BJC Health and Fitness Blog

Low Back Pain with Squats?

Written by Sarah Comensoli | 01-Sep-2017 02:15:00

Anyone who knows me will know how much I love a good squat.


When the technique is crisp, the individual is confident, and the movement occurs in an effortless fashion, I can honestly say a great looking squat can make my day.

Sad isn’t it. But I speak the truth.

Squats are (generally speaking) a marvelous exercise to have in one’s program. A well performed and pain free squat can provide significant benefits whether you are exercising for gains in strength, aerobic fitness or running speed. Squats also form an integral part of BJC’s protocol to help manage knee and hip osteoarthritis.

#squatsforlife

So enough praise for the mighty squat, why do so many of us struggle with low back pain when we attempt to do them? Am keen to share Robert’s case to help highlight some of the potential issues.

Robert was referred to our clinic for management after his bilateral knee replacement. He was keen to get moving as soon as possible as he was an avid bushwalker, and couldn’t wait to get out in the cool Sydney air for his next 3 hour trail walk. 4 weeks post operation Robert had worked his way successful through some flexibility and quadriceps activation exercises. His knees were healing and moving nicely, Robert was ready to start tackling some squats. We were both a little surprised when his first few attempts at the mighty movement didn’t feel so good. On the plus side, his knees coped brilliantly, however his lower back was definitely feeling uncomfortable and we needed to stop after only a few repetitions.

So what could be happening with Robert?

Hips, and knees, and ankles OH MY
Having already outlined some of the benefits of squats, it would be remiss of me to not also mention how b&^%y hard they can be to do well. An ideal squat requires a great level of flexibility at the hips, knees and ankles, and on both the left and right sides of the body! Unfortunately, if you are lacking the required range of movement needed at any of these levels, then your brain (somewhat cleverly) will still try to complete the movement, potentially putting extra strain and pressure on other parts of the body. Our core should act like a strong tree trunk when we perform good squats. It should remain strong, upright and unwavering as we complete the movement from start to finish. At times though, the lack of movement in our branches (think hips, knees, ankles) can effect how much work the trunk needs to do. This compensation can put extra strain through the lower back resulting in pain.

Technique, Technique, Technique
Although they might look quite simple, squats are a reasonably complex movement. If you are recovering from an injury, starting strength work for the first time or unsure of whether squats are a good movement for you to practice, it’s advisable to have someone coach you on how to squat with ideal technique. Despite there being ample videos and resources online, nothing is as good as having someone work through the movement with you. Our bodies all have individual quirks, and at times modifications to movements may be necessary to keep you safe and avoid injury. In the clinic, we use an app called Coaches Eye to help us record movements and then work with clients to help correct their movement if needed. Sometimes a thorough joint/movement assessment is also needed to understand why someone may be struggling to perform a squat. In terms of the lower back, ideally we want it to remain in a neutral position throughout a squatting movement. In actually isn’t required to move much at all, and although this sounds easy, it is actually quite difficult to control! Those who may be stiff through their spine, ankles or hips may struggle to maintain this neutral position. So learning the appropriate technique and having an ability to stabilize well through your core are essential ingredients to better managing your lower back.

Sitting and squatting aren’t the best of friends
A huge number of muscles are needed to lengthen, contract and fire in a synchronized fashion in order to perform a good looking squat. Some of these squatting muscles are prone to getting tight with long bouts of sitting. Muscles at the front of our hips and thighs actually attach up into our lower back. So if these muscles are tight, they can definitely effect the movement of the lower back throughout a squat. Taking regular break from sitting, as well as getting into a good stretching routine will both increase your chances of performing a pain free squat.

Squats are a complex movement, and like anything that offers a number of benefits, there can be some decent work needed in order to reap the rewards. Is your low back pain holding you back when you squat? Why not get one of our Physios or Exercise Physiologists to check you out?