Ways to Train with Low Back Pain

Low back pain is the most common ailment people present with to physical therapy clinics.  80% of people will experience low back pain at last once in their lifetime. Some people will have some discomfort and can go about their daily routine while others are laid up on the couch, taking pain medication, using ice or heat, and can barely move.

If you are one of those people who are laid up on the couch, go see a licensed healthcare practitioner ie. physical therapist, sports chiropractor, etc.  Also, if you are having low back pain that isn’t improving, go see someone!

For everyone else, who has either dealt with low back pain before or is currently trying to get to the gym to train, check out this article for ways to continue to train at the gym without making things worse.

1. Change Your Lifts

When someone has low back pain, they typically won’t like to back squat.  The back squat requires a great demand for mobility throughout the body. Anecdotally, most athletes and clients who’s back is bothering them will typically not tolerate the axial loading that occurs with the bar on the back.

With that being said, try other squat variations such as:

Front Squat

Goblet Squat

By changing the position of the load from the back of the body to the front or into the hands, it can improve core musculature activation as well as just simply feel better for some athletes.

2. Place an Emphasis on Technique

There is a spectrum of opinions on this topic.  Some people say that you need to have perfect form 24/7 while others say technique doesn’t matter.  Like most things, it depends.

If someone is dealing with active pain with certain movements or positions while lifting, we don’t want to keep irritating what is already irritated.  We need to let things calm down. If you are continuing to load something and it is making it worse, not better, then something has to give.

If you are rounding your low back in the bottom of the squat,

and this bothers the back and continues to make things worse, stop!  I’m not saying that you need to stop squatting all together, but adjusting your technique may be key to helping you be able to continue training and feel good.

If you are squatting and continuing to round at the bottom of a squat, try limiting your depth by using a box squat so you can maintain good technique and can still maintain a training effect.

or don’t squat as deep and maintain good technique and continue to work on improving your technique as things feel better.

Another good variation is using a goblet squat with a pulse or with a breath.

Both of these drills can be great options to train the body to control the bottom position of the squat, maintain tension throughout the body, and improve the body’s ability to attain deeper squat depths safely and pain-free.

3. Change Your Pulling Options

If pulling from the floor bothers your back, try elevating where you are pulling from using these variations:

Rack Pulls

Trap Bar Deadlifts

Cable Pull Thrus

*even though trap bar deadlifts are from the floor, it decreases the amount of mobility needed since the handles are higher as compared to a sumo or conventional deadlift.

4. Place an Emphasis on Single Leg Strength

Even though the mentioned lifts prior to this utilize both lower extremities, placing an emphasis on single leg training is key for lower back health.  Improving single leg strength can help carryover to bilateral lower extremity performance as well improve lumbopelvic stability and strength.

Here are a bunch of options for you to utilize to help give your back a break as well as maintain a lower body training effect.

Step-Ups

Lunges

Bridging Variations

Single Leg Deadlift Variations

If you are currently dealing with low back pain or have in the past and want to be able to continue to train at the gym, try adjusting your lifts, placing a great emphasis on technique, changing your pulling position, and adding in single leg training.  

This isn’t an exhaustive list of what to do/not to do with low back pain, but these are options if you want to continue to be able to train.

Andrew Millett