Hi, I’m Jim Wittstrom. I’m a physiotherapist that works with all types of high-level athletes, including National level powerlifters.
In this article, I’m going to share with you everything I know about dealing with back pain while deadlifting, from why it might occur in the first place to how you can go about solving it, both in the short and long term.
Back pain while deadlifting is a common experience. While common, it’s a sign that something is wrong, either because your technique is lacking, your training is incorrectly programmed, or there’s something structurally wrong with your back.
Assuming you want to keep deadlifting, and getting stronger, we need to cover a few things to help that process.
Here’s what I’ll discuss today:
- How To Understand The Basics Of Back Pain
- Shifting Your Mentality Through Your Injury
- Optimizing Your Deadlift Technique
- Self Assessments You Can Perform To Understand Back Pain
- Ensuring Superior Hip Mobility & Range of Motion
- Experimenting With Different Deadlift Variations
- Dealing With Disc Issues
- Dealing With Joint issues
How To Understand The Basics Of Back Pain
Back pain can arise from several different structures and tissues within the lower back.
If you’re going to have any hope at eliminating this pain, you need to arm yourself with basic, prerequisite knowledge as a means to combat what you’re up against effectively. Figuring it out, however, can seem tricky as there are a lot of different pain-generating tissues within the back.
Thankfully, when it comes to understanding what’s causing your back pain, there are several different movements and positions you can do to determine which tissues or structures might be causing your pain. This will then allow you to further refine the best possible plan for getting it under control. These movements and positions will be covered within this article.
But before we can dive into those specific tests and movements, it’s essential to have a basic understanding of lower back pain in a broad context, as it can paint a healthier and more empowering perspective for anyone experiencing it.
Statistics on Lower Back Pain
Approximately 80% of people will have at least one episode of significant back pain within their lifetime.
This is for everyone, not just lifters.
Knowing this stat is incredibly important as it can really help put your mind at ease and help shift your focus with this whole issue or process. This is certainly not to downplay or minimize what you’re going through, but rather to help turn your mindset away from fear and more towards empowerment.
Chances are that you likely would have had some form of back pain at some point, even if you weren’t a lifter, so don’t erroneously think that lifting has automatically put you in this situation. More importantly, don’t listen to anyone who ignorantly tells you that lifting is what got you here.
Yes, maybe lifting contributed a bit due to technical errors or that of the like, but chances are your back is actually more robust from your lifting than had you not been lifting.
The prognosis of getting over your back pain is quite favorable once it’s understood.1 The most important factor of this whole process is getting an accurate diagnosis. Once it’s certain what’s at fault, the process of recovery is often very straightforward.
Shifting Your Mentality Through Your Injury
I know too many lifters who have landed themselves in a lot of back pain simply by thinking it was acceptable to push through the pain.
Pain is an indicator light to your brain that something isn’t right.
Having to scale back or pivot on your training until the pain is rectified may be annoying or inconvenient. Still, it’s a whole lot easier to deal with and eliminate when it’s acute (new) and minor in its intensity.
The best lifters out there are those who exhibit great mental strength in resisting the urge to blindly push through lifting-related pain.
This isn’t to say that you will always feel absolutely wonderfully pain-free during your training, but you should always have an ongoing mission to eliminate pain whenever it shows up.
You’re not invincible, and if you’re a younger individual, you’ll eventually figure this out, as us fellow older lifters have done.
It’s imperative to know that back pain, when addressed properly, is rarely a lifelong issue, nor is it the career-ending injury that many people erroneously believe it to be.
Nothing about your strength or technique will be permanently lost as you work to train around your pain rather than through it.
However, your efforts at rehabbing your back won’t be very successful if you can’t shift your mindset to avoid training through lower back pain. If you can, though, you’ll likely have massive success and even come back better than before.
With your mindset now committed to avoiding the temptation to just push through pain, it’s time to start hunting down what’s caused your pain.
Optimizing Your Deadlift Technique
A good place to start hunting for the culprit to your back pain is by analyzing your lifting technique. It may or may not be what’s caused your back to start acting up, but without an evaluation of your technique, it’s impossible to know for sure.
There are several articles on this website that will be a good starting point for you:
No matter how experienced you are when it comes to lifting, you can’t afford to forgo evaluating your lifting technique.
Lifting is a pursuit of persistence and a game of repetition.
Even if you believe your technique to be on point, you can’t afford to make that assumption; even the slightest, most seemingly innocuous errors can erode tissue health if put through enough repetitions.
You will need to determine how to evaluate your technique best and who you should call on to help analyze it for you.
You can do this in person or remotely with a coach if the option is available for you to do so. If you want to speak with one of our coaches for free, fill out our quick questionnaire.
Otherwise, you can film yourself and send it to someone you trust to critique each aspect of your lift.
Either way, this evaluation needs to be the starting point for gaining as much insight as possible towards learning whether or not any of your back pain has likely come from technical errors themselves.
When it comes to the evaluation, it’s important to realize that your technique will likely change based on the load that you’re pulling off the floor.
You don’t want to base the evaluation on one single load or resistance that you’re pulling.
Based on how your back is feeling, it’s a good idea to film yourself or get evaluated pulling different loads (filmed from various angles), everything from deadlift warm up sets with the bar all the way up to a submaximal load of 3-5 one repetition maximum (1-RM).
Only go up to these loads if your back will tolerate doing so. If your back is too flared up to do so, use any previous lifting footage that you may have.
If anything is revealed to be less than ideal with your technique, make it a priority to start attacking it to clean it up.
In a best-case scenario, it will eliminate the pain-generating stimulus and get you back to pain-free lifting. If this isn’t the case, cleaning up your technique will help ensure you avoid any future episodes of lower back pain and provide you with superior confidence as you lift.
Self Assessments You Can Perform To Understand Back Pain
While this section should be beneficial in helping you to gain further insight as to what may be causing your back pain, please remember that it does not formally diagnose what may be going on.
The following tests and movements have high clinical diagnostic value in predicting which structures may be compromised and generating mechanical pain, but pain can be complex and multifactorial in nature. Seek appropriate evaluation from a qualified healthcare practitioner to confirm any of your findings.
Also, keep in mind that although I will mention the commonly affected lower back structures individually, they are often present together in some fashion, meaning they are not mutually exclusive to one another.
Having a qualified healthcare practitioner whom you trust to guide you through this process can be highly beneficial.
Assessing the Discs
Intervertebral discs (the rubber, hockey puck-like structures) are a common culprit of lower back pain for lifters and non-lifters alike.
They can be compromised in different ways, with the most common being bulging or protruding of the nucleus pulposus. The nucleus pulposus is the jelly-like center of the disc. This jelly-like substance can push on the nerve root exiting from the spine right next to it when bulging outwards.
Discs tend to behave in predictable patterns when irritated. Two of them being their intolerance to sitting and intolerance to repeated spinal flexion. Both of these tend to be telling signs of whether or not a disc is involved in an individual’s back pain.
The repeated spinal flexion test can be a great way to help rule in or rule out any disc involvement.
To do this test:
- Bend forward as if you’re touching your toes and then stand back upright.
- Don’t overthink this movement – perform it in whichever way feels most natural for you.
- If your pain worsens over ten or so repetitions, it tends to signify disc pathology (injury) to some extent.
Mild disc injuries may only create minimal increases in pain, while more moderate to severe disc issues will greatly flare up the pain.
Assessing the Nerves
Nerves (especially the sciatic nerve) are often involved with irritated or bulged discs, so it’s essential to determine if any of your pain is nerve-related (likely in conjunction with the disc).
If you’ve been feeling any pain running into your glute, or down through your hamstrings, or even all the way down to your heel, this is known as a radicular pattern of pain.
If you’re having leg pain and subsequently having a hard time determining whether your leg pain is from muscle tissue (the hamstrings) or an irritated nerve, you can try the slump test.
To perform the slump test:
- Sit on a chair with your arms behind the back.
- Slump forwards and bring your chin to your chest.
- Hold this position while you then take your leg and straighten it outwards as far as you can until you feel the stretch in the back of your leg.
- Hold this position and then look up towards the ceiling. If your pain/the stretch decreases as you look up, it signifies that the nerve is sensitive or irritated (likely coming from the nerve root near the disc).
Getting nerves under control can be a bit of a process; however, your best bet for nerve irritation is to start by making sure that your discs are healthy and under control.
Assessing the Facet Joints
Facet joints are the joints of the spine that link one vertebra bone to the other.
If these joints become irritated or compromised in any fashion, they can create back pain. They tend to produce pain that is sharper in nature and quite focal.
When irritated, there are positions that these joints tend not to enjoy. Try the following movements to see if any of them replicate your pain or reduce it. These movements work by putting the joint(s) into a rather compacted position or into a less compacted position.
Quadrant Testing for the Facet Joints:
Quadrant testing can be a valuable way to determine if any joints are stuck, irritated or otherwise compromised.
If a joint is irritated, it likely won’t enjoy the combined movement of extension with rotation to that particular side of the spine. Conversely, it may be quite pain-relieving to take that joint in the exact opposite couple motion (flexion with rotation to the opposite side).
As a general example:
A painful or irritated facet joint on the left side of your lower back would likely reproduce or worsen the pain with the combined movement of left rotation and extension (which approximates the joint space) but lessen with the combined movement of rightward rotation with flexion (which opens up the joint space).
If your exact pain is replicated or lessened with either of these combined movements, there’s a decent probability that one or more of your facet joints are causing at least part (if not all) of your pain.
Assessing the SI Joint
The sacroiliac joint (SI joint) has a notorious reputation for generating pain in the lower back.
This pain tends to result from the joint being slightly shifted (often termed a subluxation) from its ideal position.
Thankfully, there are very strong clinical prediction rules that you can use to figure out whether or not your pain is coming from the SI joint.
If you meet two or more of the following clinical prediction rules, there is very strong evidence to suggest that your SI joint is at least involved with your back pain, if not exclusively. Each of these “tests” is only positive if they refer to your chief complaint of back pain:
- Fortin’s finger test (shown below)
- Pain with rolling over in bed
- Pain going from sitting to standing
- Pain with walking
If your pain is coming from your sacroiliac joint, performing mobilizations specific to this joint is your best bet for reducing and eliminating the pain.
Ensuring Superior Hip Mobility & Range of Motion
Once you’ve run through the above movements, it’s then a good idea to try and evaluate your hip range of motion. It’s staggering just how many lifters experience lower back pain due to impaired mobility within their hip joint.
Anatomically speaking, the hip joint and the lower back are two separate features, but from a functional standpoint, they are the same since movement from these two distinct features must occur together in order to complete most functional tasks within life.
Think of it this way:
If the lower back is a barbell, the plates are the hip joint – Sure, they’re different and distinct entities, but they really need each other if they’re going to serve an actual purpose.
The main area that lifters run into is inadequate flexion of the ball and socket joint within the hip.
If the ball can’t spin enough within the socket, the hip movement stops and the lower back joints are forced to compensate by flexing and moving to excessive amounts. This is the common culprit of the infamous “butt wink” that lifters get when they squat.
When it comes to deadlifting, however, inadequate hip flexion prevents lifters from getting into an ideal wedge position before initiating their deadlift.
An inadequate wedge position due to lack of hip mobility forces the lower back joints (the facet joints) to flex a bit as a result. Even with just minimal amounts of this lumbar flexion, it can be extremely demanding and taxing on these joints in order to sustain this position as the weight is lifted off the floor.
To counteract this restriction, it’s likely best to go after the joint capsule itself.
This is a sort of leather-like bag that wraps around the joint. When it gets stiff and restricted, it will drastically limit hip mobility, especially hip flexion.
Sure, muscles that cross the hip can become tight as well, but in my clinical experience, most lifters have more of their hip joint restriction coming from the capsule itself rather than any of the nearby muscles.
If you’re not sure whether or not your hip capsule needs some work, try the following stretch.
If you feel a sort of tight, “jamming” sensation in the front of your hip when you do it, then that’s your hip capsule telling you that it likely needs some work.
The Hip Capsule Stretch
To perform this stretch:
- Assume the quadruped position on the floor.
- From there, rock back like you’re doing to do the child’s pose in yoga, but there’s one caveat: you can only rock backwards as far as you can without letting your lower back flex or round even in the slightest.
- You’ll notice that you won’t be able to rock too far back before you can’t move any further back unless you were to allow your spine to round (flex). Hold this position and continue to push back without any movement of your spine.
- If done correctly, and if your capsule is tight, you’ll feel a sensation in the front of your hip, which is the capsule being challenged for its mobility.
- Hold this position for at least thirty seconds or longer, then relax. Repeat as often as desired.
Now that you’re hopefully a bit more familiar with understanding the cause and nature of your pain, it’s worth going over some changes in your training activities to help you find ways to continue to train (if possible) without further irritating or compromising your back.
The goal with this section is to provide you with information that will help keep you lifting pain-free, even if you’re currently experiencing some back pain while deadlifting.
The more versatile you can be in your training pursuits, either with or without a healthy back, the better off you’re likely to be when it comes to your training longevity.
Here are my top training tips for how to train around back pain in the deadlift:
Tip #1: Try Sumo Stance for More Hip Torque and Less Low Back Torque
If you still feel that you can pull some weight or really need to keep lifting, you may want to opt to pull from the sumo position if you haven’t already been doing so.
Unlike the conventional deadlift, the sumo deadlift requires much less lumbar flexion throughout the movement.
Since irritated and bulged discs do not enjoy flexion-based patterns, you may have good success with switching to this technique since there will be much less flexion to that section of the spine.
For further sumo deadlift resources, check out:
Tip #2: Try Experimenting With Variations in Range of Motion
If switching to pulling from the sumo stance doesn’t work for you, you can consider shortening the range of motion required from which you pull the weight from the starting position.
This is most often achieved by lifting the barbell plates off of blocks, although you can also set up a squat rack so that you pull the weight off of the safety pins.
By shortening the range of motion that you pull the weight from, you put less flexion into the hip joint and thus less torque through the lumbar spine as you move into a full upright position (the lockout portion of the lift).
Tip #3: Try Experimenting With Variations in Equipment
If you’ve been doing your training exclusively with a barbell, you may find it worthwhile to experiment with the trap bar (sometimes referred to as a hex bar).
The trap bar has the unique ability to alter the biomechanics of force running through your lower back in a favorable manner.
By standing within the bar rather than in front of it, the trap bar deadlift alters the amount of force required by your lower back muscles to produce extension (standing completely upright) when performing the lift.
Tip #4: Try Experimenting With Variations in Tempo & Load
Perhaps the most important factor to correctly dial in as you attempt to get your back healthy again is to ensure that you dial in the appropriate levels of resistance to work through (both for your deadlifts as well as with all other lower body lifts).
Thankfully, there’s plenty of ways to strengthen your muscles without heavy loading. This is especially true when it comes to rehabilitation and return-to-sport progressions.
The best approach here is to get rather familiar with tempo-based training, which often involves challenging lifting sessions but with much lighter loads. This is a great way to spare excessively heavy physical loads to your back, which can greatly reduce or even eliminate your back pain if it’s only present at heavier loads.
Plenty of great training programs exist that revolve around tempo-based training using lighter loads. Many of them have proven track records for helping lifters continue to stay strong without pushing heavy loads.
To learn more about tempo training, check out our other resources:
Dealing with Disc Issues
If it’s been determined that your pain is discogenic (arising from the disc) in nature, the following are steps that you can experiment with in order to begin to get your disc issues and pain under control.
Your best bet is to likely use all of them, as the more therapeutic movement and healthier environments you can throw at your disc, the better it will respond.
Incorporate Regular Aerobic Activity (Discs Need Oxygen)
Discs of the spine require high levels of oxygen as part of the healing process, especially when it comes to getting rid of chemical-based pain that results from tissue inflammation.
Discs only get their blood supply through the top and bottom portion (known as the vertebral endplate) of the vertebrae that they reside between.
In order to increase this oxygenation to appreciable levels, steady-state aerobic activity needs to be performed at an intensity strong enough to elevate circulation throughout the entire body.
Don’t worry; doing twenty minutes of steady-state cardio at moderate activity won’t cause you to go catabolic and lose all of your hard-fought strength and muscle gains.
Simply pick an exercise method of choice and get into the routine of doing this at least four or five times per week. The goal isn’t to get you aerobically fit but rather to give your discs the elevated oxygen levels that they require.
Check out our other article on The XX Best Cardio For Powerlifters for more ideas.
Consider Performing Mckenzie Extensions
The McKenzie extension (often sometimes known as “the sloppy pushup”) is a commonly prescribed exercise as part of the McKenzie Method.
It has a proven track record in the rehabilitative world for helping disc issues to resolve. How this does so exactly is beyond the scope of this article.
There are different ways to perform the Mckenzie extension, but the standard method involves laying on your stomach with your hands in a pushup position.
To perform the movement:
- Push your upper body off of the surface you’re laying on while keeping your hips on the ground.
- Push yourself upwards as far as comfortable.
- Hold this position for a second or two, then lower yourself down and repeat.
Doing this three or four times per day, while perhaps inconvenient, can likely greatly help with your disc issue.
Avoiding Sitting as Much as You Possibly Can
Discs that are irritated or bulging outward tend to really despise sitting due to the mechanical compression that they subsequently experience.
So, as best as possible, try to avoid sitting, or at least for extended periods of time. This can be annoying to deal with but will help ensure that you avoid continually irritating the disc as you work on helping it heal by avoiding positions and activities that may keep setting it back.
Dealing with Joint Issues
For most lifters who are in their thirties or younger, joint issues of the spine tend to be more so acute (newly acquired) in nature.
This means that longstanding issues such as osteoarthritis (arthritis of the joints) aren’t typically the culprit.
Instead, these painful joint issues tend to be the result of the joints getting “jammed” or “stuck” slightly out of a position that they should be in.
This is often referred to as a subluxation or malalignment.
It’s important to know that we’re not talking massive amounts of positional shift here, just enough to alter the ideal movement of the joint, thus creating some pain and irritation.
Lifters in their forties and above can have this same type of joint issue within their spine, but they’re also more likely to start incurring arthritic-based pain.
Arthritis of the spine often sounds scary, but it’s essentially “grey hair of the spine.” It happens to all of us, and as long as you keep yourself moving properly, lift properly and keep pain under control, you’ll still have plenty of solid years of lifting ahead.
Dealing with Jammed or Stuck Joints
If a joint is hypomobile (meaning it’s not moving enough), your best bet is to give it some mobilizations.
In an ideal world, you could have a qualified healthcare practitioner do this for you as often as you need, but we don’t live in an ideal world.
If you’re someone who is looking to effectively mobilize their lower spine joints, give the following mobilization a try:
Performing the Brettzel Stretch
The Brettzel stretch is an ideal self-mobilization to try on yourself since it targets a larger portion of the mid & lower back joints while also challenging a bit of hip mobility as well.
It’s a great one to incorporate when you feel that you have multiple joints that aren’t moving all that ideally or if you’re not quite certain which exact levels of the spine joint(s) may be causing the pain.
Think of it a bit as a nuclear bomb that just gets everything rather than one precise missile strike.
To perform this movement:
- Lay on your side and bring your top leg up towards your chest. Bend the knee of your bottom leg, and then try to pull it as far behind you as possible.
- Take your bottom arm and grab just above your knee, hooking your hand around the hamstring. Use this grip to now pull your top leg even closer towards your chest.
- Take your top arm and grab the foot on your bottom leg, pulling it up towards you even more. If you can’t grab it, just get your arm as close to it as possible.
- Next, as you hold onto your legs, begin to rotate your head and neck as if you’re trying to look over your shoulder. Rotate as much as possible. You should feel the mid and lower portions of your back getting “wound up.”
- Release yourself from the wound-up position (but don’t let go of your legs) and then repeat a few more times. Be sure to then lay on your other side and target your spine in the opposite direction.
Dealing with Arthritic Joints
Arthritic joints also require movement, but for a slightly different reason than non-arthritic joints that are simply jammed up a bit. In order for joints to stay healthy, they require movement.
The movement of joint surfaces allows the fluid within the joint (known as synovial fluid) to move between the joint surfaces (cartilage).
This movement of fluid across the cartilage surfaces keeps it healthy and provides better nutrition to the joint. When joints sit still, the fluid movement becomes stagnant, and the joint surfaces don’t get the continual lubrication that they require.
When it comes to getting movements to the facet joints of the lumbar spine, continual, low-grade aerobic movement is the way to go.
No, this doesn’t mean that your goal is to perform traditional cardio for hours on end with the goal of burning massive amounts of calories. Rather, it simply means that you need to incorporate continual, low-grade movement into your daily pursuits.
As long as the movement doesn’t bother your joints, you should be good to go. Simple 20 or 30-minute walks four or five times per week are a great starting point.
The overall goal with this movement-based approach is to create a healthier environment for the joint surfaces and to slow the rate of further degeneration to the joint, which is entirely possible with the aforementioned steps.
And don’t discount how profound it can be for getting people back to their lifting pursuits – I’ve seen massive changes with this approach for those whom I treat in the clinic.
Back pain with deadlifting is not an ideal scenario to be in, but it’s by no means a death sentence.
The odds are good that you’ll be able to eliminate the pain and return to your regular lifting routine once you understand the underlying pain-generating mechanism(s) and take the appropriate actions to rectify them.
Be smart. Take the time and energy to figure out which structures are at fault and be patient as you work to correct them. Doing so will only be a drop in the bucket when it comes to any training setbacks and will prolong your lifting pursuits for years to come.
About The Author
Jim is a physical therapist, strength & conditioning specialist and former competitive powerlifter. He loves treating lifters and other active individuals in the clinic and working with them in the gym in order to help them move better, feel better and maximize their training potential.