We see two common types of low back pain associated with or affecting lifting at the gym. Each one is tied to specific movements:
1. Flexion Intolerant Back Pain: This pain occurs with forward bending movements, like deadlifting or squatting, where the spine rounds.
2. Extension Intolerant Back Pain: This type of pain is triggered by movements that cause the back to hyperextend, such as jerks or overhead pressing.
The most common of these is when it hurts bending forward, sitting is worse than standing, squats and deadlifts are painful. Here’s how we manage it:
Avoid any stretch that has the back in a rounded position. A common mistake when it’s flared up.
Avoid positions as possible that put your back in a rounded and compressed position. This includes sitting.
Stretch/mobilize and move in the direction opposite of the original injury. For example, if you injure yourself with forward flexion/bending you’re going to want to restore extension movement as soon as you can. Exercise: McKenzie press up.
Bedrest is old school as most people know by now. It’s important to keep the muscles that attach right onto the spine activated as these temd to become weak in the presence back pain.
Take short but fast walks: Walk as fast as you can for 10 minutes or less.
Use the bird dog exercise as described by McGill. It activates the small muscles on the back to prevent those muscles from weakening/atrophy.
Hip hinge with all movements in the acute stage. The phrase I use is “preserve the curve”. Restoring the hip hinge is a huge piece of the puzzle for prevention and that should start immediately.
Erector endurance is prioritized over erector strength. Wide stance good mornings, Romanian deadlifts, the reverse hyper machine, all with impeccable form and focusing on time under tension/endurance are important for prevention of future episodes.
Other good links:
Bracing and breathing (for getting back to squatting)
Hip hinge & hip flexibility workout (after the acute stage)
When can you deadlift again? (A research article helping answer this question with testing recommendations)
This is a very simplistic way of looking at lower back pain but it is a good place to start for lot of people. If you need help or have questions feel free to contact us using the chat function here or book an appointment using the schedule button above.
Alex Tapplin, DC, CSCS, CCSP
Sports Medicine Specialist Chiropractor
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