It is not uncommon for both new and experienced lifters alike to experience low back pain. At Barbell Therapy and Performance, we take pride in getting those in pain back to doing what they love in as efficient and effective ways as possible. This usually includes altering current training programs to allow for the rehabilitation process to occur. Here are a couple of our main principles when rehabbing lifters who experience low back pain while deadlifting.
Option #1: Change your Deadlift Variation– Some people seem married to the way they deadlift; “Oh, I only pull conventional, cus sumo is for sissies!” Ok, relax Chad… Changing the form of physical stress on the body can be greatly beneficial for a multitude of reasons. If you have never tried Romanian deadlifts, lifting off of blocks, utilizing a trapbar, or adding pauses or eccentrics to vary the movement pattern, you are missing out. These variations help decrease stress on overloaded structures that are taking the brunt of the load for lifters who only do conventional deadlifts all the time.
In terms of changing variations, trap bar offers us a lot of freedom in the sense that you can vary how much hip versus knee movement you can utilize. Lifters experiencing significant low back pain can use a more knee dominant trap bar deadlift to take stress off the low back and force the quadriceps to do more of the work… and guess what? You can usually still load it moderately heavy and avoid painful low back symptoms.
As a generality, training off of blocks takes lifters out of the most dicy range of motion, the bottom, and raises the starting position of the deadlift to a more low-back-friendly position. Swapping in some Romanian deadlifts, which also use less range of motion, is a nice way to avoid the more risky bottom position of hip hinge movements, while still loading the correct muscles and getting stronger.
Not only will varying your deadlifts decrease stress on overworked muscles, but it will also build up the strength of supporting muscles in the deadlift that can assist when going for max efforts on conventional deadlifts when your low back is feeling healthy again. Change is not always permanent, YOU CAN GO BACK TO CONVENTIONAL… when your PT that lifts says so.
Option #2: Vary Intensity in a More Intelligent Way– Lifting above 90% of 1 rep maxes at a super high frequency is not sustainable… I know, shocking right? But many powerlifters want to train heavy every time they prepare to deadlift. Periodization does allow for heavy blocks of training, and hopefully you feel great doing it! But lifting super heavy when your low back is irritated sounds foolish and a lot of the time, just taking some weight off the bar can greatly decrease the severity of the low back pain lifters experience when deadlifting. We need to help our lifters comprehend how beneficial it is to keep the ego at bay and lessen the weight of working sets when they are experiencing low back pain.
Option #3: Vary your Tempo– Cal Dietz made tempo training cool again, thank goodness. Using slow eccentrics or longer isometric pausses is a fantastic way to self-regulate your load and keep us honest as lifters. We all want to lift heavy, but what happens when we have a five to six second eccentric? More than likely, we’ll have to lighten the bar and clean up our form, which are both super helpful when dealing with low back pain. We can slowly lower the bar to the fringe or threshold range of motion in the deadlift where lifters start to experience painful symptoms, give a two second pause there and come back up in a controlled manner.
Option #4: Recovery and Frequency– Not many all-natural lifters can deadlift more than two times per week. Some rare unicorns can pull off three and still recover adequately, but it is not common. So if you are deadlifting four times per week and feel like junk in your lumbar spine, if we just adjust that down to two, it would be a great first step in the right direction.
Deadlifts are incredibly good at breaking down the body and later making us stronger with rest as a form of adaptation; this includes muscle fibers, tendons, and fatiguing the nervous system… This points us to WE NEED TO RECOVER in order to maximally benefit from training deadlifts any given frequency in a week. Some of the strongest natural powerlifters only deadlift once to twice per week, chances are they might be onto something and 3-4 times per week might be overkill on not only your glutes and hamstrings but your low back as well.
Option #5: Altering Volume– German volume training got really popular two years ago and I have no idea why. Ten sets of ten sounds miserable to me. Regardless, being smart when looking at the programming volume of deadlifts and their variations can greatly improve how your low back tolerates them. A great place to start is Prilepin’s chart. It isn’t the Holy Grail of programming, but it is great to make sure you aren’t going completely off the rails and burying yourself with too much volume that you can’t recover from. Prilepin’s chart shows you exactly what range of sets and reps should be performed at certain percentages in order to achieve the most effective training dose; they do also include an “optimal” number of total repetitions, but again, take that with a grain of salt. Altering volume goes hand-in-hand with intensity and frequency but when done appropriately, changing the overall workload on the body, especially for deadlifts can be super helpful when breaking down the rehab process and mitigating low back pain.
These are a couple of the principals we alter with our lifters at Barbell Therapy to keep them lifting even when rehabbing. We believe it’s rare you have to completely eliminate a movement pattern from training when loading appropriately, it’s just a matter of finding your “Goldilocks” in the rehab process with a trained and licensed Rehab professional.
-Connor Bombaci, PT, DPT, CSCS