The weightlifting belt is often considered standard issue in the weight room these days. From the competitive weight lifters to those of a more recreational interest, all would seem to agree that there is a necessity for such a device. After all, supporting the back in order to help prevent injuries while lifting is a difficult point to argue. It is because of this seemingly obvious benefit that the concept is beginning to be used in other areas as well. Besides the weight room, public and private industry have begun to provide lower back support equipment for their personnel. It is becoming more common to see these devices on stock clerks, warehouse and construction workers, as well as firefighters. While the intention is certainly prudent, is it actually understood how weight belts function to support the back? Do the weight belts in the gym support the back in the same manner as the back braces used in commercial environments? Is there a time for wearing a weight belt or back brace that is most appropriate? Furthermore, is there ever a disadvantage to wearing a lower back supporting device of any kind?

The answers to these questions could very possibly alter the thinking as to the use of a weightlifting belt or back brace. Likewise, the following information could lead to a decision not to use a weight belt or back brace at all.

Back braces differ from weightlifting belts in the overall objective to support the back. In normal populations back braces are successfully used to offer support in conditions where low back pain reduction is the primary goal. (1,2) Physical support as well as psychological comfort have been noted with these devices. (3) Even people that have not injured their back often use these corset style braces to assist them in carrying out their everyday lifestyles. It is the rigidity of the brace itself that serves to immobilize the area in a splint-like fashion thus lending support to the lower back. (4,5,6,7)

The weightlifting belt, contrary to popular belief, supports the back in a different manner. While there can be some support due to the rigidity of a weight belt, the benefit is minimal compared to the support offered by the increase in the intra-abdominal pressure (IAP). (8,9,10)

During a normal lifting maneuver such as the squat; the diaphragmatic muscles along with muscles of the torso contract generating pressure on the abdominal cavity. The abdominal cavity together with its predominantly fluid contents, known as the "fluid ball", are kept under pressure by the surrounding musculature. It is this natural intra-abdominal tension that supports the spinal column. (11) Several studies have shown that weight belts increase intra-abdominal pressure and therefore assist in this natural stabilization mechanism. (3,8,12,13,14) Other studies have shown that increased IAP by use of the weight belt not only relieves the load of the musculature of the lower back, but also reduce the compressive forces on the spinal discs. (15,16,17) Furthermore, it has been reported that the reduction in these compressive forces can be reduced by as much as 50% when utilizing a weight belt. (16,18,19)

Additional benefits exist with the use of the weight belts due to IAP. Subjects demonstrated faster lifting movement (12,13,20) , greater emphasis on hip extension relative to knee extension (12) , as well as greater comfort and sense of support. (12,13,17,20,21)

Potential Hazards of Improper Usage

The use of both weightlifting belts and immobilizing lumbar braces must be observed in terms of their appropriateness. The fact that there are benefits to wearing these devices tends to create the perception that they should be worn at all times, during any lifting activity. This is a myth that will only lead to decreased performance and potential injury.

For instance, the significant increase in IAP and thus the resulting benefit, has been shown to be with heavier lifts of the 90% maximum (1RM) condition. (12) Although during a set of higher repetitions (10 RM) it is reported that while only 61% of the 1 RM is utilized (22) , a possible significant effect of increasing IAP may be considered a cumulative benefit if the last few repetitions are close to failure. (13,17) It would be easy to surmise from this information that wearing the weight belt at all times would be the best insurance policy.

However, electromyographic activity of the stabilizing musculature is reduced when a weight belt is worn which could lead to atrophy of the postural muscle groups. (12,16,23) Injury potential is obviously higher in muscle tissue that is devoid of the optimal training stimulus.

Furthermore, lumbar support devices that increase IAP must be tightened to be effective. High IAP, however, may impede blood flow back to the heart (12) as well as significantly raise blood pressure. (24) Wearing a weight belt at all times would certainly appear contraindicated when all the criteria are examined.

Recomendations

There has been a great deal of information cited above regarding lumbar support devices. From these references the appropriate use of a weight belt or back brace should first be determined based on the person's objective. The corset-style back brace is commonly used for immobilization due to an injury. These are not directly associated with the concept of stabilization by increasing IAP and therefore could possibly be worn for an extended period. Anyone wishing, however, to use a brace of this type should consult their physician for specific direction. Individuals who are free from acute or chronic lower back pain may choose a lumbar support device in order to prevent injury as well as assist their own musculature for maximal strength enhancement. In the gym environment the weightlifting belt should not be worn at all times. The belt should only be utilized for exercises that involve the spinal erectors against high resistance i.e. squat and deadlift. (21) The belt should be loosened after every set and the individual should breathe between every repetition.

With proper training progression a person should eventually wean themselves off of the weight belt (21) and utilize the support device when intensities reach 80% of the person's 1 RM unless a set of multiple repetitions is performed to failure. (12) It is imperative, however, that training at lower intensities continue without the weightbelt. This will help ensure the natural stabilization and production of IAP (11).

In the industrial setting, the use of lumbar devices is controversial. Requiring a lumbar support device to be worn while on the job can actually be more of a hindrance than a help unless a training program be included. The training program should include proper technique as well as an exercise prescription for conditioning the body's natural stabilization mechanism.

For occupations such as fire fighting, the back brace would not be logistically convenient or biomechanically efficient simply by the nature of the unpredictable work environment. The most prudent idea to truly protect this special population would be a comprehensive hips and trunk stabilization and conditioning program. Many programs are targeted toward a healthy back when the coordination of the hips and trunk should be the ultimate focus. This is not to say that a weight belt should never be used, but rather considered more of a last resort where the appropriateness is carefully scrutinized.

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References:

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2. Axelsson P, Johnson R, Stromqvist B, Effect of lumbar orthosis on intervertebral mobility. Spine, 17: 678-681; 1992

3. Grew N, Intra-abdominal pressure response to loads applied to the torso in normal subjects. Spine, 5: 149-154, 1980

4. Lantz S, Schultz A, Lumbar spine orthosis wearing: I Restriction of gross body motion. Spine; 11: 834-837, 1986

5. Lantz S, Schultz A, Lumbar spine orthosis wearing: II Effect on trunk muscle myoelectric activity. Spine; 11: 838-842, 1986

6. Norton P, Brown T, The immobilizing efficiency of back braces. J. Bone Surg; 39: 111-139, 1957

7. Reyna, JR, et. al., The effect of lumbar belts on isolated lumbar muscle. Spine; 20, 1: 68-73, 1995

8. Harmen E, Rosenstein R, Frykman P, Nigro G, Effects of a belt on intra-abdominal pressure during weight lifting. Med Sci Sports Exerc; 21: 186-190, 1989

9. Andersson G, Ortengren R, Nachemson A. Intradiskal pressure, intra-abdominal pressure, and myoelectric back muscle activity related to posture and loading. Clin Orthop; 129: 156-164, 1977

10. Davis P, The use of intra-abdominal pressure in evaluating stresses on the lumbar spine. Spine; 6: 90-91, 1981

11. Harman E, Weight training safety: a biomechanical perspective. Strength and Conditioning; 16: 5: 55-60, 1994

12.Lander J, Simonton L, Giscoble J, The effectiveness of weight-belts during the squat exercise. Med Sci Sports Exerc; 22: 117-126, 1990

13. Lander J, Hundley J, Simonton R, The effectiveness of weight belts during multiple repetitions of the squat exercise. Med Sci Sports Exerc; 24: 603-609, 1992

14. McGill S, Norman R, Sharrat M, The effect of an abdominal belt on trunk muscle activity and intra-abdominal pressure during squat lifts. Ergonomics; 33: 147-160, 1990

15. Bartelink DL, The role of abdominal pressure in relieving the pressure on the lumbar intervertebral discs. J. Bone Joint Surg; 39B: 718-725, 1957

16. Morris JM, Lucas DB, Bresler B, Role of the trunk in stability of the spine. J. Bone Joint Surg; 43A: 327-351, 1961

17. Bourne ND, Reilly T, Effect of a weightlifting belt on spinal shrinkage. Br. J. Sp. Med; 25 (4): 1991

18. Eie N, Load capacity of the low back. J. Oslo City Hosp.; 16: 73-98, 1966

19. Lander JE, Bates B, DeVita P, Biomechanics of the squat exercise using s modified center of mass bar. Med Sci Sports Exerc; 18: 469-478, 1986

20. Cappozzo A, Felici F, Figura F, Gazzani F, Lumbar spine loading during half-squat exercises. Med Sci Sports Exerc; 17: 613-620, 1985

21. Fagenbaum AD, Liatos NS, The use and abuse of weightlifting belts. Strength and Conditioning; 16; 4: 60-62, 1994

22. McDonagh MJN, Davies CTM, Adaptive response of mammalian skeletal muscle to exercise with high loads. Eur J Appl Physiol; 52: 139-155, 1984

23. Waters R, Morris J, Effect of spinal supports on the electrical activity of muscles of the trunk. J Bone Joint Surg {AM}; 52: 51-60, 1970

24. Hunter G, McQuirk J, Pearman P, Mitrano N, Thomas B, Arrington R, The effects of a weight training belt on blood pressure during exercise. J. Appl. Sports Sci. Res.; 3: 13-18, 1989

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