Back Pain: Causes, Treatments, & Red Flags for Lifters - Beast Over Burden - #577

Barbell Logic

Back pain for lifters can be scary & frustrating & varies in severity. Learn the causes, treatments, approaches, & red flags as a lifter and coach.

Rebekah Krieg, Exclusive Coach & former long-time physical therapist, discusses back pain, how to approach it as a lifter and coach, and red flags contraindicate training.

Back Pain for Lifters: Part of the Human Experience

Back pain happens.

Whether an MRI of your back would look "normal" or "bad," back pain seems to be part of the human experience for those who exercise and train and those who do not.

It is better, all things being equal, to train and strengthen your low back. A strong back is a resilient low back.

Back pain comes in many intensities and durations, from the short-term tweaks, to the multi-month or year variety, to chronic back pain.

As lifters and coaches, we have to approach back pain with some flexibility but basic principles, an openness to refer out, active listening to our clients.

Back Pain for Lifters: Treatments & Approaches

The general approach is to focus on what you can do.

If a lifter experiences a tweak during the workout, a general approach is to do the following:

• reduce load first
• next, reduce range of motion
• next, vary the exercise selection
• be prepared to end the workout

As a coach, do not encourage or support client catastrophizing. Training curious, see what works. Even if the workout has to be ended, most likely the client will feel better after a day or two and with something easy movements like bending over at the waist to get blood flowing into the back.

Motion is lotion.

For someone with new back that comes in, encourage them to see how the back feels after a warm up (and likely a slower, longer warm up). If they are still not feeling good, than follow the steps above. Often times, though, they will feel better after a warm up.

If someone comes in with chronic back pain, they are used to back pain. Focus on excellent technique and be more conservative with them. Ensure that the back pain does not get worse, and see if it gets better. Communication will be critical, and you may include a back pain metric that helps you and the client ensure pain monitoring is a regular part of the coaching process.

If the back pain is bad and normal enough, they might never do the conventional deadlift. Focus on what they can do. If the conventional deadlift or low bar squat causes significant pain or things to get worse, it does not make sense to force them into these movement patterns.

Back Pain for Lifters: Red Flags that Contraindicate Training

Sometimes, clients should not even warm up. If the client reports any sudden loss of function since the back pain, this contraindicates training. Below is a longer list:

• lack of bowel control
• sexual dysfunction
• bilateral pain
• loss of motor function (e.g. foot drop)

Do NOT let them warm up. They need to go to the doctor.

Bekah even has said that she has had to fire a client who would not follow her recommendations and guidelines for lifting and would not see a doctor. This may be the kindest thing you can do to them.

What type of glaring signal might it send to someone that a coach will no longer take their money unless they change their behaviors?

Back pain for lifters and coaches can be frustrating and scary. Do not catastrophize, follow some basic steps and principles, and do not be afraid to refer out to another healthcare professional.

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