How Our Physical Therapists Coach Squats for People with Low Back Pain

Did you know that experts estimate up to 80% of the population will experience back pain at some time in their lives.

The sports physical therapy patients that we often assume that they no longer can perform common weight training exercises like squats.

However this is not the case. People experiencing lower back can continue to perform these exercises however may require the help of a performance physical therapist to learn how to most effectively do so.

Check out the video below to see how I coach squats for our physical therapy patients experiencing lower back pain.

Why Powerlifters Don’t Move Laterally

As most physical therapists will tell you, powerlifters typically do not demonstrate great multidirectional movement skills. Why would they?

Training for any sport is all about specificity.

The goal of a powerlifter is to squat, deadlift or bench press more weight. Their training reflects this and as a result, they become better at those lifts. Any movement qualities that do not contribute to helping perform in these lifts are likely to suffer because they are not useful to the sport.

In fact, any unnecessary movement may be detrimental to their sport because it takes energy away from what is most important.

One way to prevent unnecessary movements from occurring is to reduce the capability of doing so in the first place!

Elite level powerlifters often do not even possess the prerequisite movement capabilities to efficiently move laterally. That wouldn’t be helpful to their performance!

The highest level of performance in any sport often requires physiological adaptations that set the body up for the greatest level of success in that specific activity. Many times, this means that unrelated movement capabilities will diminish.

While this is helpful for short term performance, when taken too far, a reduction in movement options can increase the risk for injury. A lack of movement capabilities results in a limited number of ways the body can minimize physical stress.

How do we know that the body has lost too many movement options? Overuse injuries begin to accumulate, and signs of discomfort start to present themselves.

The best solution for any athlete looking to improve their performance in particular sport is to visit a professional that can assess their capabilities and personal risk profile. Our team of Doctors of Physical Therapy at Cohen Health and Performance specializes in just that.

Physical therapy for back pain often requires only 1 simple modification

Back pain remains as one of the leading causes of disability worldwide and according to research, over 70% of people will experience back pain at some point in their lives and likely require back pain physical therapy.

When back pain is measured among such a large number of people, it is impossible for each person to specify the different ways in which their back pain presents.

When treating physical therapy patients with back pain, we see this pain present in many different ways. Since we treat such active people, our patients are very aware of the different movements that elicit their symptoms.

Many times, picking objects off the floor, aka deadlifts, produce their back pain. During these movements, the body bends over by folding at the hips. This moves the spine into a position that is horizontal relative to the ground, resulting in more shearing forces within the spine. Shearing force is the force of one vertebra wanting to move forward or backward relative to the one above or below it.

For many others, squatting movements are problematic, specifically when squatting with resistance (such as when lifting weights). When squatting the spine is vertically oriented (compared to a deadlift) resulting in more vertical compression against gravity.

Do you have back pain? If so, is it worse when picking things up off the ground or when squatting with resistance?

If it is worse when picking things up off the floor, aka deadlifting, you may want to consider replacing deadlift exercises with squatting variations within your performance training program. While this should not be a permanent solution, it can help you get out of pain while addressing the root causes of the issue in physical therapy.

If your pain worsens when squatting with resistance, you may want to consider switching to more single leg squatting variations in place of double leg squats. Once again, this should not be a permanent solution (although single leg exercises are awesome!), however it can help you get out of pain while addressing the root cause of your pain.

For help addressing the root cause of your pain, contact us!

Training with back pain may only require a simple modification

Back pain is a prevalent and debilitating condition affecting a significant portion of the global population. Studies indicate that more than 70% of individuals will experience back pain at some point. The diverse ways back pain can manifest make it a complex challenge for patients and physical therapists. However, physical therapy is an effective way to alleviate and manage this common ailment without surgery.

Practitioners often encounter many symptoms and triggers when treating patients with back pain through physical therapy. One remarkable aspect of this approach is that patients, particularly physically active ones, are keenly attuned to the movements that provoke their pain. Two common movements that often exacerbate back pain are deadlifts and squats, both of which are integral to various exercise routines.

Deadlifts, which involve bending at the hips to lift objects from the ground, are notorious for triggering back pain in many individuals. This movement positions the spine horizontally relative to the ground, subjecting it to significant shearing forces. Shearing force is the mechanical stress that results from one vertebra wanting to move forward or backward relative to the one above or below it. For people with back pain, deadlifts can intensify the discomfort due to the stress placed on the spine during this movement.

Squatting is another common exercise that can exacerbate back pain, especially when performed with resistance, such as lifting weights. Unlike deadlifts, squats require a vertical orientation of the spine, leading to increased vertical compression against gravity. This added pressure can be a source of pain for many individuals suffering from back issues.

If you experience back pain, it’s essential to consider the specific movements that trigger your discomfort. Is your pain more pronounced when lifting objects from the floor or when engaging in squatting exercises with added resistance? This distinction can help guide your approach to managing and alleviating your back pain.

If deadlifting worsens your back pain, temporarily replace this exercise with squatting variations in your training program. While this isn’t a permanent solution, it can help you find relief from pain while addressing the underlying causes of your discomfort. Physical therapy can be instrumental in guiding you through these modifications and ensuring you perform the exercises correctly and safely.

Conversely, if your pain intensifies during squatting exercises with resistance, consider switching to single-leg squat variations as an alternative to traditional double-leg squats. Again, this approach is not meant to be a permanent solution but can provide temporary relief while targeting the root cause of your pain.

Consider contacting a qualified physical therapist for comprehensive support in addressing the root causes of your back pain. These professionals have the knowledge and expertise to develop personalized treatment plans tailored to your specific condition and needs. With the guidance of a physical therapist, you can work towards a long-term solution to your back pain, improving your overall quality of life and well-being.

Back pain is a common and multifaceted issue that affects many individuals. Physical therapy offers valuable solutions for managing and alleviating back pain by addressing the specific movements that trigger discomfort. Whether it’s deadlifts or squats, modifying your exercise routine with the guidance of a physical therapist can help you find relief while tackling the root causes of your pain. Don’t hesitate to seek professional assistance in your journey towards a pain-free and healthier back. Contact us for help with your back pain today!