7 Tips for Training Around Lower Back Pain

I’ve been doing this training thing for close to 20 years now, and I can tell you one thing:

Pretty much every client or athlete who trains with you is going to have some sort of issue.

In fact, training a new client or athlete with zero pain or issues would be kind of like meeting Harry Potter at your local coffee shop.

Would it be cool? Of course!

I mean, who wouldn’t want to talk about defeating the evil Lord Voldemort while crushing a tasty Americano?

But unfortunately, it’s rarely (if ever) the case.

And while I definitely get my share of people with knee, hip and shoulder dysfunction, no injury seems to squash your training gainz quite like a lower back issue.

While a lower back issue can definitely be tricky to deal with, at the same time, it shouldn’t be a death sentence to any lifting career.

In fact, I’m a big believer that when you put together a holistic training program that focuses on all the potential underlying issues, you can often get your clients bigger, leaner and stronger than ever before – even after an injury.

Now like I said up top, I’ve been doing this for quite some time now – which has allowed me to make more than my fair share of mistakes.

Here are seven tricks that I’ve used over the years to help not only train clients and athletes who are dealing with lower back pain, but to help them move and feel infinitely better in the process.

And for the sake of clarity (and personal responsibility), let me say this:

If you have a client or athlete who has a serious back issue, please get them cleared by a qualified medical professional before starting a serious training program.

Now without any further ado, let’s talk about how you can train around that back pain!

#1 – Get Out of the Sagittal Plane

I come from a powerlifting background, and I’m a huge believer that everyone needs a healthy dose of big-bang, compound lifts in their programming.

Whether it’s squats, deadlifts or bench presses, these are lifts that can help you increase your strength, build muscle, and/or shed body fat.

But even though I want every client and athlete to learn some variation or derivative of these lifts, I also know that in some cases, I’m fighting an uphill battle.

Often when clients come in, they don’t understand how to manage their sagittal plane. Their only strategy for stabilizing their body is to extend, which can cause issues at the knees, hips, and of course, the lower back.

So rather than putting them in bilateral stance exercises that allow them to default to an extension-based strategy, I’ll put them in split-stance or single-leg exercises which force them to stabilize in all three planes of motion.

This does a number of good things for us with regards to someone who has lower back issues:

  1. It forces them to stabilize in all three planes of movement,
  2. In the case of split-stance exercises, it can decrease tension and stiffness in the hip flexors (which drive extension), and
  3. Split-stance and single-leg lifts tend to decrease external loading, which can further decrease symptoms.

Now I’m not saying you can’t squat and deadlift your clients and athletes. Like I said up top, my goal is to eventually get everyone to do some variation of these lifts.

But early-on, if someone is really struggling with bilateral lifts, consider working around the issue and using more split-stance and single-leg exercises.

#2 – Stay Upright

Have you ever had that client or athlete who can front squat a house, but the second you have them hinge, their low back lights up like a Christmas tree?

Of course you have.

We all have.

Now I don’t like making broad, sweeping generalizations, but in more cases than not, the lower back deals with compressive forces far better than it does shear forces.

This next part may be slightly confusing, but I’ll do my best to make it easy…

When you keep the spine upright (as you would in a plate, goblet, or 2-KB front squat), the vertebrae of the spine are stacked on top of each other. When you think about gravity pulling down, if the torso is upright, the forces come in a straight line down through the spine.

In contrast when you bend over or hinge, gravity is still pulling down but the spine is now parallel to the ground. In this case the vertebrae are working not to “slip” on top of each other – i.e. they are resisting shear forces to keep the spine where it belongs.

To reiterate – most spines prefer compressive versus shear forces early-on.

This is why if I’m going to squat someone with a lower back issue early in their programming, I’m going to stick with a variation that keeps them upright. Both the plate and goblet squat (outlined below) would be great places to start.

#3 – Build a Serious Set of Abs

I can’t tell you many times I’ve heard the following statement from a client or athlete:

“I just have a weak back.”

No.

No.

No, no, no, no, no, no, no.

Repeat after me – you do NOT have a weak back.

Poor positioning of the spine and pelvis put the abdominals in a suboptimal position to create stability, and force the lower back muscles (erector spinae, multifidus, etc.) to do more than their fair share of the work.

Now I’ve already written more articles than I care to remember on this topic, so if you want to learn more about my approach to core training, by all means, start here.

Or if you want a one-stop shop for everything core training related, consider picking up a copy of my Complete Core Training product.

Regardless, if a client or athlete you deal with is struggling with a lower back issue, find core training exercises that allow them to be safe and successful early-on in their programming.

#4 – Unlock the Thorax

One thing that I’ve found over the years is that people who are dealing with low back issues often have little (or no) movement through their thorax.

And while I’d love to take full credit for it, it was really Bill Hartman’s talk at the 2016 Physical Preparation Summit that really crystallized this idea in my pea-sized brain.

First off, don’t let the term “thorax” scare you off. Here’s a definition:

“the part of the body of a mammal between the neck and the abdomen, including the cavity enclosed by the ribs, breastbone, and dorsal vertebrae, and containing the chief organs of circulation and respiration; the chest.”

So basically, it’s your chest and upper back area.

When it comes to unlocking the thorax, I generally think of movement here in two broad strokes:

  1. Rotating the thorax (more transverse plane movement), and
  2. Bending the thorax (more frontal plane movement).

Now I’m sure someone could be more specific or technical with their descriptions, but like Lynyrd Skynyrd, I’m a simple man so I’m sticking to these!

When we’re talking about rotating the thorax, the arm action is more horizontally focused (think forward and backward). Here’s a short video that unpacks this concept a bit more…

The half-kneeling alternating cable press is a great example. Our goal is to lock down the lower half and core, and then drive rotation up top through the thorax.

In contrast, when we’re talking about bending the thorax side-to-side, the arm action tends to be more vertical in nature (think up and down), like you’d see in this landmine press variation.

Now that we’ve covered that, here are a few coaching cues that I use to get the right movement out of these exercises.

Tips and Cues to Rotate the Thorax

  • Stay tall and exhale fully. This sets position and makes sure the core is in the appropriate position to start.
  • REACH! This is true with whichever arm is forward, and it’s why I drive to get both arms moving in all these exercises.
  • Keep the thorax BACK. When you start doing exercises like this the tendency is to lurch forward. Keep the thorax back and stacked over the lower half.
  • Point the laser! Imagine you have a laser on your breast bone, and then drive that laser from side-to-side as you move your arms (shout out to Mike Cantrell for that one!)

Cues to Bend the Thorax Side-to-Side

The first three cues from the last section all work here as well. However, here are two more to sprinkle in when we’re moving that thorax from side-to-side:

  • Open and Close the Ab Walls. Side bending of the thorax can be difficult for many to envision, so it may help to give them a different reference. What I like to do is tell them to open and close the ab wall – i.e. close the right ab wall, and then open it back up, or vice versa.
  • Keep it subtle! There isn’t a ton of movement here, so most clients/athletes will try and do too much to make us happy. Instead, cue them to make the movement subtle – lock the core down, and then subtly bend from side-to-side.

Getting motion back at the thorax isn’t going to win you any bodybuilding contests or powerlifting meets, but it’s one of those little things you can do to keep your clients and athletes healthy and moving great for a lifetime.

#5 – Use Alternate Loading Strategies

One of the biggest issues I see when it comes to training is that people assume that if you aren’t using big lifts like squats and deads, that you aren’t training hard.

But I’ll flip the script and ask you this:

What’s better – to find alternate ways to load and stress the body that are safe and effective? Or not training at all because those lifts cause pain?

Hopefully the answer here is obvious!

When it comes to working around back issues, I love finding alternate ways to load the body that don’t place excessive stress on the spine.

Whether it’s pushing a Prowler, dragging a sled, or doing something like HICT step-ups, there are tons of ways you can build leg strength while simultaneously sparing the spine.

(Unsure of what HICT is? Watch this short video…)

They may not be as sexy as a big squat or deadlift, but alternate loading strategies can play a huge role in training a client or athlete who is struggling with lower back issues.

#6 – REACH

In many cases, people who are dealing with lower back pain not only have some degree of unchecked extension (i.e. anterior pelvic tilt, flared lower rib cage, etc.) but an anterior weight shift to go along with it.

To help reign that in a bit, learning how to reach can be an absolute game changer.

Reaching is something I’ve been harping on for years now, because it does a ton of good stuff for your body:

  • It stacks the ribcage on top of the pelvis (which gets your core in the ideal position to stabilize the spine and pelvis),
  • It helps us open the upper back, and
  • It helps shift the center of gravity back.

Reaching is also why our upright squatting variations (outlined above) work so well. They get us into an ideal position to stabilize our spine, and allow the muscles of our core to create stability, versus relying on a bony, extension-based strategy.

Now while the video below was geared towards people with shoulder pain, the idea and concept of reaching still applies to someone dealing with back pain as well.

Whether it’s a lower body squatting variation, a push-up variation, or one of the thorax movements we described above, cue your clients and athletes to reach long through the arms (or elbows).

Their body will thank you!

#7 – Spend More Time in Half-Kneeling

One of my go-to positions for clients and athletes who are struggling with lower back issues is half-kneeling.

It’s kind of amazing, really – but just putting someone in this position and having them breathe can do wonders for shutting off their hip flexors and back, while simultaneously driving hip extension.

If you’re unfamiliar with half-kneeling exercises, take a few minutes out of your day to watch this short video. It not only describes how to set-up properly, but gives you a ton of exercises variations you can try as well.

But maybe your clients struggle with balance and control in half-kneeling.

What do you do then?

Easy – put them in an old-school hip flexor stretch and simply have them BREATHE.

Putting your clients and athletes in half-kneeling more will give you a massive return on investment, so find ways to make it happen as often as possible.

Summary

So there you have it – seven tips you can use to help your clients and athletes successfully train around lower back pain.

This isn’t meant to be an all encompassing piece, but it’s one that can definitely take your training game to the next level!

All the best,
MR

P.S. – If you want to get more programming and coaching tips like this, please check out my Coaching the Lower Body Lifts workshop on May 5th. I’d love to have you there!

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2 Comments

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  1. Great article Mike, but in point #2 – Stay Upright, you write “In contrast when you bend over or hinge, gravity is still pulling down but the spine is now perpendicular to the ground.”

    Don’t you mean “parallel” to the ground? When I hinge over, my spine goes from perpendicular to the ground to parallel. Am I misunderstanding this point?

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