You could be trying to put back a dumbbell when zap, pow, ow! Your lower back feels like it has been hit with lightning. Your muscles start to weaken and spasm uncontrollably. You can’t move. You can only brace yourself against the pain from a lousy, infuriating pulled back.
That was me a few months ago, except I was on the leg press. I wish I could say I hit my PB (personal best) for that but no. Bracing my core during the exercise could have prevented the incident but that’s the thing about a back injury, isn’t it? It’s always unexpected. You think you know what you’re doing because you have read articles and watched videos on what to do or not.
More pertinently, how do you remove yourself from the machine when every movement feels like you’ll trigger a pain nerve? And what do you do afterwards? Do you lie down, sit down, walk around or attempt to stretch? What do you do to recover in the hours, days, weeks and months post-injury? Should you see a doctor? When can you start exercising again?
If you have been – or are currently – backed into such a situation, here’s help from the experts. In the meantime, I’ll go get the muscle rub.
(Photo: iStock/Andrey Popov)
That’s because your lower back works very hard to keep you upright and mobile. According to this 2023 study, the compressive force on the spine, specifically the fourth and fifth vertebrae in your lower back, is strikingly high.
These two bottommost vertebrae bear the brunt of your back’s load-bearing function. For instance, simply walking exerts a force that is 2.5 times your weight on your spine; if you weigh 80kg, that’s 200kg of force your back has to endure. Runners punish their backs further with six to eight times their bodyweight with each step.
Even bending forward strains your back by a force that’s 2.5 times your bodyweight, the same study found. And if you lift a 20kg object with poor form, you’re subjecting your spine to up to nine times your bodyweight. So, yes, bruh, you do lift – or at least your back does.
Furthermore, “a formerly injured back can make you more vulnerable to future incidents because the damage is already done”, said orthopaedic surgeon Dr KC Ang from SBF Sports and Hand Centre. “It’s a degenerative condition and once it starts, it’s a slippery slope.”
“A back strain can be a straining of the back muscles, or it can be an injury to the intervertebral disc,” said Dr Ang. A sprain, according to Cleveland Clinic, is the stretching or tearing of a ligament that can occur after a sudden twist, fall or blow to the body that forces a vertebra out of its normal position.
You’ll know that something is wrong when you feel a sharp, electric-like pain zapping across your back, and sometimes, down your leg due to the compression of the nerve roots, said Dr Ang. At times, it could be an uncomfortable, tingling sensation, which could point to a pinched nerve or more serious issue like a herniated disc, he added.
(Photo: iStock/Jacob Wackerhausen)
Having weak core muscles, glutes and hamstrings from a sedentary lifestyle can increase your risk of a back strain or sprain. “When these areas are weak, the back has to compensate and take on more strain than it is meant to,” explained health and fitness coach Benson Poh of Vigeo Personal Training. You’ll know that your muscles are weak when a sneeze is enough to throw your back out.
Certain postures can also mess up your back, he said. “For instance, an anterior pelvic tilt (sticking your buttocks out like a duck's) increases stress on the spine and makes it more vulnerable during movement.”
Another factor that makes you more prone to back issues is weight, especially overweight men, said Poh. “They tend to face more restrictions in hip and spinal mobility, which increase the chances of compensation and back injuries.”
Women are vulnerable, too. “They generally have less muscle mass than men. If the body lacks the strength to handle an external load, the back often ends up compensating, leading to pain or injury,” he said.
Those are general scenarios because “every individual’s back story is unique”, Poh clarified. “But the common thread is this: When mobility, strength, technique or posture breaks down, the spine ends up taking more stress than it should.”
(Photo: iStock/ Brian A Jackson)
It’s not so much about sedentary versus active people but how much you strengthen your core muscles, said Dr Ang, who treats 10 to 20 new patients with acute back pain each month. “Not all active people have strong core muscles. Most people don’t spend enough time keeping their core strong,” he said.
While having bigger muscles usually translate into greater strength, they don’t address other important factors such as posture, body awareness or mobility, said Poh. “We have seen strong, muscular individuals straining their backs from bending to pick something off the floor.”
Meanwhile, odd-job workers with far less visible muscles move easily and without pain. “The difference often comes down to mobility, body awareness, and the ability to adapt to real-world movement, not just strength or muscle size,” he said.
“The deadlift and its variations such as the Romanian deadlift (RDL), stiff leg deadlift and rack pull are most likely to cause back pain as they place a lot of mechanical demand on the lumbar spine,” said Poh. “They are very technical exercises and are often done incorrectly.”
The most common mistake with the deadlift is the lowering phase, he said. Many people tend to round their backs instead of hinging at the hips. Letting the bar drift too far away from the body and shins is another misstep as this posture encourages you to round your shoulders as well. “This often leads to pulling with the back rather than driving through the hips and legs,” said Poh.
Also, don’t “straighten” your back by over-arching it; you’re only placing your spine in a compressed position, he cautioned. “A safe deadlift requires keeping the back stiff and braced so the legs and hips can do the work.”
(Photo: iStock/Thanumporn Thongkongkaew)
The 45-degree back extension is another exercise to watch out for. “Many people make the mistake of moving through the spine instead of hinging at the hips. This leads to rounding or overextending the back, both of which put the spine at risk,” cautioned Poh.
The common back-busting machines in the gym, according to Poh, include the seated back extension machine, abs machine and my personal “favourite”, the leg press.
Don’t be mistaken though; machines set a stable, fixed path of movement, which makes them ideal for unsure beginners and great for isolating muscle groups for experienced users. Trouble comes when your back is not stabilised during the movement and ends up doing the work instead of the hips and legs, said Poh.
You’re also heading for injury when you use excessive weight or let the weight control you. “Momentum takes over and your technique breaks down. This is what leads to the common mistakes and back problems we see,” said Poh.
(Photo: iStock/Bavorndej)
If you, like me, find yourself in pain halfway through your sets, Poh has the following tips to help you safely get out of the machine:
(Photo: iStock/People Images)
“If it is a mild strain, the last thing you want to do is stay completely still,” advised Poh. “Sitting, lying down, or avoiding movement can cause the back to seize up, and become stiffer and more inflamed.”
Instead, try to walk around gently. “Easy walking promotes blood flow, helps the back stay loose, and prevents it from locking up. Make sure to avoid movements that aggravate the pain. This is the best immediate step for feeling more comfortable and it also makes recovery over the next few days easier.”
Do not stretch the back right away. “A strain often happens when a muscle is pulled under load. Stretching places even more tension on the already strained tissue, which can worsen the injury. Even if stretching feels like temporary relief, it may actually make the problem worse,” said Poh.
See a doctor immediately if there’s a severe, sharp pain that doesn’t ease after resting for more than two days, or numbness, tingling or weakness in one or both legs, said Poh. Head for the doctor, too, if there’s a low-level back pain that doesn’t abate for more than two weeks.
If you’re unsure, it’s “best to see a doctor, get investigated, then have a good discussion based on the findings”, said Dr Ang. “It’s always good to see the doctor earlier rather than later.”
Generally, if the pain improves over the next few hours or days to a manageable discomfort only during certain movements, you’re golden and can adopt the “wait and see” approach, said Poh. It’s also good news if the soreness or stiffness is localised, and improves with gentle walking or when you change position or move around.
(Photo: iStock/Inside Creative House)
Here’s what you can do at the various stages post-injury, said Poh:
(Photo: iStock/puhhha)
You could, like my colleague joked, “don’t go to the gym”. But you can’t avoid daily movements such as bending down to pick up something or twisting your torso to reach the back of your car.
Poh opined that it’s not just a matter of doing a few back-strengthening exercises and calling it a day. Mobility, body awareness, good technique and posture are also important factors, he said.
And they don’t only apply in the gym. “In pickleball, golf or even the simple twisting in daily life, rotation should come from the hips, thoracic spine, and shoulders working together,” said Poh. “Practising movement from these areas builds good habits and reduces the chances of back injury from poor compensation. No matter how strong you are, if you move poorly, you remain at a high risk of injury.”
Don’t focus just on building six-pack abs or a BBL either. “Build strength in the entire body – especially the core, glutes, hamstrings and upper back – because the spine, particularly the lower back, was never designed to work alone,” said Poh. “Without this support system, the back is forced to absorb forces it cannot safely handle, which greatly increases the risk of tweaks and strains.”
(Photo: iStock/Thanumporn Thongkongkaew)
Good lifting technique, which involves hinging from the hips to stabilise and support the back rather than bending at the waist, also applies outside the gym. “The same mechanics that protect you during a deadlift also protect you when you’re picking up laundry, carrying shopping bags, or moving furniture,” said Poh. “When lifting is done with awareness, the hips and legs generate the power while the core protects the spine, which greatly lowers the risk of injury.”
Last but not least, posture. A good posture isn’t about sitting or standing with your back ramrod straight. One common disservice is the anterior pelvic tilt or “duck butt” that Poh highlighted earlier on.
“In this position, the lower back is already under tension even before you move,” he said. “When you add lifting, twisting or bending to it, the risk of straining the back increases dramatically.” Having a neutral and balanced posture gives your muscles the best chance to share the load evenly and allows your core to brace effectively, he added.
Continue reading...
That was me a few months ago, except I was on the leg press. I wish I could say I hit my PB (personal best) for that but no. Bracing my core during the exercise could have prevented the incident but that’s the thing about a back injury, isn’t it? It’s always unexpected. You think you know what you’re doing because you have read articles and watched videos on what to do or not.
More pertinently, how do you remove yourself from the machine when every movement feels like you’ll trigger a pain nerve? And what do you do afterwards? Do you lie down, sit down, walk around or attempt to stretch? What do you do to recover in the hours, days, weeks and months post-injury? Should you see a doctor? When can you start exercising again?
If you have been – or are currently – backed into such a situation, here’s help from the experts. In the meantime, I’ll go get the muscle rub.
(Photo: iStock/Andrey Popov)
WHY IS THE LOWER BACK SO PRONE TO INJURIES?
That’s because your lower back works very hard to keep you upright and mobile. According to this 2023 study, the compressive force on the spine, specifically the fourth and fifth vertebrae in your lower back, is strikingly high.
These two bottommost vertebrae bear the brunt of your back’s load-bearing function. For instance, simply walking exerts a force that is 2.5 times your weight on your spine; if you weigh 80kg, that’s 200kg of force your back has to endure. Runners punish their backs further with six to eight times their bodyweight with each step.
Even bending forward strains your back by a force that’s 2.5 times your bodyweight, the same study found. And if you lift a 20kg object with poor form, you’re subjecting your spine to up to nine times your bodyweight. So, yes, bruh, you do lift – or at least your back does.
Furthermore, “a formerly injured back can make you more vulnerable to future incidents because the damage is already done”, said orthopaedic surgeon Dr KC Ang from SBF Sports and Hand Centre. “It’s a degenerative condition and once it starts, it’s a slippery slope.”
WHAT’S THE DIFFERENCE BETWEEN A BACK STRAIN AND BACK SPRAIN?
“A back strain can be a straining of the back muscles, or it can be an injury to the intervertebral disc,” said Dr Ang. A sprain, according to Cleveland Clinic, is the stretching or tearing of a ligament that can occur after a sudden twist, fall or blow to the body that forces a vertebra out of its normal position.
You’ll know that something is wrong when you feel a sharp, electric-like pain zapping across your back, and sometimes, down your leg due to the compression of the nerve roots, said Dr Ang. At times, it could be an uncomfortable, tingling sensation, which could point to a pinched nerve or more serious issue like a herniated disc, he added.
(Photo: iStock/Jacob Wackerhausen)
Having weak core muscles, glutes and hamstrings from a sedentary lifestyle can increase your risk of a back strain or sprain. “When these areas are weak, the back has to compensate and take on more strain than it is meant to,” explained health and fitness coach Benson Poh of Vigeo Personal Training. You’ll know that your muscles are weak when a sneeze is enough to throw your back out.
Certain postures can also mess up your back, he said. “For instance, an anterior pelvic tilt (sticking your buttocks out like a duck's) increases stress on the spine and makes it more vulnerable during movement.”
Another factor that makes you more prone to back issues is weight, especially overweight men, said Poh. “They tend to face more restrictions in hip and spinal mobility, which increase the chances of compensation and back injuries.”
Women are vulnerable, too. “They generally have less muscle mass than men. If the body lacks the strength to handle an external load, the back often ends up compensating, leading to pain or injury,” he said.
Those are general scenarios because “every individual’s back story is unique”, Poh clarified. “But the common thread is this: When mobility, strength, technique or posture breaks down, the spine ends up taking more stress than it should.”
(Photo: iStock/ Brian A Jackson)
ARE SEDENTARY PEOPLE MORE PRONE TO INJURIES THAN ACTIVE FOLKS?
It’s not so much about sedentary versus active people but how much you strengthen your core muscles, said Dr Ang, who treats 10 to 20 new patients with acute back pain each month. “Not all active people have strong core muscles. Most people don’t spend enough time keeping their core strong,” he said.
While having bigger muscles usually translate into greater strength, they don’t address other important factors such as posture, body awareness or mobility, said Poh. “We have seen strong, muscular individuals straining their backs from bending to pick something off the floor.”
Meanwhile, odd-job workers with far less visible muscles move easily and without pain. “The difference often comes down to mobility, body awareness, and the ability to adapt to real-world movement, not just strength or muscle size,” he said.
WHAT EXERCISES ARE COMMONLY LINKED TO BACK INJURIES?
“The deadlift and its variations such as the Romanian deadlift (RDL), stiff leg deadlift and rack pull are most likely to cause back pain as they place a lot of mechanical demand on the lumbar spine,” said Poh. “They are very technical exercises and are often done incorrectly.”
The most common mistake with the deadlift is the lowering phase, he said. Many people tend to round their backs instead of hinging at the hips. Letting the bar drift too far away from the body and shins is another misstep as this posture encourages you to round your shoulders as well. “This often leads to pulling with the back rather than driving through the hips and legs,” said Poh.
Also, don’t “straighten” your back by over-arching it; you’re only placing your spine in a compressed position, he cautioned. “A safe deadlift requires keeping the back stiff and braced so the legs and hips can do the work.”
(Photo: iStock/Thanumporn Thongkongkaew)
The 45-degree back extension is another exercise to watch out for. “Many people make the mistake of moving through the spine instead of hinging at the hips. This leads to rounding or overextending the back, both of which put the spine at risk,” cautioned Poh.
WHAT ABOUT THE MACHINES? HOW DO YOU EXTRICATE YOURSELF AFTER HURTING YOUR BACK?
The common back-busting machines in the gym, according to Poh, include the seated back extension machine, abs machine and my personal “favourite”, the leg press.
Don’t be mistaken though; machines set a stable, fixed path of movement, which makes them ideal for unsure beginners and great for isolating muscle groups for experienced users. Trouble comes when your back is not stabilised during the movement and ends up doing the work instead of the hips and legs, said Poh.
You’re also heading for injury when you use excessive weight or let the weight control you. “Momentum takes over and your technique breaks down. This is what leads to the common mistakes and back problems we see,” said Poh.
(Photo: iStock/Bavorndej)
If you, like me, find yourself in pain halfway through your sets, Poh has the following tips to help you safely get out of the machine:
- Do not suddenly drop or let go of the machine’s handle: The instinct is to let go fast but this can worsen the injury. As much as possible, release the weight slowly and under control.
- Pause and calm down: Do not try to stand up right away. Sudden movements can aggravate the pain. Instead, pause, breathe, and allow your body to settle.
- Evaluate your movement: Slowly test which movements are comfortable and which increase the discomfort. If it is very uncomfortable, wait a little longer until the pain eases before moving again.
- Use support to get up: Find an angle that feels the least painful. When getting up, place your hands on your thighs or use the machine’s handles to support yourself; rely on your arms and legs rather than your back. Move slowly and avoid swinging yourself up quickly.
- Stand using your legs, not your spine: Focus on keeping your spine stable. Use your legs to keep yourself upright.
- Avoid sudden movements when standing: Stand tall, move gently, and avoid twisting or jerking. Begin walking slowly to help the back muscles relax.
(Photo: iStock/People Images)
“If it is a mild strain, the last thing you want to do is stay completely still,” advised Poh. “Sitting, lying down, or avoiding movement can cause the back to seize up, and become stiffer and more inflamed.”
Instead, try to walk around gently. “Easy walking promotes blood flow, helps the back stay loose, and prevents it from locking up. Make sure to avoid movements that aggravate the pain. This is the best immediate step for feeling more comfortable and it also makes recovery over the next few days easier.”
Do not stretch the back right away. “A strain often happens when a muscle is pulled under load. Stretching places even more tension on the already strained tissue, which can worsen the injury. Even if stretching feels like temporary relief, it may actually make the problem worse,” said Poh.
WHEN SHOULD YOU SEE A DOCTOR? WHAT ABOUT THE DAYS THAT FOLLOW?
See a doctor immediately if there’s a severe, sharp pain that doesn’t ease after resting for more than two days, or numbness, tingling or weakness in one or both legs, said Poh. Head for the doctor, too, if there’s a low-level back pain that doesn’t abate for more than two weeks.
If you’re unsure, it’s “best to see a doctor, get investigated, then have a good discussion based on the findings”, said Dr Ang. “It’s always good to see the doctor earlier rather than later.”
Generally, if the pain improves over the next few hours or days to a manageable discomfort only during certain movements, you’re golden and can adopt the “wait and see” approach, said Poh. It’s also good news if the soreness or stiffness is localised, and improves with gentle walking or when you change position or move around.
(Photo: iStock/Inside Creative House)
Here’s what you can do at the various stages post-injury, said Poh:
- The next day: Continue with the gentle walking but include more movements. You can take slightly bigger steps or add a gentle arm swing as you walk to encourage natural movement through the spine. Avoid heavy lifting, loaded spinal movements, or aggressive stretching.
- Two to five days after injury: Increase your walking duration and add gentle, indirect spinal movements if they feel comfortable. These can include moving your hips forward and back, side to side, and a small amount of rotation. Stop immediately if any movement aggravates your symptoms. Keep the focus on the hip movements rather than actively moving the spine.
- A week to two weeks later: If the pain has subsided, introduce unloaded movements that involve the spine such as a gentle Cat Cow and pelvic tilt. You can even try bending and extending your back in a slow and controlled manner, staying within a comfortable range. The goal is to restore coordination and confidence without loading the spine
- One or two months later: If you are moving without pain at this point, you can return to your training routine. But begin with light resistance and focus on your technique before loading up the weights. The same goes for compound movements such as squats, deadlifts and presses; start without weights until you can perform a full range of movement without pain.
- During this time, prioritise core stability, hip mobility, and controlled movement to maintain a stable spine and prevent recurrence.
(Photo: iStock/puhhha)
HOW DO YOU PREVENT REINJURING YOUR BACK?
You could, like my colleague joked, “don’t go to the gym”. But you can’t avoid daily movements such as bending down to pick up something or twisting your torso to reach the back of your car.
Poh opined that it’s not just a matter of doing a few back-strengthening exercises and calling it a day. Mobility, body awareness, good technique and posture are also important factors, he said.
And they don’t only apply in the gym. “In pickleball, golf or even the simple twisting in daily life, rotation should come from the hips, thoracic spine, and shoulders working together,” said Poh. “Practising movement from these areas builds good habits and reduces the chances of back injury from poor compensation. No matter how strong you are, if you move poorly, you remain at a high risk of injury.”
Don’t focus just on building six-pack abs or a BBL either. “Build strength in the entire body – especially the core, glutes, hamstrings and upper back – because the spine, particularly the lower back, was never designed to work alone,” said Poh. “Without this support system, the back is forced to absorb forces it cannot safely handle, which greatly increases the risk of tweaks and strains.”
(Photo: iStock/Thanumporn Thongkongkaew)
Good lifting technique, which involves hinging from the hips to stabilise and support the back rather than bending at the waist, also applies outside the gym. “The same mechanics that protect you during a deadlift also protect you when you’re picking up laundry, carrying shopping bags, or moving furniture,” said Poh. “When lifting is done with awareness, the hips and legs generate the power while the core protects the spine, which greatly lowers the risk of injury.”
Last but not least, posture. A good posture isn’t about sitting or standing with your back ramrod straight. One common disservice is the anterior pelvic tilt or “duck butt” that Poh highlighted earlier on.
“In this position, the lower back is already under tension even before you move,” he said. “When you add lifting, twisting or bending to it, the risk of straining the back increases dramatically.” Having a neutral and balanced posture gives your muscles the best chance to share the load evenly and allows your core to brace effectively, he added.
Continue reading...