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Fitness

How to Return to Training After a Low Back Injury

You've injured your lower back and you want to get back to training. What is the best way to proceed? What will help you heal up well so you can continue training? Here's my advice as a doctor.

Lindsey Mathews

Written by Lindsey Mathews Last updated on Oct 25, 2022

So, you’ve had a back injury, and now you’re itching to get back in the gym to squat and get a solid workout. Pump the breaks. Injuries are no joke. They are your body’s way of sounding an alarm, telling you that something is not right. That something could be your biomechanics, could be stress at work, could be related to emotions, or could be anything. So take a look at your life and be patient.

Once you’ve done that, then let’s get into returning to the gym after a low back (aka lumbar spine) injury. Before you go any further, read the article I wrote a while back in regards to the most common injuries I see in my practice – shoulder and lumbar spine injuries – that may be of some help to you especially if the problem is still present.

When I give my patients the green light to resume their regular exercise routine, we proceed with caution. Before any running, jumping, or lifting, the person must have a perfect air squat. Their pelvis must not shift to one side. Their knees must track out while feet stay firmly on the ground about hip-width apart. The axial skeleton must stay upright, active, and with no collapse of the lumbar spine (“butt-winking”). Ten perfect squats a day along with core activations and individual specific mobility are the only things I allow during the first week of recovery from a low back injury.

When the first week of activity has been completed and there is no discomfort, then we move on. During the second phase, I allow running, rowing, swimming, air squats, strict pullups, hollow holds, and perfect pushups. Yes, there will be muscle soreness from the de-conditioning that has occurred due to the injury, but if any of those things, aggravate the low back, then I encourage my patients to seek coaching for specialties such as running or gymnastics to learn the correct biomechanics.

low back pain, lower back injury, low back injury, lumbar pain, lumbar injury

Once the patient has mastered the second phase of bodyweight movement and metabolic conditioning with no pain, then we start to add a little weight in the squat. This means only the bar and only a front squat. Front squats have numerous benefits, but the greatest of all is that this particular squat creates a super strong core. A strong core is a solid foundation to any movement.

As you can see, there are a number of movements the athlete (you) can now do: running, rowing, front squats, hollow holds, pushups, and pull-ups. This is a great foundation to get back into your regular exercise program. If all is progressing nicely, start to add things back in. Do one thing a day and wait to see how your body responds the next day. Only introduce one new movement at a time.

There are a few movements that you need to approach with extreme caution when recovering from a back injury:

  • Putting any weight overhead requires an extremely stable and active midline. This means having a solid hollow position. Dusty Hyland teaches this position very well. Do not take this movement too lightly.
  • Deadlifts are great for strengthening your posterior chain, but these have to be done correctly. Use light weights and focus on the biomechanics of the movement.
  • Back squats put a lot of stress on the posterior chain. For people who have had a disc issue, I advise waiting nine to twelve months of pain free exercise before going heavy on back squats.

Injuries can be a blessing in disguise. Continue to work with your chiropractor or physical therapist as your progress. Set the intention for correct biomechanics and you will be a stronger, more efficient athlete in the long run.

Photos courtesy of Shutterstock.

Lindsey Mathews

About Lindsey Mathews

Lindsey Mathews is a chiropractor who specializes in the biomechanics of the body and balancing the musculoskeletal system. She focuses on women’s health, perinatal chiropractic, and pediatrics. Lindsey aspires to create purity in pregnancy in today’s modern world and empower women to become “birth fit.”

Lindsey was born in Houston, Texas. She grew up on the river in New Braunfels, Texas. During high school, Lindsey participated in cheerleading and played soccer. While in college, she played intramural soccer and maintained her gymnastic skills while working at the Center for Student Athletes at Texas A&M. She is the proudest member of the Fightin’ Texas Aggie Class of 2005.

While on a medical mission trip to Tanzania, Africa, Lindsey decided that she wanted to enhance people’s lives in a natural way - without pharmaceuticals. Lindsey decided to become a doctor of chiropractic. She moved out to Los Angeles and completed her doctorate at the Southern California University of Health Sciences.

Lindsey worked at the International Sports Performance Institute from 2009-2012. She currently works at the American Health Lasers Los Angeles Clinic. She also owns her own business that specializes in pregnancy lifestyle coaching. Lindsey has treated numerous active people such as Olympic and professional athletes, CrossFit athletes, and CrossFit moms, and traveled the world to be on set for demanding stunts in film and television.

Lindsey practices what she preaches. She eats a paleo diet, exercises five to six times a week, gets adjusted, and takes fish oil. She currently is enrolled in and donates one weekend a month to the International Chiropractic Pediatric Association (ICPA). She is immersed in research and is relentless in her mission to naturally improve the lifestyle of women, mothers, children, and others. Lindsey lives with intention and is a proud member of Team Original.

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