It’s estimated that about 80% of the population will suffer from back pain at one point or another. It costs the US economy around $100 billion dollars a year, between lost wages, reduced productivity, and health care costs. That’s a pretty staggering amount. More importantly, to you at least, If you’ve ever suffered from back pain, you know how your quality of life just sucks. If you’re serious about training, and have had bouts of back pain, you know how quickly it can derail your progress.
The first time I had back pain I was about fifteen years old. That’s ridiculous, yet not uncommon. I was pretty serious about martial arts, had just started working out, and the combination of sitting all day in school and then trying to be a jacked ninja was not a good one. Fortunately, it went away on its own after a short time, and I got on with life. The next time I had back issues I was 18. I crushed my back during squats that were too heavy, and herniated a disc in my lumbar spine. Immediately, my hamstring flexibility went to crap, and a very short time later I developed sciatica. At one point, it was so bad that even casually walking would cause a pull all the way up my leg to my butt. I was able to avoid surgery, but it took years to heal. Visits to both a pain clinic and a chiropractor yielded very few results. I still tried to work out for a while after it happened, but they were never the same. I ended up losing about 30 pounds (most of which was muscle) and got seriously weak. Once I got back into working out about three years ago, I was pretty much rebuilding my strength levels from ground zero. I made steady progress for a while, cautiously getting stronger. Eventually, during some deadlifts, I got out of position and felt something pop in my back. My back was sore for a while after, but nothing too devastating. I modified my workouts a little bit and then once it was feeling better I was back at my regular training. The last time my back flared up again, it wasn’t training related at all. Literally, I woke up one day and had sciatica that I just couldn’t shake. It had followed a couple weeks when I had too much going on to make it to the gym, and I had to do several months of physical therapy in order to get back in shape to lift heavy again. Through all of these episodes, I’ve learned some pretty important lessons.
Just because an exercise works when you’re pain free, it doesn’t mean it’s the best choice during a flare up. I was hitting barbell deadlifts hard, but when my back or sciatica was acting up, it was a crappy choice. At this point, trap bar and kettlebell deadlifts were my go to hip hinge patterns. The same goes with bent over rows. Since I couldn’t get into deadlift position, there was no way I was going to get into and hold that position while rowing a heavy barbell. The pain free option for me was chest supported dumbbell and barbell rows. The takeaway should be this; no exercise is mandatory. If you need to swap exercises out to get through a painful period in your training, don’t worry about it. Do what you can to maintain your strength but don’t worry about dropping the intensity a wee bit.
You can still do some barbell lifts, but you’ll be better off doing the tough ones more towards the end of your workouts. For me, there was no way on earth I was going to stop squatting, but squats were bugging my already irritated back. The solution was to hit my legs hard with single leg work first, and finish up with squats. I couldn’t use the same weight as I would have if I had started with it, but at the end of the workout I could still go at them as hard as I could and get a great training effect. In addition to backing off on the weight, it’s even more important to make sure your technique is dialed in.
Proper core work will make all the difference in how quickly you recover. Note the use of the word proper. If your idea of core work is 500 crunches followed by Russian twists to “smoke those obliques, bro,” then you need to reevaluate your training. Core stability is going to be your best bet, combined with glute work. This means planks and variations, pallof presses or cable anti-rotations, side planks, loaded carries, glute bridges, bear crawls. De-emphasize the exercises that require movement, and prioritize the exercises that require anti-movement. This will go a long way to making your feel better, and more quickly. As you feel better you can start to throw in some appropriate core exercises involving trunk movement, but keep the volume a little lower to start.
Mobility in the proper areas will help with stability in the corresponding areas. The joint by joint approach popularized by Mike Boyle and Gray Cook states that mobile joints stack on top of stable joints, and vice versa. For instance, your ankles should be mobile while your knees should be stable. This moves up the kinetic chain and when you get to the back, we see that the lumbar spine needs to be stable, while the thoracic spine needs to be mobile. There are two things to note here. One, the lumbar spine requires stability, and so it shouldn’t be stretched. Sure, there are a lot of lower back stretches that may feel good in the moment, but in the long run they will do more harm than good. Two, your upper back should have a decent amount of mobility. If your mid and upper back aren’t able to rotate, flex, and extend the way they should, they will place more burden of movement on the lower back, increasing the likelihood of pain or injury. Often, loosening the upper back will do more good than trying to stretch the lower back. Another thing to pay attention to is that if you have an issue surrounding one joint, it can cause dysfunction in a completely separate and seemingly unrelated area of the body.
If you’re having back pain, there’s no reason to stop training, you just have to do it a little more intelligently. Don’t let your ego control your actions, don’t do exercises that cause pain just to do them, don’t be afraid to take a step back and re-evaluate your program, and you’ll be back in fighting shape in no time. If you don’t do any exercise, you’re likely to suffer from the pain for longer, so even if all you can do is get out and walk a little, it will be worth it.
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