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# The back advice everyone knows, and it does not work
- URL: https://the-health-brief.ghost.io/the-back-advice-everyone-knows-and-it-does-not-work/
- Published: 2026-10-01T14:00:22.000Z
- Updated: 2026-10-01T14:00:22.000Z
- Description: Four thousand postal workers were taught to lift properly, then followed for five years.
- Author: Walt Brennan

| Live well Bend your knees. Keep your back straight. Lift with your legs. You have heard it your whole life. It is the most repeated piece of back advice in the language… and it is on a poster in every warehouse in the country. And when somebody finally tested it, it did not prevent back pain. I will not pretend that went down easily. I have been saying it to my own children for thirty years. A quick question · tap to answer Were you ever taught how to lift properly? Tap one. A ready-to-send reply opens, just press send. [Yes, at work](mailto:hello@thehealthbriefdaily.com?subject=Lift%20training%3A%20work&body=Yes%2C%20at%20work.) [Yes, somewhere else](mailto:hello@thehealthbriefdaily.com?subject=Lift%20training%3A%20other&body=Yes%2C%20somewhere%20else.) [No](mailto:hello@thehealthbriefdaily.com?subject=Lift%20training%3A%20no&body=No%2C%20never.) The postal workers About 4,000 postal workers in the United States were followed for more than five years. The trained half were taught back safety. Lifting posture, exercises, how to handle pain, with refresher sessions along the way to keep it fresh. At the end there was no reduction in back injuries. No difference in what those injuries cost. No change in how people actually lifted. One finding from the middle of the study has stayed with me. The trained group knew more about safe lifting. They simply did not lift any differently. And it is not one odd study A Cochrane review gathered nine randomized trials covering 20,101 workers. Moderate quality evidence, and the conclusion was flat. Handling advice and training does not prevent back pain or back pain disability… whether you set it against nothing at all or against some other approach. A review in the British Medical Journal put it more bluntly. No evidence to support advice or training in working technique for preventing back pain. So this is not a stray result that got out of hand. It has been the settled position for years… and the posters are still up. What I take from it Not that lifting technique is nonsense. If a thing is heavy and awkward, getting close to it and using your legs is still sensible, and it will feel better while you do it. What the trials say is narrower than the poster. Teaching people the technique does not stop them hurting their backs later on. Which points somewhere less comfortable. The load matters more than the form. If a thing is too heavy, no posture is going to save you. Make two trips. That is the advice the evidence actually supports, and it fits on a smaller poster. Since we are here, the mattress The other thing everybody asks. A review gathered 39 studies on mattresses and backs. A medium firm mattress came out ahead of a hard one. The main trial behind that put 313 people with long running back pain on one or the other for 90 days, and the medium firm group did better on both pain and getting about. Medium firm. Not hard. The board under the mattress is advice from a previous century. Hold it loosely, mind. Most of those 39 studies were not randomized, which is a polite way of saying the field is thin. What to stop worrying about Whether you are lifting exactly right. Training people in technique does not prevent back pain. Getting close to the load, and making two trips, does more than perfect posture ever will. What to actually change If your mattress is hard, or has a board under it, that is advice from another era. Medium firm came out ahead. And if it is over ten years old it has likely stopped being whatever it was sold as. Anyway, I still bend my knees. Not because a trial told me to, but because a heavy box feels better that way… and feeling better while you do a thing counts for something on its own. When to stop and call your doctor Sudden severe back pain while lifting is worth a call rather than a wait. Especially with pain running down a leg. Go to a hospital now if you lose bladder or bowel control. Same if you go numb around the saddle area between your legs. A leg that is getting weaker day by day counts too. And if you are over 50 and this is the first really bad episode of your life, have it looked at properly. Quick poll · tap to answer How long do you sit without getting up? Tap one and just press send. [Under 30 minutes](mailto:hello@thehealthbriefdaily.com?subject=Sit%3A%20%3C30&body=Under%2030%20minutes.) [About an hour](mailto:hello@thehealthbriefdaily.com?subject=Sit%3A%201h&body=About%20an%20hour.) [Hours](mailto:hello@thehealthbriefdaily.com?subject=Sit%3A%20hours&body=Hours%20at%20a%20time.) I read every reply. Here is to two trips instead of one,**Walt** |
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