Low Back Pain from Deadlifts

Pain & Rehab Forum [Moderated]
1

Good day BBM! I need guidance on how to deal with what I think is non specific low back pain.

I’ve read Dr. Baraki’s articles on pain (Aches and Pains and The science of where your pain comes from) and listened to the pain management podcasts.

I’ve been training with my girlfriend in the weight room. Last week, a day after training in the gym, she told me that her lower back hurt. She feels discomfort bending her back to pick things up, but has no problem with bodyweight RDLs and even back squats.

Here is her workout from last week:

Aug 5
Squat 3x5: 110lbs
Deadlift 3x5: 110lbs
Push-ups and Inverted Rows 3x10
Leg Raises 3x10

The week previous to that (July 29), she was able to squat and deadlift 105lbs for the same sets and reps without any problem. The weights moved at an RPE of 8 based on my judgement.

With her pain experience in mind, yesterday, I tried replacing her deadlifts with rack pulls just below the knee (basically RDL ROM) 4x5: 99lbs. She was able to do 77lbs x5 for warmup without a problem. She started feeling pain with 88lbs. This wasn’t something I expected and so I decided to let her skip the rack pulls. I let her do 3x10 bodweight back extensions (not fully flexed at bottom) instead.

Aug 11
Squat 5x3: 110lbs
3x10 Back Extensions, Leg Raises
3x10 Push-up, Inverted Row

Today, she still feels pain and told me it may have gotten worse. She feels pain even when sneezing.

We also play Ultimate frisbee (the reason we weight train). So it will be difficult for her to catch low passes and maybe land and/or change directions. The season is just about to begin, but she’ll be able to weight train probably at least once a week.

Moving forward, I hypothesize doing RDLs with lighter weight (I was thinking 4x6 with around 66lbs) (tempo maybe?) would let her train the hinge with less pain. From what I understand, this would allow her to train through a similar movement and eventually progress ROM to give her confidence and likely lessen the pain experience eventually. Is this correct?

Additionally, I plan to let her continue doing BW back extensions to let her move through the flexion and do decompress the spine via deadhangs. I know the “compression” isn’t likely the cause, but doing deadhangs probably won’t be harmful so it’s worth trying.

I’d love to receive comments, suggestions, and guidance! Also, does she need a check up?

2

Hi, thanks for the questions and post! How long has she been training for? Is this her first episode of low back pain?

I would say based on the current recommendations for acute onset low back pain, she should continue to train and perform activities within her tolerance, as natural history will be on her side and she should start seeing symptom improvement over time. Therefore, a check up is probably not necessary at this point. The exercise and load selection on your end is totally fine, I wouldn’t worry about what she is able to do now vs what she did at the previous session, but rather use symptom tolerance as a guide. Being flexible with the load selection will make things easier on both your ends. Tempo RDLs and back extensions are good ideas, but I would not recommend dead hangs as traction is no longer supported by evidence and has the potential of being “harmful” from instilling the feeling of needing to “decompress”. Otherwise, I think you’re on the right path as long as you both remain patient and flexible with the training.

Feel free to follow up with updates and more questions!