The age-old debate. We settle it once and for all.

Resources mentioned in the episode:

• You can bias lower abs from upper abs by doing posterior pelvic tilt vs ab curl here
• People with LBP lift with LESS flexion in their lumbar spine here
• There was low-quality evidence that greater lumbar spine flexion during lifting was not a risk factor for LBP onset/persistence or a differentiator of people with and without LBP here
• Only 4% difference in total load on the vertebrae during stoop vs squat lifting here
• Load shifts posteriorly away from disk as you flex here at close to full flexion less than a quarter of extensor moment is from disk and deep ligaments
• People lift more efficiently in spinal flexion (more efficiently = same force output with less muscle activity) here
• That’s probably why elite powerlifters increase spinal flexion automatically as they approach maximum loads here
• Spine posture in general has not been shown to be a causal factor in LBP according to a systematic review of systematic reviews in 2020 here
• Even lifting a box from knee height when instructed to keep the spine neutral, results in 22 degrees of lumbar flexion here
• Experienced physical therapists can’t detect lumbar flexion of less than 34 degrees during a squat here
• In lab experiments compressive load - not flexion or extension - causes disk injury here
• “Bad technique” doesn’t cause injury - Crossfit injury incidence is 0.27 - 3.3 per 1000 hours of training here
• Injury incidence in running is 2.5 - 33 which is almost exactly 10x higher here
• Injury incidence in ballet is 3.9-4.4 per 1000 hours - which is higher than Crossfit even though ballet dancers practice in perfect alignment here
• Most injuries in fitness centers result from people falling off equipment or dropping weights on themselves here
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