I Have A Bad Back: Training with Back Pain

Article written by Alanna Casey

“I can’t deadlift, I have a bad back.”

“I can’t squat, I have bad knees.”

“I can’t ‘insert exercise here’, I have an ‘insert excuse here’.”

We all get injuries, we all could make excuses. Some are actually legitimate, but the majority are just that: excuses. Unfortunately, body pains are part of the world of lifting heavy things, especially back pain. But, you don’t have to accept the pain. Instead, you can do things to mitigate back pain or eliminate it all together. I will start with the disclaimer that if you have persistent, unmanageable pain, symptoms of nerve damage (numbness/tingling), or loss of bladder control then get to a doctor ASAP.

I have struggled with back pain for years. Ever since I started deadlifting/squatting over twice my body weight I have had to manage back pain, especially lower back pain. Many of my world class powerlifting/strongman friends suffer from back pain as well. Even my friends who participate in crossfit have back pain. There are many different causes of back pain. Within the strength community the most common are muscle strains, nerve impingement, disk degeneration and muscle imbalances. My personal back pain is from muscle imbalances which led to muscle tightening in my lower right side, which led to nerve impingement. It took me about 10 doctor’s visits and 3 years to figure that out,but I finally got it! Yay.

I would first recommend seeing a doctor about your particular issue but, given my issues I’d like to offer some advice on how to alleviate your pains. 1. Stretch

I hate stretching! Its sooo boring: it takes foreevver, it’s uncomfortable and most importantly, I cannot feel myself immediately getting bigger/stronger when I’m doing it. Yes, I understand stretching sucks. But it’s immeasurably important. At a minimum, I recommend stretching your shoulders, back, and hamstrings prior to any lifting workout. See the below illustration for some simple back stretches. Stretching is important to your next PR attempt. Here’s why. Stretching will improve flexibility and increase your range of motion (especially important on squat). Stretching will lengthen tight muscles that are pulling your body away from their optimal and balances position (correct posture). Stretching also can decrease your chance on injury by preparing them for work. AND stretching after you train could possibly decrease muscle soreness by increases blood and nutrient supply to muscles which helps to clear and distribute lactic acid build up.

2. Take note of your posture

As you are sitting at your computer at work, or driving your car, watching tv, or sitting on the bleachers cheering on your kid during her soccer game, take note of your posture. Is your spine aligned or are you slouching over? If you’re slouching, correct it. Is your head at neutral or are you constantly looking up or down? As you sit do you have equal pressure on both cheeks or are you favoring one side? 

I found that I had a tendency to lean to the right when sitting. This meant that my left side was constantly getting a stretch but that my right side was tense and constricted. This contributed to my back pain. I now make a conscious effort to correct my posture, no matter where I am. 

3. Use proper form on squats

Yes, I’m talking about squats NOT deadlift! A lot of people end up hurting their back while squatting (or trying to squat). Women especially seem to have this problem for some reason. I am referring to the tendency to lean forward when squatting (see figure below). Many people (myself included) make the mistake of allowing their back to fall forward on the squat. When this happens the lower back has to work 1000% harder and in a 3D plane instead of a 2D one. Some people call this “clamming.” When you squat, you want your upper body as erect as possible. When you feel yourself leaning forward, your lower back has to try and compensate to keep you from toppling forward. Essentially, you end up doing a good morning while squatting. If you can keep your back straight up and down, your lower back will not be overworked. 

But, in order to do that you must have enough flexibility in your hips and hamstrings, ESPECIALLY your hamstrings. During my last training cycle I stretched my hamstrings about 5-6 times a day for ten minutes (my doctor recommended 10 times a day but 5-6 was the best I actually did). I would also stretch my hips after each deadlift and squat session. One really good way to stretch your hips is to stand directly in front of a wall, get your legs into your squat stance, spread your arms onto the wall, parallel to the floor, and then squat. Concentrate on keeping your hips open and knees out; it’s the only way you will be successful. 

4. Work your lower back muscles

Your back hurting (alone) is no reason not to train your lower back. My doctor recommended that I perform isometric (static, non-moving) back exercises, with lesser weight, as opposed to full range of motion exercises. Some great exercises for lower back are:

Barbell row

Standing or seated good mornings (I prefer seated)

Back extension (great exercise to make isometric)

Reverse glute ham raises

5. Get a good spotter

If you know that your back might be an issue, having a good spotter for heavy exercises is a must. Brief your spotter on exactly how you want him/her to assist you. Tell him what you will say if you need assistance and exactly what you expect him/her to do. I see a lot of people “spotting” on squat but, if their partner actually needed help, I’m not sure they would know how to properly assist.

If I am spotting someone on the squat, I squat directly behind and with my partner. I put my arms under their arms by their lats. If he/she needed help I would place my hands on or under his/her chest and squat the weight up using my legs. As you spot someone on the squat you want the lifter to be able to maintain form. 

If you start to experience extreme discomfort in the middle of a lift, you want someone there (who is capable) to help you out to avoid injury. If you don’t have a spotter at least use a safety rack.

5. Know when you call it quits

There is a fine line between discomfort and pain. When pushing yourself in any exercise you will be uncomfortable. But, if you feel sharp pain, I recommend you stop your exercise. About once a month I will end a session early because my back is in sharp pain following an exercise. When this happens “pushing through it” will only cause greater damage. If you feel pain during any workout I suggest you stop that movement and either dramatically correct/change your form OR drastically lighten the weight OR start a cool down complete with stretching. It’s important not to let your ego get the best of you in this situation. Do what is best for YOU every day. Just because your lifting partner is doing a certain exercise or weight, doesn’t mean you have to do it. Exercise your brain as well as your muscles.

6. Deep tissue massage

I invest in a deep tissue massage about once every 4-8 weeks. If I had the funds I would do it every single week. Deep tissue massages help to release toxins from your muscles and help to prevent scar tissue from forming after muscle tears/strains. Deep tissue massage can also break up and eliminate scar tissue from previous injuries. If your deep tissue massage is an enjoyable and relaxing experience then your massage therapist isn’t doing it correctly. A true deep tissue massage will be quite painful as muscle knots are broken up. Be sure to drink lots and lots of water following a message.

7. Strengthen your core

Back pain may be caused by an imbalance between your lower back and your abdominals. Strengthening your abs will help correct this imbalance. I recommend training abs 1-2 a week, especially women.

8. Ice

I recommend icing your back for 20 minutes prior to going to sleep. Just make sure you don’t fall asleep with a bag of ice on your back and wake in a puddle! Icing will reduce inflammation and ultimately decrease your pain.

9. Osteopath vs Chiropractor

If you do all these things and still have back pain I would recommend and MRI. If the pain isn’t caused by a herniated disc, you might have a nerve pinched. In this case a Doctor of Osteopathic Medicine (D.O.or DO) would be able to best help you. Unlike a chiropractor, an osteopathic physician is a doctor. I have found that osteopaths are more likely to offer a more permanent solution to pain rather than short term pain relief. My osteopath realigned my spin and corrected the nerve impingent. I had been to a chiropractor many times before and he offered a 60 second massage, 60 seconds of hip stretching, and 10 minutes of a TENS unit (electrical stimulation). That did offer me relief but it only last a day or so. When I go to the osteopath my relief lasts a month or so, big difference.

I hope this article helps you to manage your back pain. Remember, pain doesn’t mean you shouldn’t use a particular muscle group, just that some sort of correction needs to be made and attention given.