Programming Deads & Squats for "Non-Specific Low Back Pain?"

Back in March I hurt my back. No idea how but it just started hurting. After a couple months it “healed” but pain is still lingering. I was convinced I had some kind of bulging or herniated disc so I did everything I could to rehab that… tons of spinal decompression, upper back strengthening (lat pulldowns, pull ups, chest supported row, etc), glute and core exercises, etc. Pain is better if I don’t do anything to flare it up then it stays around a 1/10. Like a sharp tingling sensation right near the disc around L4/L5. Physical therapy isn’t helping much.

Well I finally convinced my doctor to order a MRI and it came back mostly normal. Seeings that I don’t have a bulging or herniated disc I want to get back into doing deadlifts but I’m afraid because the last time I tried it flared my pain up really bad and I was only doing 65lbs. Before I hurt myself I used to be able to do a below the knee rack pull w/ 405lbs for several reps and with good form. I did not train the conventional deadlift from the floor at heavier weights because I experienced form breakdown when training heavy, mostly due to mobility issues.

Anyways, lately I’ve been doing band kneeling hip thrusts and those seem to help. I’m really hesitant to add in deadlifts but they may be just what I need to rehab my back. I’m also debating starting w/ front squats because I can keep a vertical torso and gain strength there without actually doing deadlifts yet. Would appreciate ya’lls advice.

I do need to be very careful that the work is being done by my hamstrings (hip hinge) and not my lumbar spine. My low back is very strong, much stronger than my hamstrings and I think esp when doing conventional deadlifts, it takes over and places more strain on my back.

I’ve had sporadic bouts with low back pain, sometimes pretty severe. I could barely move for days once after botching some zercher squats. Is there a particular reason you have to deadlift, like competitive lifting? If not, there are plenty alternatives to conventional deadlifting. The trap bar deadlift is my go-to when I have back pain (and it’s also a contested lift in strongman so win/win).

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No, I really don’t care if I pull from the floor ever again. I’m just a recreational lifter. I want to recover from the injury and do whatever I can to remain injury free. I think I might be at the stage in recovery which I need to start loading my spine.

I may have to do different variations. I think sumo would be good except I never did sumo before I hurt my back so I might not be doing it right now. I do remember a rack pull from about 3" below the knee felt way better than a conventional deadlift for me w/ my leverages and such. It was easier to keep tight and prevent form breakdown and also I personally got a much better hamstring workout from it.

Glad you know of some good, pain free variations. If you don’t compete, just do a hinge movement that doesn’t hurt. My wife-to-be switched to sumo after having issues with sciatica and feels a ton better now. I’m sure you could get really strong doing those rack-pulls. There is nothing special about a conventional deadlift anyway. It doesn’t deserve the pedestal it’s on as the height is totally arbitrary; it’s the pattern that’s important.

EDIT: hell, GHR, kettlebell swings, & back raises would fall into that hinge pattern too, doesn’t have to be barbell movements

Were you given the diagnosis of non specific back pain? Was extensive testing done of possible contributing structures and symptom sources? Seems like a cop out.

Khangles,

Yes I was. “mechanical back pain” was the exact wording. Was basically told I have back pain with no known cause of it. Honestly I think the diagnosis itself is a cop out. It was given after a 5 minute exam and w/o any diagnostic imaging. I only just now got an MRI and for all I know maybe I did have a bulging disc and it healed.

Extensive testing? No. It was around 5 minutes in the examination room. They found I had anterior pelvic tilt and I’ve been working on strengthening my glutes and core. Doing so has definitely helped prevent the pain from flaring up but it hasn’t made it go away. Also I’m military so my care isn’t as good as it could be, at least so it seems.

Was this a doctor or physical therapist? Military or civilian?

Guess they make sure you a healthy af going in but once your in… Probably not in their best interests to go around telling their patients that they are disabled or injured. Loss of money/compensation, man hours and such.

Am a physio/physical therapy student so can say that unless there they recognized a clinical pattern in your presentation that indicates that a certain condition is probable they’d not have taken 5 minutes.

Non specific mechanical spinal pain is given when, by process of elimination all other possibilities are ruled out. Then the focus becomes what is “driving” or perpetuating the pain/symptoms.

Anterior pelvic tilt is as cookie cutter as they come. Means nothing by itself and may not even be a contributing factor. Probably just using jargon to justify the diagnosis.

Without an extensive history, full physical, diagnostic imaging and treatment + reassessment for effectiveness that call shouldn’t have been made. Definitely a cop out. You’ve been fucked good lel.

Have you researched the QL muscle?

Also, make double sure your abs are tight when squatting. Example: If you box squat and your abs aren’t tight when you sit, your spine may move side to side.

Maybe you have tight glutes pulling your pelvis forward and causing an excessive arch in the lumbar spine?

Try doing glute stretches in the morning & at night and before training and see if you get any relief :slight_smile: