deadlifting with back pain prehab guys

Deadlifting With Back Pain

If you spend an afternoon at your local gym long enough, you will inevitably see someone deadlifting in a way that could make your own back hurt! Chances are, you may have even strained your low back trying to master this complex exercise. Yet, you’ve also heard the deadlift being praised as the best exercise for maintaining a strong and healthy back. So, which is it? Is the deadlift the problem or the solution to your back pain? In this article, you’ll learn how the deadlift exercise can help you to overcome back pain, how to perform proper deadlifting with back pain, as well as some key measures supported by research that you can use to evaluate when you are ready to deadlift after a back injury!


Deadlifting With Back Pain: Why Is Deadlifting Important?

More than just a common gym exercise, the deadlift is an integral part of daily life. If you’ve ever squatted down to pick up your kids, you’ve deadlifted! If you’ve rearranged the furniture in your house, you’ve deadlifted! If you’ve brought in a heavy package from Amazon, you’ve deadlifted!

Thus, if you want to get back to a full life after a back injury, deadlifting with back pain is likely going to be a part of the road to get there.  Deadlift training can be the solution to your back problem if you follow some basic principles discovered by scientific research. This article will highlight when you can start to deadlift with back pain, the best deadlift variations after a back injury, and some awesome complementary exercises to battle-ready you back to the gym and for life!

Learn The Ultimate Warm-Up Before Deadlifting!


Deadlifting With Back Pain: What Should I Do?

First and foremost, you are not alone, back pain is the leading cause of disability in the world today.1 Researchers estimate that up to 80% of people will experience an episode of low back pain at some point in their life.2

While back issues can have a wide variety of presentations, the majority of the time the primary symptom is pain. Whether this pain is just in your back or extends down into your leg, the sooner you can get moving, the better. Simply put, MOTION IS LOTION!

While you may not feel like getting out of bed, finding a comfortable range of motion and continuing to move in that range is crucial for limiting the negative effects of an acute back injury.

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One note on safety: in rare cases, a low back injury can be accompanied by bowel and bladder changes as well as significant changes in the strength, sensation, or reflexes of your lower extremities. If you have any or all of these symptoms you should seek a consultation with a healthcare professional.

In all of the above cases, the key is to focus on what you can do, and do it! Rather than focusing on your pain and limitations.


So When Can I Start Deadlifting With Back Pain?

Fortunately, a research study in Sweden sought to answer the exact question of which people with back pain would benefit from deadlift training.3 They identified two criteria for those who would benefit from deadlifting with back pain, which you can easily assess on your own:

  • Patients with pain severity less than a score of 60 on a scale of 1-100.


  • Patients with a score of greater than 60 seconds on the Biering-Sørensen test of hip and back extensor endurance.


Essentially, if your back pain allows you to, and your low back muscles are strong enough to support you during the movement, you not only CAN deadlift with back pain, but you SHOULD deadlift with back pain!  The participants in this study who met the above criteria had significant improvements in pain, strength, and functional abilities from 1-2 deadlifting training sessions/week for 8 weeks.


How To Test Yourself If You’re Ready To Deadlift With Back Pain: The Biering-Sørensen Test

A modification of the Biering-Sørensen test can easily be performed on a table with a partner or in the gym using a Glute Ham Developer (GHD) machine. The test is designed to assess the endurance of your posterior chain by using your glutes, hamstrings, and low back muscles to hold your unsupported upper body in a neutral position. In this context, the goal would be to hold the position for > 60 seconds to fit the criteria to benefit from barbell deadlifting with back pain.  Watch the videos below for a more detailed explanation:

Deadlifting With Back Pain: Biering-Sørensen test


What If It Still Hurts While I Am deadlifting?

While this may come as a surprise, participants in this study were successful despite being instructed to continue deadlifting with back pain.  As long as the pain did not exceed the level of 5/10, did not continue after a set was complete, and the proper form was maintained; they were given the green light! This is a major point! These subjects had massive improvements, despite being allowed to continue deadlifting with back pain.

Now, this is not an instruction to continue deadlifting through worsening back pain. Rather, it is an important illustration of the fact that, as you train your back for the stresses of a fully functional life, you may feel some discomfort and that is OKAY! As physical therapists, our goal is to decrease a patient’s pain and improve their function. Unfortunately, we can sometimes spend too much time focusing on decreasing pain that we fail to return a patient to their full functional capabilities due to fear of pain or discomfort. This is especially true when it comes to low back pain, where the effects can be so debilitating. However, this study is a good reminder that focusing on improving your strength, form, and functional abilities will more than likely address your pain along the way!


Proper Deadlift technique

To see the same benefits as the participants in the study when deadlifting with back pain, proper form is crucial! To achieve this, you must start with a weight that will allow you to maintain proper form. Participants in this study started with weights of 20-45lbs. The most critical form aspect is to maintain a neutral spine throughout the motion. This is accomplished by keeping a flat lower back, taking care to avoid excessively rounding or arching your low back. In addition to the proper technique, it is very important to perform a proper warmup to ensure your body is ready to meet the demands of the task you are about to perform. This is not only applicable to deadlifting, but any activity you may perform related to exercise, including running, squatting, jumping, and so forth. We have a previous blog article where Mike takes us through the deadlift warmup essentials that you can read below with included videos!

READ: DEADLIFT WARMUP ESSENTIALSdeadlift with back pain warmup essentials the prehab guys

Deadlifting With Back Pain? Watch This Deadlift Tutorial


What if I don’t fit the criteria?

The criteria described above are for barbell deadlifting with back pain. However, if you do not yet meet these criteria, you may find success with other deadlifting techniques. One excellent option is the hex bar deadlift! An EMG study evaluating the difference in muscle activation between barbell and hex bar deadlifting found that using the hex bar required significantly less activation of the muscles of your low back.4 Thus if you haven’t developed the strength to reach 60 seconds on the Sorensen test, you might want to try the Hex bar in the meantime! Additionally, deadlifting from an elevated surface, such as blocks, shortens the range of motion required.  Thus, this can make it easier to maintain a neutral spine at the bottom of the motion. The videos below describe the proper technique for the hex bar deadlift and barbell deadlift off of blocks:

Deadlifting With Back Pain? Try The Hex Bar Deadlift

  • HOW: Inside the hex bar, find your “power stance” with your feet shoulder-width apart. Grab the bar in the middle of each handle. Slightly bend your knees, chest up, and pull the bar up by pushing into the ground and squeezing your hips at the top.


  • FEEL: You should feel your glutes, hamstrings, and low back working.


  • COMPENSATION: Keep your back flat, don’t arch it. Control the weight going up and down.


Deadlifting With Back Pain? Try The Deadlift in decreased ROM

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