WARNING! Stop Wearing A Weightlifting Belt For Back Pain!

I once worked with a powerlifter who was trying to recover from a recent flare up of back pain. During one of our sessions where we were re-introducing the barbell back squat, he asked if he could use his weightlifting belt. In his mind, a belt was to be used any time you touched the barbell to keep your back safe. It was his reassurance that his back wouldn’t “go out” the next time he squatted heavy.

What I told him next may surprise you. What I’ve come to find is that a large majority of athletes and coaches are using belts incorrectly and many times for the wrong purposes. Let me explain.

WHY USE A BELT? 

Before we jump into the use of a belt in the context of back injury, lets first discuss why someone might wear one in the first place. Research shows that a weightlifting belt provides additional stability for your lower back.1 It does this by aiding your core muscles.

When we get under a heavy barbell, we need to take a big breath and brace our trunk muscles so that the weight on the bar does not bend us in two. This action of breathing and bracing of the core amplifies the pressure inside our abdominal cavity and creates tremendous stability. A helpful cue for some is to think “fill the tank” as you push your breath into your gut. If you do this correctly, you will feel your stomach rise and fall. Not your chest. This breath should then be held for the duration of a single repetition.

Essentially the volume of the body’s intra-abdominal cavity will increase when we take a big breath. If we couple this expansion in our core by bracing our trunk muscles, the pressure inside the abdominal cavity grows because the volume can no longer expand. This is how intra-abdominal pressure (IAP) is created.

Think of IAP like an unopened soda can. If you place a full unopened can of soda on the ground and stand on it, it will remain strong and won’t crumple under the weight of your body. This is because the pressure inside the can gives it strength and stability.

It is quite common to hear some coaches use the breathing cue, “inhale on the way down and exhale on the way up”. This is not appropriate if you are attempting to lift heavy weight. Could you imagine what would happen if a powerlifter started to exhale at the start of his squat ascent with 900+ pounds on his back? If you let your air out too soon during the ascent of the squat (or you don’t take a big enough breath at the start), you have already started draining your “tank” and ultimately cause a loss of stability. This is synonymous to opening the can of soda, draining it, and then trying to stand on it again. Obviously the can is instantly crushed under your body weight as the pressure inside was removed. In order to maintain the desired stability, hold your breath until you have passed the sticking point of the ascent (usually about ¾ of the way up) and then you can slowly let it out.

Proper breathing and bracing mechanics of the core muscles when lifting activate our body’s “natural weightlifting belt.” A weightlifting belt therefore is just another “layer” to our body’s “tank.” The belt does NOT replace our core muscles, but rather it acts as another restraint. This can be extremely helpful if your goal is to lift tremendous weight. In fact, research has shown that when use of a belt is combined with a correctly braced core and a held breath IAP values can increase anywhere from 20-40%, which means more trunk stability.2,4-6

HOW TO USE A BELT

When most use a weightlifting belt, they do so incorrectly. Ask yourself if this scene sounds familiar. You look towards the squat rack and see an athlete struggling with all their might to fasten their belt as tightly around their stomachs as possible as if they are donning an 18th century corset.

Proper use of a belt is much more than just wearing it tightly around your stomach! In order to properly use a belt, you must breathe “into the belt”. If you only cinch it tight, you miss out on the benefits the belt has to offer. Always think about expanding your stomach into the belt and then bracing against it.

Researchers have shown that athletes who wear a belt correctly tend to lift heavier weights with more explosive power. They are also able to maintain their trunk stiffness for more reps during higher rep maximum lifts like an 8 RM attempt.2,3

If you’re interested in purchasing a high quality belt that will last a lifetime, check out Cardillo belts.

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WHEN TO WEAR YOUR BELT

Most athletes start wearing a belt for the following reasons:

  • They observe elite athletes wearing them and think they need to wear one as well.
  • They want to lift heavier weight.
  • Their back is sore or starts to hurt and they think a belt will help.

Just because an elite athlete (who has spent years training and competing) wears a weightlifting belt, doesn’t mean you need to as well. First ask yourself this question, “Am I competing in a strength sport like weightlifting or powerlifting?”

If the answer is yes, I strongly encourage you to spend your first few years in training for that sport without using a belt. It is crucial during these early years to hone in on developing proper technique. Take this time to cultivate your “natural weightlifting belt.” Doing so will help you build a solid foundation of stability so that if you decide to use a belt when reaching for heavier weights one day, you can do so with better technique.

If you have no desire to compete in powerlifting or weightlifting, and instead use the weight room to train for other sports (such as football, basketball or baseball), I highly recommend limiting belt use to a minimum. You wouldn’t wear a belt while participating in any of these sports, so it’s probably not the best idea to wear one in the weight room. Instead spend your time building a stable torso and lifting with pristine technique.

There is nothing wrong with the desire to lift heavy, but it should not ever come at the expense of technique. While wearing a belt can be very helpful on heavy lifts, the long-term use of a belt on ALL lifts can have some harmful effects. By using a belt ALL the time, the body naturally starts to rely on the passive support the belt supplies. You can potentially weaken your core by relying on the belt as a crutch. Therefore, learning how to brace and create stability on your own with lighter weight should be the first priority of all lifters. For serious lifters, I recommend programming days of training with and without the belt so that you so you continue to build the capacity for maintaining stability with heavy lifting.

A belt should also never be used with the goal of taking away back pain or soreness. Doing so is like covering up a hole in your car’s tire with duct tape. It may give you some short term relief, but it is not a smart long term solution. Simply put, a belt has no place in the rehab process of back pain. Once pain has been completely eliminated with proper rehabilitation and an athlete has shown the ability to maintain sufficient technique and stability while training with moderate weight, you can then introduce a belt.

If you are currently dealing with back pain, the first step is to go through a proper screening process. Check out this BLOG POST to see how I recommend screening low back pain.

FINAL THOUGHTS

We should always work to ensure that we are lifting safely and with the best technique possible. A belt can facilitate this, especially with heavy weights. Some athletes will not use a belt, even with maximum attempts. That’s okay, as long as they maintain good technique. However, if you are going to use a belt you should know how to use one correctly.

Until next time,

Author Photo
Dr. Aaron Horschig, PT, DPT, CSCS, USAW

With

Kevin Photo
Dr. Kevin Sonthana, PT, DPT, CSCS

References

  1. Cholewicki J, Juluru K, Radebold A, Panjabi MM, McGill SM. Lumbar spine stability can be augmented with an abdominal belt and/or increased intra-abdominal pressure. Eur Spine J. 1999;8:388-395.
  2. Lander JE, Hundley JR, Simonton RL. The effectiveness of weight-belts during multiple repetitions of the squat exercise. Med Sci Sports Exerc. 1992 May;24(5):603-609.
  3. Zink AJ, Whiting WC, Vincent WJ, McLaine AJ. The effect of a weight belt on trunk and leg muscle activity and joint kinematics during the squat exercise. J of Strength Cond Res. 2011;15(2):235-240.
  4. Lander JE, Simonton RL, Giacobbe JK. The effectiveness of weight-belts during the squat exercise. Med Sci Sports Exerc. 1990;22(1):117-26
  5. McGill SM, Norman RW, Sharratt MT. The effect of an abdominal belt on trunk muscle activity and intra-abdominal pressure during squat lifts. Ergonomics. 1990;33(2):147-60
  6. Harman EA, Rosenstein RM, Frykman PN, Nigro GA. Effects of a belt on intra-abdominal pressure during weight lifting. Med Sci Sports Exerc. 1989;21:186-90

 

Published by

Dr. Aaron Horschig

Doctor of Physical Therapy, CSCS, USAW coach and athlete.

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