Deadlifts are often seen as the ultimate strength benchmark — but how relevant are they for long-term health, especially as we age?
In a recent conversation between Dr. Peter Attia and renowned back pain expert Dr. Stuart McGill, the two explored this exact issue in depth: Are heavy compound lifts like deadlifts still worth it for middle-aged or older individuals, or does the risk eventually outweigh the reward?
This isn’t just about fitness performance — it’s about sustainability, joint integrity, and the longevity of your musculoskeletal system.
If you’re someone who enjoys lifting but has doubts about how to proceed as your body ages, you’re not alone.
Why Deadlifts Can Be a Double-Edged Sword
Deadlifting is a powerful movement that engages the entire posterior chain, activates core musculature, and offers measurable feedback on full-body strength. As Peter Attia noted, the deadlift can serve as a “wonderful audit of your stability system.”
But it also carries a narrow margin for error — especially as the years go by. Even with perfect technique, the act of repeatedly lifting heavy loads from the floor introduces axial loading that may exceed what aging joints and tissues can manage long term.
“It’s not that deadlifts are bad,” Attia said. “It’s that the operating window for safe execution becomes narrower with age.”
Dr. McGill reinforced this view, pointing out that in professional powerlifters, training to set new personal bests often results in microfracturing of the vertebral endplates. While these can heal and strengthen the tissue over time — provided there’s adequate rest — too frequent loading can lead to chronic spinal damage.
“You set a true personal best in the deadlift — you just micro-fractured your spine,” McGill explained. “Now if you lift again 3 or 4 days later, those stress injuries can accumulate until there’s a full-blown endplate fracture.”
The Case for Sufficient Strength Over Max Strength
McGill encourages a shift from chasing numbers to embracing sustainability and freedom of movement. His concept of “sufficient strength” reflects what many lifters sense as they age — the body no longer benefits from constant pushing but thrives under smarter, adaptive loads.
Instead of 1-rep max goals, McGill often asks his clients: “Would you rather have the ability to deadlift 500 pounds, or play on the floor with your grandkids at 80?” For those who choose the latter, the path becomes clear: prioritize functional longevity over personal bests.
And that doesn’t imply weakness or regression. According to McGill, many top-tier athletes have transitioned away from deadlifts and squats, gaining joint durability and maintaining elite fitness through alternative methods.
Alternatives That Preserve Strength Without Sacrificing Joints
For those stepping back from traditional deadlifts, McGill lays out a compelling regimen packed with purpose:
Hill Backward Walking: Strengthens posterior chain and knee stability without axial stress. Leaning into the hill adds neurological challenge and balance work.
Monster Walks: Targets hip stabilizers and glutes in functional, joint-friendly ways.
Loaded Carries: From farmer’s walks to cinder block carries, these movement patterns build grip and core strength — crucial markers of longevity.
Split Squats and Step-ups: Provide unilateral loading benefits without the compressive force of backloaded squats or deads.
Sled Work: Replaces heavy squats with low-impact horizontal resistance that enhances strength endurance.
Even advanced lifters find these modified exercises surprisingly effective. As McGill shared, one powerlifter struggled to walk backward 30 meters up a hill despite years of barbell training. These movements tested and trained real-world strength, often neglected in traditional gym routines.
The Longevity Benefits of Stability and Grip
Both Attia and McGill highlighted grip strength as a top biomarker for longevity.
“You don’t get high grip strength from just squeezing a gripper,” Attia noted. “You earn it through carrying heavy things, chopping wood, or doing real work.”
The reason grip strength stands out so prominently in longevity research is simple: It reflects an integration of neuromuscular coordination, full-body stability, and sustained effort over time.
Similarly, VO2 max — another reliable predictor of lifespan — isn’t something you can fake. It requires years of cardiovascular training and metabolic adaptations. These two variables, grip strength and VO2 max, serve as outcome measures for smart, sustained training practices that promote true healthspan.
Moving Forward: How To Train Smarter at Any Age
For lifters wrestling with the decision to keep deadlifting or shift gears, the answer lies not in black-and-white thinking, but in assessing personal goals and risk tolerance.
If the goal is healthy aging, joint integrity, and function, the cost of heavy barbell loading may no longer serve the same purpose it once did.
Instead, here’s a smart framework to guide sustainable strength training:
Audit Your Capacity: Use pain-free reps and controlled tempo as your guideposts — not the number on the bar.
Cycle Intensity: Like the pros, treat peak physical feats as events, not lifestyle habits. Allow full recovery, both muscular and neurological.
Base Goals on Function: Design your training with life’s demands in mind — getting off the floor, lifting grandchildren, carrying bags, or hiking a trail.
Prioritize Core and Grip: Develop functional strength from the inside out. Strong stabilizers and fascia-integrated movement protect from injury far more than muscle size alone.
Embrace Simpler Tools: Resistance bands, sleds, hills, and loaded carries can train the same muscles with less systemic load.
The Bottom Line
Deadlifts aren’t inherently unsafe — but chasing heavy numbers into middle age, especially without factoring in recovery and technique, is a gamble with diminishing returns.
As Peter Attia said, he now deadlifts based on how his body feels that day. And he’s content swapping the lift out for lower-risk movements when needed — provided they support the same muscle groups in smarter ways.
It’s not about abandoning strength — it’s about evolving how you build and express it. The goal is to remain strong enough, stable enough, and mobile enough to meet life’s demands for decades to come.