Can a weightlifting belt reduce the risk of low back injury with exercise?

If you have ever walked into a gym and wondered why everyone is wearing big belts around their waist, you’re probably not alone. Owing to the increasing popularity of CrossFit, powerlifting and Olympic Weightlifting, weightlifting belts have increased in popularity. The wearing of the weightlifting belt was initially limited to powerlifting and Olympic lifters, however in recent years recreational lifters of varying skill and experience levels are wearing them too. But is the weightlifting belt useful for the everyday gym-goer to reduce the risk of injury to the low back during strength training?

This blog will examine research related to the use of weightlifting belts and their effectiveness in providing assistance or injury prevention during lifting exercises, primarily squatting and deadlift-type movements.

What is the purpose of the weightlifting belt? The weightlifting belt is a means of bracing the abdomen during exercises such as squats and deadlifts. Weightlifters wear the belt when lifting very heavy weights for additional support and often state that they “feel safer” wearing the belt when exerting large forces.

A weightlifting belt provides continuous compression to the abdominal region, and by doing so increases intra-abdominal pressure (IAP). When you increase IAP the pressure inside the abdominal cavity pushes on the spine to support it internally, while your core muscles (such as your obliques and abs) and lower back push on the spine from the outside. This is thought to reduce the load that the extensor muscles (erector spinae) are under when performing heavy squats or deadlifts. It is also thought that the belt can help provide feedback to the person on body position. However, recent research has questioned the validity of using these belts to reduce the stress imposed on the lower back and the muscles acting posteriorly to these structures, primarily the erector spinae, as seen below.

What does the research say about lifting belts? Research and literature have shown the use of weightlifting belts is overly inconclusive and that these supports have no influence on risk of injury to the lumbar spine.

Cholewicki et al. (1999) stated in their article published in the European Spine Journal, that “the overwhelming evidence suggests that belts have no effect on muscle strength, fatigue, or low back injury incidence”. While a few studies reported marginal improvement in lifting capacity with the use of abdominal belts, the overwhelming evidence suggests that belts have no effect on muscle strength, fatigue, or low back injury incidence.

Research on this topic has been very limited for the last 20 years, and there is a need for further evidence to make a conclusive statement on whether wearing the lifting belt in the gym setting can be effective for reducing the incidence of low back injury with lifting.

Conclusion Despite the fact that the literature is inconclusive on whether or not weightlifting belts can help prevent low back injuries when lifting, there are a few speculated ideas as to the mechanism of how the belt may work. These include increasing the IAP which is thought to assist in stabilising the spine during heavy lifts such as squats and deadlifts and to remind the lifter of proper lifting mechanics/body position, especially when performing maximal lifts.

However, wearing a weightlifting belt should not be a stand-alone solution or the sole preventive measure for back injury. Learning proper lifting techniques and performing the appropriate exercises with appropriate load are the best primary interventions to reduce the risk of injury during exercise. Of course, you can always increase your own IAP pressure by performing what is known as the Valsalva manoeuvre on your own (breathe in, hold your breath and tense your abs). The belt acts as a feedback mechanism to give your stomach something to push against.

If you are unsure about your lifting technique, it is best to consult an appropriately qualified coach in your field or a physiotherapist.

This blog was written under supervision by Bailee Stubbs, final year physiotherapy intern at Breathe Physio and Pilates. We'd be happy to answer any questions you have!

References: Bauer, J. A., Fry, A., & Carter, C. (1999). The Use of Lumbar-Supporting Weight Belts While Performing Squats: Erector Spinae Electromyographic Activity. Journal of Strength and Conditioning Research, 13(4), 384–388.

Cholewicki, J., Juluru, K., Radebold, A., Panjabi, M. M., & McGill, S. M. (1999). Lumbar spine stability can be augmented with an abdominal belt and/or increased intra-abdominal pressure. European Spine Journal, 8, 388-395. https://doi.org/10.1007/s005860050192

Kingma, I., Faber, G. S., Suwarganda, E. K., Bruijnen, T. B., Peters, R. J., & van Dieën, J. H. (2006). Effect of a Stiff Lifting Belt on Spine Compression During Lifting. Spine, 31(22), 833-839. doi: 10.1097/01.brs.0000240670.50834.77

Miyamoto, K., Linuma, N., Maeda, M., Wada, E., & Shimizu, K. (1999). Effects of abdominal belts on intra-abdominal pressure, intra-muscular pressure in the erector spinae muscles and myoelectrical activities of trunk muscles. Clinical biomechanics (Bristol, Avon), 14(2), 79–87. https://doi.org/10.1016/s0268-0033(98)00070-9