป๐—ด๐—ฒ๐—ฟ ๐—ผ๐—ณ ๐—™๐—ฒ๐—ฎ๐—ฟ

โ—ผ๏ธ The idea behind this review extends beyond just body mechanics; it touches on psychology.
โ—ผ๏ธ LBP is strongly influenced by biopsychosocial factors, including negative beliefs and a fear of movement.
โ—ผ๏ธ When authorities constantly warn people that bending their back is dangerous, it can create a pervasive fear of normal human movement.
โ—ผ๏ธ Because there is no in vivo evidence to support the warning that lumbar flexion causes LBP, the researchers argue that continuing to prescribe the "straight back" advice is unjustified and potentially harmful if it makes people unnecessarily afraid to move their bodies.

โš–๏ธ ๐—ก๐˜‚๐—ฎ๐—ป๐—ฐ๐—ฒ ๐—ฎ๐—ป๐—ฑ ๐—Ÿ๐—ถ๐—บ๐—ถ๐˜๐—ฎ๐˜๐—ถ๐—ผ๐—ป๐˜€

โ—ผ๏ธ While the idea that we don't need to fear spinal flexion is liberating, the review does come with a few important caveats.
๐Ÿ”น Low-Quality Evidence:
โ—ผ๏ธ The researchers graded the overall quality of the available evidence as "low," largely because biomechanical studies often use small sample sizes and different motion-capture methods.
๐Ÿ”น Weight Limits:
โ—ผ๏ธ The studies included in the review only tested participants lifting objects weighing up to 12 kg (about 26.5 lbs).
โ—ผ๏ธ Therefore, these findings confidently apply to everyday lifting, but we cannot safely extrapolate them to heavy occupational lifting or maximum-effort weightlifting.
๐Ÿ”น Laboratory Settings:
โ—ผ๏ธ All the analyzed studies took place in labs, meaning we need more field-based research to see how these mechanics play out during repeated manual labor in actual workplaces.

โœ… ๐—ง๐—ต๐—ฒ ๐—ง๐—ฎ๐—ธ๐—ฒ๐—ฎ๐˜„๐—ฎ๐˜†

โ—ผ๏ธ The central idea of this comprehensive review is a paradigm shift: there is no credible evidence that bending your lower back when you lift causes low back pain.
โ—ผ๏ธ While we still need more research on heavy occupational lifting, the current science suggests that the human spine is robust and capable of bending safely.
โ—ผ๏ธ Instead of fearing flexion and forcing a rigid "straight back," we may need to rethink our approach to manual handling and focus on building resilience rather than restricting natural movement.

-----------------
โš ๏ธDisclaimer: Sharing a study or a part of it is NOT an endorsement. Please read the original article and evaluate critically.โš ๏ธ

Link to Article ๐Ÿ‘‡

31/12/2025

Happy New Year! ๐Ÿฅณ

We are moving from the year of the snake ๐Ÿ to the year of the horse ๐Ÿด - I am hopeful!

Looking forward to working with you all in 2026

๐Ÿพ๐ŸŽ๐Ÿƒโ€โ™€๏ธโ€โžก๏ธ๐Ÿ™‹โ€โ™€๏ธ

Wishing everyone a very merry Christmas!๐ŸŽ„๐ŸŽ…๐ŸŽ‰
23/12/2025

Wishing everyone a very merry Christmas!๐ŸŽ„๐ŸŽ…๐ŸŽ‰

05/12/2025
Autumn walks ๐Ÿ‚๐Ÿ๐Ÿงก
30/10/2025

Autumn walks ๐Ÿ‚๐Ÿ๐Ÿงก

27/10/2025

๐Ÿ’ช 4-Week, 5-Minute Daily Eccentric Exercise: Big Benefits in Little Time

Even just 5 minutes of daily home-based eccentric training for 4 weeks can yield remarkable results for physical fitness, mental wellbeing, and adherence โ€” especially in previously sedentary individuals.

๐Ÿ”‘ Key Findings

๐Ÿฆต 1. Improvements in Physical Fitness

โ–ช๏ธ Muscle Strength:
Significant improvements were noted in Isometric Mid-Thigh Pull (IMTP) strength, which increased by 13.0 ยฑ 18.5%. The change in IMTP was significantly greater during the training period compared to the control period.

โ–ช๏ธ Strength Endurance:
Significant gains were observed in both push-up endurance (66.1 ยฑ 86.5% increase) and sit-up endurance (51.1 ยฑ 78.7% increase). The change in performance for both push-ups and sit-ups was greater during the training period than the control period.

โ–ช๏ธ Flexibility:
Sit-and-Reach (S&R) flexibility increased by 9.1 ยฑ 20.0%.

โ–ช๏ธ Cardiorespiratory Efficiency:
The Heart Rate (HR) change during the 3-minute step test decreased by 4.8 ยฑ 7.1%, suggesting improved cardiorespiratory efficiency.
The Rating of Perceived Exertion (RPE) reported after the 3-minute step test also decreased significantly.

๐Ÿง  2. Improvements in Mental Health and Perception

โ–ช๏ธ Mental Health Scores:
Mental health scores improved significantly, with the SF-36 survey increasing by 16 ยฑ 29% and the Subjective Vitality Scale (SVS) increasing by 20 ยฑ 3%.

โ–ช๏ธ Subjective Vitality:
The change in SVS was significantly greater over the training period compared to the control period.

โ–ช๏ธ Perceived Health:
After the 4-week intervention, participants highly agreed that they felt โ€œstrongerโ€ (81 ยฑ 10%), โ€œfitterโ€ (71 ยฑ 16%), and โ€œhealthierโ€ (78 ยฑ 12%).

๐Ÿ“ˆ 3. High Adherence and Retention

โ–ช๏ธ Adherence Rate:
Adherence to the daily program was high, averaging 91 ยฑ 12% (18โ€“28 sessions over 28 days).

โ–ช๏ธ Enjoyment and Recommendation:
Program enjoyment was high (89 ยฑ 10%), and recommendation to family or friends was 91 ยฑ 10%.

โ–ช๏ธ Continuation of Exercise:
Post-intervention, all participants showed a willingness to continue some form of exercise.
Four weeks after the intervention ended, 83% of the participants eligible for follow-up reported continuing to exercise.

โš–๏ธ 4. Measures Showing No Significant Change

โ–ช๏ธ Body Composition:
No significant changes were detected in body mass, fat mass, or lean mass.

โ–ช๏ธ Maximal Movement Tests:
Handgrip (HG) strength, squat jump (SJ), and countermovement jump (CMJ) did not significantly change.

โ–ช๏ธ Health Markers:
No significant changes were observed in resting heart rate, blood pressure, or blood markers (including glucose, insulin, cholesterol, and hsCRP).

โœจ

๐Ÿฉบ Clinical Implications

โฑ๏ธ 1. Overcoming Barriers to Exercise

โ–ช๏ธ The primary implication is that this minimalistic eccentric-focused protocol offers a promising solution to address the common barrier of perceived lack of time, which often hinders exercise participation and adherence.

โ–ช๏ธ Minimal Time Commitment:
Requiring only 5 minutes daily, the program effectively encourages sedentary individuals to incorporate exercise into their routine.

โ–ช๏ธ Facilitating Adherence:
The combination of short duration and flexible timing were identified by participants as key facilitators of adherence.
This "minimalistic" approach may combat sedentary behavior by producing detectible outcomes quickly, thereby increasing an individualโ€™s perception of their own competence and facilitating long-term engagement in physical activity.

โ–ช๏ธ Foundation for Future Activity:
The program may serve as a crucial foundation for establishing a consistent exercise routine, potentially leading individuals to progress to more robust exercise programs as their fitness improves.

โœจ

โš™๏ธ 2. Specificity of Adaptation

โ–ช๏ธ The results emphasize the principle of mechanical specificity.
Since improvements were seen mainly in tests that closely matched the training exercises (IMTP, push-up, sit-up), while tests requiring explosive, high-velocity movement (SJ, CMJ) did not improve, it suggests that future programs should be designed specifically according to the individual's main movement goals.

โœจ

๐Ÿ’š 3. Dual Benefit to Physical and Mental Health

โ–ช๏ธ The simultaneous improvements in physical metrics (strength, endurance, flexibility, movement economy) and mental wellbeing (SF-36, SVS) are clinically important, suggesting the exercise offers a holistic benefit.
โ–ช๏ธ The noted correlations between physical outcomes (S&R, 3-min step test HR) and mental health scores suggest an interconnectedness that warrants further investigation.

โœจ

โค๏ธโ€๐Ÿ”ฅ 4. Cardiovascular and Functional Health Trends

โ–ช๏ธ The decrease in RPE during the step test, coupled with the reduction in exercise HR, is of practical significance, as reduced perceived effort makes individuals more likely to complete activities.
โ–ช๏ธ Additionally, the observed 9% increase in S&R distance suggests broader benefits, potentially contributing to improvements in activities of daily living.
โ–ช๏ธ While blood pressure changes were not statistically significant overall, the reduction of 5 mmHg or greater in systolic blood pressure seen in 7 participants suggests a possible benefit that could become clinically relevant if the intervention duration were extended.

-----------------
โš ๏ธDisclaimer: Sharing a study or a part of it is NOT an endorsement. Please read the original article and evaluate critically.โš ๏ธ

Link to Article ๐Ÿ‘‡

Exercise first!Physiotherapy can help you find and achieve the level of exercise that is most comfortable and effective ...
11/10/2025

Exercise first!

Physiotherapy can help you find and achieve the level of exercise that is most comfortable and effective for youโ€ฆbefore turning to pills or surgery ๐Ÿ’ช๐Ÿ‘

Stiff knees, aching hips and the slow grind of chronic joint pain are often accepted as an unavoidable part of getting older.

The annual weekend of learning! ๐Ÿค“
05/10/2025

The annual weekend of learning! ๐Ÿค“

06/09/2025

Good luck Alex and Eddie! ๐Ÿ€
30/08/2025

Good luck Alex and Eddie! ๐Ÿ€

With little over a week to go โ€˜til the start of Burghley 5*, we are excited to say that Ardeo Premier (aka Eddie) is feeling amazing!!
Itโ€™s always a huge effort to get a horse to this level and Iโ€™d like to thank my whole team!
I canโ€™t wait ๐Ÿ˜Ž
fansEquilibrium Products
Equiclass Boots
WeatherBeeta UK
Henry James Saddlery
Protexin Equine
Devoucoux
Connolly's RED MILLS
British Eventing Support Trust
Better4Hooves
Flex-on
Gatehouse Hats
Event Collection
LotusRomeo
GS Equestrian & Country
Cannington Enterprises Ltd
FLAIR Equine Nasal Strips
Dengie Horse Feeds

Great visit to Harry Derham racingโ€™s stable tour as part of national racehorse week.  Lovely set up with happy horses an...
30/08/2025

Great visit to Harry Derham racingโ€™s stable tour as part of national racehorse week. Lovely set up with happy horses and the boys were chuffed with their horseshoes!
A pleasure to teach the younger generations about manโ€™s relationship with the mighty thoroughbred ๐Ÿ™Œ๐Ÿคฉ๐Ÿ‡
Best of luck for the season ahead!


Address

Somerton
Somerset
TA11

Alerts

Be the first to know and let us send you an email when Anna Risius Physio posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Share

Share on Facebook Share on Twitter Share on LinkedIn
Share on Pinterest Share on Reddit Share via Email
Share on WhatsApp Share on Instagram Share on Telegram