Insights into Deadlift progressions

: today's episode, insights into deadlift progressions. small hamstring tendinopathy. This podcast is designed to help you understand this condition, learn the most effective evidence-based treatments and bust the widespread misconceptions. My name is Brodie Sharp. I'm an online physiotherapist, recreational athlete, creator of the Run Smarter series and a chronic proximal hamstring tendinopathy battler. Whether you are an athlete or not, this podcast will educate and empower you in taking the right steps to overcome this horrible condition. So let's give you the right knowledge along with practical takeaways in today's lesson. written down. Bear with me for the echo. I'm in my new podcast studio and the walls are very empty and so sound is bouncing everywhere. I just got a text message just before we started recording that some of my artwork for the clinic for the studio is arriving today so that will definitely help things. I have written down a bunch of deadlift progressions today because A couple of things. One, I see a lot. People think that deadlifts are detrimental for them. They think deadlifts make things worse. They think they've tried deadlifts in the past and haven't worked, have just flared you up. So made the conclusion that deadlifts are not a good thing and maybe you should just stick to weighted bridges, which I always say. Um, so why did I decide to do the episode on deadlifts? I think everyone should be doing deadlifts some form of another, if you are recovering from PhD, if you are struggling to return to sport, if you're struggling with sitting, if you are struggling with, um, just loading up the hamstring in general, deadlifts are one of the one exercise that I think I include in all of my patients programs in some form of another. And so for those who are not familiar with a deadlift, it is kind of looks like a squat, except there's subtle differences with like sitting back in a sitting back kind of action. So if you can imagine you are holding on to some dumbbells or you're holding on to a bar and you're standing upright. and you want to hold on to those weights and kind of squat down. What you do is you're sitting back like you're sitting back into a chair, um, as the weight slightly, um, rolls down your thighs and past your knees and down your shins, and then you come back up into that standing position. Well, that's a, a Romanian deadlift anyway, which, um, I had the, the definition, let me have a look. So there's a difference between. just your classic deadlift and your Romanian deadlift. So in your classic deadlift, you can always just YouTube this if you're, it's not, if you're not receiving this or if it's just going straight over your head through this audio format. But if you have the bar on the ground, a pure classic deadlift, you're actually starting from the floor. The weights are on the floor. So you have to pick it up from the floor, come all the way up into standing and then back down to the floor. That's what a Romanian, that's what a classic deadlift is. with your Romanian deadlift, subtle differences, you're actually starting standing up. You're actually in the upward up position. So you pick the weights up, or you might wanna pick it up from standing if the weights are placed on something in front of you. And what you do from there is you slowly start to move it down either to your knees or to your shins, and then you come back up. So you don't necessarily need to go all the way down to the floor. And so a Romanian deadlift, starts to engage more of the glutes and the hamstrings, whereas the classic deadlift where you're picking the weights up from the floor actually engages a little bit more of your quads and mid-back. And so for a lot of my, unless you have like a weightlifting background and you want to get back into weightlifting, for most of my PHT clients, recommend the Romanian deadlift. So That's why I decided to do this episode. There's a lot of confusion. A lot of people think it's detrimental because it's fled them up in the past. Um, it's a common, it's a common thing that I see. Um, most people think deadlifts are bad for them because they've tried them in the past, maybe their PTAs put it in their program and then they have, it's fled them up and they're just, uh, too fearful, too worried that they'll get fled up again, so they've disregarded. deadlifts and say it's not part of my program, let me do something else that doesn't flare me up. Makes a total whole bunch of sense, but that's the idea of me starting this episode is that I can give you slow progressions because all that's happened is you've started a deadlift that has been too much for your hamstring. So only, um. only reasonable approach I take because deadlifts need to be in your program if you're doing some sort of strengthening is that we need to start with a modified version or like a really regressed kind of modification so it's super easy for you, the hamstring can tolerate it and then you slow the build your way up from there. So I have a whole bunch written down on my sheet of very, very slow progressions, how to start from absolute baseline and then work your way up. So I've started at the, like I said, the bare minimum, but when you're listening to this, you feel free to start at any stage. You didn't have to start at this bare minimum because a lot of you will have a capacity to jump in like maybe halfway through these progressions. but for someone who is not tolerating a lot, tolerating very little and still flaring up, I still need to cover these very bare minimums in order for them to have a starting point somewhere. So if you're listening to this, you don't have to start at these very, very start bare minimum basics. You can start halfway through and just based on symptoms, find your starting point and then work your way through. The other deliberate attempt I have done with this episode is to just... have these progressions in like very minute steps, but you feel free to progress as quickly as symptoms allow. You don't have to necessarily go through all of these methodical minute progressions, if that makes any sense. So I want to start with, if you can't do a deadlift, if you can't tolerate any version of a deadlift, I'd start with a hip hinge, which is I've described on this podcast a couple of times before. It's kind of like a Nordic. drop, feel free to YouTube this if you like. So most people are familiar with, you know, you're kneeling on the ground, your ankles are hooked or secure to the ground by like, you know, even moving it under a couch or moving it under some sort of weights, just securing them in place. Some of my patients have their partners or children like hold on to their ankles so they don't go anywhere. And instead of doing a Nordic drop where you're dropping your whole entire body forward, you're only just bending at the hips So everything stays nice and still back stays nice and flappy just dip forward at the hip like a drinking bird and then come back up but Understanding that's quite tough. You might want to start just with isometrics. So holding that position So you might want to dip forward with your body uh just maybe a quarter of the range and then just hold that hold that for 10-15 seconds come back up so we're introducing some form of compression we're introducing some sort of load to the hamstrings you might only want to do say um five second 10 second holds do that 10 times see how you respond and once you have progressed enough maybe getting to about three sets of 15 seconds, say. I probably should be a bit more clear with that one. So if you are dipping forward, you do that for 10 seconds, you come back up, that counts as one. If you do that five times, that counts as one set. If you're doing three of those sets, then, and your hamstrings are tolerating it quite well, then you're able to move into this first progression of deadlifts. And so the first progression I have for the deadlift is you start at the top, you hold onto your weights. It might be five kilos or like 10 pounds. So... very manageable and instead of doing the full range, moving down into a full deadlift and coming back up, if you can't tolerate that, what we can do is very basic, low range, isometric exercises. So you have your dumbbells, you hold them on your thighs and you just dip forward until the weights, until the dumbbells reach just above your knees. So you're still sitting back, you're still getting some of that compression and you sit back, the weights come just above the knees and then you just hold that. Hold that for 10 seconds, come back up, do that five times. That counts as one set and then take a rest. Do that for three sets. Sounds simple enough, but that can be the very first introduction into your deadlift progressions. And again, based on symptoms, if you feel quite comfortable with that, if that was really easy, then we can progress and we can progress by increasing the range of movement, still keeping to those isometrics. So isometrics is just a fancy word to say. holding. So we're not moving in and out of that range too quickly. We go down, we hold that position and then we come back up. And so we can progress to half range. So you might want to take sit back in that deadlift action. You might want to take those dumbbells or the bar a little bit just past the knees. So before we're on top of the knees. Now we're just past the knees doing those Romanian deadlifts. And again, you can do 10 second holds, you could do 15 second holds if you wanna progress that, do that five times, that counts as one set, do three sets. Once you've done say three quarters of a range and you're doing all three sets, you're managing that quite well, then we can start progressing by doing, working through range. And so when we start working through range, again, it doesn't need to be full range, it can be half, or it can be less depending on your symptoms. This is all just based on trial and error, based on how things are feeling. And so I've got an example here. Let's say we wanna just start, we've done all our isometrics and we're responding quite well. Now we wanna introduce some sort of movement set. We can start the first set. of an isometric. The first set can be totally isometric based on what you've done in the past. Then the second set can be this new movement deadlift. So you take the weights. you do that deadlift action, let's say we do half range. So we take our dumbbells just past the knees and then we come back up. So we're not holding it and we repeat that maybe 10 times. So deadlift down, past the knees, come back up, deadlift down, past the knees, come back up. So we're moving through that range. So first set was isometrics. second set was through range, then we can work out what we want to do for our third set. Maybe we do the isometrics or we repeat that second set through range. That's how we are slowly working our way to the full range three sets. normal kind of deadlift action. So let me recap. So we started with the hip hitches just in isometrics, just one quarter range, only just 10 seconds, five times for three sets. Then we, once we're negotiating that, we progress to our Romanian deadlifts, we're holding on to our weights of 10 pounds, 5 kilos, and then we just delve into isometrics. We work our way through the isometrics, and then we progress by slowly introducing the full range of movement deadlift with a couple of isometric sets here and there, depending on your symptoms. Once we've done that, we can start moving into three sets of deadlifts with our normal Romanian deadlifts. but we can start at half range. If that's good, then we can work our way to three quarters of a range. If that feels good, then we progress to full range. That might be through one set, two sets, three sets, however you want to manage it yourself. And pay attention here, this, when we get to this, this is probably, I've listed maybe six progressions already. Where we're up to right now in this episode, that's probably where most people start. They might start with three sets of three quarters of a range, Romania deadlifts, 10 pounds. They think that's the foundation. They think that's the bare minimum. And then they get flared up and then they believe that deadlifts are bad, but there's been so many progressions to get us to this point, if your capacity is, if you can't tolerate a lot of load at the moment. So. keep an eye out where we don't want to, you know, hit the ground running when it comes to our deadlifts if your capacity is quite low. So now we're going through full range. Let's say hypothetically we've progressed to we're doing three sets. We've got our 10 pounds, five kilos. We're working through range, maybe three quarters of a range, three sets doing 10 reps, something like that. then we can start progressing. We can start progressing by adding weight. We can go from our 5 kilos to 10 kilos or 8 kilos and just slowly work our way up. Most people know how to adjust that themselves so I don't need to go into too many details about how to increase weight. What I will say though is that you can progress the weight. It doesn't have to be the entire dosage where the weight is increased. I've got an example. So let's say you're used to doing three sets of 10 for deadlifts and you use 10 kilos and you want to progress that. You're, um, instead of jumping into all three sets being a heavier weight, we could go from 10 kilos, we can do that for our first set, then for the second set, you might want to increase the weights and do say 15 kilos. Then for the third set, you might want to drop back down and do 10 kilos. And so that's still a progression. Only one set has been increased, but then based on symptoms, if everything felt okay, next time you might want to do two sets of that 15 kilos. So in terms of sets, it might go 10 kilos, then 15, then 15. And you can judge that yourself. Um, you can have help a health professional or a PT or physio help guide you with that progression. But it's usually just based off symptoms, which hopefully you're familiar with earlier episodes of this podcast. Um, you might also, also in earlier episodes of the podcast, you might, um, have recalled pain symptoms during, now I haven't really discussed that yet in this podcast, but, um, pain levels of about a two or three out of 10 is acceptable during deadlifts provided that baseline symptoms return within 24 hours or that pain levels are very minimal after the cool down later on that day and the next morning and 2 hour 3 hour 10 pain is like a you know you can notice it there it's a little bit uncomfortable but it's not severe enough for there to be like a lack of confidence in producing force through that. through that side, like you still feel quite strong, you still feel quite powerful, you still feel like you can lift it on your own, you don't have to rely on the other side to do it. It's just, you just notice that they're in the background. And so, just to recap, so we've gone from our isometrics, we're then moved into three sets of 10, full range, but now we're increasing the weights. We're slowly increasing the weights and we're... aiming for this 2 to 3 out of 10 pain. And you might actually want to what I call chasing 2 to 3 out of 10 pain. This is once the tendon itself becomes a bit more stable. I've experienced this a couple of times as well because I in the past when I have had a PHT flare up, but I still recognize my tendons are quite strong. I follow this all the time. So I might say, okay, my hamstrings are sore, time for me to really focus on deadlifts. I have been doing them, say, once or twice a week. Now I need to do them maybe every second day to get this flare up under control. So I start my deadlifts, let's say I start with 20 kilos, and there's a two, let's just say there's a three out of 10 pain during that set. I might then... start my second set and it's only a one or two out of ten pain so based on that first set my tendons are actually feeling better because they love the slow heavy load but I think I want to challenge my tendons more by staying or chasing that two to three out of 10 pain. So right now during my second set, if it's a one or two, I might increase that weight, say to 25 kilos, so that it still remains a two or three out of 10 pain. That way I'm still loading it under these acceptable conditions. And so during that second set, Um, my third set might actually feel a bit better. My, my third set at that 25 kilos might be a one or two out of 10. So for the third set, I might want to increase the weights again to say 30 kilos and load it up again. So my tendons, um, not just for the high hamstring, but for my knees, for my, um, feet in the past, when you do slow heavy load, it, the tendons feel great because of it. And I just. progress and chase that within that set within that workout in order to reach those acceptable pain levels. Hope that made sense. This podcast episode is sponsored by the Run Smarter Physiotherapy Clinic, which is my own physio clinic where I help treat a wide range of PHT sufferers, both locally in person and all over the world with online physiotherapy packages. In the years I've been self-employed as a physio, close to 70% of my entire caseload has been helping people with proximal hamstring tendinopathy, which is why I decided to launch this podcast. So if you're building upon your own rehab knowledge through the podcast, but still require tailored assistance, I'd love to be on your rehab team. Whether you are a runner or not, head to runsmarter.online to see your available options for working together. If you're still unsure if physiotherapy is right for you, or if you need a rehab second opinion, you can always schedule a free 20 minute injury chat with me. Find the free injury chat button on my website or in the podcast show notes to be taken to my online calendar to book in a time. Okay, so continue to move forward. We're feeling good. We're increasing the weights in our deadlifts. We're doing full dosages, full range, and we're starting to get a bit more. confident, we're starting to respond quite well to these heavy loads, making good progress. Now it's time to kind of have it in our regular routine of increasing and making sure that we're being progressive with our with our weights because I see this so many times, people start to feel good with their certain exercises and they think they think it's doing a lot of benefit, which it is, but then they just keep to that dosage for four weeks, several months sometimes, sometimes even more. Sometimes after 12 months, people just do the same dosages without progressing where all the evidence points to your rehab needs to be progressive. Otherwise the tendons are gonna get quite complacent. You're not gonna trigger any adaptation to get stronger and tolerate more loads. And so you do need to be quite progressive, even though it's slow, it needs to be considered. So what I've done, especially when with my usual routine, when I'm feeling quite good and I'm recovering well, my legs are feeling good and I only get maybe one or two days of maybe one day of delayed onset muscle soreness the next day, I found myself a really nice routine where I have deadlifts say, two months ago I was doing deadlifts and I was doing 30 kilograms. And so I do my three sets of eight. Next week I do 30 kilograms, so same weight, three sets of 10. Next week I do three sets of 12. So I'm progressing by the reps, but then when I get to three sets of 12, I don't want to increase the reps beyond that. So what I do is I increase my weight by five kilos, so I go from 30 to 35 kilos, and then I drop my sets down to eight again. So I've increased the weight, dropped my reps down to three sets of eight, and then I repeat. So one week I'll do three sets of eight. Next week I'll do 3 sets of 10, next week I'll do 3 sets of 12, then I increase from 35 to 40 kilos and I drop back to 8. And so I have gradually worked on that, built that up, I'm up to 40 kilos now. of that has been on hold. I've been at 40 kilos for maybe three or four weeks now only because I've moved house and a lot of stress, not a lot of sleep and don't want to progress while I'm in this kind of stress, not stressed out, but it's a pretty big life event. And due to COVID and all that sort of stuff, it's had its hassles. So I've made the conscious decision to not progress, but once things start getting in, um, if I start feeling a really good space, my recovery is starting to be really good, this is the same method that I'm going to adopt. So 8, 10, 12 reps, increase the weight, drop back to 8 and then repeat. I will definitely hit a plateau with increasing by 5 kilos, because that is quite a big jump every, you know, three weeks or so. But my progression will still be the same but instead of increasing by five kilos I might increase to two and a half kilos something like that. Keep that in mind it might plateau out but the idea to continue progressing is always there. So that's the next progression so by this stage you are feeling really good you are feeling really strong. tolerating a lot of compression. This is where your sitting becomes more tolerable because the tendons can tolerate more compression. Your running starts to improve, cycling starts to improve just because that overall hamstring tolerance is building up. Now I have the next progression which is introducing power, it's introducing speed because at the moment all it is a slow heavy load which tendons love. but in order for us to make sure we're covering all the rungs on your rehab ladder. So at the top of that rehab ladder is the demands that you require in your sport or in your athletic endeavors. And so if a lot of that is like sprinting for running, if a lot of it is changing direction, jumping, landing, a lot of power-based sort of stuff, you need to introduce power and speed into your workouts in order to complete those rungs on that rehab ladder. And so kettlebell swings is a good progression. You might wanna do that maybe once a fortnight. It has that deadlift action. So that's why I've included this in as a deadlift progression. But doing kettlebell swings like doing a power speed movement into that deadlift action. But you also might want to do if you're not familiar with kettlebell swings is just within your deadlift set, maybe once a week, maybe once a fortnight, you might want to do a set, a set or two where you go very slow down into your into the deadlift action, but then you increase the speed back up. So it's a slow eccentric and a strong fast concentric phase. So slowly lowering the weights and then quickly bringing it back up to that starting position. So we're introducing speed into those deadlifts. Now if you are doing those speed sets, you might want to reduce the weight. Or you might want to reduce the reps because that requirement for the hamstrings is quite a big jump. So you might want to make a conservative effort just to drop back off a few of those variables. Introduce that speed if you haven't done it for a while. If you feel fine. If the next day things are okay then you can continue progressing. But... Introducing speed, introducing power. We do want to be a bit creative depending on you as the individual, depending on your goals. Like I said, you might be a sprinter, you might want to do team sports or like a lot of the PHT clients I see, you just might want to... sit for more than an hour, you might want to sit for a two hour car drive that if that's just your goal and you don't want to return to running, then maybe perhaps you might just continue doing the slow heavy stuff into compression, or just doing more exercise into compression so the tender can tolerate compression which is sitting. So it all depends on the individual at this stage of your progressions, we want to get a little bit more specific around the goals that you have. But at least this is getting you to a stage where you're fit, healthy, strong capacity. Um, and I should say, like, as we're wrapping up this episode, like these progressions, this style of progressions, this can, you can do this with any exercise, we can do this with your bridging, we can do this with lunges, we can do this with a single leg deadlift. Um, it's all a bit of, um, it does require a bit of assistance, like sometimes say like physios, me for example, I work with PhD clients all the time, very used to these sort of progressions or suggesting these progressions and if it's all a bit too much, if you get a bit too flustered, if it all seems like it's a bit... if you're unable to manage on your own, that's when you require assistance. That's when you might want to get a health professional to coach you through these progressions, um, and just lay out a plan. And so you don't have to do any of the thinking yourself. You just have these, the plan, um, moving forward. And so as we wrap up a bit of a recap, so you might want to start with just isometrics might just be lightweight, half range of movement or a quarter range of movement, just hold. See how that feels. Once you start to tolerate isometrics quite well, we can work one, two, three sets into movement. Might only be half movement, but slowly. progressing to the point where you're doing all three sets through movement and all three of those sets are through full range then we start to increase the reps that's when we start to increase the weight that's when we're progressing with our weight and start getting really strong and building up a lot of capacity in that third stage slowly starting to introduce speed depending on your goals and your athletic endeavors. That's it for today's episode. Hopefully I've convinced you, hopefully for those who are listening, the thought that deadlifts have fled them up in the past, they're no good, never going to do them again. Try something else. Hopefully this kind of convinces you to at least make a start, or at least try to start and see how the hamstring feels. If you do need guidance, I'm obviously here. I do online physio with PhD clients all the time. Feel free to jump on a, an injury chat with me. in every episode in the show notes. There's a link to jump in for a free 20 minute injury chat. And I'd love to have a discussion and see what we can do if there's any missing pieces in your rehab. Okay, guys, I have a few I'm trying to get a hold of a few more success stories in the pipeline, because I know you guys love those. So I'll keep in mind to do a few more of those in the future. And we'll catch you next time. Thanks once again for listening and taking control of your rehab. If you are a runner and love learning through the podcast format, go ahead and check out the Run Smarter podcast hosted by me. I'll include the link along with all the other links mentioned today in the show notes. So open up your device, click on the show description, and all the links will be there waiting for you. Congratulations on paving your way forward towards an empowering, pain-free future. And remember, knowledge is power.