Top 5 Exercises Making
Your Back Pain Worse


Dr. RJ Burrby Dr. RJ Burr
Updated August 31, 2018

Not all Exercise is Good for Your Back Pain

What if I told you the exercises you’re doing for health, fitness and to even strengthen your low back are doing more harm than good?

You’ve adopted a healthier American lifestyle: eating better, moving more often, purchased a convertible standing desk, no longer scaling up and down the parking lot hunting the closest spot when you could’ve been inside the grocery store by now, yet you still have nagging back pain.

You may be surprised to know that some of the most popular, mainstream “core” exercises performed in gyms and home living rooms across the nation are a double edged sword — you’re burning calories but at the cost of increased risk of injury.

There’s a better way!

I want to be very clear up front: no movement is inherently bad. Heck, if people would simply move more they would have a lot less physical health concerns.

Movement is medicine. Motion is lotion. However, when it comes to body mechanics, it’s crucial to become familiar with how we use our bodies all day, then assess whether what we’re doing in the gym is actually helping. If you’re going to expend energy to exercise (which you should), wouldn’t it make sense to spend your valuable time getting better opposed to nursing frustrating setbacks?  

Back Pain and Body Mechanics

To why most traditional “core” exercises, like crunches and sit-ups, are a greater risk than reward, we need to understand low back and core mechanics — how it works in real-world application.

Your spine and pelvis — entire skeleton for that matter — cannot hold itself up on its own. The skeleton is held up by muscles and has been described as "floating" within our musculature.

The core is the center or fixed point where the arms and legs are anchored to create movement. The core is a transmission of forces, not an engine generating force. For clarification, the core is meant to reflexively resist movement or “anti-move” rather than drive movement. Though this is how the core works it’s, unfortunately, not aligned with conventional wisdom.

Feed Forward Stabilization Mechanism -Exercises that cause back pain

1. Crunches and Sit-ups

Crunches and Sit-Ups - Exercises that cause back pain

Ahhh, crunches and sit-ups -- the classic core exercise, right? Crunches are the quintessential “abs” exercise and you most certainly feel your abs doing it.

How would you feel if I disclosed crunches can not only cause or make a back problem worse but doesn’t even train your core the way it’s meant to function?

Relieved, because crunches suck anyway? I couldn’t agree more.

Upset. Don’t fret, because I’ve got some alternatives to give you that core burn fix you desire.

You get a standing desk because you know sitting all day, every day at work is not good for us, correct? Maybe the sole reason you got a standing desk is that sitting all day was causing you back pain.

Sitting without support tends to perpetuate a forward, slumped posture which drives our low back into a sustained imbalanced position of forward flexion (extension is backward; the opposite). Let’s say you’ve done this on and off for eight hours at work, which is not a far cry. Does it now make sense to do 100 crunches which is essentially repetitively driving that forward flexion even more? It’s driving the imbalance even further, which can cause mechanical low back pain.

To understand mechanical low back pain, take your finger and bend it backward. Bend it back even further, further, and further. Hopefully, you’ve stopped because the stretch started to hurt and you let go!

Notice how the finger feels a bit stiff and achy at first but quickly returns back to normal?

Is your finger broken or damaged? No.

This imbalanced, “stretchy” pain is mechanical pain and is the same type of pain we feel in our back from prolonged poor postures and positions.

Not only can crunches perpetuate back pain, but it doesn’t train the core the way it’s meant to function. Think about: when in life is flexing your midsection forward required for daily living? Standing, walking, running, throwing, pulling, lifting, jumping, underwater basket weaving; never!

The abs are meant to do the reverse of crunching: keep your midsection connected at the ribs and pelvis to anti-extend so we don’t crush our spine.

If you want “abs,” diet is key, not crunches!

What to do instead

Work your abs in anti-crunch fashion with exercises such as a plank roll-out, proper positioning of planks and pushups, and a triceps exercise turned anti-abs.

2. Roman Chair Back Extensions

Roman Chair Back Extensions - Top 5 Exercises Making Your Back Pain Worse

Take what I just said about crunches and flip it and reverse it: does it make sense to repetitively bend backward to train our “back abs”?

But what about my sitting posture  isn’t this doing the opposite which would balance it out?

Great question. In theory, yes. In practice, no. Explain? Glad you asked!

Using the aforementioned ”bent finger” example, would it make sense to you to take that bent back finger then jam it forward in the opposite direction? Going from one extreme to the other is a recipe for T.V. dinner Salisbury Steak: absolutely terrible.

Your fingers function best somewhere in between end-range positions  same with your core and all the other joints in your body. Understanding body mechanics, performing Roman Chair Back Extensions “ strengthen” a group of your back muscles collectively called your erector spine muscles, or paraspinals. The paraspinals makeup only one part of your core canister. As you know, the core functions as a whole and not as a sum of its individual parts.

Training your paraspinals in Roman chair fashion drives an “Abnormal model” of spinal stabilization (first image below) described as an “open-scissors” position (look for the scissors icon).

Abnormal Models - Exercises that cause back pain
Optimal Model - Exercises that cause back pain

In the first image, notice the bulging back muscles and redness of the white space between the bones of the spine compared to the second image (Optimal Model)? Repetitive back extension drives this type of pattern, putting excessive strain on the structures of the low back, and can lead to problems in other remote areas of the body, e.g., hips, knees, neck, shoulders, etc.

What to do instead

Rather than cranking down on your back muscles, train how to work all your core muscles in concert with true core exercises such as a Dead Bug with heel taps, a challenging Dead Bug variant, and variations in the Bear position.

3. Reverse Hypers

Reverse Hypers - Exercises that cause back pain

Reverse Hypers is a perfect segway from back extensions as they’re an extension of, well, extensions.

If you’re not familiar, a reverse hyper is essentially a Roman chair back extension where the torso is fixed to the machine while the legs whip cyclically up and down with typically too much weight on the pipes. Its roots are from a popular powerlifting group as an accessory posterior chain, i.e. muscles of the back of the trunk and legs, strengthening exercise.  

The problem? Compare pictures regarding the lady’s back position at the waistline.

I’ve got an idea, how about you bend your spine back and forth a bunch of times. Oh yeah, and let’s make that idea even better by adding plenty of cold hard steel to it.

What you’re seeing is open-to-closed scissors position in repetition, oh, and with weight added to it. Luckily, this gal hasn’t stacked on the plates.

Cyclic back and forth bending of reverse hypers is like bending a paperclip back and forth. Just like the paper lip will eventually break, you’re bound to break (injure) your back!

The founder states in a demonstration video, “full flexion and extension of the spine,” and, “it will cure a bulging disc.” That’s quite a claim especially since there’s evidence of cyclic spinal flexion and extension increasing risk for a disc bulge.

The powerlifting community may crucify me because it’s the words of a legend in their eyes, but I don’t care -- he’s not a clinical musculoskeletal specialist assessing and treating back problems day-in, day-out.

Yes, there is a way to execute this exercise well by slowly driving upward motion from the hips, not over extending the spine in order to bring the ankles parallel with the torso, then slowly controlling the downward descent to starting position. However, it’s difficult to pull off given the swinging pendulum nature of the machine.

There may be a viable argument for a strength athlete to integrate the Reverse Hyper into their programming, but for the general population, there’s way more risk than reward.

Just because the pros are doing it doesn’t mean you should too.

What to do instead

If you’ve even heard of this machine you’re likely inundated into some sort of weightlifting sport. Instead of causing a back problem, focus on the fundamentals of the basic lifts, e.g. dead-lift, barbell squat variations, with emphasis on understanding the mechanics of “neutral spine,” better positioning, and better lifting.

4. Burpees

Burpees - Exercises that cause back pain

What could possibly be wrong with a burpee?

I’m sure you’ve picked up on the trend by now, it’s the repetition spinal bending.

Remember the paper clip example?

Bending that paper clip back and forth over and over again is similar to what we are doing with our backs with the traditional burpee.

You see, your hips can only flex (forward) and extend (backward) so far until the range of motion is exhausted. To get your hips to go further, such as pulling your knees into your chest during the burpee, you have flex your spine forward to make up for what your hips can't do.

Now imagine doing this over and over again while you’re fatigued thus peeling yourself up off the ground after every repetition -- this is when back injuries occur.

I can’t trash the burpee completely, it has its place. But if your coach or trainer programs Burpees into your program, get a new trainer. Burpees are mindless, so if you’re paying someone for quality coaching, they need to have brains and know how not to use them.

What to do instead

There are many ways to modify a burpee. Two of my favorite ways is to get the feet wide into a “sumo” stance, and dropping into a “bear” position at the bottom opposed to pulling the knees to chest. Both version significantly reduces the amount of spinal flexion needed to perform the burpee.

Check out the burpee modifications in this video.

5. Oblique Side Bends

Oblique Side Bends - Exercises that cause back pain

Let’s be frank, we’re (figuratively) beating a dead horse here.

“Working the obliques” is the side-bending cousin of crunches and back extensions. Whether they’re performed as a twisting crunch, standing side bend with weight in one hand, or side-lying leg lift or “v-up,”  they all consist of repetitive spinal bending and don’t train the core in a way it functions in real-life activities.

What’s odd is if you’re training obliques specifically, it’s likely for aesthetic purposes of getting that lean, cut waistline. However, training them in a stereotypical way yields a more bulky, boxy midsection.

What to do instead

Simply, anti-bend by walking around with a weight in your hand like carrying a suitcase. You can modify your positioning in a good ol’ plank to greater challenge the obliques. If you’re interested in working your obliques while reaping benefits for rotational sports such as golf and throwing sports, you’ll want to go this route and never come back.

Conclusion

Some of the most popular and pragmatic core exercises may be causing your back pain rather than “strengthening” it in the way you intend — to curb your back pain.

Back pain doesn’t have to be so complicated.

If strengthening was the answer, then high-level athletes would never have back pain, yet they do. Our daily postural habits and behaviors are a better predictor of back pain than the strength of back muscles.

To clarify, training the exercises discerned in this article are not guaranteed to cause injury. You may very well be able to do all five of these exercises multiple times a week and never have a problem. However, the risk is greater than the potential reward. I’d put money on the fact it would eventually catch up to you, but I digress.

The point is there are way better ways to train your core in the way it’s intended to function.

Let’s be thoughtful in the way we train our bodies.

What are your goals? Does the training program or exercises you choose coincide with your goals? Why train like a powerlifter or professional athlete when your goal is to be generally fit and healthy?

The risk outweighs the reward.

Let’s stick to the basics: pressing, pulling, carrying, climbing, squatting, lifting from the ground.

Please, no BOSU balls and circus tricks.

A dead-lift is one of the greatest core exercises out there, yet the mainstream point of view doesn’t see it as core exercise — they see crunches. Take that dead-lift and turn it into a single-leg move and you’ve got yourself a killer full-body core exercise.

Move more, sit less, and eat well. You’ll be just fine.

Actually, you’ll be more than fine, you’ll be living without compromise.