Back pain, especially lower back pain, is really common.
It’s so common that up to 8 out of 10 adults will have back pain at some point in their life, according to a Canadian study.
A lot of people think that if you’re active and lift weights (including squatting or deadlifting), you’ll lessen your chances of developing pain by strengthening your body.
However, this isn’t always the case.
In this post we’ll discuss what to do when you get a sore back after squats and deadlifts, which are:
Make sure you don’t have any alarming symptoms that would require you to be seen by a medical professional right away
Take a few days to rest and avoid activities that cause your back to get sore
Listen to your body and stop when your back gets sore according to the “rule of twos”
Back down on the weight you’re using and increase your reps or use bodyweight exercises
Be sure you’re using the correct form for your squats and deadlifts
Try a different variation of the squat or deadlift
Improve your overall core strength and flexibility
Use training modifications such as a lifting belt
Check that you’re using the appropriate footwear
Apply heat instead of ice
Coordinate with a medical professional for non-medication and medication therapies
Before we take a deeper dive into what to do when you get a sore back, I want to stress that it’s not normal to have back pain after squats or deadlifts. Let’s talk about why this can happen.
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Why Does My Lower Back Hurt After Squatting or Deadlifting?
Note: We’re discussing why people get a sore back after squats or deadlifts. One thing I should mention is if you already have a pre-existing back injury or have an undiagnosed back injury you should consult a medical provider before attempting squatting or deadlifting. Don’t be a Dr.Google. Be safe out there.
For the sake of this article we’ll focus on non-traumatic acute back pain, which is defined as pain lasting up to four weeks and is not a result of a trauma (AKA not because you dropped the barbell on your lower back while squatting).
It’s really difficult to do this with back pain because the majority of people with back pain have non-specific (no diagnosable medical conditions) cause for the pain. Less than one percent of people with back pain actually have a serious medical condition (i.e. cancer, spinal infections, serious nerve damage).
The other thing is that most back pain improves within a few weeks regardless if it’s treated or not (as long as you don’t injure it again).
So now that we’ve discussed low back pain, let’s review the potential diagnoses for a sore back or low back pain after squats or deadlifts. This list is not for those that already have a history of back pain and/or surgeries of the back.
Related Article: Make sure to read How To Get Big Legs Without Squats.
1. PARASPINAL MUSCLE STRAIN
A paraspinal muscle strain is also known as a “pulled muscle.” It’s when you stretch your muscles too quickly or too much and can sometimes cause a small muscle tear. There is no such thing as a muscle sprain – a sprain refers to a “pulled ligament.”
Paraspinal means the muscles around the spine (on the left and right side of the spine). Therefore a paraspinal muscle strain is when you pull the muscles in your back around your spine. This is really common to happen when squatting or deadlifting, especially if you’re not using proper technique which we’ll discuss below.
2. SACROILIAC JOINT DYSFUNCTION
Sacroiliac joint dysfunction is also known as the “SI joint,” which is the connection of the hip bone with the spine. This can sometimes get stuck or misaligned with repetitive squatting or deadlifting, especially with unbalanced forces through the pelvis when using incorrect form.
Scoliosis can be due to curvature of the spine at a young age which can progressively get worse and can contribute to back pain, especially with excessive squatting and deadlifting. The spinal curve is usually monitored to see if it gets worse over time.
Hyperkyphosis is also known as a “hunchback.” This can develop over time with aging, especially with people that have a history of low bone density, spinal fractures, genetic conditions, or degenerative spinal disease. The forces from a squat or deadlift can potentially cause back pain as a result of the uneven forces through the spine as a result of the hunchback.
5. BERTOLOTT’S SYNDROME
Bertolotti’s syndrome is when an individual has an abnormality in the bottom few bones of the spine (they can be fused together or be attached loosely). This can change the force distribution with weight lifting such as squatting and deadlifting which can then contribute to back pain.
6. SPINAL STENOSIS
Spinal stenosis is when there is a narrowing of the spinal canal, areas around the spine, or the areas the spinal nerves travel through. This can be a result of degenerative spinal disease. If you already have this, you can easily develop worsening symptoms of back pain with squatting or deadlifting, as you put increased amounts of forces through the spine.
Interesting note: If you have acute back pain and go see a medical professional, you won’t necessarily get an x-ray done. This is due to the fact that earlier x-raying of low back pain is not necessarily associated with improved treatments but increases the use of invasive (painful) procedures.
What Should You Do When You Get A Sore Back After Squats & Deadlifts?
In this section, we’ll take a deeper dive into what you can do when you have a sore back after squats and deadlifts. Some of these tips may be used to actually prevent back pain as well.
1. MAKE SURE YOU DON’T HAVE ANY ALARMING SYMPTONS THAT WOULD REQUIRE YOU TO BE SEEN BY A MEDICAL PROFESSIONAL RIGHT AWAY
The following are alarming symptoms associated with back pain that should prompt you to be seen by a medical professional:
Unintentional weight loss
Fever or night sweats
History of cancer
Neurologic symptoms (such as weakness, falls or trouble walking, or numbness)
History of recent bacterial infections (particularly bacteremia or bacteria in the blood)
Recent history or current use of IV drugs
History or current use of steroid medications
Recent history of spinal procedures
If you have any of these alarming symptoms along with your back pain it can be a sign of a serious medical condition.
Depression, surprisingly, is also a common cause of back pain, and should also prompt you to see a medical professional.
2. TAKE A FEW DAYS TO REST AND AVOID ACTIVITIES THAT CAUSE YOUR BACK TO GET SORE
It’s hard to tell people that are used to being active to “take a break” but it’s totally necessary sometimes.
I’m not saying you should lay in bed and not go about your regular day. On the contrary, I would want you to lay off the squatting and/or deadlifting for a few days to give your body a break.
One relatively unknown issue people experience by “laying in bed” or “completely resting” is something called kinesiophobia. It’s basically fear of moving because you want to avoid pain. The last thing I would want is for you to experience this – it’s better to continue your regular routine (except for the strength training) as much as possible, and with as little discomfort as possible while you’re resting.
Some things you can do during the rest period to help are:
If an object is too heavy, ask for help
If you’re lifting an object, bend at your knees, not at your waist
Tighten your stomach muscles as you lift or lower heavy objects
Try to lift heavy objects using your leg muscles
3. LISTEN TO YOUR BODY AND STOP WHEN YOUR BACK GETS SORE ACCORDING TO THE “RULE OF TWOS”
The rules of twos is when you rate your pain on a scale from zero to ten (zero being no pain and ten being the worst pain imaginable) then compare it to your level of pain in your back after squats and deadlifts.
If the pain goes up by two levels for more than two hours, you’re doing “too” much and need to either back down or be evaluated by a medical professional.
4. BACK DOWN ON THE WEIGHT YOU’RE USING AND INCREASE YOUR REPS OR USE BODY-WEIGHT EXERCISES
By decreasing the weight you’re lifting, you’ll decrease the forces along your spine, which can limit the amount of pain you’ll experience or injuries you’ll sustain. If you want to still get a good workout, you can try to increase your reps instead. This should help limit the amount of back pain/soreness you experience.
Of course, this is assuming that you’ve been using the correct form for your squats and deadlifts.
5. BE SURE YOU’RE USING THE CORRECT FORM FOR YOUR SQUATS AND DEADLIFTS
Let’s review the technique involved in the conventional squat and deadlift, and its relation to back soreness that you may experience afterward.
Place the bar on your upper back, with your feet shoulder-width apart. Some coaches advocate for not keeping your toes straight but rather approximately 30 degrees outwards.
It was found that having your feet turned slightly outwards lowered the loading forces of the spine when lifting weight during a squat, which could potentially save someone from having a sore back.
Flex your stomach and glute muscles
By flexing your stomach and glute muscles you’ll make your back more rigid, allowing you to support the weight from the squat much easier. This will also help you avoid leaning forward during the squat which can lead to uneven forces through the back, causing potential soreness.
Move your hips back, while maintaining a neutral (not bend forward or backward) lower back, and squat down using a controlled tempo
Squat until the tops of your legs are parallel to the floor or lower
Slowly return to the starting position while keeping your back upright and your hips under the bar.
You want to avoid having a rounded back by keeping your chest up (this keeps your lower back neutral), as a rounded back during a squat can lead to a sore back. Also, avoid rotating at your hips while squatting to maintain a neutral lower back.
Stand with your hips and knees locked at the top
By locking your hips at the top of the squat, you’ll be able to distribute the forces from the weight evenly through your entire core (this maintains a neutral spine), rather than unevenly into the muscles around the spine.
Stand with your shins on the barbell, with your feet about shoulder-width apart
Don’t start with the bar far from you as this causes increased load to the spine and can contribute to back soreness.
With a neutral spine, flex your stomach and glute muscles
While picking up the bar off the ground, raise your chest to maintain a neutral spine
When you’re lifting the weight, imagine doing a “leg press” and push your feet down into the ground so you don’t try to lift the weight using just your back. Extend with your knees first.
Avoid hitting the barbell against your knees, then thrust your hips forward until you are standing up straight
A big mistake lifters make is holding the bar too far from their body to avoid hitting their knees. In theory, this is great because it avoids a knee injury but by holding the weight farther from your body, it increases the forces along your lower spine.
Also, if you don’t thrust your hips forward, especially at the top of the deadlift, you’ll round your back (not have a neutral spine), which can cause soreness.
Bring the bar back down to the start position
When performed correctly, the deadlift can be an excellent strengthening exercise for the back, even in populations with chronic (> 12 weeks of pain) low back pain
6. TRY A DIFFERENT VARIATION OF THE SQUAT AND DEADLIFT
We discussed the conventional squat and deadlift and its effects on back soreness with improper form, however sometimes it might be worth a try to change up the exercise variation to see if it decreases or eliminates the back soreness.
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Your starting stance it with your legs wide apart and your toes are more turned out which gives you a great workout to your inner thighs and butt muscles, and takes some of the force out of the lower back as long as you maintain a neutral spine.
The bar is placed in front of you instead of on top of the back. This works the muscles in the front part of your body more than the back which can be beneficial if you have a sore back.
For this squat, you’ll use a kettlebell or dumbbell instead of a weighted bar. This by nature will cause you to use a lower weight which can decrease the forces in your back.
Trap Bar Deadlift
This one requires a “trap bar” however you can’t always find them at the gym. It allows you to use your thigh muscles more, which takes the pressure off of your back.
7. IMPROVE YOUR OVERALL CORE STRENGTH AND FLEXIBILITY
Core strength (including the pelvis, abs, upper/lower back muscles) is involved in almost all aspects of squats and deadlifts. If you’re getting sore, it’s worth strengthening the muscles that allow you to perform the exercises correctly.
In terms of flexibility, by increasing it, it will allow you to have a greater range of motion to distribute the forces from the bar, which can potentially help lessen the forces on your lower back as well. Stretching was also found to lessen low back pain in prior research studies
Note: The research evidence on warming up to prevent injuries before exercise is weak and was mostly done in runners.
8. USE TRAINING MODIFICATIONS SUCH AS A LIFTING BELT
A lifting belt can be used to lessen back soreness as it is similar to tightening or flexing the stomach and glute muscles, that we mentioned earlier, to create a rigid spine.
Mechanically, wearing a weightlifting belt stabilizes your trunk by reducing the amount of bending and flexing of the spine in all directions, requiring your legs, rather than your back, to do more work during a lift.
When your spine is protected and you have correct form, you are in the safest and most steady position for lifting a heavy weight.
9. CHECK THAT YOU’RE USING THE APPROPRIATE FOOTWEAR
Surprisingly, a lot of lifters don’t realize that if you aren’t wearing the proper footwear or have the appropriate arch support (if you have flat feet) it can change the way the weighted bar distributes forces throughout the body including the spine.
You can have this evaluated by a sports medicine physician. If you go to the office be sure to take your running shoes with you as the wear and tear pattern on the bottom can be used to see if you need a certain type of arch support.
10. APPLY HEAT INSTEAD OF ICE
There’s always a debate between using heat or ice.
Heat is usually recommended to reduce muscle spasms and has been shown to reduce pain and disability in folks with low back pain.
11. COORDINATE WITH A MEDICAL PROFESSIONAL FOR NON-MEDICATION AND MEDICATION THERAPIES
There are numerous options for people to treat their back soreness with certain types of therapies or medications.
Let’s review them, including the research evidence behind them.
MANIPULATION (OSTEOPATHIC OR CHIROPRACTIC)
Manipulation is a form of manual therapy to move tissues and joints.
A lot of people think of the cracking and popping sounds that are made when an Osteopath or Chiropractor provides manual therapy to patients, but the treatment doesn’t need to produce sounds to have an effect on the body.
In fact, a lot of manipulation doesn’t involve making these sounds, and still provide patients with good relief. Spinal manipulation has been shown to improve pain and function in those with back soreness.
Acupuncture is a type of medicine that involves poking the tissues with small needles to reduce pain.
The evidence in the treatment of low back pain is limited in populations with acute pain (remember less than 4 weeks). However, interesting enough, the evidence is better for people with chronic low back pain (> 12 weeks), showing that improvements can be made.
A lot of folks swear by massage treatment to alleviate back soreness, however, the research evidence is still lacking.
Massage has not shown to reduce low back pain, however, it has been shown to increase patient satisfaction. This means although folks weren’t improving in terms of their back pain, but they enjoyed the massage overall (so there could be a mental health component to this).
You’ll notice a lot of people in the gym recommending “rehab” or physical therapy for those suffering from acute back pain. Don’t be that person!
In general, it’s not recommended to treat acute low back pain with exercise or physical therapy. Those treatments have been found to be helpful in folks with chronic (> 12 weeks) low back pain. It is thought this is due to education regarding how to avoid recurrences of back pain and activities to avoid.
ANTI-INFLAMMATORY MEDICATIONS OR MUSCLE RELAXANTS
Don’t take medications or self-diagnose yourself without consulting a medical professional first.
For acute pain I usually suggest a trial of a few weeks of as needed Ibuprofen or Naproxen (at the lowest tolerable dose).
These medications do have the potential to cause more side effects (like an upset stomach) when compared to medications such as Tylenol.
In terms of muscle relaxants, they have been found to be effective in the treatment of acute low back pain.
Tylenol is what a lot of people have on hand in their homes to treat pain. It’s usually a great option, however, in terms of the evidence for low back pain, the verdict is mixed. Some studies have shown a benefit and some have not. Given this information, if someone can’t take Ibuprofen or Naproxen, this may be a good option to try.
DON’T ASK FOR STEROIDS
A few old school docs prescribe this for acute low back pain however there is no research to support the use of steroids. They compared using steroids to placebo (sugar pills with no medication in them) in patients with acute back pain and found no benefit.
If you look in the pharmacy section for pain relief you’ll find a ton of topical creams and gels. Out of all the topical options, capsicum was the only one to provide some relief for acute low back pain.
Both squats and deadlifts are great exercises to perform in any strengthening routine. However, if not performed properly and if you’re using a weight that is too heavy it can lead to back pain.
You can avoid or limit back soreness in particular by: listening to your body, backing down on the weight you use and increasing your reps instead, correcting your form, improving your flexibility and core strength, and treating yourself with the help of a medical professional.
If you do these things, you’ll be back in the gym in no time.
About The Author
Dr. Niraj Patel is a physician and assistant professor of family medicine and sports medicine at the University of North Texas Health Science Center. He completed his family medicine residency training through Cleveland Clinic Akron General where he served as the Chief Resident and House Staff President. He completed his sports medicine fellowship through Ohio Health Riverside Methodist Hospital; team physicians of the Columbus Blue Jackets (NHL) and the Columbus Crew (MLS). In addition, he has completed a Certificate in The Principles of Aviation & Space Medicine through NASA / The University of Texas Medical Branch where his final project was on the topic of “Muscle Loss in Spaceflight.” Niraj has been published in the Clinical Journal of Sports Medicine as well as Current Sports Medicine Reports, the official review journal of the American College of Sports Medicine. In his spare time, Niraj enjoys reading, working out, watching sports (especially hockey), and spending time with his family.