When back pain strikes, you think you’re the only person suffering, but that’s not the case with back pain. In the U.S., many people will suffer from chronic or acute low back pain at some point in their lives. And about 2% to 10% of people who experience low back pain develop chronic low back pain.
Google “back pain,” and you get roughly 4,280,000,000 hits (give or take a few), so there is no shortage of information, but how much is practical? Finding helpful information to train around back pain can sometimes be a struggle, especially when going through your own low back issues.
So, whether you have woken up with a sore back, are suffering the after-effects of a lower back injury, or your back is dragging because of a bout of heavy lifting, try these exercise swaps for lower back pain from six coaches in the know.
(Note: Many different types of lower back injuries cause pain and discomfort. The following article is about exercises to train around back pain, not injury. Please consult your doctor before exercising with acute or chronic back pain.)
Landmine Hack Squat: Chris Cooper, strength and nutrition coach at Nerd fitness
You get to the gym ready to train, but after your warmups, you notice you’re not feeling 100%. You have some nagging aches in your back that you can’t get out of no matter what you do. Looking at your program, you see back squats on the menu, and you know that your body won’t be able to handle those. So, what do you do?
Swap out Back Squats for Landmine Hack Squats
This exercise allows you to train the squat pattern you had planned while taking the stress and loading off your achy back. Due to the angle of the bar and the angle at which our body squats in this exercise, we take the vertical loading off the spine seen in the back squat and keep it more on the quads.
At first glance, this one may be a bit unnerving, as you’re trusting your angle. Start light and get used to the movement before bringing the weight up. Make sure to keep constant pressure on the floor as you squat.
How To Do It
Place the end of a bar into a corner or a landmine attachment and load appropriately. I find using larger bumper plates works best so you can lean into them.
Lift the weight up, place the bar on one shoulder, and lean into the plates. You’ll be facing away from the bar at this point.
Hold the bar in place with one arm and walk your feet out till you’re at a comfortable angle.
Squat for reps appropriate to your goals, although you may not be able to load this one super heavy.
2 of 6
Reverse Hyperextensions: Allan Bacon, Ph.D., an online personal trainer specializing in training powerlifters and body composition clients
I recommend swapping reverse hyperextensions for deadlifts when back pain is in play. Deadlifts place a significant load directly on the lower back; reverse hyperextension allows you to rehab this area without demands of balance and posture in play.
Reverse Hypers target your hamstrings and glutes and provide particularly beneficial activation of the lower back musculature through the full range of flexion to extension. This can be used to rehab the lower back from pain and dysfunction and strengthen all the muscles involved.
This can be programmed for either rehab or strength purposes.
Rehab: 3-4 sets of 12-15 reps as the last exercise in a workout.
Strength: 3-4 sets of 6-8 reps.
How To Do it
Set up by placing both feet into the strap. Make sure you keep the strap taut throughout the entire exercise. It should never go loose.
Hop onto the pad, so your torso is supported, with the hips hanging off the end.
The exercise involves a pendulum motion through a full range that is performed mainly by flexing the glutes, hamstrings, and lower back musculature from flexion through extension.
Both at the start and finish…progress momentum safely to start/finish to prevent the machine arm from contacting your shins or knees.
3 of 6
Belt Squats: Andrew Heming, MS, CSCS, NSCA-CPT, a former university head strength coach, professor, and trainer
You have all heard that squats are the “king of all exercises!” However, what do you do if low-back pain keeps you from squatting? One of the best alternatives is a belt squat. This powerful squat variation will hammer your legs while giving your back a much-needed break.
While most people think you need a fancy belt squat machine, you can use this powerful exercise with a barbell, bench, and dip/belt squat belt. This is programmed for strength and size.
Strength: 3-5 sets of 5-8 reps, rest 3-4 minutes between sets. Go heavy and focus on weight progression at most training sessions.
Size: You can build quad mass with a huge range of repetitions. You can use the traditional 8-12“hypertrophy range” or experiment with higher reps in the 20- to 30-rep range. The extra balance and stability from holding on make this a safer option for high-rep training. Do 2-4 sets and rest 2-3 minutes between sets.
How To Do It
Place a barbell on the end of a weight bench and load it with as many plates as you need. The plates should be on the bench. The other end of the bar will be on the floor—no need to use a landmine if you do not have one.
Attach a collar to the end of the bar.
Grab a dip belt and hook the chain on the end of the bar, just inside the collar (note: as you get stronger, you will want to invest in a quality belt made for belt squats). Make sure the belt is sitting comfortably on your hip bones. Then step to the side.
Grab a power rack or other sturdy object for balance – not for arm assistance.
Spread your knees and sit down into the squat. Stay tight like you would during a regular squat.
If the plates touch the ground before you get to the bottom of your squat, use small-diameter plates (e.g., 25s or 35s) or stand on blocks/steps.
Step sideways to return the weight plates to the bench when you finish your set.
4 of 6
Split-Stance Row: Mike T. Nelson, Ph.D., a metabolism fitness professional, strength coach, and educator specializing in tailoring nutrition to each individual’s needs.
Do you have back pain when doing a bent-over row with a barbell? If you do, I’ll give you a suggestion for what you can do better. The barbell bent-over row is not necessarily a bad exercise, but what can happen when you have a heavier load is that your low back goes into extension, which can put more stress on the low back.
If you’re having pain from it, I’ll show you an alternative to do instead—the one-arm split stance dumbbell row. I wouldn’t say I like having one knee on the bench, like with traditional one-arm rows. I think that’s too unstable and doesn’t make sense.
The split stance takes some of the stress off the lower back, and you go through a large range of motion for more considerable muscle-building potential; that’s what I call a win-win.
How To Do It
Put your opposite hand on the corner of a bench and get into your split stance. The dumbbell hand and leg back are on the same side.
Your shoulder blade should come all the way down and keep your chest up and shoulder down.
Row the dumbbell towards the back hip, thinking about driving your elbow towards your back pocket.
Pause for a second and lower back to the starting position. Reset and repeat
5 of 6
Jefferson Deadlift: Travis Pollen, Ph.D. an exercise science professor, personal trainer, co-creator of the Strength for Yoga program, and cofounder of 3M Athletic Performance gym.
Research has shown that being active while experiencing back pain often trumps rest. For us lifters, though, back pain can throw a wrench in our workout plans—mainly if those plans include exercises that require substantial back engagement.
There’s no one-size-fits-all approach to working around back pain in the gym. Lots of methods can work. Even walking is effective for back pain. With that said, one technique I’ve found to work well is introducing asymmetry. For example, if conventional deadlifts aren’t feeling so hot, try swapping in the “Jefferson deadlift.”
The Jefferson deadlift is a unique deadlift variation in which you straddle the bar and pick it up between your legs. The weight placement requires a more upright, squat-like execution, which tends to direct some of the load away from the back and into the legs. Plus, the asymmetrical stance requires you to fight trunk rotation as you lift, engaging your back and core in a novel way.
Perform 2-3 sets of 4-6 reps/side for the Jefferson deadlift. Start light, as this movement may feel unnatural at first.
How To Do It
With a loaded bar on the floor and standing hip-width apart, straddle the barbell, so it is underneath your hips.
Squat down and take an overhand grip on the front leg and an underhand grip on the back leg.
Get your chest up and shoulders down and stand up. The barbell should be touching or almost touching your back leg.
Slowly down and reset and repeat. Make sure to keep the torso rotated forward the entire time.
6 of 6
Tempo RDL with Nerve Floss: Dr. Bo Babenko is a physical therapist and strength coach specializing in strengthening the mind, body, and soul.
Here is one of my go-tos for helping someone move better and feel better when they’ve had some symptoms in their back. Or even if they are aiming to be proactive and avoid such symptoms. A tempo-style RDL, especially with a focus on controlled lowering, should elicit increased tension in the posterior chain.
Supersetting this with some nerve floss is a phenomenal way to build resilience in the system and take a lot of the likely unhappy tension that causes issues. If you do this properly and get good tension with each rep, you probably only need 3 to 5 good reps to prime your posterior chain.
How To Do It
The basics of RDL apply here. Push your hips back with the knees not locking out; focus on keeping them over your ankle and feeling all the tension in your hams/glutes/calves, never in your low back.
Only go as far as you can without losing any low back integrity while also thinking of pulling your shoulder blades back together. I like to cue faster up and slow down.
For the nerve floss, pull your thigh bone back close to 90 degrees if you have the flexibility; the stretch/floss comes from the ankle pumping up and down. You can play with your thigh angle and shin angle to increase or decrease the intensity of the flossing.
