140. Deadlift Variations 101: From Conventional to Sumo and Beyond

In this episode of PT Snacks Podcast, we dive into the world of deadlifts, exploring various types including conventional, Romanian, stiff leg, hex bar, and sumo deadlifts. The episode highlights the importance of understanding different deadlift variations for effective patient rehab. Learn how these exercises differ in muscle activation, setup, and application to tailor treatments based on individual patient needs. 

00:00 Introduction to Deadlift Variations

01:05 Overview of Deadlift Basics

02:09 Conventional Deadlift Setup

02:51 Variations in Deadlift Activation

04:25 Romanian Deadlift

05:17 Stiff Leg Deadlift

05:52 Hex Bar/Trap Bar Deadlift

06:26 Sumo Deadlift

06:58 Comparing Deadlift Variations

07:07 Choosing the Right Deadlift for Patients

08:25 Equipment and Load Considerations

10:03 Coaching and Rehab Applications

Transcript

0:27

Today we're gonna dive into more on deadlifts, not just conventional deadlifts, but a little bit more on the different variations that we see, how they differ and why we might use one versus another. Hey everyone. Welcome to PTs Snacks podcast. This is Casey, your host, and if you're tuning in for the very first time, what you need to know is that this podcast is meant for physical therapists and physical therapist students who are looking to grow your fundamentals in bite-size segments of time. And before we dive in today, if you are in the need for CCUs and are on a budget, med Bridge is actually offering listen listeners a huge discount, like we're talking over a hundred dollars off for a year subscription For online CCU courses, you can do at your own PACE webinars and specialty exam prep courses like the OCS and SCS. I used it for my OCS but just check out the proma code in the show notes. And also if you're a student, you get an even bigger discount. So don't miss it on that. But now diving into today's topic, we're gonna talk about deadlifts. And I don't know about you, but in PT school I learned a lot about more so diagnoses, anatomy, all that kinda stuff. Not as much strain in conditioning. That's not to knock on PT school. There's only so much time to learn everything. So today we're gonna be talking more about. The deadlift, the very basic setup and all the different types just to build familiarity with the different variations. So that if you have a patient that maybe needs one variation versus another, or they're describing a certain lift that they wanna get back to, or that they've been doing that you have a good idea on that and you can use it in your rehab with your patient. Now when we're talking about deadlifts, essentially this is a posterior chain dominant exercise. But essentially by the time we're done with this episode, you should be familiar with the deadlift, the different variations that. Are most common and some things to keep in mind in how to utilize this with your patient. So when we're talking about a conventional deadlift, this is essentially where you're gonna set up feet about hit width Arms are gonna be outside the thighs and bar positions gonna be over the midfoot. Goal here is to keep the bar path over the midfoot. When, what I mean by bar path is essentially when you're lifting up the bar and you're looking from the side, you can draw a straight line up from the floor to the ceiling. It's not moving back and forth. That is an issue We could probably dive in more in the future of there's a lot of extra energy being expended with inefficiencies. So goal is for a vertical bar path. Now with deadlifts in particular. We are gonna see different changes in activation between variations, mainly dependent on the amount of hip flexion in relation to knee flexion, that lift is taking someone through. Other factors also where the feet are in position to the bar, what piece of equipment that you're using, the person's body anthropometrics, and then also even some of the studies that we're looking at in a lot of these biomechanical models, keep in mind that some of these studies not every single one is in agreement. And the reason being that a lot of these study studies. May or may not indicate where. The electrode location, the size, the inter electrode distance that was used. All of these things need to be reported in order to replicate the exact results. Other things to consider is, in a lot of these studies, it's not necessarily indicated whether that patient was lifting in a concentric or eccentric phase. Also. When trying to skit the maximum voluntary contraction studies don't always indicate whether the isometric contraction that is being conducted, is pushing or holding to get. That contraction. So with that, we do see some variations. So I'm gonna keep things pretty vague so that you're using your own discretion and as more and more research gets out comes out, then you're able to piece that to a basic framework of these different variations. But the variations that we're gonna talk about today, besides the conventional deadlift, is the Romanian deadlifts. Stiff leg deadlift hex bar or trap bar deadlift and the sumo deadlift. So with the Romanian deadlift, the stance is gonna be the same as the conventional, meaning bow, shoulder width feet are right outside the thighs. The thing is, the knee joint angle is not gonna be exceeding more than typically about 50 degrees of flexion during the lift, so definitely a lot more movement around the hip joint rather than the knee joint, and the barbell is gonna stay in contact with the legs throughout the execution. In terms of activation, studies have found a high biceps femoris activation mainly, and then gluteus, gluteus maximus and quadriceps activation. It also has a high gastroc activation. Now with the stiff leg deadlift, it is not much knee flexion at all. Mainly working through the hip extensors. It's the same stance as the Romanian, but the bar is not in contact with the legs. The bar path is gonna be slightly in front. It's going to involve more posterior chain than quads in this lift and. While there is some controversy and differences in activation between the semi tendinosis and biceps smores, we do see a high tibialis and director spine eye activation. In a hex bar or trap bar or deadlift, that is where you're lifting with a different bar that is like a cage around the person, it's gonna allow a more upright body. People tend to be able to lift more. With this particular lift, it does reduce spinal compression loads and has an increased activation of knee extensors in relation to the conventional deadlift, as well as more glute max compared to biceps for morriss activation and more. VAs lateral is then biceps femoris activation as well. With our sumo deadlift, the stance set up is gonna be a little bit different, with this, the hand grip is going to be between the legs and stance wider than shoulder width, maybe with toe out with varying degrees. It is going to allow a more erect back alignment, which requires greater recruitment of hip musculature, and it will have a high activation of the vastus lateralis and medias and gluteus maximus, as well as a lot of gastroc anemia. When we're comparing all of these, I would encourage you to look at pictures of these. Then the question is like, why are all these lifts out there? What do we do with all of these? And a common theme that we find throughout these is when a lift has less knee flexion tends to be less quad involvement, whereas more knee flexion means more extensor musculature being used. So point number one, we can see if we are treating someone and we want to utilize more quads, maybe we wanna use a lift that has a higher activation of quads, or maybe we're trying to use the quads a little bit less. Maybe we wanna use a lift that has a lesser quad activation, and we use some of these other ones that are mentioned, like more of the Romanian or stiff like deadlift. On the flip side with. Lifts that use less quad activation and a higher degree of biceps mors involvement. For instance. This has an impact on if someone is recovering from, let's say, a mid belly hamstring strain, and if they have not quite done the rehab to build up to that might be pretty intense of an exercise versus we need to get them back to sprinting. This might be a great exercise to work them towards that stage where they're starting to work into return into sport. With, let's say barbell versus Hex X-bar 0.2, the equipment can change things. So with the hex bar, the displacement of load in relation to the body mass is at both sides of the patient. And this allows it to shift a little bit more of that load into the knee sensors rather than a barbell that's in front of the patient. So with that, again. That allows a more upright torso. It also allows more quad activation. So maybe someone who's recovering from a back injury and can't tolerate the higher hip pinche maybe a hex bar is a good place to start. Whereas if we are trying to load them more into a hip pinch or maybe they're getting back to CrossFit, we wanna make that more specific to them then we're working them more into a barbell. There are of these lifts. Some lifts is point number three that can tolerate more weight being loaded than others. In a lot of these studies, higher loads allow for higher muscle activation, but loads where the barbell is away from the center of mass. Cause a lever angle to increase and it limits the ability of the body to be able to handle higher loads. And we're talking here about the stiff leg deadlift and the Romanian deadlift, whereas lifts like the conventional sumo and the hex bar, the bar and the body are lifting together as one unit. So tend to be able to handle higher lows at that level. Now, keep in mind that beyond using different lift variations, there's also a lot of ways if we are trying to work people towards sport and being able to work around injuries and things of that sort, we still wanna make sure that we can actually coach these lifts, and that's probably gonna be a topic for a future episode on coaching specific errors in fixes. But essentially what you should have gotten from this episode is not necessarily the answer for what to do with your patient, but a further. Analysis of why you're using certain lifts versus others. Why might you use a conventional dead lift versus a X-bar, Romanian stiff leg, sumo, et cetera. And a lot of your whys should be dictated by. What your patient can tolerate, what they're trying to get back to doing, what exactly you're treating, and whether that specific tissue of what you're treating is ready for a particular load, or if you need to adjust the lift that you're doing for that particular load. Yes, you can also. When you are rehabbing someone, limit the overall load. They're lifting the range of motion that they're lifting through other additional lifts that can help them be able to tolerate more weight in the first place beyond just going right into a deadlift. But it is important to. Not only be good experts in strength and conditioning and be able to coach our patients effectively but to be able to understand its impact in rehab so that we can help our patients be the strongest that they have ever been or at least work them towards that confidently. So if you have any questions at all, feel free to reach out at pt Snacks podcast@gmail.com. Or if you just. Maybe you want more episodes on particular topics or you don't like episodes like this where we're not talking about different diagnoses. I still wanna hear it all because I wanna make sure that this show is being as useful as possible, but. There's also a link below in the show notes too, where you can submit ideas for topics. If you don't wanna email me directly, but you wanna throw your hat in the throw your idea in the hat, definitely please utilize that. Lastly, if you're not following the show and you don't wanna miss out on any episodes. Definitely go ahead and hit shot follow. You can support the show financially, but if you are not in a place to do totally get it. I've been there. But do me a favor and share this with someone who you think would really benefit from it. Other than that, I hope you guys had a great rest of your day, and until next time.