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As we have detailed in the Endurance Paradox a strength exercise that is intended to be performed for the purpose of maximizing bone strength needs to contain several elements including be site specific.  Site specificity refers to the fact that only the bone tissue that is under direct load or strain will be stimulated to remodel.  An upper body exercise will exert no influence over the lower extremities; an exercise performed by the right upper extremity will have no effect on the left.  Although there are some circumstances in which strength training may exert more systemic improvements in bone strength, including the modulation of hormone levels, site specificity is an important consideration for exercise selection. 


Endurance athletes are at risk for losing bone mass in skeletal regions that contain a high percentage of trabecular or “spongy” bone.  Trabecular bone is sponge like in appearance when viewed under the microscope (see below).  The photo on the left is normal trabecular bone in which void or empty spaces are small relative to the amount of bone tissue.  On the right is a photo of osteoporotic bone in which the percentage of void space is large relative to the amount of bone tissue present.    

Skeletal remodeling occurs mainly on the surface rather than inside of bone tissue.  Because trabecular bone has an enormous amount of surface area these regions are most likely to lose bone tissue and thus overall mass and structural strength as a result of accelerated rates of bone resorption.  Bones that contain a high percentage of trabecular bone include:  the radius (wrist), vertebral bodies (spinal vertebrae), and femur (hip).  

The dead lift is considered by most strength experts as being one of the most fundamental exercises for overall strength development and may be the single best measure of total body strength.  Nearly every muscle in the body is engaged during the execution of a properly performed dead lift including the muscles that protect the spine, hip and wrist. 


Olympic barbell and weight set (225-300 lbs.) are the only essentials.  A rubber mat or a rubber backed carpet remnant will protect the floor and dampen noise as well as provide a non-slip surface to train.  For those individuals that have a history of discogenic back pain or lack flexibility in the spine or hips a specialized deadlift or hex bar is a better option than the conventional straight bar.  Shoes without elevated heels and minimal cushion are best.  Training in a minimalist shoe or in bare feet is an excellent practice as improvements in foot strength and perception are realized.    

Deadlifting technique:
  1. Stand facing the bar with your feet approximately shoulder width apart.

  2. Feet should point in a direction that allows your hips to maintain a relatively neutral position between external (pointed out) and internal rotation.  For most individuals this will be achieved with the feet pointing straight ahead, for some the feet will be slightly turned out.  For those individuals with excessive hip internal rotation mobility (anteversion), a consultation with a movement specialist may be indicated in order to help establish proper lower extremity positioning.   

  3. Stand over the bar in a manner that the bar is located directly above the middle 1/3 of your foot (close to your shin).

  4. Inhale deeply but not to the extreme (about ¾ of maximal) and then hold the breath prior to descending to grasp the bar.  The descent should be a hinge of the hip with the inward curve of the lower back (lordosis) being maintained at all times.  

  5. Head posture (and eyes) should be maintained in the horizontal plane or rotated slightly upward.  This will help to ensure that the proper spinal position is maintained.  Looking down generally encourages the spine to flex forward rendering it susceptible to injury. 

  6. During the descent, lower legs (shin bones) should remain relatively vertical while the hips travel in a backward path.  If you do not possess the necessary mobility to reach the bar, spine and hip mobility must be addressed prior to starting the routine.  

  7. As you descend, weight should be transferred to the heels and the musculature of the foot must be activated.  “Gripping” the floor with your toes should be encouraged to provide a stable base of support.  Please take note, do not allow the knees or ankles to collapse toward the midline.  Knees should track in line with the second or third toe, while the inner longitudinal arch of the foot should be maintained in the neutral or slightly elevated (supinated) position.

  8. While you are descending to grip the bar your entire body should feel “tight”.  The development of abdominal tension is critical to the protection of the spine and entire body.  

  9. Grip the bar with either an overhand or alternate technique.  The alternate technique is preferred by most strength athletes as the stronger fingers are able to handle greater loads than the thumb.  Remember to switch hands regularly.

  10. Generate tension throughout the entire body prior to executing the lift.  Attention to maintaining a tight abdomen and grip will improve your strength, stability of form, and safety.

  11. Visualize yourself pushing the floor away from you rather than moving your body away from the floor.  This will allow you to better maintain trunk stability and proper alignment.  

  12. The bar should be maintained close to the legs at all times.  Once the bar has cleared the knees, hips should move forward.  This phase of the lift will be facilitated by contraction of the gluteal muscles. 

  13. The lift should be finished with you standing fully erect in the neutral (not hyperextended) position with the bar “resting” on your thighs. 

  14. At this time, you may release a bit of air.  Do not exhale fully as this makes it difficult to protect the spine. 


To start to return the bar to the floor, inhale and develop maximal whole body tension, reverse the process by allowing hips to travel backwards and guide the bar back to the floor.            

A number of technical modifications can be made upon the execution of the conventional deadlift.  These modifications may improve the safety of the lift for individuals that have atypical trunk or extremity lengths or movement losses and/or provide variety in a comprehensive deadlifting program.  Alternative deadlifting styles or modifications in technique include the following:

  • Sumo Style

  • Stiff legged or Romanian Style

  • Box or Platform

  • Wide or Snatch Grip

  • Single Handed (performed with a dumbbell)

  • Health Lifts or “Partials”


The acquisition of flawless technique must be the initial goal of learning a new exercise like the deadlift.  Many individuals capacity for proper execution of the lift will be limited by joint mobility constraints (spine, hips, ankles) or muscular flexibility deficits (gluteal, hamstrings, soleus).  Additionally, becoming proficient at balancing on the heels and maintaining the alignment of the knee and foot/ankle posture is mandatory prior to adding significant load.   

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