Asymmetric low back loading in asymmetric lifting movements is not prevented by pelvic twist

Asymmetric lifting is associated with an increased risk of low back disorders. Especially in lifting movements, characterized by a small amount of asymmetry, it is still the question if asymmetric lumbosacral torques occur, or if subjects try to avoid asymmetric back loading by twisting their pelvis with respect to the feet. An increase of the lifting speed or the box weight might amplify the lumbar torques but might also result in an attempt to limit further increase of asymmetric torques by increasing pelvic twist. In the current study, asymmetrical lifting movements were analyzed with the aid of a 3D linked segment model, using cuffs mounted to the body segments. Eight subjects performed lifting movements with five different asymmetry conditions, ranging from 0 to 90 degrees lifting asymmetry with respect to the sagittal plane, using two lifting speeds and two box weights. A significant increase in lateral flexing and twisting low back torque was found for each increase in asymmetry of the lifting movement. Pelvic twist accounted more or less constantly for about 25% of the lifting asymmetry and was hardly influenced by lifting speed or box weight. Even for 10 or 30 degrees of lifting asymmetry, subjects did not twist their pelvis far enough to avoid asymmetric loading of the low back. Assuming that asymmetric loading of the low back is more strenuous to the spine than symmetric loading, the current results indicate that even small deviations of a lifting movement from the sagittal plane can explain an increased risk of low back disorders.