If I'm understanding your question correctly (please clarify if I'm not), you are asking - Is there a correlation between technique and risk for injury?
To define our terms - technique = how a movement is completed
injury = much more difficult to define but here is what we have as definition(s) in the research evidence: a) missed practice or competition due to reporting of pain and/or dysfunction (amount of time missed before warranting the label of injury is variable in the research) or b) reporting of loss of bodily function or structure and/or c) reporting of pain.
As
Matthew Rupiper, PT mentioned - defining injury is complex because we are realizing more and more that tissue alteration is not a sufficient observation for the label of injury given how often we find tissue alterations from textbook "normal" in the absence of symptoms (pain and/or dysfunction).
Austin and I recently were discussing this on the podcast and in essence if an athlete thinks they are injured due to experiencing pain then they may self-select activity (dysfunction) and therefore are "injured". This can further complicate the discussion given the misunderstanding of what pain means.
With all that said, this is a discussion of burden of proof (at least in my mind). We (BBM) doubt the "truthfulness" of the statement - "bad" technique = "injury", for the reasons discussed above. Therefore, the person(s) making such a claim need to demonstrate evidence in support of this claim - not those doubting the claim.
Also, this isn't an absence of evidence argument (no research has been done on this topic) or an argument of ignorance (something is true because it hasn't been proven false or something is false because it hasn't been proven true) - we have evidence of what is strongly correlated to injury occurrence (as cited above). Perhaps as more investigation occurs we would find such evidence regarding technique but ethically this may be unlikely given it would most likely require imposing harm on study participants.This is likely related to the topic of falsifiability as well.
However, I argue, if load is managed appropriately then it is likely technique is irrelevant. We have examples of movements not as prevalent for those outside of the weight lifting world such as the Jefferson Curl (
).
We do have evidence from a kinematics standpoint how a movement like the deadlift is completed is different based on the structure of the individual - see
Pavlova.
I discuss this in the mobility blog on BBM. Excerpt:
"Pavlova recently completed a study examining the curviness of participant’s lumbar spine and its effect on lifting an object from the ground during three different trials. The first trial the participant lifted “freestyle”, no cueing. The second trial the participants were cued to squat (“keep the back straight and bend at the knees”), and finally the third trial to stoop (“keep the legs straight and bend at the back”). The authors’ findings:
“In this study we have shown that the curviness of the lumbar spine is associated with the way in which individuals lift a weight from the floor. When no instruction was given, individuals with more lordotic lumbar spines preferred to stoop down to pick up the box, while those with straighter spines preferred to squat. Our results also suggest that these natural movement preferences are maintained when instructions are given, especially in individuals with curvier spines who prefer to lift by stooping. In changing between lifting styles, individuals adjusted their knee flexion while maintaining their preferred lumbar flexion range.”
These findings certainly question the forced constraint or “one size fits all mentality” rather than allowing for variability and a degree of subjective preference when completing a task.
The authors go on to conclude:
“These results could be important for a reassessment of lifting guidelines, one size does not fit all, and for training of athletes where a given task may place different demands on different athletes depending on their natural lifting technique, which may depend on the shape of their lumbar spine.”"
Clinicians, coaches, athletes, etc are the ones applying movement constraints and making claims how movements should be completed to not "cause" injury but the research evidence we have is against this stance. If you continue reading the blog, I discuss the research on movement variability and how it is an important component for learning (most especially when learning novel tasks).
Blog:
https://www.barbellmedicine.com/mobility-explained/
