Take my word for it, there is nothing better than nailing a new PR on your favorite lift. Nothing gets my blood pumping like crushing a heavy power clean or standing up a new front squat max. But as with any weight-lifting session there are ups and downs (literally).

Back pain, both chronic and acute, is a frequent performance inhibitor in the weight room, often stalling or halting progress completely.
So, what now?
How can you continue training at a high level, reduce your pain, and not lose all of your hard earned "gains" because of the stubborn pain in your back?

For starters, understanding your body and its symptoms and knowing when to get assessed by a Doctor of Physical Therapy is essential.

Common low back symptoms that should be further evaluated include:

  • Loss of sensation or altered sensation in the medial thigh and groin

  • Loss of bowel and bladder control

  • Excruciating night pain with inability to sleep

  • Shooting numbness and/or tingling into the legs

So, you don't have any of these symptoms, great! Then now it's time to put in the work and start training smarter with your injury, not harder.

The Importance of Staying Active When It Hurts

The biggest piece of advice I can offer when it comes to managing and dealing with back pain is to continue to stay active. The absolute worst thing to do is continue to "deal" with the pain, suffering through scheduled workouts or painful movements, bearing through the pain. This type of behavior creates a vicious cycle of pain and dysfunction that not only inhibits athletic performance but can be extremely mentally taxing.

There are a few common themes seen within the CrossFit and weightlifting community regarding back pain and specific movements that can generate or cause pain. These general movements include the deadlift, overhead press, and squat and can easily be modified and trained around with a little bit of guidance, creativity, and willingness to adapt with a long-term goal in mind. When looking at these specific movements and their modifications, I like to address a few simple yet effective principles including efficient load management, improved trunk positioning, and effective movement carryover. We don't think shying away from exercise is a good idea! So we put this together for you so you can stay active in and out of the gym even if your low back is hurting!

5 Moves to Keep You In the Gym When Your Lower Back Hurts

1) Front Foot Elevated Reverse lunge

The front foot elevated split squat (FFESS) or reverse lunge is a meat and potatoes type of lower extremity movement in my book. For experienced or new weightlifters, it can be progressed or regressed and provides an excellent loadable, scalable single leg exercise. I especially love the FFESS as an alternative for someone experiencing back pain due to its limited strain on the spine and ability to maintain an upright trunk while lifting heavy. Additionally, it is an active way to improve hip mobility through a loaded position, which many back pain suffers can benefit from.

Utilizing the plate or a small step to raise the front foot above floor height allows the hip to sink deeper into flexion, facilitating glute and quad strength. More importantly, the deeper hip flexion position "locks" the spine in an upright posture, stabilizing the pelvis, and creating increased stability within the lumbo-pelvic system. Essentially, this is a fancy way of saying your hips must move more (something most low back pain sufferers can benefit from) and the back moves less allowing for increased loading and repetitions without pain.

The staggered stance can be adjusted based on your mobility and range of motion. With the trunk in a stable, loaded position, you can sink into an active hip flexor stretch at the bottom of the lunge. Hip flexor tightness can be a generator of low back pain and rather than stretching for hours on end, we prefer to load the tissues into an active stretched position, allowing the nervous system to relearn and retain the newly acquired mobility, creating improved range of motion and decreased pain.

Quick tips when performing the FFESS…

  1. Start small with the step height. I recommend starting somewhere between 2 and 4 inches (A 25 lb. bumper plate is approx. 2 inches, 45 lb. bumper plate is approx. 4 inches) and allow yourself to really sink into the bottom position, progressing in height once you can control the descent and ascent appropriately.

  2. Knee position matters--kinda! I personally prefer a slightly forward knee position, with my knee over my shoe laces when performing the FFESS, but there are several variations that can work for you. A good general rule of thumb is, the more forward the knee, the more quad focused the movement is. Whereas, when the knee shifts back, centering over the heel, the more glute focused a movement is. Experiment on your own and see what feels best for you to ease your low back pain.

  3. Rear foot placement needs to be far enough away to "stretch" but close enough to maintain a stable base and allow for a smooth, controlled ascent. Often when I first start teaching this movement, I see people reach as far back as possible and arching their back, when this isn't the intention of the exercise. Focus on keeping your torso upright, and once your rear foot is planted, sink your knee down towards the floor rather than trying to drive the hips forward. This aspect takes practice and will vary for everyone, so don't compare yourself to others. Get some practice and hit it hard. I promise your booty, quads, and low back will thank you.

2) Goblet Squat

Goblet squat? Kettlebell squat? Dumbbell squat? Hold an object at chest height and squat? You wouldn't be wrong with any of these exercise names, but why is the goblet, kettlebell, dumbbell hold at your chest squat so beneficial? For starters, holding the dumbbell (or any other object) allows the trunk musculature to work in an optimized angle and maintain a vertical position creating less unwanted movement and shearing of the spine.  Additionally, holding the goblet position, distributes the load forward over the toes, allowing the hips to move into deeper ranges while limiting the amount of unwanted low back motion.

The goblet squat follows a common theme in this post:
keeping the trunk in an upright
pain-free position
limiting unwanted, compensatory movement patterns of the spine
and emphasizing novel (new to you) loading strategies to promote muscular gains of the legs and trunk while continuing to exercise as your low back pain improves.

Considerations for the Goblet squat:

  1. Start light, so you can feel the controlled descent and push out of the deep squat position, using your movement quality to guide you in your future weight selection. Use your movement to track progress, not the weight. It is so easy to pick a set weight for the goblet squat and then force feed your body to perform subpar and lackluster repetitions. Don't let a heavy weight cause you to bend forward and lose the integral vertical trunk position.

  2. Tempo is your friend. Utilizing different tempos of a movement can provide the perfect stimulus your body needs to help mitigate pain and keep training at a high level. This holds true when performing goblet squats. Two tempo recommendations I use frequently are: 3 second descent, 3 second hold at bottom, 1 sec ascent, 1 sec at the top OR try a 5 sec descent, 1 sec hold at bottom, 1 sec ascent and 1 sec at the top. Both of these tempos will have your legs burning, with a nice pump, but also allow the back and surrounding musculature to work within a manageable load tolerance helping to improve pain symptoms and build strength.

  3. Adequate foot width allows the hips to sink deeper into the squat and maintain an upright trunk. There is no perfect distance, or one size fits all, but find something that feels comfortable at the top and the bottom of the squat. Too narrow, and you'll start to bow forward and hit your knees on the weight. Too wide, and your hips won't have the mobility to get low or worse, you might break in your new gym shorts a little too much!

3) Half-Kneeling Press

The ½ kneeling position is the Swiss Army Knife of positions when it comes to training.

You can train just about any upper body movement out of the ½ kneeling position, not to mention it has a ton of versatility in core and midline training (but that's another blog post!)

What we commonly see when overhead pressing is the loss of a vertical trunk which can be problematic in people sensitive to extension of their spine (arching). This loss of a rigid, vertical trunk most commonly is caused by insufficient midline strength or decreased range of motion at the shoulder and/or hip. The ½ kneeling kettlebell press addresses both of those deficits, while also providing a unique core training position and the ability to build endurance, strength, and intensity in the overhead position without increasing load.

Quick tips when performing the ½ kneeling press

  1. Hip positioning is critical when first establishing the appropriate ½ kneeling position. Keeping your pelvis locked down, in a posterior tilt, engaging the abdominals and squeezing the glutes should be occurring on every rep of every set up. This position of the pelvis allows for a more upright, rigid trunk and increases the glutes and abdominals role in the movement. Additionally, the pelvic tilt can increase the stretch in the hip flexors, which as I mentioned before, can be beneficial for people overcoming their low back pain. Keep the feet under the knees, so both knees are at approx. a 90-degree angle. Hips stay in line with the knees, keeping your feet from becoming too narrow. Experiment with the rear foot position (toes flexed on the ground or relaxed with laces on the ground) and see what feels best. Keeping the back toes on the ground not only amplifies the stability demands of the exercise and can help intensify the hip flexor stretch which is why I prefer it-- if it doesn't compensate for the overall movement.

  2. Keep your ribs down and squeeze the glutes. If you maintain a solid hip position as mentioned above, you shouldn't have a problem. As reps increase, don't let fatigue cause your chest and ribs to flare up, allowing the back to arch. I love seeing someone lower the weight mid-set, reset their trunk and hips, then finish out the set with impeccable form. No shame in moving pretty. You'll impress your friends and earn a high five from me if I spot you in the gym.

  3. If you've never performed a kettlebell press of any kind, then be on notice this movement can be fairly forearm intensive. If you "death grip" the kettlebell or have sensitive forearms, the kettlebell might take some getting used too. If the kettlebell seems too problematic, try loosening your grip on the handle or substitute with a dumbbell to achieve the desired stimulus while avoiding the forearm brutality.

This movement can be performed in various ways, two of which we will address later in this post. Additional options for modification include using a dumbbell instead of a kettlebell or holding another kettlebell/dumbbell in the non-pressing hand, to emphasize trunk strength and challenge the upper back and core to remain stable while pressing.

Dumbbell Deadlift

The deadlift has one of, if not the worst, reputations when it comes to back pain. Some argue the deadlift is a back breaker of an exercise and will do just that if you dare to even try it. I'd argue (as does the research) that the deadlift is a critical movement in developing trunk and core stability, lower extremity strength, especially in the hamstrings and glutes, and builds resiliency to the tissues that often are injured or weak in people who experience low back pain.

Building resilience is key. Rome wasn't built in a day and neither is the tissue resiliency of your trunk and back musculature. When I say tissue resiliency I mean, the ability of your body to handle the loads placed upon it during the deadlift (or any other movement). This is why the dumbbell deadlift is such an invaluable training tool. Using the dumbbell keeps the load low, but provides for the ability to tension the muscle over longer periods of time at higher rep ranges. All of which contribute to a fundamentally sound and pain-free barbell deadlift. Additionally, the dumbbell is raised higher off the floor than a conventional barbell deadlift. The added height allows for a more advantageous spinal position, especially when experiencing low back pain.

Quick tips for the dumbbell deadlift-

  1. Start the dumbbell between your shoelaces. This starting position at your setup will keep the dumbbell within your center of mass and gives you the necessary balance of trunk and hip coordination in the pull off the ground and lowering phase of the movement.

  2. Where the head moves, the body will follow. A common fault seen in people deadlifting is looking up towards the sky. When the neck extends up, it creates a ripple effect down the entire spine, causing little movements at each segment extending into the low back, which can cause poor trunk mechanics and over time, low back pain. The best practice is to stay focused somewhere in the middle, that's comfortable for you and could be maintained for hours on end. I like to cue clients on looking towards the corner of the ground, where the drywall meets the floor and maintaining that position through the set.

  3. Drive the hips back, not down. When lowering the weight to the ground, think about pushing the hips back, rather than down towards the floor. Maintaining this slight adjustment allows for the hamstrings to contract in sequence with the glutes and trunk musculature, while also providing for decreased sheer at the spine.

  4. Scale, Modify, Adjust. The deadlift is one of the easiest movements to scale so don't be afraid to drop your ego and change things up. Using the dumbbell is an excellent way to build resilience in the movement, however, so is using lifting blocks to raise the barbell higher, dropping the weight to promote improved mechanics or incorporating bands to tension the pull at different stages.

Another great way to improve in the deadlift when managing low back pain is to add accessory exercises to focus specifically on hamstring strength and mobility which we will dig into further below.

GHD Hip Extension

When we look at targeted hamstring strength and mobility, the GHD is my tool of choice. Not only does it phenomenally develop the glutes and hams (hamstrings), but it also adds a mobility component, which is valuable within the back-pain population.

So why is the GHD so valuable in training with back pain? And how's it going to help my deadlift?

As I touched upon earlier, the deadlift gets an undeserved bad reputation and shouldn't be demonized within the back-pain population. Training to build resiliency in the deadlift is critical and to do that, I love implementing the GHD. Far too often is targeted hamstring strengthening overlooked, especially when concerning the deadlift and its appropriate technique. As weight increases and repetitions become more challenging, we see compensations in the spine and hips to complete a lackluster rep. This compensation, even if minimal, can be enough to flare up anyone's back pain, putting a damper on progress in the gym and your mood.  I utilize the GHD hip extension for 3 main reasons.

  1. It allows the trunk to stay in a neutral position, while simultaneously targeting the glutes, hamstrings, and abdominal musculature. (critical components of the deadlift and aesthetics!)

  2. When deadlifting, the hamstrings are commonly the weakest link in the movement, causing movement compensations and increased loading of the back and trunk musculature. Improving hamstring strength and increasing your body's tolerance to loads, can help to reduce the future risk of movement breakdown and improves your ability to train pain free!

  3. In the lowering portion of the movement, the hamstrings benefit in both flexibility and strength. This component of the exercise is called eccentric loading and allows flexibility and strengthening to occur synchronously. Weak muscles are tight muscles so let's load the hamstrings, check both boxes, and look cool doing it!

Tips for performing the GHD hip extension—

  1. Hip position is critical. Like extremely critical. We want the trunk and spine to maintain a stacked, static position throughout the movement. When we see mistakes is when the trunk begins to extend because the hips are not positioned properly. In order to properly tension and strengthen the glutes and hamstrings, the pelvis needs to move freely in unison the trunk. To do this properly, position the leg pad at thigh level, with the hips above the top of the pad. When lowering down, your hips should be free to move, without being blocked by the thigh pad. Try adjusting the thigh pad to a lower position on your thigh if you are predominantly feeling the exercise in your back musculature compared to your legs. Utilizing this set up decreases the amount of trunk extension, which as I mentioned above, can be a contributor to back pain and also places the emphasis of the exercise on the glutes and hamstrings as it should.

  2. Tuck the neck and chest. This may seem counterintuitive when trying to keep the trunk rigid, but I do encourage a slight amount of flexing the trunk during this exercise. This minimal amount of flexing the head and trunk helps to take emphasis off the back musculature and transfers it to the glutes and hamstrings. Remember, you shouldn't be feeling this exercise in your low back musculature, but instead the backs of your legs and rear end.

  3. R & R – Reps and range of motion. This exercise should be performed in higher volumes, meaning sets of 12, 15, 20, 25 are ideal. Initially, build up to these numbers with sets of 8, 3, or even single reps to build strength and competency within the movement. Additionally, performing the GHD hip extension movement within a set range of motion is critical to decreasing unwanted tension and strain off the spine and trunk. When rising to the top, keeping the trunk rigid, using the hamstring and glutes to "pull up", bring yourself up to a point where you couldn't raise any higher without using low back musculature. In other words, at the top of this movement, don't extend the trunk, and lose your rigid, stiff spine. Overextending in this movement is VERY prevalent, and you have most likely seen this firsthand on the GHD or other similar pieces of equipment. Every exercise has its purpose, and the GHD hip extensions purpose is to extend the hip, not the spine.

Back Pain can be pesky, bothersome, emotionally draining, and physically limiting.

With such a profound impact on your life, it's easy to succumb to the beast that is your pain.  However, I prefer to take an optimistic, energetic approach and it's no different with back pain.

Take this half-glass full approach and get moving again, building a foundation for a pain-free future. Implementing the principles touched on above, you can take an active approach to overcoming your pain and limitations while preparing to be the best version of yourself, both in and out of the gym!

Lift More, Limit Less.

Looking to get a thorough game plan for the pain & mobility limitations that are holding you back? Click below and let's get started!

About the Author

Physical Therapy Rochester Hills, Michigan

Matt Zoelling SPT, CF-L1

Matt Zoelling is currently in the final stages of earning his Doctor of Physical Therapy degree from Indiana State University. Matt is an Oakland University alumnus, receiving his BS in Health Sciences and is a CrossFit Level 1 Certified Trainer (CF-L1). He is Graston technique IASTM Certified, Rockblades FMT IASTM certified, and a Rocktape certified provider with additional training in Myofascial Decompression (Cupping). In addition to being a CF-L1 coach, Matt has extensive knowledge in exercise science principles with a background in strength and conditioning implementation and programming. He is a born and raised Michigan native, with a love for the great outdoors. His passion is rooted in enhancing lives and human performance through optimizing movement while instilling confidence in his clients to overcome their obstacles.

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