Returning to the gym after a back injury can be scary. It’s hard to know when you are ready to progress or even what that next step should be. Our goal is to take some ambiguity and confusion out of the process. Continue reading for a progression we often (successfully!) use with those who have had a recent flare up of a back injury!
Step 1: PVC Hip Hinge
When pain is high or the back injury is recent, find a PVC, dowel, or something similar. Your household broom also works just fine. Position the PVC along your back making three different points of contact – your sacrum (tailbone), mid back, and back of your head. With the PVC in place, hinge forward at the hips (your knees will NOT move), and see if you can complete a hip hinge without causing pain.
If you cannot complete this motion without pain, only go through the part of the motion that does not cause discomfort. Perform this exercise 20+ times. The goal is to desensitize and calm down your back. As you complete repetitions through a shortened range of motion, the amount of pain-free motion should gradually increase. Once you can complete 30 PVC deadlifts, you are ready for the next step!
Step 2: Activate Your Back Muscles
Next, the goal is to get your back muscles working pain-free while under load. We have found the best results by performing a reverse hyper. To begin, lie on a surface that is approximately hip height (a box, table, bed, etc. will do just fine) and lift your legs straight up, then lower them back down.
The principles that applied in the PVC Hip Hinge apply here as well. If the full motion is painful, stay within the motion that is pain-free. Over time, your pain-free motion should increase. Once you can perform at least 20 reverse hypers for the full range of motion, you are ready for the next step.
Step 3: Deadlift Initiation
At this point, you are ready to start deadlifting. To be successful, we will start with modifications – substituting a kettlebell and raising our starting point.
A kettlebell is substituted for a barbell in order to keep the load closer to your body. Keeping the load closer to your body decreases the amount of effort your back must expend to lift the object. Decreasing the effort lowers the chance of re-aggravating your back injury. Place the kettlebell between your feet to take full advantage of this modification.
Raising our starting point decreases the amount of motion necessary to lift the object. At the bottom of the deadlift, the forces on the lower back are the highest. Decreasing the height of the deadlift removes the point of the deadlift where a back injury flare-up is most likely to occur.
Once you are comfortably deadlifting moderately heavy weight (or the heaviest kettlebell your gym has), it is time to lower your starting position. If you initially chose a high starting position (higher = easier), gradually decrease the height instead of moving directly to the floor. When increasing the distance the kettlebell moves it can be helpful to decrease the weight. This effectively neutralizes the increased distance and keeps the total strain on the back muscles relatively the same.
After switching to the floor and increasing the weight, the deadlift itself should feel fairly comfortable. Now you are ready to move to the barbell.
Step 4: Back to the Barbell
You’ve made it! That metal bar is finally back in your hands and it feels SO good! To make this transition go well start from an elevated surface and decrease the weight. You should begin by lifting less than you were deadlifting with the kettlebell. Since the barbell is further away from the body than a kettlebell, lifting the same amount of weight will require more back strain. Similar to decreasing the weight when you switch to deadlifting from the floor, decreasing the weight neutralizes the increased forces from switching to the barbell, keeping the total amount of work the back does the same.
If this goes well, slowly increase the weight, then switch to deadlifting from the floor and decrease the weight a bit. From here, do what you normally do – deadlift!
What Happens when things don’t go well?
There can be a few things that can trip you up with along the way. The most common roadblock is a back injury flaring up. If this happens, do some light cardio activity, gentle stretching, and continue to exercise – just use different muscles. Slowly build back up to where you were. A flare up can feel like the end of the world, but it is a normal part of the process.
Some Pointers Going Forwards
Sometimes individuals struggle to work through this progression due to improper technique. No matter how strong you are, if you are deadlifting wrong, there is an increased chance of developing a back injury. If you want to know how your deadlift technique stacks up against the ideal, check out our free ebook here.
Once you start deadlifting, progression to the next step should be governed by how you feel during, immediately after, and 24 hours after you have deadlifted. If you want to know how much discomfort is appropriate and how much is too much, check out our blog article here.
Finally, if you are struggling, let us know. We love deadlifting and we do not want to be deadlifting alone! If your back injury is preventing you from being active and nothing is working, pursue individualized advice, not general recommendations. If you think you may need individualized advice, we would love to help.