How To Strength Train Without Injuring Your Back

The prevalence of back pain is very high in Western countries.

On a personal level, an episode of back pain can be quite a distressing thing to experience and these episodes can escalate overtime into a chronic condition.

Severe, chronic low back pain is also a societal issue, with lots of healthcare resources being funnelled into treating low back pain.

Back pain can also get in the way of healthy pursuits like strength training.

What’s The Cause?

Back pain is now conceptualised as being a multifactorial issue with numerous inputs: mechanical stress, socioeconomic status, occupation, sleep, pain related beliefs, anxiety / depression plus more.

Mechanical causes have traditionally been overstated and the problem of back pain framed in terms of machinery. This is understandable (the skeleton is a system of levers after all) yet substantially limited.

This is evident in the core stability paradigm which reigned supreme in the late 90s and early 2000s. According to this framework, back pain was often caused by weakness or low activity in the muscles directly adjacent to the spine.

Sadly, core stabilisation exercises did not deliver that much in terms of outcomes.

Which is not to say these exercises are bad, or never warranted (I train my core muscles quite a bit). It’s more that the framework was deficient in some major areas.

It did not give sufficient attention to the brain attached to our backs. This is now appreciated by leaders in this field, and contemporary musculoskeletal care pays a lot more attention to holistic factors (stress, sleep, beliefs and behaviour surrounding pain, nervous system sensitisation etc).

So, Is Mechanical Stress Irrelevant?

No, mechanical stress is still one factor that causes or perpetuates back pain.

And it is an important ingredient in resolving back pain, too.

If someone is to experience recovery (whether short term or long term), the back will need to be able to handle a normal level of mechanical stress.

So, the strain we subject our backs to is relevant for these different groups of people:

1/ People seeking to improve back pain using physical training which stresses the spine (plus mind and body)

2/ People experiencing back pain seeking to use strength training to improve health (and not necessarily improve back pain)

3/ People without back pain seeking to improve health through strength training without injuring their back

People looking to improve back pain through strength training need to subject their spine to the right amount of stress. Too much can make things worse and too little gives the body no reason to adapt.

People with back pain who want to strength train for health need a way to do this without severe or frequent flare ups (note that zero pain flares is probably unrealistic).

People without back pain who are looking to build strength may need skills and principles to ensure they lift weights in a safe manner.

What’s The Path Forwards?

To achieve these things, it is helpful to learn about how you can vary strength training exercises to modulate the amount of physical stress your spine is being subjected to.

It is also good to have a general understanding of which exercises are more demanding for the back. That way, you can position yourself at the right level in the progression from easy to challenging; the level which will deliver just the physical stress you need for where you’re at right now.

It’s good to be able to vary the physical stress even if the pain is driven by psychology (e.g. anxiety).

As an example, a person with severe anxiety seeking to do graded exposure to physical stress on the back in order to challenge their fear of catastrophic injury needs a “ladder” to climb. The ladder consists of small incremental steps, starting with easy exercises and progressing to very hard.

Principles and Progressions

Now I want to walk you through some general principles to follow when modulating the stress on the spine in the gym.

And then I’ll guide you up a “ladder” of practical exercise progressions, from easy to hard.

PRINCIPLES

Principle 1: Lift an appropriate weight in all exercises

If you can't control the weight, or it is way, way heavier than anything you've attempted before, it's too much too soon.

Similarly, if you feel very apprehensive when you first start to perform the exercise, it is wise to limit yourself to a smaller progression.

There is nothing wrong with taking your time to progress the weights you lift. Limiting yourself to smaller progressions builds confidence. Big steps up in weight may be perceived by your mind as too threatening, and this can trigger the onset of pain.

Principle 2: Decide whether you’ll transmit load through the spine

Some exercises have you position a weight across your shoulders, in which case the load travels through your spine.

Other exercises have you holding a weight in your hand in a standing position, which also transmits load through your spine, albeit differently (via your arm, shoulder complex and neck).

But in some exercises the weight bypasses the spine more-or-less completely - like in a preacher curl exercise (which strengthens the biceps).

The choice about whether to take a load through your spine depends totally on your individual circumstance.

The point is that you can strength train all the major muscles of the body in ways which are more or less stressful on your back.

Low stress exercise suits some people, high stress exercise suits others.

Principle 3: Be mindful of fatigue

If you’re feeling run down (physically or mentally) then you may be more vulnerable to injuries or flare ups. Now, this does not necessarily mean resting from exercise (although it may mean that).

A good rule of thumb is you should feel like you have something to give after you complete a training session.

If you’re training yourself extremely hard each session (even when you start the session feeling tired) then you’re asking for trouble.

Implementing this principle is best done in conjunction with a skilled and caring healthcare professional (e.g. GP, Physio etc).

Principle 4: Limit the range of motion

You can make an exercise easier by moving the weight through a smaller range of motion. Sometimes this can feel a little awkward because you may be used to using the stretch on your muscles at the bottom of a movement to help you lift a weight up. Nevertheless, it’s a useful principle to have at hand.

For example, a person with back pain may wish to squat to a box.

Principle 5: Limit the speed

Moving slower can enhance your feeling of control.

This can benefit you for different reasons. It can downgrade your body’s perception of threat, which may limit pain during and post exercise.

Also it can enhance your technique. When you slow down, you can get a greater sense of the intricacies of an exercise. This can help you to move with greater skill.

Principle 6: Use more or less stabilisation to make it easier or harder

More stabilisation equals less physical strain and an easier exercise.

There are different ways an exercise can be stabilised.

It can be through supporting your spine on some surface (like when you have your back against a wall when you do a wall sit).

It can be through adjusting your body position by using a wider stance.

Or it could be through using abdominal bracing or breath-holding to stiffen your back under heavy weight.

Principle 7: Learn proper technique

It is beyond the scope of the article to go into the weeds on this point, but investing time and money into learning how to do different exercises can help you move better under weight.

Importantly, this often translates into moving better in real life situations.

Learning to deadlift helps you shift a couch.

Learning to do a bench press helps you hold good posture when you do freestyle swimming.

PRACTICAL PROGRESSIONS - LEGS

Here are some practical examples of some easy exercises progressing through to harder exercises, in terms of back stress, with a little commentary from me on each one.

Exercise 1: Machine Leg Extension Or Hamstring Curl

These are nice because you can stress your quadriceps in a highly supported position and no load on your back

Exercise 2: Wall Sit

Also an exercise for the quads (with help from your glutes). This is more technically challenging than the machine leg extension but also contains no load being transferred through your spine apart from your bodyweight.

Exercise 3: Dumbbell Goblet Squat

This one is nice. Because the weight is held on your front side and quite low down on your body, it is less demanding on your upper back muscles than a back squat (which is high on your back).

Exercise 4: Machine Leg Press

This exercise shows a lot of support for the spine, but the load and range of motion can be very large indeed. To limit stress on your back, I encourage you to not let your knees bend beyond 90 degrees. More than that can cause a lot of spine bending under a heavy weight, which can sometimes be an issue.

Exercise 5: Back Squat To Box

This exercise shows how limiting the range of motion can reduce physical stress. The video shows the person touching their bottom on the box, but you can rest there momenterily, and pivot back too (so your back is vertically straight for a moment’s rest).

Exercise 6: Back Squat

Not the most stressful exercise for your back, but still pretty demanding and - all things considered - the most difficult exercise in this little progression.

PRACTICAL PROGRESSIONS - ARMS

Upper body exercises still stress the spine.

Here I want to show you how you could progress an upper body pushing movement from easy to hard.

Exercise 1: Incline Barbell Push Up

This exercise is very stable and can have minimal work against gravity if the incline is steep. The flatter you get, the harder it is.

Exercise 2: Dumbbell Incline Chest Press

This is a nice exercise because you can adjust your arm position a lot to make yourself feel comfortable and efficient. You also have a good view of the path of the weights more or less all the time, which is less true of the bench press, which occurs more in your peripheral vision.

Exercise 3: Barbell Flat Bench Press

This one I decided to designate as being harder than the one above because it is quite technical and usually has the shoulder joints in a higher degree of elevation, which is more demanding.

Exercise 4: Push Up

The step up here introduces more demand onto the back, owing to the need to hold your body up from sagging onto the floor.

Exercise 5: Strict Press

At the top of the strict press movement, you have quite a lot of weight coming down through your shoulders into your back. Your back and core muscles have to work quite hard to hold your spine quite straight, which enables your shoulders to get where they need to be.