Lifting Weights with Lower Back Pain

Plague Maiden

Hi.

First off, I have no intention of beginning weight training without first confirming it with my GP. I have an appointment with him on Tuesday in relation to another matter and I will raise the issue with him then.

As the title suggests, I suffer with lower back pain. I've been to a physio and things have improved, however my GP thinks I have degenerative disc disease and, if so, I'll have it for the rest of my life.

I'm just wondering what exercises are most suited and best avoided for someone in my situation? Th obvious stuff to cut out are deadlifts and squats, but I'm wondering about barbell curls, shoulder presses, stuff like that. Should I be doing everything seated on a back-supported seat?

Working out at home would suit me a lot more than a gym because I have a long commute each day and have minimal time to myself in the evening. However I think at the outset I should join a gym and take advice on correct technique. I used to lift when I was younger, and I'd like to think that I have good technique, but better safe than sorry.

So yeah, any advice would be appreciated, particularly from people in a similar situation. I have no intention of going hell for leather or making big gains each week. I just miss the positivity and self-esteem that weight training used to bring me and I want to safely find a way of doing it again.

Many thanks.

COH

Plague Maiden wrote: »

Hi.

Hello

First off, I have no intention of beginning weight training without first confirming it with my GP. I have an appointment with him on Tuesday in relation to another matter and I will raise the issue with him then.

Talking to a GP about resistance training is like talking to a car salesman about an engine problem. You'll just get the opinion of someone who's agenda is only loosely related to the problem.

As the title suggests, I suffer with lower back pain.

#MeToo

I've been to a physio and things have improved, however my GP thinks I have degenerative disc disease and, if so, I'll have it for the rest of my life.

Ah we all degenerate - sadly we are designed to do so... I think something like >60% of people over 35 will exhibit degenerative discs on an MRI scan but whether or not that degeneration is directly responsible for your pain is another question altogether (and the one worth asking )

Re: Physio. Great! But if your progress has stalled it might be time to work with another physio. They are not all created equal and you might benefit from someone who can attack the problem from a fresh perspective.

I'm just wondering what exercises are most suited and best avoided for someone in my situation?

The answer to that is 'it depends'. Worry about movement quality first, flexibility, mobility, stability where required, learn how to breathe, brace, understand neutral spine, how to maintain it through movement, identify imbalances, work on them, THEN see what exercises you can perform without pain. If all that seems a bit daunting then I'd look for help from someone who has a track record of working successfully with people who have had the same problems. You can rule out most PTs in commercial gyms here by the way

Th obvious stuff to cut out are deadlifts and squats,

I don't know - like you'd want to make sure you have all the above boxed off before you preclude yourself from anything specifically. I can guarantee that you'll need to do SOME form of squatting and hinging in your training... but that might not necessarily be with a barbell.

but I'm wondering about barbell curls, shoulder presses, stuff like that. Should I be doing everything seated on a back-supported seat?

Again - box off the above and have someone help you with exercise prescription based on your current ability and pain threshold. Like having your back supported wont help you if you can't stabilise your own midsection.

Working out at home would suit me a lot more than a gym because I have a long commute each day and have minimal time to myself in the evening.

I would say that a supervised environment would be much better suited to your needs.

However I think at the outset I should join a gym and take advice on correct technique.

Where are you based?

I used to lift when I was younger, and I'd like to think that I have good technique, but better safe than sorry.

Work on the assumption that you don't have good technique at all and attack the problem from there. I'm not saying you don't have good technique... but I am saying you probably don't :pac:

So yeah, any advice would be appreciated, particularly from people in a similar situation. I have no intention of going hell for leather or making big gains each week. I just miss the positivity and self-esteem that weight training used to bring me and I want to safely find a way of doing it again.

Many thanks.

I've had more backpain then most - some cumulative as a result of years of poor movement and some acute as a result of sports injuries, motorbike crashes etc. The stronger I am (to a certain degree) and the better my movement quality the less pain I experience. Not everyone gets that, my GP in particular really didn't get it, he just wanted me to stop lifting and take anti inflams. I surrounded myself with amazing passionate people in their respective fields of expertice... from chiropractors, osteopaths, physios, sports doctors, other coaches etc. and the common trend with all was to move as much as you can without pain, play the long game, practice the things you are bad at (flexibility/breathing/whatever) and close the gap on the person you are today and the person you think you could be one step at a time.

This concludes my yearly contribution to this forum... ha

Reps4jesus

yeah if you are suffering lower back pain avoiding anything that involves hinging would be advisable (depending on what the doc says). Deadlifting and its variations, squatting (particularly low bar), barbell rows, back extensions etc are all most likely to aggravate it, as are the Olympic lifts. Overhead pressing could be dodgy too if you allow your back to arch. you basically want to try keep you back as vertical as possible

coley

Have you had an MRI yet to determine if you have degenerated discs? - is your pain/lack of range of movement etc. bad enough that the GP could refer you for one?

As everyone will tell you all backs are different - people who have scary looking MRIs can have little or no pain once they are aware of limitations and manage accordingly.

Has your physio given you an exercise regime to improve your core?

I've degenerated L4/L5 and L5/S1 - After MRI and referral to neurosurgeon he told me - you now have a "bad back" - aggressive rehab for me and back to physio. - worked for me, won't necessarily for all. But he didn't want to see me back in a few years due to me not keeping it all up. I don't do weights but regular exercise pilates/swimming etc.

whippet

COH wrote: »

Ah we all degenerate - sadly we are designed to do so... I think something like >60% of people over 35 will exhibit degenerative discs on an MRI scan

Don't be telling me that COH !! .. I'm only getting in to the groove at 40+

I only started proper strength training just over two years ago .. before that my body was showing signs of the degeneration that COH mentioned .. a lifetime of abuse from competitive football and really not looking after it.

Since I started lifting all these little aches, pains, mobility have started to go away .. replaced by other pains .. but all due to training.

My father in law spent the best part of two years with horrendous back pain and sciatica .. wasn't uncommon for him to spend a week at a time laid out on a couch. for almost a year now he is doing some resistance training (with a coach) .. doing three 20/30 mins sessions a week .. all focused on slowly introducing movement and weight .. he is like a new man. He has gone from barely being able to tie his showlaces to deadlifting 110kg without pain.

However .. as COH explained - get proper advice and coaching

freemenfitness

I was going to post but knew it would take me a long ass time to write out all of my relevant points but COH did an awesome job.

ALL discs degenerate its called aging.

GPs know medicine a tiny proportion know about exercise and sports science. Sadly doctors make money on trying to fix issues things like pain are still an incredibly new area of science. I have had the luck of talking with some incredibly knowledgeable people on the topic and we simply dont understand it much even less so in much of main stream medicine.

To reinforce what he said while MRIs can be useful overall they are not great. 70% of a group of Olympic athletes were shown to have some form of back injury on them while performing at the top tier.

Physios are great there are some good and some terrible like any industry there are also therapists who have amazing knowledge of pain science so there is a lot of options.

Again with COH flexibility, mobility, stability this should be your number 1 thing to look at then work from there.

The neutral spine thing is a debate for another day though

Again most PTs are pretty god awful especially many in commercial gyms.

Final note the concept of never squat or hinge is simply ridiculous good luck if you need to tie your shoes or take something off a low shelf or pick up your child. Dont avoid the problem figure out what the cause is and address it or else find someone who can help you to do that.

Caliden

Contrary to what we've been told with a back injury (i.e. take it easy, bed rest) the opposite is now in fact what's being prescribed.

The muscles in the back/posterior are among the largest and strongest in the body and you're not going to break in half should you put them under any load.

As other's have said, if feel your current physio isn't doing you any favours try a dedicated sports physio.

I also wouldn't just focus on curls/shoulder press and you could end up with tight shoulders/upper back rounding.

Brian?

My better half fixed a multitude of back problems with deadlifts and squats. Obviously it’s a study where N=1, so it’s not for everyone. But a GP will prescribe Diphene and send you to bed for most back issues. A decent Physio is the way to go. They’re the experts. G=general after all.

andyd12

I would look into gaining more movement and control in your back and joints before lifting any weights.
I had a long term back issue, went to doctor, physios etc, all mostly saying I have chiropractic issue but never anything definite. Always kept coming back up.
Movement 101 in swords, Dublin are super at help you to gain more control and movement of back/hips. Very detailed.
I am just someone who went to these and within a few weeks I seen a world of difference by doing specific excercises

Transform

Check how much of this applies to you

https://youtu.be/_mAjbv4FDzE

This is what i see the most often in my practice and feeds into the advice thats been suggested already but just the practical side of what to do

kal7

Best advice build strong but still flexible back muscles. Only reason not to do weights sensibly is you could injury yourself, then cannot train and go backwards. If load progressive and you don't go above your body tolerance should be a help to back pain.
All spines/people differ so in end trial and error.

Bear in mind, alot of top athletes do varied level of weights, light core in one session, medium lifting another and heavy sometimes, this builds stability and strength across all types of usage.

Learn to hinge properly so you can use this as well use flexion and extension movements,life needs both.

get advice from osteopath or physiotherapist

beauf

I found Pilates made a night and day difference. But it was Pilates with a physio, and more importantly it was Pilates that was almost entirely focused on the core and back. But it took a few months to get the benefit of it. Also I started when I was still pretty bad. But I did it under the direction and advice of a GP and physio

But I also went back to square once I stopped doing it. So it's about maintaining it. Use it or lose it.

Teyla Emmagan

coley wrote:

Have you had an MRI yet to determine if you have degenerated discs? - is your pain/lack of range of movement etc. bad enough that the GP could refer you for one?

You don't need a referral for a MRI, not if you have Vhi anyway. You just ring somewhere like Affidea and book it.

It will probably tell you there is something wrong with your back anyway, nearly everyone apparently does. So you won't necessarily be any better off.

I would forget about the GP. You need a good physio, but they will probably recommend pilates and not lifting. Personally I have found pilates useless for lower back pain but we are all different.

beauf

The Physio can use the MRI to guide your exercise.

Though its true to say it finds a bunch of stuff you don't even know you have.

Mink

I had awful back problems up until Jan of this year. Spent a fortune on various treatments, painkillers etc. The simplest thing would put it out and I'd be out of action for days. I was constantly told by various practitioners that I needed to strengthen my core to protect my spine, I'd give pilates a stab here and there but never anything consistent enough.

Since I started strength training in Jan (a mix of weights, core, HIIT, crossfit) I have not had a single problem with my back and I put this down to just developing my strength and flexibility to the point where my spinal column is properly supported and protected.

This is the longest I've ever gone in decades without an issue.
I started off slow and have been extremely conscious of good form. No exercises are off the table for me now.

ec18

Hi OP,

I've MRI confirmed lower disk degradation and there's no exercise that I have been unable to do. I've been strength training for the last two years with no pain. The best thing if it's something you want to do is to go to a strength coach, not just a PT in a gym as the quality will vary from gym to gym.

Obviously all going well with Doc/Physio