• Lisa Corken, PT, DPT

Unilateral Training

The importance of unilateral training for overall body strength

A question we often get as physical therapists is: “What’s the best way to protect my body when lifting weights?” Of course, there are several different ways to answer this question. This blog is going to emphasize my professional and personal approach on how to reduce risk of injury when you are lifting weights.


There are so many amazing different lifting techniques that are great for strength building. A few of the popular ones are deadlifts, snatch and cleans, front squats, back squats, pull-ups and bench press. These are more of your power moves that are great for strengthening, but often are performed incorrectly. Now, you may have every intention of performing the exercise perfectly, but your body just won’t cooperate. This is where I incorporate my approach to protecting your body.

We commonly see patients in the clinic who have a dominant side. This is totally normal! However, this can also lead to imbalances in your squat, deadlift, pull-up, etc. I use slow motion video technology to see if you are using one side more than the other and then address it with a more appropriate warm-up for these power moves. This usually involves a more unilateral approach to strengthening. Thus, I prescribe SINGLE LEG squats, SINGLE LEG deadlifts, and other challenges that will engage each side of your body prior to bigger lifts.

The reason that this ends up protecting the entire body is that it increases overall core activation. The big squat and deadlift are very bilateral motions where the majority of the force is going through the center of our body - the spine. While the spine is a very strong structure with complex ligamentous support, muscular stability, and discs - it still has its limits. Now, if we take your standard front squat with dumbbells as shown in the picture on the left you can see that the force is through the midline of your body. Most of my patients believe this to be ideal as they feel centered, but in fact it places more strain through the spine if not performed perfectly. If we compare it to the picture on the right where you are holding a dumbbell on just one side, this will create a sidebending force thus increasing more oblique and core activation to stop you from leaning or falling that way. This more rotational torque helps move the force from straight down your spine to now requiring that core control.


Squat with Unilateral Load


Front Squat with Dumbbells


The same principle can be applied to upper body lifting as well. See below the difference between bilateral overhead military press compared to unilateral military press. If the man on the right didn’t engage his RIGHT obliques, that weight in his left hand would cause him to tip over!



Bilateral Overhead Press

Unilateral Overhead Press

The last piece of the puzzle I like to incorporate to ensure proper mechanics for all lifts is a good balance challenge. We know through research that standing on unstable surfaces will reflexively engage more muscle activation during performance of an exercise. A lot of my patients who do these big power lifts often really struggle to balance on one foot on a bosu! Unsurprisingly, it will usually be harder on one side over the other. Sometimes, I educate my patients to perform multifaceted exercises. If you see in the picture, this young man is challenging his balance on one side while performing an overhead press on the other to thus engage more core activation. It’s a little bit like patting your head and rubbing your belly, but with the emphasis on neuromuscular recruitment and improved motor control.


Overall, these are just a few tips I like to educate my patients about when returning to bigger powerlifting or weight lifting. They are great ways to continue strengthening while promoting a healthier and stronger core. The purpose of this blog was meant to shed light on how unilateral vs bilateral forces on the spine can be manipulated to improve muscle activation in addition to adding a balance component for full body involvement. Ultimately, the best approach to a routine like this is to schedule an appointment with your physical therapist to have them evaluate your squat, bench press, deadlift, etc after which they can create an individualized program for your specific workout needs!

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