If You’re Dealing with Back Pain, Not All Squats Are Created Equal
In my physical therapy practice, I work with a wide range of athletes and active individuals dealing with back pain. Earlier today, I had a conversation with a local personal trainer who is about to start working with one of my patients—a patient currently in physical therapy for back pain.
We were collaborating on how to design a training program that supports their recovery. Naturally, the topic of squatting came up. It’s a staple in most fitness routines, but when you’re dealing with low back pain, the type of squat you choose can make a big difference.
Why Back Squats Might Not Be Ideal for Back Pain
Let’s get one thing clear: I’m not saying back squats are inherently bad. But when it comes to physical therapy for back pain, we have to weigh the risk-to-reward ratio of every exercise.
In a traditional back squat, the barbell rests behind the head. This positioning shifts the center of mass forward and often leads to excessive lumbar extension—or over-arching of the lower back. That posture increases spinal compression, limits hip mobility, and can aggravate existing pain.
For patients going through physical therapy for their back, this added pressure on the spine is something we want to avoid—not just for comfort, but for long-term recovery and performance.
Better Squat Alternatives for Back Pain Relief
In my work with patients, I often recommend squat variations that are more compatible with spine-friendly movement mechanics. Examples include:
- Goblet Squats
- Safety Bar Squats
These exercises shift the load in front of the body, promoting a more back-friendly spine position, stronger abdominal engagement, more open hips, and reduced stress on the lumbar spine.
In fact, many patients find that these alternatives not only feel better but allow their legs to work harder—because their back is no longer overcompensating for poor positioning.
What This Means for Back Pain Rehab
One of the most important principles in physical therapy for back pain is knowing what to modify and when. You don’t need to stop training—you just need to train smarter.
If you’ve struggled with low back pain in the past or are currently recovering from an injury, making small changes like adjusting your squat style can protect your spine while still building strength, muscle, and endurance.
Need Help with Your Training Program?
At our Bethesda and McLean clinic, we specialize in physical therapy for back pain and helping people return to high-level performance without re-injury. Whether you’re a weekend warrior, a competitive athlete, or someone simply trying to move pain-free, we’re here to help.
Simple contact us and we will take things from there.
