However he did add a caveat and that was for those participating in extreme athletic lifting. In other words, those who are at the top of the international charts with their weights. In these cases Dr. McGill said “where belts appear to increase torso stability to reduce the risk of buckling and provide some elastic extensor recoil to assist with the lift. But the possible liabilities underscore the counterpoint to this proposition.”
McGill states that belts also increase intra-abdominal pressure which in turn increases the Central Nervous System fluid pressure in the spine and, in turn, the brain. This decreases the transmural gradient (the pressure difference between the arterial blood pressure in the brain vessels and the brain itself) which in turn may reduce the risk of aneurysm, or stroke. Whereas others have argued this effect is detrimental the return of venous blood flow back to the heart.
Since so many people are wearing these belts from the lifter to the warehouse employee it is not unreasonable to be confused about when to wear one. McGill reported in 1993 that wearing a belt in an occupational setting supported the following documented effects.
The loads on those who have never had a previous back injury seem to offer no additional protection by wearing a belt.
Wearing a belt appears to increase the degree of injury making it more severe.
People seem to have the perception that wearing a belt means they can lift more and in some cases this is true; the placebo effect personified. However in many cases this fosters a false sense of security. Given this attitude each person should receive a lifting course on the correct way to lift. This course would of necessity include topics that provide information on how the tissues become damaged, back sparing techniques, and finally what to do with the feelings of discomfort that generally precede injury.
Increased intra abdominal pressure, elevated blood pressure and higher heart rates result from using the belt. Individuals considering the use of a belt ‘on the job’ must be screened by medical personnel due to these heightened cardiovascular concerns.
The lifting style of those using the belt appears to either increase or decrease pressure on the spine.
So why are so many using the belt? Perhaps it is due to the anecdotal gym talk that their use reminds them to lift correctly. Other reasons that don’t stand up to rigorous scientific inquiry include:
The belt helps support the shear loading on the lumbar spine resulting from gravity acting on the weight in a handheld position while the upper torso is in a semi flexed position under the load.
The belt reduces the compressive loading of the lumbar spine through the hydraulic actions of increased intra abdominal pressures.
Wearing a belt provides a splint effect between the upper and lower torso by reducing the range of motion (ROM), and provides a stiffening effect, thereby lowering the risk of injury.
The belt increases warmth to the region and helps reduce muscular fatigue.
Finally those who use the belt claim that there is an enhanced proprioceptive ability to feel the pressure associated with the perception of increased stability.
Belts are not meant to substitute for poor lifting technique. There is a natural belt formed by the abdominal wall and the lumbodorsal fascia. The active training of this area, known as the core, increases the stabilizing effects via strength and motor control synergy thus encouraging and making them work as a team to enhance the backs ability to remain stable.
The use of the belt by the serious strength training athlete
No one in their right mind would dispute the fact that a few more pounds of torque may be generated by the body with the assistance of the belt. This is due to the elastic recoil of the flexed torso augmented by the stiffness of the belt. But, and this is a big but…IF the neutral spine is kept constant throughout the entire lift the belt effect is minimized.
To put it another way if the lifter is using poor technique then the belt will help preserve the back, up to a certain point! However there are other methods that can be employed to increase and maintain torso stiffness, one of which is maximizing air intake and then holding the breath, i.e. the Valsalva maneuver. This is not advised for other than highly elite athletes who are under constant medical attention due to the drastic rise in blood pressure resulting from this technique. Sipping the air keeps the lungs filled and the torso tight.
Counter considerations of belt use include the fact that people change their motor patterns when using a belt. Theses changes elevate the risk of injury in an athlete who is used to wearing one when NOT using a belt in training. The injury is generally more severe in these situations if a belt is worn.
Evidence suggests belts are adopted for use for one of the following three reasons:
- Peer pressure. They have seen others using them and assume that is the thing to do.
- Their backs are getting sore and they believe a belt will alleviate the pain.
- They desire to lift more weight and think the belt will add these additional pounds to their total.
Not one of these reasons is valid or consistent with the objective of better health. If a person wants to groove better lifting motor patterns that require a stable torso then it is better not to wear a belt. The answer in this case is to train the core musculature.
Curl ups, birddogs, arm and leg extensions, bridges in the supine, prone and side positions and back extensions provide sufficient muscle and motor pattern stress to accomplish this strengthening process in a safe and effective manner.