I've dealt with back problems my entire life. By problems, I don't mean the occasional lower back tweak, but rather serious complications that greatly affected both my training and my overall quality of life.
Suffice it to say, my issues weren't the sort that a few Advil and ten minutes on the foam roller could cure. I'll spare you the gory details, but things came to a head in 2005 after involuntarily wetting the bed several times and being forced to have surgery to repair a disk at L5-S1.
I was also an athlete and exercise junkie, but after the surgery I had a lot of trouble (and still do) running and cutting, which obviously ruled out most sports. So I turned to lifting weights for my daily endorphin fix.
My drug of choice is leg training. There's just something satisfying about it – not necessarily fun, but satisfying. Leg day will push you to your physical limits and show you what you're made of along the way.
It's also a surefire way to separate the real lifters from the prima donnas. Big arms and broad shoulders are a dime a dozen, but when I see a guy with strong and muscular legs, he's got my respect because I know he's put the work in. There's just no other way.
Leg day can be a slippery slope for those with back problems. On one hand, you've got to push it hard to see results, but most traditional leg training programs can wreak havoc on your back if you're not ultra careful.
You don't want to risk getting hurt, but you also don't want to be relegated to a life of wussy training and wearing sweatpants at the beach, either. I struggled with this for a long time, and I suspect many reading this do too.
Through considerable trial and error, I've learned (often the hard way) how to modify leg training to not exacerbate my back problems while still training with the brutal intensity required to make progress. If what I'm saying resonates at all, this article is for you.
The Program Basics
For many, a typical training session will look something like this:
• Single leg knee-dominant exercise
• Posterior chain/hip dominant
• Bilateral knee-dominant exercise (Optional)
It's basically your run-of-the-mill leg program, only in reverse. Traditional methods will have you starting with some form of heavy squat, followed by something for the posterior chain before wrapping up with single-leg exercise accessory work.
This method has built many a big set of wheels and is no doubt effective, but if you have a preexisting back problem, it may also be setting you up for a world of hurt down the road.
In this back-friendly program, we're still including all the same basic components of a traditional leg workout. We're just flipping the order in which we do them.
I'll now discuss the "whys" and go into each part of the workout with more depth.
Single Leg Work
Single leg training is an effective way to overload the legs without stressing the spine, making it a great option for those with back problems. You'll start each workout by picking one exercise from the list below for 3-4 sets of 6 reps per leg.
• Rear-foot elevated split squats
• Single-leg squats
• Lunges (reverse, forward, or walking)
• Skater squats
Remember, we're using the single-leg work as a primary exercise, so treat it accordingly. Don't just breeze through it. Work your way up to a top set where you go as heavy as you can for 6 reps using good form.
I recommend taking 60-90 seconds rest between each leg to allow sufficient recovery (except for walking lunges, which will obviously be done in a continuous fashion), and at least two minutes between sets. If you're doing it right, you'll need every last second of it.
You'll be surprised at how much weight you'll be able to handle when you take it seriously. It may feel a little awkward at first, but the learning curve is typically very fast, so stick with it.
First Things First
Placing single-leg work first in the training session will allow you to get much more out it. When performing it at the end of the workout in a fatigued state, stability becomes much more of a limiting factor. When fresh, stability isn't nearly as much of an issue, allowing the focus be placed on strength.
For those new to single-leg training, I recommend starting with rear-foot elevated split squats because they'll be the most stable.
Once you master those, lunges will be the next easiest to learn, followed by skater squats and single-leg squats. Be conservative with your weights the first couple times out to allow sufficient time to familiarize yourself with the movements and let your body adapt to the new stimulus.
Starting too heavy will only slow the learning process and leave you crippled with soreness. Trust me on this one.
You'll notice I omitted step-ups. I'm not a fan of step-ups as a primary strength exercise for two reasons. First, many complain of knee pain from heavy step-ups. Second, it lends itself to heavy cheating from the back leg, especially as the weights get heavier.
If you feel strongly about step-ups and can do them pain-free with good form, certainly use them. I think most people will be better off choosing exercises from the list above.
Posterior Chain Work
It's best those with back issues avoid heavy spinal loading. Unfortunately, this rules out some great time-tested strength and mass builders like deadlifts, Romanian deadlifts, and good mornings. If you still want to train the hip hinge pattern (you definitely should), try single-leg RDL's, cable pull-throughs, or kettlebell swings instead.
I'm also not a big fan of machine leg curls. Sure, they won't hurt your back directly, but they could indirectly contribute to low back pain by neglecting the glutes.
The glute-ham raise is my favorite alternative here because it works both the glutes and hamstrings simultaneously while putting lower amounts of stress on the spine in comparison to heavy deadlifts and good mornings.
For more on the glute-ham raise, including how to do it, check out this article. For those who don't have access to a glute-ham bench, you can try some of these leg curl variations that are superior to machine-based alternatives.
Pick one exercise per workout and do 3-4 sets. Reps will depend on which exercise you choose. Glute-ham raises and single leg RDL's are best done using slightly lower reps (5-8) while pull-throughs, kettlebell swings, and the various leg curl variations work better in the 8-15 rep range (swings can go as high as 20).
Bilateral Finisher (Optional)
This isn't optional because I'm a softie, but because I believe that once you become proficient with single-leg work, you won't need it.
Think about it, if you gradually work to 250+ for rear-foot elevated split squats, 250+ pounds for lunges, and 100+ pounds for skater squats and single leg squats, and consume adequate amounts of protein and calories to support hypertrophy and weight gain (the most important and oft-neglected part of the equation when it comes to building muscle), your legs will have no choice but to grow.
In my case, I've transitioned almost exclusively to the single-leg stuff for my knee-dominant work (i.e. quad exercises), and don't see myself turning back any time soon. I've gotten stronger, my legs have grown, and my back has never felt better.
Making the Leap to Single-Leg Training
I realize not everyone is ready to make this leap. Some find that as they first transition into single-leg training, they aren't able to work their legs to the extent they'd like to. While this diminishes as form improves, some just love squatting and aren't ready to part with it entirely.
For these types, placing squats at the end of the workout makes sense. My problem with bilateral squatting for back pain sufferers isn't the bilateral movement pattern – it's a very important pattern to learn and master – but rather the extreme spinal loading associated with heavy squatting, as well as the form breakdown that can occur as a result of heavy loads.
Doing them at the end takes care of both of these problems as it drastically reduces the amount of weight your legs will be able to handle. For those with back problems, lighter loads means less load on the spine, and it will also make it much easier to keep good form. I also prefer front squats over back squats for this reason because they require less overall load and promote a more upright torso, thereby reducing the shearing forces on the spine.
Still, with heavy front squats, the limiting factor for most will be the upper back, not the legs. Doing heavy single-leg work first fatigues the legs without fatiguing the back, so when it comes time to squat, the legs again become the limiting factor, making it safer and more efficient.
I recommend doing 2-4 sets of 6-10 reps. I usually prefer a lower rep range with front squats when they're being performed at the beginning of the workout. Since the weights will be significantly lighter here, supporting the bar shouldn't be a problem, and the higher rep ranges mean less load for the back and greater time under tension for the legs.
The weight you'll use for front squats will depend largely on your proficiency with single-leg work (the better you are at it, the more it will tax you), as well as which exercises you did previously. Start light. You probably won't be able to handle nearly as much as you think you can. (I personally use about 65-75% of what I could handle if I were fresh.)
Taking it a step further, you can even do things to consciously make the front squats harder so that less weight is required.
One way to do this is to slow down the eccentric portion of the rep.
Another technique to use on occasion is "1.5" reps, which I picked up from Charles Poliquin. You may want to have a fire extinguisher on hand because these burn.
If you're feeling particularly masochistic, you can try something I got from Dan John called "Goji" front squats, using kettlebells suspended from chains. Be prepared for a roller coaster ride.
Sure, the weights will need to be lighter than you may be used to, but I assure you won't be thinking this is easy. Those used to squatting big numbers may at first suffer a little ego bruising, but your back and legs will ultimately thank you.
Still not sold on the idea? It might help to think about it in bodybuilding terms as "pre-exhausting" the legs. Bodybuilders have long used leg extensions or the leg press to pre-exhaust their quads before squatting. That's exactly what we're doing here, only I'd argue that single-leg work trumps either of those other exercises in both safety and efficacy.
As a rule, I try to avoid using absolutes. I won't push my luck and say that everyone should train like this as there are many different ways of doing things. I will say that everyone with the goal of getting bigger legs could train like this – bad back or not – and get great results.
Healthy individuals that enjoy heavy squatting would still be well advised to train like this periodically to deload the spine and keep it happy for the long haul. You might not think it's important now, but you may change your tune when instead of lifting you're stuck playing Angry Birds on your physiotherapists' table.
Try it for yourself and see how it goes.