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Low back pain with lifting - 4 ways to stay in the gym

Lower back pain can really slow you down and take you away from your gains and your goals. Here are 4 strategies that can help you keep exercising with lower back pain, especially when used in combination with each other.

Get your head right.

1. Get your head right - First and foremost, I want to stress that the human body is not fragile. We are capable of enormous feats, and the capacity for those feats is inherent in every single person. Accordingly, here are some facts to help ease your mind when you think “I’m going to blow my back out if I work out” :

  1. There are 17 muscles in the lower back and associated core at that level. Mind you, that’s 17 named muscle GROUPS, not just individual muscles. In addition to that, there are a lot of muscles and major ligaments that contribute to strength and stability for the lower back that are not directly involved, such as the gluteals and the hip flexors.

  2. Even when you DO hurt your lower back, a LOT of lower back pain is known as “self resolving” - I.E. it will heal all on it’s own if you just let it do it’s thing. The statistics are wildly variable in the literature, but it paints a picture that there may be recurring instances of pain or discomfort that aren’t serious. 

  3. Your fear of getting hurt by doing things may actually be hurting you. It’s called the Fear-Avoidance model, and one aspect of it means that when you are afraid of causing pain, you may in fact avoid things that would actually be beneficial and help get you out of pain.

  4. Movement and motion (as long as they are not painful) can actually help override pain sensations. One major theory in the world of pain science is the Gate Control theory, which (in short) states that non-painful input from the body can override and deactivate painful input.

All of these points together should stay in the front of your mind, so you know that you can still get in the gym and get it done without fear and anxiety. 

Change your load.

2. Change your loading style - Maybe if your lower back is feeling a little “tweaky”, it’s time to consider altering your lift choices until either things get stronger, you recover more, etc. That means that instead of conventional straight bar deadlift, you consider doing Sumo pulls, or Hex bar deadlift instead. Below is a list of some of my favorite modifications and variations for lower back pain with exercise.

For pain when you Deadlift: Try Banded Romanian Deadlifts, Hip Thrusts, Hex Bar Deadlifts, Sumo Deadlifts, or Kettlebell Deadlifts instead.
For pain when you Back Squat: Try Front Squat, Belt Squat / Pit Shark Squat, Goblet Squat, Split Stance Squat (Stationary lunges), or Leg Press instead.
For pain with Kettlebell Swings: Try Rows, Battle Ropes, Banded Romanian Deadlifts, Single Leg Hip Extensions or Kickbacks instead.
For pain with Crunches/Ab Exercises: Try Front Planks (ONLY IF DONE PROPERLY), Side plank, Glute bridges, Anti-Rotation exercises, Renegade Rows, Ab Wheel Rollouts, Strap Support Plank and March, or Dead Bugs (weighted or banded as able).

Look outside the gym.

3. Examine your “out of gym experience” - Most training in the gym is done to improve your ability to do things - lift heavier stuff, run further, move faster, etc. A good training program should also include recovering well in order to be better prepared to handle the stress you intend to put on your body again. 
Take a look at :
- Sleep schedule. Are you resting enough? Here’s a good question for you to ask yourself in order to find that answer : Are you always tired? Fatigue can be a lack of rest and sleep in your schedule, not getting enough calories in the day to actually fuel the work that you are doing, or you may be sick and need to let your body recover. The bottom line is this : If you are tired, then you aren’t going to perform (and recover) as well as you would like to. 
- Your diet. A really, really hard and honest look for some of us. Are you eating foods that are intended to fuel your body and help you feel better, or just things that taste good or are convenient? What are your goals, and how much are you willing to balance psychological food desires with physical caloric needs?
- Stress levels. If you have a great gym program but are so stressed at work or home that your body is running your cortisol levels through the roof on overtime, you won’t be recovering and healing well. Sometimes the best thing you can do to help with recovering is to take a mental rest and find some peace. Mental health is still a part of your overall health and definitely ties in to your physical health. 
- Daily habits. If you work out 7 times a week for 2 hours a day, thats still only 12% of your time throughout the week spent being active and working on your body. What else are you doing with the other 88% of your waking time? Are those activities the ones that are contributing to your back pain? What can you do to address that problem?

Get objective.

4. Find an objective viewpoint - No matter who you are, nobody is great at seeing themselves without some bias. You may not be able to see what you are doing wrong, whether that’s your training program, your form on an exercise, your diet, or anything else. Sometimes the best thing you can do is get an outside observer to help you be responsible. That may mean a coach or a trainer who can be present with you when you workout. It could be a workout buddy who also needs to check in on you and make sure you are doing your meal prep at home and not ordering pizza every night. It could be a healthcare professional who can take a look at the whole situation and help you break down what’s going on. Whatever the case, finding an objective viewpoint can be incredibly useful for figuring out how to solve your lower back pain and keep you on track to your goals.


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Dr. Paul Harris holds a Doctor of Chiropractic degree from Texas Chiropractic College and a Master’s of Exercise and Health Sciences from University of Houston Clear Lake. He is the owner of Delta V Chiropractic and Sports Medicine and an avid human movement specialist.