Most people who experience back pain are told that it is usually due to a disc bulge or sciatica and told things such as:
You shouldn’t lift while you treat this injury.
“Deadlifts can be bad for your back”
“If you keep lifting, your back won’t heal.”
This advice is simply false. In most cases, you can and should continue lifting weights and training even if you have low back pain. If you stop lifting weights because you have back pain for a long period of time, you will likely become less able to lift the same weights when you return to the gym.
Deadlifts don’t necessarily cause back pain, so there is no reason not to do them.
Research (Fischer SC and co-workers 2021) has shown that deadlifts can effectively be used to relieve low back pain in people who are suffering from it.
We know that deadlifts can actually be done safely and effectively to help with low back pain. But the question is: How can we avoid causing back pain or flare-ups when doing deadlifts?
Modifying your deadlift training is the best way to achieve this. This will allow you to build low back strength and endurance while not causing pain.
We can adapt many aspects of training and specific exercises to achieve our goals. We will be discussing some of the most effective options.
Reducing load and/or volume
People who experience back pain from lifting heavy objects may find there is a limit to how much load (weight on the bars) they can handle before their symptoms become severe.
Any that is above those load or volume thresholds will cause back pain to flare up. These thresholds can be identified and training can be modified so you are training for a while just below the threshold, then gradually increase the load or volume.
One of our clients had back pain from deadlifting. While anything below 315 lbs was fine, he would feel severe pain if he lifted 315 lbs. We had him perform his most difficult sets of deadlifts at 295 pounds for about two weeks. Then, he would gradually increase to 300 lbs, then 310, and finally to 315 lbs as part of his rehabilitation. His pain began to subside and he was soon able to lift 315 pounds without any problems.
You will find that you gradually increase the number of reps per set and decrease in sets. This will help you get back to your normal training level.
Reduce the range of motion
People with back pain may find that some parts or positions of the lift are more painful than others. People often find their back hurts more the further their torso is bent over relative to the ground. You can temporarily change the lift’s range of motion to avoid these positions and then return to them when your back feels better.
You can deadlift by using blocks or pins to pull from. Then slowly lower the height until you are pulling off the floor again!
Use specific times and/or pauses
Tempo simply refers to the speed at which parts of a rep can be performed. Tempo is usually written as a 4-digit number such as WX-YZ-Z.
W = The length of the eccentric/lowering phases
X = The length of the pause at the bottom
Y = The length of the concentric/lifting phase
Z = The length of the pause at top
Tempo training can be used to train around pain or injury. You can use slow tempos or have pauses to allow you to train while minimizing the chance of aggravating pain.
We love to use these tempos with our clients:
3-0-3-0 tempo (3 seconds down, 3 seconds up, no pauses)
5-3-1-1 Tempo (5 seconds down, 3 second pause at the bottom, 1 sec up, 1 sec pause at the top)
Alternatively, you can just use pauses during lifts (including multiple pauses during a single repetition). If heavier deadlifts cause back pain, you can do reps where pauses are just off the ground, below the knees, and again above the knees.
Both options allow lifters to train hard (ie, high internal intensity), but the pauses or tempos will cause there to be less weight on bar (ie, lower external intensity).
Change exercise variation
There are many ways to alleviate back pain from lifting weights or doing exercises at the gym.
These variations may be in the form of changing your body position such as sumo deadlifts instead or conventional deadlifts or trap bar deadlifts instead.
You can also do unilateral lift variations (single-arm/leg variations) in place of regular lifts. You could, for example, do single-leg deadlifts instead of regular deadlifts.
Do some core work before you lift
We are not saying that “core weakness causes back pain” (because it does). However, this doesn’t mean you can’t train your core in these situations. These exercises can build strength and endurance in our trunk muscles, as well increase our confidence while lifting. This is a win-win situation.
You can usually tolerate them very well and start with isometric exercises like plank variations, pallof hold/press, farmer’s carries, or suitcase and farmer’s carries.
You should not do these exercises until you are unable to perform your training.
If you’re interested in a free phone consult with one of our Doctors of Physical Therapy, you can apply for one of those by clicking here: https://prokinetixrehab.com/
