Is it safe to do weight training when my back hurts?

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Yes! The World Health Organisation recommends:

  • Muscle strengthening exercises involving 2 or more muscle groups

  • Strength exercises to be performed on 2 or more non consecutive days a week

  • Getting clearance from your health professional while experiencing back pain

It is ideal to do 2 sessions of strength/weight training a week, making sure there is a rest day in between.  We recommend starting on light weights, body weight and/or elastic bands. This will help reduce the risk of injury and ensure good control throughout the exercise and assist good technique.

There are specific muscle groups that support the spine, like the ‘core,’ which is made up of the transversus abdominus, the small muscles along the spine, the diaphragm and the pelvic floor and acts a bit like a ‘corset’ for the body. These muscle groups should be included in your exercise program.

When doing weights, perform them slowly, with control and generally with your pelvic floor gently lifted. When you get the hang of the exercises you may like to build in a set breathing regime - usually exhale on the ‘work’ and inhale on the ‘rest’. Remember: quality over quantity!

It is common after a back injury, or when struggling with chronic low back pain, that some of the back muscles can be in a pattern of spasm or fatigue and are difficult to ‘switch on.’ For example, when your back hurts, often the deep abdominal muscles and gluteals switch off, so you may need further guidance on how to activate or ‘switch on’ these groups before you can progress with your exercise.  Likewise, other muscles such as the hip flexors or spinal extensors (‘back straps’) can remain in spasm as a protective mechanism that is no longer helpful. It may be useful to seek guidance on releasing these muscles before starting a weights regime, in order to get your body moving in a new, healthy pattern.

Some back injuries are made a little worse by loading activities, so it is important to get the right advice on weights exercise that is performed in a more unloaded posture, for example lying on your back with arm weights.  If your back issues have lead to a more sedentary lifestyle for some time, you may also be carrying more body weight, and this will therefore increase the force and pressure through your joints, ligaments and muscles. You can reduce some of the increased pressure by performing your weights in a seated, semi reclined or side lying position.

Ideally, when you have medical clearance, we recommend finding a fitness professional who has a working knowledge of the back pain guidelines, and has experience working in this field.


REFERENCES

Almeida M, Saragiotto B, Richards B, Maher CG. Primary care management of non-specific low back pain: key messages from recent clinical guidelines. MJA. 2018; 208(6):272-275. doi: 10.5694/mja17.01152

Foster, Nadine & Anema, Johannes & Cherkin, Dan & Chou, Roger & P Cohen, Steven & Gross, Douglas & Ferreira, Paulo & M Fritz, Julie & Koes, Bart & A Turner, Judith & Maher, Chris & Buchbinder, Rachelle & Hartvigsen, Jan & Underwood, Martin & Tulder, Maurits & P Cohen, Stephen & Menezes Costa, Lucíola & Croft, Peter & Woolf, Anthony. (2018). Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet. 391. 10.1016/S0140-6736(18)30489-6.

Exercise for chronic low back pain. Handbook for non-drug interventions. RACGP. https://www.racgp.org.au/clinical-resources/clinical-guidelines/handbook-of-non-drug-interventions-(handi)/musculoskeletal/exercise-for-chronic-low-back-pain

Booth J, Moseley GL, Schiltenwolf M, Cashin A, Davies M, Hübscher M. Exercise for chronic musculoskeletal pain: A biopsychosocial approach. Musculoskeletal Care. 2017;15:413–421. https://doi.org/10.1002/msc.1191

Dahm K, Brurberg K, Jamtvedt G, Hagen K. Advice to rest in bed versus advice to stay active for acute low back pain and sciatica. Cochrane Database of Systematic Reviews. 2010;(6): CD007612. DOI: 10.1002/14651858.CD007612.pub2

Maher, CG, Williams C, Lin C, Latimer, J. Managing low back pain in primary care. Aust Prescr 2011;34:128-32. DOI: 10.18773/austprescr.2011.069 https://www.nps.org.au/australian-prescriber/articles/managing-low-back-pain-in-primary-care

Authors:

Millie Shields & Dr. Rhea Psereckis

Marco van der Heide