It has been said that 80% of the American population is going to suffer from lower back pain at some point in their life….That’s A LOT of people!  The sedentary lifestyle of most human beings in 2012 is probably one of the main causes.  If you’re a strength and conditioning professional or a personal trainer chances are you’ll deal with a good number of people suffering from low back pain throughout your career.

The first thing to do is assess the client or athlete and identify where the problem lies.  You should also decide if referring out to a another health professional is appropriate.  Either way, you’ll want to use appropriate corrective strategies, if appropriate, to make the person correct the source of the problem.

What you won’t want though is to turn the training session into a rehab session.  You still want your clients or athletes to feel like they can get a training effect.  They definitely shouldn’t feel like a patient; that’s not your job.  You want to make them feel like athletes and you should focus on what they can do, rather than what they can’t do.

The big problem with most low back pain is that it limits your lower body exercise options quite a bit.  Most of the time any variation of bilateral squat or deadlift will be out.  So where does that leave us?

Although every person is different, there are options that are generally going to be safer than others.  The first thing I would tell you to do is stick to the “do no harm” rule: if it hurts don’t do it.  As simple as that.

That being said here are some options to consider with your low back pain clients and athletes:

Reverse Lunges

Depending on the type of back pain and how severe it is, your athlete might be able to get away with lunge variations using a front squat grip or a back squat grip, but usually DBs are going to be a safer alternative.

Rear Foot Elevated (RFE) Split Squat

In the video above, coach Dan Gabelman demonstrates a bodyweight RFE split squat. If your athletes are pain-free and strong enough, you can load them with 2 DBs or with one DB in the goblet position.

1-Leg Squat

This one might not be an option in some low back clients, but is usually OK with most if you keep a neutral spine throughout the range of motion, even if it means limiting that range of motion.  Someone who’s flexion intolerant and has limited hip mobility might round at the back in the bottom position, which could exacerbate the problem. Usually just bodyweight is plenty hard for most people, so you don’t even have to use any external load to make the exercise challenging.

Sled Drag

What I really like about sled drags for athletes or clients with low back problem is we can use so many variations of them, and also still load them pretty significantly without any negative effect on the low back.

Again, the “do no harm” rule is king.  Make sure you don’t do anything that hurts your athletes.  You should also be smart about what you prescribe them, make sure it’s not making their problem worse, and when in doubt refer out!

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