I have taken the academic aspect of strength sports seriously, seeking council from the best and brightest minds I've had access to. I've been to dozens of seminars, read hundreds of articles, and strained my brain to reconcile why seemingly conflicting training ideologies seem to provide similarly effective results. I am a self-made athlete. I have no athletic background to speak of and in the wasted time of my youth as a couch potato, I demonstrated zero predisposition to strength, size, speed, or general coordination. Aside from the terrible direction of hack high school football coaches and a year or so under the direction of a reasonably competent personal trainer, my only 'handler' has been myself. I decide the protocol, the weights, the rest periods, the technique, the cues, the volume, the intensity, and whether or not I have it in me to grind out that One. Last. Rep. Given my chosen path of trial and error, it should come as no surprise that over 15 years of lifting specifically for strength, I have had my share of missteps.
When I was a teenager and fell in love with the heavy lifts, I knew only to grind. Every workout, every set was done right up to and a little past failure. This worked, of course, because intensity (in the sense of both load and effort) is THE driving force behind strength gains. And it worked because 16 year olds are fucking indestructible. Besides putting 50lbs on my lifts every 3 months and thinking I was the smartest trainer to ever walk the Earth, I was also conditioning piss-poor lifting mechanics on the lifts where good mechanics are paramount. I was also slowly chipping away at the integrity of structures you really need integrity in if you are going to succeed in these sports. Long story short, I got strong and my back got weak.
Don't do this.
At 18 years old and all of 210lbs, I attempted my first ever deadlift at 545lbs. My short femurs sank parallel to the ground as I gripped the bar and pulled myself into a full squat. A belly full of air tightened my midsection, adding every bit of stability I could muster to my disproportionately long torso. Eyes to the ceiling, I pulled. My knees straightened, shoving my hips up and forcing me into some sloppy variation of a bent row position. My back rounded in a way that would make Konstantinovs cringe. As the bar drifted forward, yet still up, I thought 'I got this'. Then something popped.
This was my first of many injuries to my lower back that have caused great pain and discomfort, threatened my lifting career, and cost me countless ounces of gains. Every pull, strain, and tear was a lesson for sure, but one that took 3-6 months of recovery time to sink in. The following is, in a nutshell, the pearls of wisdom I have picked up along the way that have kept me progressing while staying healthy (or reasonably so) as I enjoy steadily declining recovery capabilities with each year.
First of all, we need to define what we are talking about. My expertise, if you can call it that, is in rehabbing damage to the tissue of muscles and connective tissue in and around the lumbar spine. Not all lower back injuries are created equal and, thankfully, I have been spared bulging, herniated, or compressed discs. While some of the wisdom contained herein may alleviate symptoms and make life less miserable with those ailments, injuries involving the actual vertebrae will not heal themselves over time in the same way that soft tissue damage will. Severe back injuries should always involve consultation with someone who actually went to medical school, as opposed to the blogger who has subjected his own lumbar spine to 7 or 8 injuries over the years. I'm well aware that general physicians tend to be useless to injured athletes, unless ice, ibuprofen, and rest are novel approaches to you. But with serious, persistent issues, find a specialist. Don't take 'no' for an answer.
The primary principle in recovering from muscle or connective tissue damage in the lower back is that an active approach must be taken. Do not wait around on the couch for the problem to take care of itself and DO NOT use this as an excuse to be lazy. Not only will proper active recovery aleviate pain, but it will expedite the healing process while teaching you in the best way possible how to handle your future workouts in a way that will prevent this from happening again. The worst thing you can do in this situation is nothing at all.
HEAT AND ICE
So you were performing a max effort beltless deadlift from a 6” deficit and now you can't tie your shoes without getting a helping hand back up. First thing's first: reduce the intense swelling that will be kicking in momentarily. NSAIDS and ice. Obviously this is the most basic advice anyone can give you, but that's because it works. Don't be the dick that bitches about his wrecked back but can't find 30 minutes to put an ice pack on it. Immediately after an injury your body maintains structural stability by causing swelling around the injured site. While it is a part of your body's long term healing process, pressure from swelling creates a barrier that hinders the removal of waste product and delivery of nutrients. Limiting swelling early on is going to significantly reduce pain and allow for more fluid transfer of nutrients to the injury. It is important to note that ice should never be used before physical activity, as this will GREATLY increase the chances of making the injury worse if not causing a new one.
Since we have established that reducing swelling is a key to expediting recovery, it stands to reason that heat by itself IS NOT a form of treatment. Heat dilates blood vessels, contributing to the swelling process and, again, blocking the fluid transfer of nutrients and waste products to and from the injury sight. Heat can be used, however, as part of contrast therapy and as a preparatory routine before physical activity. Alternating ice and heat (contrast therapy) causes the blood vessels to repeatedly dilate and constrict, forcing blood to the injury site and back out again. This flushing effect is thought to accelerate the recovery process by rapidly pushing away damaged cells and waste products and bringing in nutrients necessary for healing. Side note: this also works with typical DOMS (delayed onset muscle soreness). Heat should also be used to add temporary pliability to an otherwise stiff back immediately before physical activity. Use this technique comprehensively and sparingly.
Tissue damage in the lower back can result in spasming as well as swelling that results in it's own special kind of Hell. Rolling over, sitting up, and even tying your Goddamn shoe turns into a chore that leads to sweating and swearing. Everything from the back of your neck to your achilles heel is connected as a unit called the 'posterior chain', and if one link is tight, all the links are tight. To alleviate pain and allow you to function as a basic human being, you must encourage mobility in as much of your chain as possible. Stiffness in your hips, hamstrings, and upper back occurs after long periods of sitting or laying down and, in the context of a lower back injury, can be excruciating.
Immediately before exercise, and at any other time during the day, utilize a foam roller to dig into any tight area of your body that may be pulling on the injured site. For me personally, this was everything from the belly button down. 10-20 rolls on my obliques, spinal erectors, glutes, hip flexors, and hamstring takes all of 5 minutes and made me feel brand new. You will find that gradually increasing mobility in these areas will take an immense amount of tension off of your lower back, allowing you to be useful as a human being and once again making life worth living.
Flexibility is an important part of mobility and equally useful as foam rolling, but take care not to stretch the injured site. Stretches like the couch stretch, glute/piriformis stretch, and a variety of hamstring stretches will be life savers, but I would recommend heavily against just bending over and touching your toes. Start sloooowly at first to gauge pain and discomfort and only progress as the tenderness of your injury will permit.
3 great stretches to promote hip mobility.
Perform under control and limit flexion of the spine.
With the basics pain of management covered, you now need to take note (for the first time in your life, perhaps) of bio-mechanics. The spine is unique because it isn't one bone that supports a load, but a sequence of tiny vertebra that each has a small range of motion in relation to the others. This gives your torso the ability to maneuver in ways that are useful in life. Under a max effort load, however, this instability can present a problem. Chances are that the injury was caused because you allowed your body to conform into a piss-poor position under a heavy load or allowed a more subtle bad habit to persist over and over for 1000's of repetitions over the years. If you want to prevent injury in the future (as well as be able to sit up and bend over right now), you need to be aware of your own positioning and how to improve it.
In the context of heavy lifts, from deadlifts to squats to snatches, your spine should be the one rigid piece in a series of fast moving and dynamic points. Even in day to day life, things like bending over should be cued by pivoting at the hips and knees and not flexing at the spine. Since the tissue around your lumbar spine is already tender and inflamed, your nervous system is going to do a pretty good job of letting you know every time your spine changes position. Pain is indeed the best conditioning stimulus, so take this rare opportunity to shock yourself out of some bad habits.
Begin by analyzing what a neutral spine looks like. The lower back should have a slight curve to it, and this position should be maintained at all times on max effort lifts. When the musculature surrounding the lumbar spine begins to fail (as it does under a max load), the spine rounds forward counter to it's natural curve. Get it in your head that this should never happen; not under a max load and not to pick a penny up off the ground. Brace your midsection by breathing deep into your stomach as you pull your abdominals in to your spine, creating resistance against your breath. This isn't the same as arbitrarily shoving your stomach out as a lifter would against their weight belt; you are attempting to activate the deep abdominal muscles into maintaining proper spinal position.
After taking a few breaths with this new technique, start to practice basic squatting and deadlifting technique without any load. With a Romanian deadlift, take a breath, brace your abdominals, and keep your spine completely rigid as you hinge at the hips and knees. Emphasize pushing your butt back as you fold over like a lawn chair, putting tension in your hamstrings and not your lower back. With a squat, it may benefit you to work with a wider stance for now and emphasize an upright position until the injury is further along. Brace the abdominals, shove the knees out, and push the hips out while keeping complete control over the position of your lumbar spine. This will eventually become second nature, allowing you to move in the meantime with less pain as well as setting you up for big weight jumps in the future.
Ryan Brown and Chad Smith demonstrate effective breathing techniques.
Use this to maintain position around the injured site and improve mobility in nearby structures.
Again, the key to rehabbing a wrecked back is active recovery, and this can only be done if you are adequately mobile throughout your hips and hamstrings. Sitting down for long periods of time causes the musculature of your hips to become stiff in a shortened and typically shitty position. If you have had a lower back strain for more than a day, this should be evident to you by now. While it is unreasonable to assume you can avoid sitting for long periods of time in your day to day life, there are plenty of things you can do to curb the ill effects.
The stretching exercises that were outlined earlier are a powerful tool in the war against sitting. When you feel your back tighten up after prolonged sitting, stand up, walk around for several minutes, and perform three or four stretches that target the psoas, hip flexors, glutes, and hamstrings. Focus on maintaining good breathing and spine position. This can be done infinite times per day and will alleviate short term pain and improve long term performance.
Laying down obviously causes the same ills, but can be much, much worse if you have a shitty mattress or a bad sleeping position. Quick side story: I strained my back deadlifting 2 weeks before breaking my ankle in the summer of 2014. I needed surgery and wouldn't be able to lift for at least 3 months. I welcomed the lay off from heavy lifting, figuring it would do my achy joints some good to breathe for a while. I was wrong. After 6 weeks of hopping around on crutches, my right leg was completely atrophied from the hip down. An imbalance had developed between both limbs, causing an amount of pain in my lower back that led me to believe I would never deadlift again. The worst part of all of this was at night: it seemed that there was no position I could get in, no arrangement of pillows that wouldn't cause me to wake up in the morning stiff as a board and in excruciating discomfort. Until I read this article on primitive cultures and sleep:
The first night I slept on the floor was incredible. Not only did I sleep soundly through the night, but I woke up with the normal fire in my lower back reduced to a dull ache. A week later, I was confident enough to do light positioning drills on the squat and deadlift with 135lbs. Three weeks later, the pain was gone. Obviously, this was all done in concert with all of the other things I recommend here, but the dramatic reduction in pain and improvement in basic utility was most pronounced with this one single change. I believe a lot of back problems stem from developed nation's insisting that they have every right to sleep on a fucking cloud. Mattresses are stupid. Ditch them.
Primates as well as primitive cultures sleep without the aid of a mattress.
This has been correlated with less instance of musculoskeletal problems.
I would advocate at least a week away from any weighted lower body training after sustaining a pull or strain in the lower back. Take this time to reduce the swelling, practice positioning, foam roll, and stretch. By the first week you should have a 'pain baseline' that will allow you to gauge the effects of your workouts after the fact. If these methods have had time to work and you find the pain slowly subsiding, cautiously pick up a barbell and begin the long road back. Know that it is probably going to be a while before you can pull or squat heavy again. Even severe muscle tears heal relatively fast, but any damage to tendons or ligaments can take months to adequately heal.
I like to use Romanian deadlifts liberally, starting with a broomstick and, over the period of a week or more, adding weight. Since we are rehabbing here and not setting world records, take the movement excruciatingly slow, keep spine position tight, and keep the tension on your hamstrings and off of your back. Turn the exercise into a stretching marathon, using exceedingly light weight to drill positioning over dozens of reps through as significant a range of motion as your injury will allow. When I say make weight jumps slowly, I mean 10lbs per week. This work will help loosen your hips in the meantime, improve setup on heavier attempts in the future, and allow the damaged tissue to heal in the context of the activities you do on a regular basis(something that will help prevent scar tissue formation).
Squatting movements should follow the same protocol; again, starting with an empty bar and progressing very slowly for the first 6-8 weeks. I find that a wide stance and an upright position is optimal for maintaining rigidness in the lumbar spine, which is priority number 1. If you were a narrow stance/high bar squatter, this will noticeably improve hip strength. If you are like me and stiffness in the musculature of the hips causes a tail tuck at the bottom (butt wink), squat to the shortest box that allows you to keep position, even if it puts you above parallel. Work on mobility through the prescribed stretches and wait until you are further recovered before trying to drop it like it's hot.
As far as accessory work goes, use a bit of common sense. I have had injuries where squatting was out of the question, but lunges didn't bother me. This doesn't mean that lunges should be a go-to for every person reading this article; it means that exercises should be chosen based how much pain they do or do not cause you. Front squats and leg presses are probably a terrible idea, but extensions, hamstring curls, lunges, step ups, sled drags, and reverse hypers may be your saving grace. Start extremely light and slow, focus on breathing and positioning, and only make jumps as high the pain will allow (there should be no pain; this isn't a test of pain tolerance).
For Crossfit athletes: program met cons intelligently by eliminating movements that cause pain or agitate the injury (duh). Complete the WOD at a pace that allows you control over the movement. For example, burpess may be OK for you if done with control, but might make your back feel like absolute shit if you try to do 45 in a minute. Air squats may feel ok, but a wall ball sprint might wreck you. What I'm trying to say is slow the fuck down. It is not imperative to your eliteness that you go balls out at the expense of your recovery, nor is it mandatory that you run or row if it's screwing with your back. Substitute for a jump rope or Airdyne machine if you have to.