How to Eliminate Back Pain During Squats Once And For All
Squats are one of the most popular exercises on the planet and one that also brings about some heated internet debates in terms of style and technique.
Back squats vs front squats.
90-degree depth vs ATG.
Narrow stance vs wide stance.
High bar vs low back.
People even love to argue about which way to hold your arms when doing front squats.
These people are probably at the forefront of arguing politics on social media as well. Because that is going to change someone else’s mind.
The reality is squats, of any kind, with any stance or depth, can be amazing. No one variation or version will work for everyone.
Force-feeding a specific type of squat that doesn’t work for you is a great way to ruin a good thing.
More specifically, there is a greater-than-good chance force-feeding a certain kind of squat will cause you some back pain.
So, if you are dealing with low back pain (LBP) when squatting, I am going to walk you through some of the reasons why and give you some ideas to help get out of pain.
PAIN. IT SUCKS
Before we get into the type of squats and some other variables, let us first look at your pain to get a better idea of what’s going on.
One important note before we go any further. These ideas and strategies are going to work best for chronic back pain that doesn’t appear to have an origin.
The kind that just came out of nowhere.
If you recently hurt your back and know exactly what you did to get yourself into pain, these ideas are not going to help as much. At least not right now.
Make sure you get checked out to make sure you know what you can and cannot do.
Navigating movement when there is pain is tricky. Sometimes, it is ok to continue doing what you are doing and other times it is not.
If you squat and you have pain that radiates down the leg and/or you have any numbness or tingling in one or both legs, I would stop squatting for now.
This type of pain is nerve pain. You are compressing or irritating nerves somewhere. The compressive load from squatting is less than ideal at this point.
This type of LBP should be evaluated by a skilled clinician. You may still be able to train but it needs to be under the guidance of a skilled clinician, not an Instagram influencer.
Now that we have added some data points to our exclusion criteria, let us move on to more pressing matters.
Click the image to learn more about chronic vs acute injuries.
THE PAIN RULES
If you are dealing with pain and trying to exercise, you must play by different rules.
I specialize in helping people get out of pain. Normal sets and reps and volume DO NOT apply in the beginning.
Your goal is to move without pain. Or, at least with no increasing pain.
Here are some general guidelines to help you get started.
It is ok to have some low-level pain when exercising. But, there are very specific rules that you need to follow.
The pain needs to be low to start. Like 3-4/10 low.
If the pain stays consistent at that number while you are moving then the movement you are doing is not directly irritating the problem and is probably safe to keep doing.
If your pain increases you must stop.
If you had no pain at the start of your workout, you should not have pain during the workout either.
Before you can progress what you are working on, there are three boxes you have to check off.
No increased pain during the workout
No increased pain later that day
No increased pain the following day
If all three boxes are checked off, it means whatever you did was well-tolerated by the body and you could add a little bit more.
A little bit more might only be 1-3 more reps total. Progress must be slow in the beginning.
When you are dealing with pain, the goal initially is to manage fatigue not induce fatigue.
Sets are usually kept under 5 reps to focus on technique and to allow adequate recovery. Since there is a heavy focus on technique, there is a lot of mental energy being expended.
Traditional sets, reps and volume tend to make things worse in the beginning. The rules must change when trying to get out of pain.
Follow the pain rules or chronically be plagued by unnecessary pain. See what I mean in the video HERE.
PAIN ON THE WAY DOWN
Let’s start to break down when you start feeling your pain during the squat.
First, we are going to look at pain you notice while lower down during the squat.
What’s going on here?
A lot of people, even those who have been exercising for a long time, demonstrate a poor ability to move through their hips.
Their squat is very knee-centric.
The issue here is that the glutes are not able to contribute as much as you need them to and it puts a ridiculous amount of stress on ankles, knees and low back.
It will be very difficult to maintain proper spinal alignment without performing a proper hip hinge.
Most people also have poor ankle mobility. This means the ankle joint doesn’t move like it is supposed to.
When you do not bend at the hips and ask tight ankles to move more than they can physically move, this invites the spine to join the party.
One thing that can happen is you will flex (bend) your spine in an attempt to help the motion and keep your balance. A lot of bending the spine under load has all the ingredients to make some spicy LBP.
Remember back when I mentioned that a lot of people have poor ankle mobility? Those were good times.
If the ankles are tight, you may also find yourself getting too much weight on your toes and very little on your heels.
When the heels come off the ground, it is very difficult to get your hips/glutes involved in the squat.
Your body will try to compensate by bending too far forward, which we already talked about being a bad idea, or it will try to keep your torso too vertical.
Rounding too far forward is no good. Trying to keep your “back straight” is also not good.
When you try to keep your back straight when bending down, you prevent the spine from staying in its neutral position.
This position tends to extend (arch) the back more to compensate. This excessive arching in the low back is very stressful and does not allow the spine to support loads as well as it should.
You may also feel like you are falling back which can cause you to overcorrect by rounding the spine to maintain your balance.
This faulty vertical torso setup is common when using a smith machine or when doing squats with a ball against your back that is against the wall.
If you are getting pain on the descent of your squat, check out this video for some guidance.
PAIN ON THE WAY UP
What if you are ok during the descent of the squat but have pain when coming back up?
This issue usually starts at the bottom.
Every exercise has a part in the movement where you transition from moving in one direction to the opposite direction.
If you want to nerd out with me, this is typically when you go from the eccentric portion of the movement to the concentric part of the movement.
This change of direction, in all movements, is a common point of technique breakdown.
Many things can go wrong here.
Core tension can be lost so the back becomes vulnerable.
The weight shifts forward, causing the spine to bend forward too much, making the back vulnerable.
In an attempt to come out of the hole fast, the low back starts the motion by arching, as opposed to the hips, making the back vulnerable.
Sometimes, pain on the way up is due to poorly controlling the descent.
A lot of people drop down with very little control and attempt to turn on all of their muscles and control the weight and change direction.
You can probably imagine how well that goes.
Let’s break down pain on the way back up right here.
BACK PAIN AFTER YOU SQUAT.
This one can be a little trickier to sort out because you are trying to make sense of things after the fact.
Back pain after, generally speaking, is more muscular.
You do have muscles in and around the low back and they do get worked when doing things like squats. These smaller muscles are spinal stabilizers not movers. If you ask them to help too much with your squat, you are playing with fire, scarecrow.
So some back soreness/tightness is not always bad news.
Pain after is not ok. It could mean the following:
Your technique needs some work
You are using too much weight
You are programming too much volume (too many sets and reps)
The type of squat you are choosing is not the best for you at this point
Your setup is no good
All of the above. In which case, you have a lot of work to do.
Let’s get into some strategies to fix your squat to help get rid of your back pain.
Take a deeper dive into your back pain after you squat in this video.
BACK PAIN DURING SQUATS - FIX YOUR SETUP
I am not going to go off on too much of a tangent here but some of these points are worth mentioning.
The width of your stance and the depth to which you squat are going to be largely determined by your anatomy. More specifically, your hip anatomy.
Hip anatomy is so variable from person to person that no one squat stance or depth will work for everyone.
Spoiler alert! You cannot change your hip anatomy.
And, there can also be anatomical differences between your right and left hips!
One of the biggest mistakes you can make is forcing a certain stance or depth when squatting.
Not everyone will be able to squat ATG under load. Dropping ATG to fire off some heat in the woods is not the same as squatting ATG with a couple of hundred pounds on your back.
With just bodyweight or a very light load, experiment with different stances, including slightly staggered stances.
If you have anatomical differences between your right and left sides, you may find a slightly staggered stance to be the most comfortable.
Once you find a stance and depth that works for you, stick with it. Anyone that tells you that you MUST squat a specific way is an idiot. Tell them to go pound sand.
All that being said, there can be soft tissue restricts and other movement abnormalities that could also limit your squat.
This is where the deloading can also play a role. This will be discussed in more detail in the next section.
If you find a depth that works, squat to a box or a bench that is around that height. This ensures proper depth but limits you from going too far that the squat becomes provocative.
Forcing yourself into the wrong stance and forcing depth is a one-way ticket on the pain train and a visit to your local physical therapist.
Your goal is to find a stance and depth that feels the best and has the least amount of pain. You can then use deloading to get more information.
This is also a good time to start to work on controlling the descent of your squat. It should not resemble a trap door being opened below your feet where you come crashing down.
You should be creating tension in your body at the top and maintaining it all the way down and back up.
This idea is simple but it is not easy. This is also why you should start working on this concept with light loads as it will be far more exhausting than you will expect it to be.
Forcing yourself into the wrong position is only going to cause you more problems. Check out this video to see what I mean.
DELOADING FOR THE WIN
If squatting with any kind of load causes pain, you first need to see if you can squat without a load without pain.
If you can squat with just your bodyweight and there is no pain then your pain is load-dependent.
Remove the load and you remove the pain. This is good info to move forward with.
But, what if you have some LBP when just squatting with your bodyweight?
First, it could be your setup, as we have already discussed.
But if you have nailed down a good setup for you, using a deloaded squat can give you some excellent information.
Using a band or a pulley, you are going to perform some squats. The band/pulley will provide assistance, making the squat easier.
In many cases, not only will the squat feel easier, but there will be little to no pain and there will also be an increase in range of motion.
Continue to experiment with different stances and depths during the deload until you find what feels the best and has the least amount of pain.
This will give you valuable information to move forward with.
If the deloading takes away the pain then squats CAN be done without pain. Either the load or your suspect technique is the culprit.
Pain that is removed with a deload means you should start with deloaded squats to help groove your squat pattern and work on some of the other strategies that follow.
Remember, the goal is to move pain-free.
Deloading your squat is an underutilized technique for helping to get you out of pain. Learn how to deload.
SOMETHING HURTS? BLAME THE ABS
Like the middle child, many things can be blamed on weak abs.
Most people do the bare minimum of ab work and the work they put in is typically done with retched technique.
This will give you a false sense of security when you get under a bar because you think your abs can handle the workload.
Oh, if your abs could talk.
If you do not know how to keep your low back in a neutral position as you move, almost any movement can become painful.
Especially when you have a bar resting on your shoulders.
I have worked with a ton of people who are strong and lift decent weight but have poor positional awareness of their spines and who demonstrate a poor ability to engage their abs THROUGHOUT the entire movement.
Bracing your abs at the top of the squat is great. But, if you slowly lose your tension, for whatever reason, as you lower down that initial tension did you little good.
Keeping your body tight throughout the motion is key. The transition from the bottom position as you start coming back up is the most common time for the abs to take a break.
Once that stability is lost, the low back becomes exposed.
If you are already strong, doing some basic core stabilization movements will always seem like a waste of time.
They’re not.
If you cannot master basic core movements in supported positions, you are not going to be able to do them under load.
And just because you can get away with it currently doesn’t mean what you are doing is working.
If your back is hurting when you squat (during or after), this is low-hanging fruit. Improve this and not only will your pain dissipate but your weight lifted will also go up.
You can, and should, train your core while you are working on improving your squat technique.
Work on specific core exercises and work to incorporate that concept into your squat pattern.
Don’t sleep on your core-specific work. See the benefits in this video.
STOP FORCING BARBELL BACK SQUATS
Back squats are a great exercise. And just so we are clear, when I say back squat, I mean a straight bar on the upper back.
You can fight about high bar vs low bar position later.
While the back squat is a great exercise, it is not great for every person.
There are some mobility requirements just to get under the bar. If you do not have the requisite mobility then you probably shouldn’t be getting under the bar.
It doesn’t mean you cannot squat, it means that back squats are not the best choice for you.
Force-feeding a movement that doesn’t work is not doing you any favors.
Try front squats.
Try yoke bar squats (also known as safety bar squats)
Try goblet squats.
If everytime you perform back squats you have back pain then you have to be smart enough and willing to change something. Or a bunch of somethings.
Barbell back squats are great but not great for everyone. See why HERE.
SAMPLE PROGRESSION
Another important concept when dealing with pain is that there is no specific timeframe at which you progress.
You don’t follow a rehab plan for 4 weeks and progress. You progress when your technique and symptoms suggest it is time.
This could take weeks. Could take months. But it will never be as fast as you want it to be.
Here is a progression of one of my clients. This took months of work to move through all of this.
This is also only highlighting their squat progression. This person was also training the rest of their body at the same time.
Deloaded squats - we worked on hip hinge, setup, proper depth and a smooth transition from the bottom back up
Box squat - bodyweight to start
Sit between each rep - continue to work on hinge but gives the person a chance to reset the low back and limits the sudden eccentric/concentric change
Progress to a tap and go - forces improved core stability and tension. Watch for lumbar spine arching to start the movement back up
With plate reach - helped to engage their core more and offers a counterbalance.
Goblet
Tap and go - Continued with the tap and go on the box to maintain proper depth as we added weight.
Holds - We progressed to adding holds at the bottom to work on staying tight in the bottom position
Yoke bar
Not all of my clients squat with a bar on their back. It is not a goal for everyone. In this case, we did.
The arm/shoulder position on the yoke bar made this a better option for this client instead of a straight bar.
We brought back the box to maintain depth as we progressed the movement.
A lot of my clients never progress past the goblet squat because it doesn’t align with their goals. We also work on a ton of single-leg work so their lower body strength is always improving.
Well, that was a lot and I’m exhausted. I hope some of that info helped out in some way. Always reach out with any questions.
Until next time,
Dr. Tom
