Rhabdo – The New Black

Mike would not be happy

In the late 1990’s a member of the Tufts University in Boston Massachusetts reached out to me. As a result of that initial email exchange, he first attended a live seminar with me in his home city in 2000,  and from there attended every professional development opportunity held in the US and some additional ones abroad. He was committed to this role, serving the athlete.

His name was Mike Pimentel.  Mike’s initial qualification was as an Athletic Trainer and he worked in the Tufts Athletic Training Department for about a decade, from memory. In the 1990s he was then approached to start up and run a new department at Tufts, their ‘strength & conditioning department’.

Faced with serving the entire athletic preparation at the university of over 700, Mike was no stranger to going the extra mile for his clients. Sleeping under the desk in his office due to working late and the long drive home and back for an early start, was just one example.

Being at the coal face, Mike felt pieces were missing and was looking for the answers, looking for a better way to prevent injuries and enhance performance.  That’s where I came in.

From about 2002 to 2018 I visited the university annually, providing guidance and learning more about the challenges faced.

One of the many innovations Mike put into place was a course that resulted in students with the qualifications to provide training supervision to their cohort.  Mike was a pioneer in solving the challenges faced by NCAA colleges, where the demand for athlete preparation services typically exceeded the budget.

I know I speak for all the students and alumni during Mike’s 30-year contribution at Tufts that all were blessed by his presence. It may have only been a Div. 3 college, but they received first-class service.

Just six years after Mike’s passing, his beloved Tutfs was home to the latest new-age equivalent of vomiting to prove how tough the training session was – heat induced near fatal rhabdomyolysis.

So what is rhabdomyolysis?

Rhabdomyolysis is a big word for saying that training was so intense, and the body temperature was so elevated, the muscles started breaking down, releasing their content into the bloodstream, and endangering organ status in doing so.

Rhabdo is the abbreviation.

What are some other variations?

Rhadbo symptoms can appear similar to heat-related illnesses and dehydration. It’s likely that athletes training in hotter environments show extreme symptoms of heat stroke first. The only way to determine if you have rhabdo is through testing.

How dangerous is it?

According to the US Centers for Disease Control and Prevention it is “a serious medical condition that can lead to permanent disability or death.”

How common is it?

Rhabdo is fast becoming the gold standard of ‘conditioning training intensity’. Here are some other examples (this list is not exhaustive):

Year Institute Sport # affected Timing
2024 Tufts Univ. Boston[1] Men’s Lacrosse 12 out of 50

(25%) confirmed [2]

Sep 16 2024
2023 Mid America Nazarene University in Kansas, American Football Pre-season football late July
2023 US Miltiary[3] Military training 52 – 40.5 cases per 100,000 person-years, the highest rate observed during this study’s 2019–2023 surveillance period.
2018-2022 Between 2018 and 2022, at least 11 football players in the US—at the student and professional level—have died of heat stroke. And the number of young athletes diagnosed with exertional heat illness has been increasing over the past decade or so…[4] [5] [6] [7]
2020 Manly-Warringah Rugby League Club, Sydney[8] Rugby League 1 death 23 Nov 2020; First training back in the off-season
2019 Manly-Warringah Rugby League Club, Sydney [9] Rugby League 1 near-death offseason conditioning
2012 Ohio State University[10] Women’s Lacrosse 6 athletes admitted to hospital March[11]
2011 University of Iowa [12] American Football 13 athletes admitted to hospital offseason conditioning, return from school break
2010 Oregon high school American Football Among 43 players, 22 (51%) experienced rhabdomyolysis; 22 patients had upper arm myalgia; 12 were hospitalized; 3 experienced triceps compartment syndrome. an upper arm exercise held in a non-air-conditioned wrestling room.

Conclusion

There was a time when getting an athlete to vomit during ‘conditioning’ training was a sign of how ‘tough’ the session was, perhaps a badge of honour for the trainer. Not that I agree with this approach but it cannot be denied as a phenomenon.  Now it appears the stakes have been raised. Vomiting is not good enough. Near-death or death appears to be the new gold standard in ‘that was a tough workout.

That’s not encouraging. It’s insane, but is it going to turn around? Based on the lack of accountability I see in the official who ran the programs highlighted above, I suspect the answer is no.  It is going to get worse.

What you and I can do, if you share my thoughts on this, is to ensure that no such situation or outcome occurs on our watch.

We are here for the athlete, and I cannot see now near-death or actual death experiences from off-season conditioning training is serving the athletes.

On its surface, a statement such as this should be redundant. But it isn’t, considering the trend.

I believe Mike would not be happy about the event that occurred at his beloved alma mater in 2024. And no one who puts the athlete first should be happy with this new ‘training trend’.

 

References

[1] https://www.usatoday.com/story/sports/2024/09/23/tufts-university-lacrosse-players-rhabdo-training/75347715007/

[2] https://www.nbcboston.com/news/local/tufts-mens-lacrosse-players-hospitalized-following-workout-led-by-graduate-of-navy-seal-training-program/3494987/

[3]  https://pmc.ncbi.nlm.nih.gov/articles/PMC11107841/ The 529 reported incident cases of exertional rhabdomyolysis among active component U.S. service members in 2023 represent an unadjusted annual incidence rate of 40.5 cases per 100,000 person-years, the highest rate observed during this study’s 2019–2023 surveillance period. This increase in crude incidence rates was most noticeable in the Marine Corps,

[4] https://www.motherjones.com/environment/2023/09/football-players-deaths-excessive-heat-coaching/

[5] https://www.theguardian.com/world/2023/sep/24/football-player-heat-deaths-athlete

[6] https://www.usatoday.com/story/news/nation/2024/09/21/heat-kills-student-athletes-how-schools-can-help/74843984007/

[7] https://www.theguardian.com/sport/article/2024/aug/23/high-school-football-deaths-heat-stroke

[8] https://www.theguardian.com/sport/article/2024/may/03/nrl-player-keith-titmuss-died-after-inappropriate-training-session-coroner-finds

[9] https://www.foxsports.com.au/nrl/nrl-premiership/nrl-2024-former-prop-lloyd-perrett-launching-legal-action-against-sea-eagles-heat-stroke-keith-titmuss-news-videos-highlights/news-story/f444cc32ea5ef9d968a7d5b899af09c8

[10] https://www.dispatch.com/story/lifestyle/health-fitness/2013/03/09/rhabdomyolysis-laid-low-6-athletes/23706206007/

[11] In the Ohio State case, Kelly Becker told university officials that on March 6, 2012, the women lacrosse players performed a series of grueling upper-body workouts unlike anything they had done to that point in the season. The workout included pull-ups (she did 56), chin-ups and triceps-crunching dips without rest during a 20-minute workout. Two days later, they pushed football blocking sleds. The six players went to the hospital the next day.”

[12] https://www.espn.com/college-football/news/story?id=6061650

 

Principles – The North Star of Physical Preparation

The enduring power and importance of training principles

Before maps and compasses, humans would look for guidance when travelling, typically seeking them from stars that were consistent in their visibility.   Even in the more modern times, these same stars provide an enduring back-up system to travellers.

One can liken training to travelling. The purpose of training is to take our athletic and or physical qualities from Point A- where we are today – to Point B – where we want to be in the future.

In this physical training journey, decisions are made moment by moment. This is the reality of what earlier European literature referred to as the ‘training process’.  Ideally you begin with a plan, but the realities of the body combined with the environment require constant adaptation.

In making these constant and in the moment decisions we again ideally have something to guide us, in the same way stars were used for navigation before the advent of compasses and maps.

From my earliest professional development, I was influenced to believe that training principles would be used to serve this purpose.

What are training principles?

I describe training principles as:

Principles of training are general rules or guidelines that can apply to all aspects of training.  It is important for a student of physical preparation know these principles, to understand them, and most importantly, to consistently apply them in the training of the athlete.[1] [2]

For me ‘principles of training’ fall within ‘the theory of training’, and I appreciate not everyone wants to embrace theory. However, I strongly suggest that for the safety of the athlete/client, and for the optimization of retaining, that all physical preparation coaches embrace and internalize the principles of training. For this reason principles of training feature prominently in our coach education since it’s commencement in 1999.

What are examples of principles of training?

The following lists describes dominant principles of training as they were presented from 1999 in our coach education courses and books.  They are listed alphabetically, not in any order of importance: [3] [4]

  1. Active and conscientious participation.
  2. Contrarian principle.
  3. General to specific.
  4. Individualization.
  5. Opposite and equal effect.
  6. Progressive Overload.
  7. Recovery.
  8. Reversibility.
  9. Specificity.
  10. Transfer.
  11. Variety.

Do principles change over time?

The upside of learning and internalizing the principles of training is that, unlike trends in training, they do not change.

In fact, it is a tenant of what I seek to learn, master, and teach – the concept of generalized principles. Concepts that remain unwavering over time, despite many other things changing around it.  I credit the US thinker and inventor Buckminster-Fuller for the term ‘generalized principles’ – things that never change – and mastering and teaching these are far more important than ‘science’ or ‘trends’.

I am proud to have contributed to the area of principles of training, an area I have so much respect for, with a number of original principles.  I look forward to them standing the test of time…[5]

The world, society and the training environment is subject to continual change. There is the risk that some may assume that newer ways of doing things, such as the arrival of new trends of training, may over-ride or negate the role and importance of training principles.  I suggest this is not the case.

It would appear I am not alone in stressing that changing times do not mean principles wane or change. In his augural address, the 54th President of the United States said:

“As my high school teacher, Miss Julia Coleman, used to say: “We must adjust to changing times and still hold to unchanging principles. [6]

What happens when we ignore these principles of training?

 When we ignore the principles of training there are levels of risk that may result.  I list them below:

  1. Overtraining
  2. Imbalanced adaptations leading to acute or chronic injury
  3. The shortening of the career, the quality of life, or of life itself.

1. Overtraining

Overtraining can occur very easily and subtlety, with the chances are the moment that it occurred and the decisions make that caused it going unnoticed and unrecognized.  It takes a commitment to objective review and high standards of excellence in outcomes to provide a measure of analysis and comparison.  In other words, most of these moments in training are missed and lessons are not learnt.   This is particularly applicable when the implications of that overtraining are not immediately and blatantly apparent.

Overtraining can lead to sub-optimal training and competition results, onset of injury, reduction of career span and quality of lifelong term.

2. Imbalanced adaptations leading in the acute and/or chronic injury

As with overtraining, any inherent imbalance in training stimulus – in all macro and micro variables – can be subtle, delayed in their appearance, yet significant on the downside.  And again, due to the subtle nature of these negative adaptation, and the lack of clarity around what is an optimal adaptation, the moments that these occur are typically missed, and the lessons fall to be received.

Case Study #1 – Acute or/or chronic Injuries

The following refers to an Australian NRL teams first season under a new coach:

The Titans came into their 2024 campaign with high expectation — and at one stage they were even exceeding it — but the season ended with a whimper after injuries decimated Des Hasler’s squad.

 Tino Fa’asuamaleaui was the first to go down with an ACL rupture ending his season in Round 3, while Jayden Campbell had a delayed start due to a knee injury before copping two more setbacks in another knee concern and a hand injury.

AJ Brimson battled with a niggling groin injury which eventually caused his season’s end prematurely, while Beau Fermor, Phillip Sami and David Fifita also had stints on the sideline.[7]

3.  The shortening of the career, the quality of life, or of life itself.

These subtle failings in training that it appears everyone is not held accountable for, can and most likely will result in significant life-changing implications. These range from shorter careers, through to shortened quality of life post-career, through to premature (or in some instances immediate) death.

Case study #2 – Career ending injury.

Here is a case study that highlights this risk.

“We went on a run, weren’t allowed any water and told ‘if you don’t like it, you can take your car keys to the field and go home’.

“Coaches and trainers do this regularly – try to see how tough you are.

“We had a run, then a short break, then got sent on another run… again without water, then a third run. 

“I guess my mind was stronger than my body. I don’t remember what happened – I collapsed and woke up in hospital with around seven doctors and nurses around me… I thought I was going to die.

“I couldn’t move my arms or legs … I’ve never been more scared.

“I was literally on my death bed … and it was 100 per cent avoidable.

“A nurse later told me that 60 per cent of people who get heat stroke die … I was one of the lucky ones.”

Perrett was just 23 at the time but his career was over. “I stayed at Manly but was never the same,” he said.[8]

Perret is now taking legal action against the club.[9]

Case study #3 – Life ending injury.

In November 2020, during the first training session back in the general preparatory phase at the NFL franchise Manly Warringah Sea Eagles, a 20 year old rugby league player passed away as a result of the training session.

Keith Titmuss lost consciousness immediately after a 139-minute training session at the team’s headquarters on Sydney’s northern beaches on November 23, 2020.

A coronial inquest into his sudden death heard several experts concluded the forward was suffering from exertional heat stroke when he had a seizure at an indoor facility. [10]

On the face of it one might consider the athlete may have had a pre-existing condition that led to his passing. However, evidence presented at the subsequent coronial inquiry may provide a different perspective. On 4 November 2019 the club doctor Luke Inman sent an email to the then head of sports science at the club warning about heat and the need for head monitoring at training:

“You are leaving yourself open to litigation from a player if they suffer heat stress or at worst, dies,” the email warned.[11]

This email was followed up the 7th April 2019 with the same warning, this time to more stakeholders within the club:

On 7 April 2019, Dr Inman forwarded a copy of his 4 November 2018 email to Mr Booth, copying in Mr Bonasera, Mr Hasler and Mr Singe, and relevantly wrote: Hi Mark, I am well aware of the NRL policy and guidelines. Furthermore, John Bonasera forwarded you my email in Nov 2018 regarding heat measurement at training and the clubs stand on the “recommendation” is that it is performed at every training session during the hotter months in preseason (see below). You were made aware of the clubs medical policy for heat measurement at training by John Bonasera and have not complied. You are leaving yourself and the club open to litigation from a player if they happen to suffer from heat stress or worse, die. We have already had one extreme example of this. I would strongly advise that this measurement is continued at training please. It does not take long to set up.

The counsel assisting the coroner Adam Casselden SC said the evidence before the coroner showed the training session had been “objectively tough”:

“It was unnecessarily and inappropriately tough, given it was the first extended training session of the new season,” he told the NSW State Coroners Court.

“With the benefit of hindsight, (it was) an inappropriately high level of intensity and not of a safe level or environment.” [12]

The coroner concluded:

“… the training session was “more likely than not inappropriate”, given a range of factors including the hot and humid conditions during the indoor part of the session.[13]

You can read the transcript from the coroners inquest here. [14]

Conclusion

 The coronial magistrate inquiry into the tragic passing of Keith Titmuss provided a number of recommendations including:

* Mandating a 14-day period of controlled training load acclimatisation following an off-season or extended break for players.

* It should also consider screening and classifying players for EHS risks, the mandatory reporting of every EHS incident and identifying what cooling strategies should be implemented for outdoor and indoor training sessions, he said.

* Magistrate Lee also recommended Manly make improvements to its record-keeping policies.[15]

It’s unfortunate to see the profession of physical preparation acting in a way that requires the oversight of the judicial system.  Does our profession really need a Magistrate to remind them of the fundamentals of the theory of training, including the principles of training? Simple concepts such as progressive overload and individualization?

From my perspective the risks involved when one ignores the principles of training can be serious. The case studies shared, and those that were not, are all for the most part avoidable. They do not need to happen.

It is important for a student of physical preparation know these principles, to understand them, and most importantly, to consistently apply them in the training of the athlete.[16] [17]

Our thoughts are with these athletes and their families.

 

References

[1] King, I., 1999, Foundations of Physical Preparation (Course)

[2] King, I., 2000, Foundations of Physical Preparation (Book), p. 26

[3] King, I., 1999, Foundations of Physical Preparation (Course)

[4] King, I., 2000, Foundations of Physical Preparation (Book), p. 26

[5] King, I., 2011, Legacy (Course), Unit 5 – Principles of Training, p. 2

[6] Inaugural Address of Jimmy Carter, Thursday 20 Jan 1977, https://avalon.law.yale.edu/20th_century/carter.asp

[7] https://www.foxsports.com.au/nrl/nrl-premiership/nrl-2024-gold-coast-titans-season-review-ins-and-outs-transfer-targets-des-hasler-challenge/news-story/e1b658203153a70f60ef2deb13675fd0

[8] https://www.nine.com.au/sport/nrl/news-2024-the-mole-exclusive-lloyd-perrett-legal-action-manly-sea-eagles-keith-titmuss-20240501-p5jb0s.html

[9] https://www.nine.com.au/sport/nrl/news-2024-the-mole-exclusive-lloyd-perrett-legal-action-manly-sea-eagles-keith-titmuss-20240501-p5jb0s.html

[10] https://www.foxsports.com.au/nrl/nrl-premiership/teams/sea-eagles/inappropriately-tough-session-before-rising-manly-stars-death/news-story/6f20fa3b30ed01621a271fa4a49086db

[11] https://www.abc.net.au/news/2024-02-09/nsw-ex-manly-coach-des-hasler-evidence-keith-titmuss-inquest/103448148

[12] https://www.foxsports.com.au/nrl/nrl-premiership/teams/sea-eagles/inappropriately-tough-session-before-rising-manly-stars-death/news-story/6f20fa3b30ed01621a271fa4a49086db

[13] https://www.abc.net.au/news/2024-05-03/keith-titmuss-inquest-findings-inappropriate-training-session/103800424

[14] https://coroners.nsw.gov.au/documents/findings/2024/Inquest_into_the_death_of_Keith_Titmuss.pdf

[15] https://www.abc.net.au/news/2024-05-03/keith-titmuss-inquest-findings-inappropriate-training-session/103800424

[16] King, I., 1999, Foundations of Physical Preparation (Course)

[17] King, I., 2000, Foundations of Physical Preparation (Book), p. 26

 

 

Does exercise accuracy matter?

Introduction

When speaking to physical trainers, therapists and other aligned professionals as I travel on the quest to answer the question ‘What is the best way to train?’, I appreciate learning from them. What they think, what they say, and what they do with athletes and clients.

This journey has involved the privilege of travelling the world for many decades seeing these training trends firsthand.  When asked what the most common exercise I see being done from my innovation, it is, without question, the single-leg stiff-legged deadlift.  The only problem is that I almost never see it being done in the way I intended. It would be difficult to walk into any gym in the world now and not see someone performing an imitation of a small oil rig.

Over time I also hear the words used to describe the exercise and the interpretation of when and how to use it varies more and more.

For example, I was recently in a seminar when one of the participants  – a highly qualified and experienced practitioner, albeit a post-2000 entrant to their profession – repetitively referred to my exercise innovation of some forty years ago as a ‘single leg RDL’. And spoke about their application of it to rehab a client’s chronic hamstring injury. With limited success.

It may have been that little bit of German heritage in myself, but my excellence-at-risk meter tends to rise towards the red line when I see and hear these things that for me are the opposite of exercise accuracy. But perhaps that is my problem. Perhaps exercise accuracy doesn’t matter?

When I speak about exercise accuracy, I refer to the origin, name, execution, the application.  I will continue on with the theme of the exercise I called the single leg stiff leg deadlift.

The origin

In this section, I share my observations of the evolution of the stiff-legged deadlift.

The stiff-legged deadlift

First, there was the stiff-legged deadlift.  It was an exercise done for the most part by competitive lifter – Olympic and power – as a supplementary exercise to pulls and deadlifts.

I described this exercise many years ago in the following way:

MG Stiff Legged Deadlift:  Take a medium grip (about shoulder width) and commence in a standing position.  Lower the bar down by bending at the hips, not at the knees.  In the start, the knees should be slightly bent and remain exactly at joint angle during the lift. [1]

It was a two-legged (bi-lateral) loaded exercise using the barbell.

You will find this exercise championed in books that shaped training through the lat half a century including but not limited to:

The single-leg stiff-leg deadlift

During the early 1980s, I concluded that the dominant approach to strength training was creating muscle imbalances because of the bias in programs towards exercises such as the bench press and the squat.  I didn’t want that collateral damage for the athletes I trained, and I set about developing a categorization of exercises to avoid such imbalance in program design. This led to the concept of ‘Lines of Movement’, where I introduced terms and definitions to place every strength exercise into an exercise category.

 The following shows a breakdown of the body into major muscle groups/lines of movement, and then into examples of exercises. It is what I call ‘the family trees of exercise’. Use this to assess balance in your exercise selection.  

To help you understand how to divide and balance out your training, Ian came up with a list of major muscle groups that reflects their function:[3]

Horizontal pulling (row)
Horizontal pushing (bench press)
Vertical pulling (chin-up)
Vertical pushing (shoulder press)
Hip dominant (deadlifts)
Quad dominant (squats)

So, when I was writing a program, I increased the balance of the program by ensuring balance in the Lines of Movement.

When developing the term ‘hip dominance’ and defining what constitutes a hip dominant exercise, I realized that there were too few exercises in this category and that I needed to match the number, joint involvement and loading potential of exercises in the ‘Quad Dominant’ category.

I leaned on the traditional double leg barbell stiff-legged deadlift to create a single-leg, nil, or low-loaded variation option.

During the 1980s I refined the movement however, as with all my innovations, I trialled and tested it for a decade before extensively publishing it commencing from the late 1990s.

You can see the original exercise in the image below, taken from the How to Teach Strength Training Exercies Video Series (2000).

The ‘Romanian Deadlift’ (RDL)

The “Romanian Deadlift’ appeared in the US in the early 1990s. Initially, this exercise had no known name, or at least not one that the person I learnt it from gave it.  Dragomir Cioroslan, (a former Romanian national weightlifting coach who went on to work with the US Weightlifting team) and his protegee’s were doing a series of demonstrations and seminars during the early 1990s when many, including myself, were intrigued by a unique exercise that they were using as a supplementary exercise – somewhat of a cross between a deadlift and a stiff-legged deadlift.

I had been analyzing the physiques of Dragomir’s athletes for a few days before I got to see them train, and I was puzzled by their hamstring development. There were other shape differences between the and other weightlifters of that era, but that was the one that I linked to this exercise. So, before I got to see them lift, they had my attention.

I began integrating the ‘Romanian Deadlift’ into my training programs and in the absence of a name I called it the Romanian Deadlift, in respect of the origin. I have since noted others came to this same name conclusion. In all publications since that time, I have continued to use that name for this exercise.

The name

By the time I learnt of the loaded bilateral single-joint exercise we called the Romanian Deadlift, I was already well advanced in using the exercise variation I had developed and named the single-leg stiff-legged deadlift.

I began integrating the ‘Romanian Deadlift’ into my training straight away, however, it was not as a substitute or synonym for what I had developed but rather as an additional tool in the toolbox. In my mind they were two different exercises.

Not only was one unilateral and the other bilateral, but also because they were conducted with strikingly different techniques and loading potential.

When I see or hear the term ‘RDL’ to refer to the single-legged deadlift as I had innovated, I question their understanding of that person as to the execution and intent of each exercise.

For me, the only thing they have in common is that they are both relatively isolated posterior chain exercises i.e., they only involve the hip, rather than the knee and the hip.

The execution

To commence the discussion of the difference in execution between the single leg stiff legged deadlift and the Romanian Deadlift, I share the descriptions of each I provided in the late 1990s.

Romanian Deadlift

In plainer terms this is a flat back version of the stiff-legged deadlift.  With the bar on your back, take a shoulder-width stance and slightly bend the knees.  The knee angle is now not to change during the lift.  Flex or lower forward from the waist, keeping your chest up and hip/spine flat i.e. aligned.  Only flex forward as far as you can PRIOR to any rounding of the spine or posterior rotation of the hip.  For most, this will not be very far!

You can also accentuate the hamstring involvement by pushing the bum back and allowing your weight to drift to your heels during the lowering.     During the lift, squeeze the gluts.  This increases the hamstring involvement, which is the aim.[4]

Single Leg standing Stiff Legged Deadlift

Let the fun begin!  Stand on one leg – have the other foot off the ground, but kept roughly parallel with the leg doing the supporting.  Bend the knee slightly, but that knee angle should not change during the exercise (get a partner to watch for this, as it will be tempting to do so!).  Now bend at the waist, allowing the back to round and reach slowly towards the floor.  If your range allows, touch the floor with the fingertips and return to the starting position.  Use a speed of 3 seconds down, 1 sec pause at the ends, and 3 seconds up.

You may struggle with balance, but persist – you will be developing the muscles in the sole of the foot!  The first time you do this you may find you are touching down with the non-supporting foot regularly to avoid falling over.  This is ok, but in later workouts, try to minimize this.  When you have mastered this exercise, and touching of the ground by the non-supporting leg means terminate the set – this is your challenge.

Don’t be surprised if you can only do 5 reps on day 1!  Look to increase the reps from workout to workout.  Hold light DB’s in your hand ONLY when you get to 10 reps at the speed indicated.  No warmup set necessary.   Remember the weak side rule. [5]

Unfortunately for the world’s interpretation of how to execute the single leg stiff legged deadlift, only a few years after I began more openly sharing the exercise in publications, it appeared unreferenced in a prominent magazine, performed in a way that reflected the ‘author’s’ lack of understanding (and perhaps also the male models lack of flexibility, balance and single leg strength – to be able to do the exercise!). Learn more about that here.

To be clear, consider the following comparison:

Variables SL Stiff Legged DL Romanian Deadlift Similar Different
Hip dominant exercise

*

Isolated hamstring Less so More so (1)

*

Number of limbs One (unilateral) Two (bilateral)

*

Loading on feet Central Rear

*

Spine shape Rounded Flat

*

Chest shape Collapsed Up

*

Loading potential Lower Higher

*

  • When done correctly as per the manner originally intended.

Between the descriptions provided and the table above, it may be clearer why I do not see the words ‘RDL’ relevant to the single-leg stiff-legged deadlift. There are far more differences than similarities.

The application

The original rounded-back stiff-legged barbell deadlift is an excellent exercise for strengthening spinal segment strength in addition to hamstrings. However, the political correctness trend in exercise has veered away from exercises and variations that include a rounded spine. That’s unfortunate for athletes who experience loading and/or impact in a less-than-neutral spine shape.

The application of the exercise I innovated, the single-leg stiff-legged deadlift, is not as clear-cut as many assume. In theory, being a unilateral, single-joint exercise, it would have a broad application earlier in the training career, year and return from injury/surgery.

However due to the range involved, the increased loading on the hamstring due to the more bloated nature of the exercise, the increased demand on balance, and the fixed load of the body, this exercise needs to be reviewed and reflected on prior to being included in a training program.

Additional points to consider include:

  • When conducted in an optimal manner (as per it was developed) – with the non-working leg remaining still and parallel to the working leg – the range may be limited by the hamstring flexibility (this was not a problem for me during the developmental decade, because of the premium I placed on flexibility training).
  • If the athlete/client lacks the balance and or range to execute the movement tin the intended manner, you can choose between developing these qualities or default to the influence of allowing the back leg to raise.
  • If you go with the softer option, you are reducing the work (including balance) in general due to counterbalancing of the back leg, and reducing the workload and isolation on the hamstring by allowing the pelvis hemispheres to diverge.
  • Therefore, a decision needs to be made regarding progression – to work on improving range, repetitions, and or load. Generally speaking, I recommend working from the former to the latter.

The Romanian Deadlift (RDL) provides greater loading potential than the single leg stiff legged deadlift version, however, the following are important points:

  • The RDL should not be considered as an equal and opposite of a squat, as the relative loading potential of this exercise compared to the squat is less.
  • The RDL as a rounded back exercise should not negate the inclusion of a rounded back variation in athletes who may be exposed to loads in their sport where the spine is less than in neutral (rounded).
  • If the pivot at the hip joint is not maintained as the exclusive pivot point, the relative load/work/isolation on the hamstrings is reduced.
  • Therefore, considering the progressively reducing nature of athlete flexibility, you may not be working through the range you initially expected or anticipated.

Now to touch briefly on a key point in the application. There has been a long-retained belief, at first in the physical therapy disciplines and now also in the physical training disciplines, that isolated hamstring strength training is the key to rehabilitating or preventing hamstring strains.

Many decades ago, I reached an alternative conclusion. It’s not the aim of this article to go deep on this subject, however, I feel it may be remiss of me to not touch upon it.

Keep in mind my suggestion that if you fail to identify the cause of the injury (and I suggest weak hamstrings are not the cause in the overwhelming majority of cases), then your ‘solution’ may contribute to the problem.

Learning that the single leg stiff legged deadlift – an exercise near and dear to my heart because it is essentially one of my ‘babies’ –  is being used in a ‘hamstring strengthening program’ to rehabilitate athletes with hamstring strains, or prevent hamstring strains, is difficult to hear.  I do not believe the goal will be achieved, and the athlete does not deserve to be a guinea pig for this misguided paradigm.

Conclusion

For almost twenty years now I’ve watched the single-leg stiff-legged deadlift gain global acceptance – in and out of the gym. The only problem was that it was not being done in the intended manner.  More recently I have seen this popularity expand into rehabilitation, and this becomes even more concerning.  And to hear the confusion around the name, such as the use of the term ‘RDL’ in the same exercise name, is a reflection of a lack of understanding o the nuance of the RDL to achieve the hamstring isolation.

Maybe that’s just me being too German-like, seeking precision and excellence in the process.

Maybe exercise accuracy doesn’t matter?

 

References

[1] King, I., 1999, Get Buffed! 1 (book), p. 244

[2] King, I., 1998, How to Write Strength Training Programs, P. 32

[3] Shugart, Chris, 2001, The Ian King Cheat Sheets, Part 1 – A quick and dirty look at all the cool stuff Ian King has taught us so far, Fri, Aug 24, 2001, T-mag.com

[4] King, I., 1999, Get Buffed! I, p. 230-231.

[5] King, I., 1999, Get Buffed! I, p. 210-211.