Many people have low back pain.  In fact, about one in three Americans will experience low back pain.  Trainees are no exception.  Some trainees have made some unwise exercise selections that contributed to their low back pain.  Others simply developed low back pain and they happen to train too.  The problem, and the question, is: how should you train around the low back pain?

Veteran trainees (ten or more years of consistent training) often find they must give up the same exercises.  Time after time, these trainees will say “I had to give up bent over rows because of my low back pain”, “I had to stop squats because of low back pain [or knee pain], or “I had to give up bench presses [or press-behind-the-neck] due to shoulder pain”. 

I addressed squats and low back pain previously in this column.  The first thing to do while squatting is to stop looking up.  This increases the curve of the low back and shifts the weight bearing to part of the vertebra that shouldn’t be taking so much weight.  Instead, look down slightly and this can shift the weight bearing to a more appropriate area of the spine.  Also, stop performing twists or seated rotary torso machines.  This places too much shear force on the discs (shock absorbers and spacers) between the vertebrae, and this weakens the outer wall of the disc and can pain.  If the squats still cause back pain, try changing to front squats.  Many trainees who cannot back squat can still front squat.  If this still fails, try the horizontal squat machine and hack squat machine.  Does this process of elimination sound familiar?  If all these methods fail, you can take a break from any squats for 4-6 weeks and try again with lighter weight and see if you simply needed to let the inflammation calm down.  If you have too much low back pathology (e.g. collapsed disc), you may have to permanently substitute the 45 degree leg press, but don’t let your knees come all the way down so your pelvis doesn’t lift away from the back of the seat and stress the low back.  Do not use the vertical leg press unit if you have low back pain.  The vertical leg press fell out of favor many years ago and one of the reasons is the low back pain it can generate or aggravate.  

If you enjoy bent-over rows, you can first try to pull the bar to your lower abdomen instead of your chest.  By pulling towards your lower abdomen, you will shorten the lever around your low back.  This may reduce your low back pain during this exercise.  Bar position is more difficult to control on the T-bar rows.  The T-bar rows are usually dropped early in training programs.  Many trainees will find the seated cable row in which you lean forward and lean back as you row will be tolerated much longer, but is often dropped from workouts.  Again, lighten the weight and perhaps cycle the poundage so the back isn’t being hammered by the same heavy weight month after month, year after year.  If all three of these rows cause low back pain, try the dumbbell row and perhaps a seated row machine (machine with a chest pad to lean against).  I rarely support the use of machines, but this is a situation where a machine could be useful.  Pulldowns with various grip widths and handles can provide a great variety of training with the dumbbell rows and seated machine rows.

Many trainees cannot perform squats, rows or deadlifts anymore.  However, these trainees may be able to perform hypers, or sometimes called back extensions.  The hyper bench is usually about 45 degrees or is horizontal.  Raise your body to the point that your spine is straight.  Do not arch or hyperextend your spine.  If this exercise can be performed without low back pain, then the back muscles (paraspinals or erector spinae) glutes and hams can have a terrific workout.  The leg press won’t seem like it has missing components anymore.  If the hypers are uncomfortable, then you can try another machine.  There are a variety of low back machines.  These are usually seated with a pad across the upper back and the trainee pushes back against the pad. 

The back muscles, along with the abdominal muscles, need to be strong to protect the back.  I hope this column can help you work around your low back pain and keep you training.  Train smart first, then train hard.