Back pain during training isn't always an injury. Sometimes it's a load pattern, a structural imbalance, or something that's been building for longer than the last session.
Back pain during training is common enough that most active people have normalised it. A bit of tightness after deadlifts. Stiffness the morning after a long run. Something that twinges when the load goes up.
Not all of it is a problem. Some load-related discomfort is part of training. But there's a difference between appropriate muscular fatigue and the kind of back pain that keeps recurring, builds over a training block, or shows up consistently with specific movements. The second type is usually telling you something worth listening to.
The lower back is one of the most load-bearing structures in the body, and one of the most frequently asked to do things it wasn't primarily designed for. Most training-related back pain falls into one of a few broad patterns.
Compressive load. Exercises that increase axial load through the spine, particularly under fatigue, create compressive stress on the intervertebral discs and facet joints. When the muscles supporting the spine are fatigued or when motor control breaks down under load, that compressive force is distributed less evenly, and structures that shouldn't be primary load-bearers end up carrying more than they're designed to.
Movement asymmetry. A significant proportion of training-related back pain is driven not by the exercise itself but by an asymmetry in how the body executes it. One hip that rotates less than the other. A thoracic spine that doesn't extend adequately, forcing the lower back to compensate. A pattern of gluteal inhibition that puts excessive demand on the lumbar erectors. These aren't things most people notice until they cause a problem.
Accumulated load without adequate recovery. The spine adapts to training stress, but that adaptation requires recovery. A training block that progressively increases load without adequate recovery between sessions can produce cumulative stress on spinal structures that eventually presents as pain, often at a point that feels arbitrary but is actually the result of weeks of accumulation.
Pre-existing structural patterns. Most adults have some degree of structural change in their spines, changes in disc hydration, facet joint loading, segmental movement restriction, that developed long before they started training. These don't always cause pain. But under training load, particularly as volume increases, they can become symptomatic in ways that are hard to manage without understanding the underlying structure.
When we assess training-related back pain, we're not just asking where it hurts and when. We're looking at the mechanics of the whole system: how the hips move, how the thoracic spine extends and rotates, where movement restriction exists, what compensations the body has built around that restriction, and how load is being distributed across the structures of the lumbar spine and pelvis.
This information changes what the management looks like. Back pain that's driven by thoracic restriction needs different input than back pain driven by hip mobility limitation or gluteal inhibition. Treating them the same way produces unreliable results.
Back pain that resolves between sessions and doesn't worsen over a training block is worth monitoring but not necessarily stopping for. Back pain that is getting worse, that's present at rest, that's associated with nerve symptoms like tingling, numbness or weakness in a leg, or that significantly affects your ability to train warrants assessment sooner rather than later.
The most common mistake is waiting until something is acutely limiting before getting it looked at. By that point, the structural pattern is usually more established, the compensations are more entrenched, and the return to full training takes longer.
Back pain during training is common. It isn't always inevitable, and it isn't something you have to manage indefinitely. Understanding what's driving it is the starting point for addressing it properly.
Wild Chiropractic is a nervous system-led chiropractic practice in Shenton Park, Perth.
