Training with a sore or injured back is tricky. If you were to avoid working it altogether, your workout would likely be comprised of vacuums, dead bugs, and pulldowns. But it doesn't have to be that way. There are plenty of modifications you can make to existing exercises that'll keep back issues at bay while still pursuing good numbers in the gym.
Don't mistake training around an injury as its own form of rehab. It also doesn't mean that you should be chasing new 1RMs, even if a replacement exercise feels awesome. You're hurt, and the primary concern is to get back to 100%. That's going to take the combined efforts of you and a good clinician to properly diagnose and treat the injury.
So be careful here, and be smart. Lifting big while you're hurt is risky business, so there needs to be a method to the madness. These tips aren't for people who are still immobile due to throbbing pain. They're for people who are on the mend and are still able to do stuff.
After finishing a low-back heavy, compressive exercise, the first thing you should do is just hang somewhere, like on a pull-up bar. It's a natural response in wanting to feel better, take pressure off the spine, and stretch the surrounding muscles at the same time.
Be mindful of how much compression you put your spine through each workout. The cumulative amount can come back to haunt you, even if your back is healthy.
Exercises that create upward forces on the spine instead of downward forces should be included in your workout. Here are some good examples of movements that can still provide an appreciable load for hypertrophy or strength gains:
- Parallel Bar Dip
- Pull-Up or Chin-Up
- Lat Pulldown
The lift provided by lifting shoes can create a more vertical torso and a more quad-dominant and less low-back-dominant squat. That sounds like a good thing, but it can cause a lifter to rely less on his own mobility to reach full depth in his squat.
Anyone can squat deeper with what appears to be good form when his heels are elevated. Chances are, especially if your low back is aggravated, the ass-to-grass depth may be a bit of a stretch for the muscles, tendons, and ligaments of the lumbar and sacral region and could lead to further issues.
It's better to keep the heels flat on the ground, work on improving true mobility, and limit your depth to just below parallel until you've made those improvements.
If you're worried about bearing load with a severe forward lean (creating shear forces on the spine), keep in mind that, in theory, the back squat is probably the one squat variation where you have the least amount of control over the degree of lean.
Switching to front squats, Zercher squats, and even overhead squats requires more of a vertical torso and ultimately a stronger load-bearing position for the spine.
Just remember that with a change in load placement, you'll likely enable yourself to get deeper into the squat. For that reason, squatting to a pre-determined target depth (a shallower range) may be something worth implementing for the time being.
Injured lifters gravitate towards the leg press machine as a substitute for the squat until things get better. But these two lifts are not biomechanically similar. The leg press starts in a hip-flexed position and simply goes into a flexion so great that (ideally) the thigh is pressed right up against the torso with a knee flexion angle of around 90 degrees.
As an example, stand up and squat to mimic that exact position and you'll see how unfavorable it is for the low back. Though there's a minor save in the fact that the lifter has the load on his feet rather than his back, it's not enough to offset the fact that the lumbar spine likely goes into some deep flexion under heavier loads, especially if proper care isn't taken to watch form and technique.
Even with good form, we shouldn't forget that constant tension and shortening of the hip flexors, paired with the absence of hip extension due to the mechanics of the lift, creates residual low-back discomfort.
Here are some better squat-free alternatives to the leg press that allow you to get a good lower body workout:
- Reverse Lunge or Deficit Reverse Lunge
- Rear-Leg Elevated Split Squat
- Hip Thrust
You can still pull from the floor, but modify your positioning to ensure a lower risk. Switching to the medium sumo foot position with a straight bar can be a saving grace to your spine, especially if you're a taller lifter.
It's a lift variation that also works for healthy lifters because it allows for a taller spine position and it lets the shins move outside the forearms when preparing to pull. This makes the lift slightly less low-back dominant and allows for a deeper knee-bend for leg drive. If this variation doesn't agree with you, try the trap bar instead of the barbell before eliminating the lift.
One more thing, when pulling an object from below, it's important to kill the negative rep. Trade the tap-and-go method for a dead-stop method with minimal negative tension.
Yes, eccentric tempos are worth their weight in gold for developing strength and bolstering the spine, but there's no point in taking a risk for increased time under tension and neural stress while still technically injured and on the way to recovery.
Slow negatives, paused reps, and the like should only be reintroduced once there's no concern over re-injury or regression from rehabilitation. That's the smartest, safest way to ensure technical proficiency.
I remember it being a milestone to pull a triple with 315 pounds, since not long before I had tweaked my back pulling 275, which was about 50% of my max. Using the approach shown in the video was a huge contributor to keeping the deadlift pattern in my routine.
There's no point in trying to lift 80 or 90% of your max while you're hurt, even if you can technically handle it. There's just too much risk. Moreover, there's too much risk in training for higher rep ranges.
Lift in a lower percentage for an even lower number of reps. That means if 65% of your 1RM would normally get you 12 reps, do it for 6. To bridge the gap, give your body the rest it needs between sets and just do more sets of the exercise.
The problem with bent-over rows is directional change. The start position and even the finish position may not be a spine-killer, but transitioning from eccentric to concentric on every rep can contribute to some unfriendly issues popping up.
The truth is, when you want to change the direction of a heavy object in motion, you'll have to fire your muscles even harder to decelerate it and send it in the other direction with the same intended speed. That can be very jarring on the affected segments of the spine if they're not at full strength. Beyond this, holding a bent-over position with load is probably bad news for a lifter who's trying to safely rehab from an injury.
Likewise, a single-arm dominant pull movement probably isn't the safest choice to promote balance and stability of the lumbar region. Better options:
- Seated Row
- Chest-Supported Row
- Inverted Row
Don't be a hero, and don't forget that you're still injured. It's a miracle that you're finding a way to pull these big lifts off in the first place, but somewhere along the path to recovery you're going to feel like a fried turd.
Sticking to the plan can come back to bite you if you don't listen to your body, and that's even more important when you're on the mend. If, after a couple of sets, the back isn't feeling good, don't hesitate to make a massive overhaul in favor of doing mobility work, stretching, training an entirely different muscle group, or even calling it a day. A smart lifter should end his workout on a high note. That will keep him out of trouble.