Back pain is an epidemic in this country.
Too many people suffer from it and it is often preventable.
It might not be as important as a lot of the other issues but let’s stay on topic.
Back pain is often caused my prolonged poor posture and a lack of muscular strength. A lot of people like to pin it on exercises in the gym but is usually activities outside of the gym that make the problems worse.
There are two ways that posture can influence back pain. One is through extension. An extended posture is seen when there is an exaggerated curve in the lumbar spine and ribs flare out.
Extension based injuries usually take place with the structure of the spine and the facet joints.
We can also have flexion intolerance. People who display a rounded low back are spending too much time in flexion. Adding load and potentially rotation to a rounded back is a good way to decrease resiliency in the vertebral discs.
Posture is determining what happens to the spine for 23 hours per day, not the 1 hour in the gym. Exercises may not be helping anything out. Someone in pain needs to be real careful about which exercises they pick.
There are other people that feel good for the most part but then start to hurt when they sit for too long or after squatting.
Back pain can also rear its ugly head when someone has not strengthened the right muscle groups. The glutes and hamstrings are most important here. A lot of people struggle with the hip hinge and therefore are weak in the posterior chain.
Then we have core stability. The ability to resist movement and activate all of the muscles of the torso. For too long, core training meant ab training and ab training meant crunches for days.
We are smarter than that now and know that is a poor strategy. It is now about stability exercises. These are going to be very important anytime anyone is dealing with back pain.
The strategy for strength training with back pain is straight forward.
- Don’t make anything worse
If you are not sure whether it is a good idea to squat heavy when the back feels iffy, it’s probably a good idea to skip squats that day.
Not everyone is going to be in perfect standing at the gym. Some people have bad days and we need to recognize that.
Showing up and doing something (credit: Dan John) is the real key to the gym. If you can do that you will be better off than 80% of the population.
Movement is great for those with back pain and bed rest is going to make the problem worse. Show up and do something.
- Activate the core and glutes first
A lot of ab work gets saved for the end of the workout. When someone has back pain, stability work is very important and gets pushed to the beginning.
Doing some light core work will get the muscles of the torso activated and firing. This will provide some protection for the spine and improve performance for the rest of the workout.
The same goes for the glutes. Most people’s glutes are not strong and we need to change that.
Getting those muscles ready to go will improve the chance of having a great workout without a setback.
- Use single leg work
Single leg work usually involves a lighter load on the back than bilateral lifts. Most people are not as strong on one leg as they are on two in terms of absolute weight. This reduction of loading will relieve pressure off of the back and allow the legs to get some good training.
Bulgarian split squats are very demanding and do not need to be loaded very heavy to start hating life.
- Use pauses, pulses, and negatives
Using a pause or negative reps are two ways to make an exercise really hard while keeping the weight low and promoting stability.
A 3 second pause or a hold can be used with a split squat to make a lighter weight more challenging.
A 6 second eccentric squat will really tax the legs with less weight on the bar
Adding a pulse to a lateral lunge is just like a pause but instead of forcing the person to count they will pulse the weight out instead.
Utilize these 4 methods to get a good training effect when the back feels iffy. Just remember point number1: is something is questionable, don’t do it.
Fighting through back pain is often a losing battle and we should stick to training around it.