Back pain can be a real pain in the… yeah you know. Most of us will experience back pain in some form over the course of our lives with it affecting around 85% of people in Westernised countries. With back pain being so prevalent, odds are you’ve been confused when it comes with what you should actually be doing in the gym to a) manage it and b) prevent it returning in the future.
As an Exercise Physiologist, this is where I come in. The gym can be a great place to start to work on managing your back pain, as long as you know what you’re doing. Here are my tips to getting on-top of your back pain so that it doesn’t put a stop to your training:
STEP 1: NAIL MOBILITY
Getting on top of your mobility is essential if you want to return to lifting. Use a trigger ball to release through your upper and lower body. My go-to spicy spots are: pec minor, lats, piriformis, TFL, and calves.
It’s important to also include a functional, movement-based mobility warm up so that your body can move through a full range of movement before you start your training. Try including cat cow stretches, bow and arrow or thread the needle thoracic rotations, and knee rocks.
STEP 2: START WITH THE BASICS
Getting your glutes and core working before you start to load them will mean a) these muscles are neurally activated and b) you can feel the muscles working more acutely during your sets.
My favourite, infallible glute warm up is a glute bridge with a band around the knees. Add a set of knee push outs after each set of glute bridges, completed 3×12 of each, and feel the burn.
Functionally activating your core means more than pulling your deep core muscles in and holding. Add some 90-degree toe taps or, to make it more challenging, try a banded deadbug. The aim is to keep your ribs stacked over your hips while you breathe normally. If you’re finding it hard to breathe, take a step back.
STEP 3: CONTROL SINGLE LEG FIRST
We can’t nail double leg compound movements if we can’t control our hips or balance on one leg. Think bulgarians, controlled step backs, and LOTS of tempo work that causes you to really focus on your hip positioning and control. I love a 3-3-3 tempo with single leg work to overload the muscles without having to utilise heavy weight or, often, any weight at all.
STEP 4: CROSS PATTERNING
Your posterior oblique sling connects your latissimus dorsi to the gluteus maximus of the opposite side through the thoracolumbar fascia. This connection needs to be utilised and strengthened to allow for balance and control. My favourite posterior sling exercise is a lunge row: hold a static lunge, and perform a standing row (with a cable machine or band) with the same arm as leg back.
STEP 5: PERFECT THE HINGE
I know you want to get back to heavy deadlifts, I do, but trust me when I say you’ve got to start slow and build your way back up. And this doesn’t just mean drop the weight. If you need a bit of a technique refresher, here is my a-b-c of hip hinge setups:
- Weight through your heels
- Tension through your hamstrings (this is usually where people go wrong)
- Lock in through your lats
- Head neutral
- Ribs stacked over your hips
To lift well, maintain the tension through your hamstrings and lats, squeeze your butt and tuck your tailbone under at the top. Start light, and off blocks or with a rack pull if you need to. There’s no need to rush this process.
Back pain doesn’t spell the end for resistance training, it just means you have to be more intelligent about the way you train. This advice is generalised and based on my experience in training clients with back pain. If you have a pathology which is causing your back pain, such as a disc injury, stenosis, or any pain that radiates down your leg, seek specialised advice.
Rachel is an Accredited Exercise Physiologist based in Australia. She has worked with hundreds of clients to help them become fitter, stronger, healthier and more confident regardless of age, injury or experience level. She is the founder and director of RE.connection Project – an online program and community aiming to make health and wellness more accessible to women around the world.