Can you use the Orthodox Lift? The dangers, legality, and safe alternatives.

October 2, 2025 •

4 min read

In 1987, the Royal College of Nursing officially condemned the Orthodox Lift as an unsafe manual handling technique due to the significant risk of injury to both patients and staff. As a healthcare professional, care worker, or family caregiver, it is crucial to understand that you absolutely cannot use the Orthodox Lift today.

Quick Summary

This outdated and high-risk lifting method is banned in many care environments because it places both the care recipient and providers at significant risk of musculoskeletal injury. Modern practice dictates using safer, mechanical, or assistive equipment instead.

Key Points

Condemned technique: The Orthodox Lift is an illegal and unsafe manual handling practice that was officially condemned in 1987 due to high injury risks.
High-risk for patients: The method is unstable and can cause falls, shear forces, skin damage, and significant discomfort for the person being lifted.
Harmful to carers: The lift places immense and unnecessary strain on the back, shoulders, and wrists of carers, leading to potential musculoskeletal injuries.
Modern, safe alternatives exist: Safe and legal methods, such as mechanical hoists, slings, and sliding sheets, should always be used instead.
Proper training is mandatory: All caregivers should receive up-to-date manual handling training that emphasizes modern, safe practices and the use of assistive equipment.
Refuse to use unsafe methods: It is a caregiver's ethical and legal duty to refuse to perform unsafe or banned lifting techniques like the Orthodox Lift.

What is the Orthodox Lift and why is it dangerous?

The Orthodox Lift is a historic patient handling technique that involves two carers standing on either side of a person and joining hands to form a 'cradle' to lift them. The technique typically involves clasping wrists behind the patient's back and under their thighs, and lifting them together. This method was once used to move patients, but is now considered extremely dangerous and is strictly prohibited in professional care settings for a number of critical reasons.

The clear dangers for patients

For the person being lifted, the Orthodox Lift poses several serious hazards:

Risk of injury: The lifting motion is jerky and unstable, increasing the risk of dropping the patient or causing a fall.
Shear forces and skin damage: The hands and arms clasped under the thighs and back can cause significant skin damage due to shear forces, especially on fragile skin.
Physical discomfort and pain: The lift is uncomfortable and undignified for the patient. For individuals with existing painful conditions, such as arthritis or back problems, the method can cause immense distress.

The inherent risks for carers

The Orthodox Lift also presents a high risk of injury to the care providers performing it. The technique requires lifting and twisting at a distance from the body's centre of gravity, placing immense strain on the lower back and shoulders.

Increased strain on the back: The poor posture and twisting motion required during the lift directly contribute to back strain and long-term musculoskeletal disorders.
Shoulder and wrist injuries: The method of clasping wrists and lifting a person's entire body weight at arm's length puts extreme pressure on the carers' shoulders and wrists.
Uneven weight distribution: The weight of the patient is often unevenly distributed, further exacerbating the risk of injury for the carers.

Legal and professional consequences

The use of the Orthodox Lift is not just unsafe; it is a breach of professional and legal guidelines in many regions. Since its condemnation in 1987, many health and safety authorities have reinforced the ban on such manual techniques. Using this method could lead to professional misconduct charges, disciplinary action, and even legal prosecution for negligence.

Modern and safe alternatives to manual lifting

Professional healthcare practice has moved far beyond outdated and dangerous manual lifting methods. Today, caregivers are trained to use a range of specialised, assistive equipment to ensure the safety and dignity of both the patient and themselves. Here are some of the most common and effective alternatives:

Hoists: These mechanical lifts are the primary method for moving patients who cannot bear their own weight. They can be mobile or ceiling-mounted, using slings to safely transfer a person between beds, chairs, and other surfaces.
Sliding sheets and transfer aids: For repositioning a patient in a bed or chair, sliding sheets reduce friction and allow for smooth, effortless movement without straining the carer's back or causing shear forces on the patient's skin.
Transfer boards and belts: These tools are used to assist with a transfer from one surface to another (e.g., bed to wheelchair) for patients who have some weight-bearing ability but require assistance.
Gait belts: These belts are placed around a patient's waist to provide a secure handhold for a carer during assisted walking or standing, significantly reducing the risk of falls.

A comparison of lifting techniques

To highlight the difference between dangerous and safe practices, consider this comparison between the condemned Orthodox Lift and modern, approved methods.


Feature	Orthodox Lift	Modern Mechanical Hoist	Modern Transfer Aids (e.g., Slings)
Equipment Used	Hands, arms, and wrists only	Mechanical hoist, slings	Specialised sheets, belts, boards
Safety for Patient	Very low; high risk of injury, shear forces, and falls	Very high; controlled, stable, and comfortable	Very high; reduces shear, promotes dignity, controlled
Safety for Carer	Very low; high risk of back, shoulder, and wrist injury	Very high; removes physical strain from the carer	High; reduces physical strain and improper posture
Dignity of Patient	Low; can be frightening and undignified	High; comfortable and controlled process	High; promotes patient participation where possible
Legal/Compliance	Illegal; officially condemned practice	Fully compliant with modern health & safety laws	Fully compliant with modern health & safety laws

Training and prevention of injury

For any person involved in caregiving, mandatory manual handling training is essential. Proper training covers not only the safe use of equipment but also the risks associated with improper techniques. Resources like those from the Health and Safety Executive (HSE) provide detailed guidance on best practices.

Best practice manual handling principles

Assess the load and environment: Always evaluate the situation before acting. Is the path clear? Is the load manageable?
Use appropriate equipment: Never rely on manual lifts for a task that requires mechanical assistance. Hoists, sliding sheets, and transfer belts are available for a reason.
Maintain proper posture: When any lifting is required, even with a gait belt, keep your back straight, bend your knees, and use your legs, not your back.
Communicate clearly: If another person is helping, coordinate your movements and communicate clearly to ensure a smooth, controlled lift.

Conclusion

The Orthodox Lift is a relic of a past that did not prioritise patient and carer safety. It is now a universally condemned and unsafe technique that should never be used. Modern assistive technologies and proper training have replaced these dangerous practices, ensuring safer, more efficient, and more dignified care for everyone involved. If you are ever in a situation where this method is suggested, it is vital to refuse and insist on using approved, safe equipment and techniques. Prioritising health and safety is not only the legal requirement but also the ethical responsibility of every caregiver.

Frequently Asked Questions

It is considered dangerous because it is unstable, creates a high risk of dropping the patient, and causes excessive strain on the backs and shoulders of the carers performing the lift. It is also highly uncomfortable and can cause shear forces that damage the patient's skin.

Yes, in many regions, the Orthodox Lift is an officially condemned and banned practice. Using it would be considered a violation of health and safety regulations and could lead to legal and disciplinary consequences.

You should use modern assistive technology, such as mechanical hoists with slings, sliding sheets, or transfer belts. These pieces of equipment are designed to perform transfers safely, protecting both the patient and the carer.

All caregivers should receive mandatory manual handling training that covers the proper use of assistive equipment and reinforces safe lifting principles. This training helps ensure compliance with legal and safety standards.

Unlike other lifts that may have variations, the Orthodox Lift is specifically banned. Modern manual handling focuses on using mechanical aids and proper ergonomics to eliminate the risk inherent in relying solely on human strength and twisting motions.

No. Any modification of the orthodox or cradle lift is also banned. The risk of injury to both parties remains, regardless of the patient's weight. The safest practice is to always use approved, assistive equipment.

You should refuse to perform the lift and report the instruction to a supervisor or your health and safety representative. Using a banned technique is a serious breach of protocol that puts everyone at risk.