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  • Dr. Alex Tapplin

Back Pain In The Gym?

Updated: Jan 28


There are two common types of low back pain* associated with lifting at the gym.


The first type of back pain is extension intolerant back pain. This type of pain is present with extension-based movements. An example of this kind of movement would include low back pain with overhead movements like jerks.


The second type of back pain (more common) is flexion intolerant back pain. An example of this would be any flexion-based movement associated with the gym such as a deadlift or any pulling movement from the floor.


Common Symptoms:

  • Pain with flexion-based movements

  • Examples of these movements include:

  • Sitting at the computer

  • Driving

  • Bending down to pick something up

  • Bringing the knees to the chest


Some questions:


Do you have first thing-in-the-morning pain or awakened by the pain? The reasons for this are due to the swelling of the discs that occurs overnight

  • Do you have pain putting on your their socks and shoes?

  • Did it occur from a lifting or bending injury?

  • Do you have pain when getting up from sitting?


What can be done to help with low back pain?


According to Dr. Stuart McGill, “The first step in any exercise progression is to remove the cause of the pain, namely the perturbed motion and motor patterns”. He recommends eliminating spinal flexion completely which has been proven very effective.


Our Recommendations:

  1. Avoid any stretch that has the back in a rounded position.

  2. Avoid positions as possible that put your back in a rounded and compressed position. This includes sitting.

  3. Stretch/mobilize and move in the direction opposite of the original injury. So, for example, if you injure yourself with forward flexion/bending you’re going to want to restore extension movement as soon as you can. Exercise: McKenzie press up.

  4. Bedrest is old school as most people know by now. It’s important to keep the muscles that attach right under the spine activated as these shut down in the presence of flexion tight back pain.

  5. Walk as fast as you can for 10 minutes or less.

  6. Use the bird dog exercise as described by McGill. It activates the small muscles on the back to prevent those muscles from disengaging/atrophy.

  7. Hip hinge with all movements in this acute stage. The phrase I use is “preserve the curve”. Restoring the hip hinge is a huge piece of the puzzle for prevention and that should start immediately and continue from then on.

  8. Erector endurance is prioritized over erector strength. Wide stance good mornings, Romanian deadlifts, The reverse hyper, all with impeccable form and focusing on time under tension/endurance are important for prevention of future episodes.


Modern and comprehensive chiropractic for low back pain is available in Appleton and Neenah with Dr. Tapplin. Physical therapy for low back pain in Neenah with Dr. Ashbeck. Both providers use a comprehensive treatment approach to keep you in the gym and get you back to full strength as quickly and complete as possible.


*This way of categorizing low back pain ignores the actual pain generator (disc, joint, SI joint, muscle, connective tissue, nerve, etc) That is a different topic and article. I will write that article if I have enough requests. The classification here focuses on what the athlete can do, what's in their control.

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