Squatting is undoubtedly one of the most fundamental movements. Not only in sport but in life. It’s one of the first exercises I prescribe to my patients, young and old for developing performance and improving quality of life.
In athletes, squats are essential for developing strength and power which carries over to nearly every sport on the planet.
In the elderly, it’s a simple exercise which builds strength, improves balance and bone density, all of which are proven to promote better confidence, function and ultimately independence (Haraldstad et al., 2017)
Trained athletes can still struggle with squats however, and in this article, I’m going to break down one of the biggest complaints during a squat, lower back pain. This is almost entirely preventable but can normally be broken down into three main issues.
1. Glute weakness
2. Poor hip mobility
3. For me the biggest issue, poor ankle mobility
Glute weakness:
If you initiate from the bottom of your squat, and you rely on quad strength mainly to get you out of the base of the movement, it leads to a much greater load travelling through the base of your spine.
If you see in the first example vs the second. Initiating knee extension first, and hip extension second is a sure fire way to place additional load on the lower back.
The solution?
Strengthen the glutes. By far the best exercise for glutes specifically is the glute bridge. Add a slight pelvic tilt at the top of the movement to gain additional emphasis through the buttocks. Ensure you travel through a greater range of motion. You don’t see many blokes doing this in the gym but men and women should both be performing regular glute bridges to ensure they have a posterior chain capable to perform. It’ll help improve performance in sport, and it’ll certainly improve performance in your squatting technique.
The second key part of this is improving the prompting when actually performing the squat. This can require a tiny bit of re-training. You may even need to swallow your pride a bit and drop the weight to allow things to operate in harmony. Driving through your feet and initiating hip flexion at the same time as knee extension will help to drive the bar up more smoothly, and without placing as much strain on the back.
Poor hip mobility:
Poor hip mobility can lead to all kinds of issues when you squat, especially lower back pain. There are lot’s of areas that can contribute. I will hold my hands up and say I’m not a very flexible person, but thankfully there is no link to flexibility and strength. Furthermore, there is also no link between flexibility and pain.
In a meta-analysis done by Afonso et al., 2021, there was no difference in strength training vs stretching for improving range of motion. I favour strength training by far because of all the other health benefits that can be gained, including bone density, power, strength and injury prevention.
Hamstring tightness and/or weakness can certainly contribute to lower back pain when you squat. Tight hamstrings can pull your pelvis into a posteriorly tilted position at the bottom of the squat, also known as ‘buttwink’. A small amount of buttwink isn’t an an issue but excessive amounts can place additional strain on the lower back. Building a tolerance over time can help, but I would ensure exercises focussing on hamstring strength whilst also providing some lengthening stimulus are also a good idea.
Romanian deadlifts, good mornings and single leg Romanian deadlifts are a great addition to any routine as they not only strengthen but also take the hamstrings through a good range of motion and thus help to improve the mobility around the proximal attachments and hip function can benefit from this greatly during most athletic movements, but especially with the squat.
Poor ankle mobility
The reason I feel that any athlete should find ways to increase ankle mobility is because the list of benefits goes on and on, beyond just gaining dorsiflexion and improving squat technique.
Let’s start with the squat though.
Poor dorsiflexion restricts the ability of a user to place their knees over their toes during a squat. This leads to the forward-leaning of the back to bring the bar further forwards. This more horizontal position places more stress on the lower back immediately.
Ankle mobility exercises are quite time-consuming but improving dorsiflexion is one of the quickest ways to improve your squat without spending weeks and even months slowly changing movement patterns through strengthening and re-training.
The A-FLEX transforms the speed with which someone can improve their ankle mobility. It was designed after I lost dorsiflexion following a nasty ankle sprain. My dorsiflexion was significantly reduced which grew increasingly frustrating when trying to run and squat. My lower back was particularly sore when I squatted which is partly why I’m such a believer in ankle mobility. Thankfully, with the help of my brother James, we developed something that transformed my dorsiflexion from the first use, and made it easy to continue the progress beyond this.
My ankle mobility improved and immediately so did my squat. Both in weight and in comfort.
If you’re squatting heavy for sport, then another reason to improve ankle dorsiflexion is you’ll reduce your chance of foot, ankle, knee and hip injury when playing team and running sports. A key example of this is reduced ankle dorsiflexion has been shown to increase Anterior Cruciate Ligament (ACL) injury risk. ACL rupture can be a career-ending injury, or at the very least take 6-12 months to recover from.
Furthermore, this doesn’t even mention the improvements in performance. Improved ankle dorsiflexion will help you improve your squat weights, your jump performance, improved torque for cyclists, the list goes on….
Injury prevention is something I’ve always been passionate about, so reducing lower back pain when an athlete squats is something I’ve assisted with time and time again. However, if you can do so by also improving your safety in sport and reduce the injury risk throughout the lower body, it’s a great deal and something that I think you’d be crazy not to take seriously.
So there you have it….
Back pain when you squat?
These are my three top tips, coming from years of experience in the game, it’s very likely these will be a great deal of help.
Haraldstad, K., Rohde, G., Stea, T., Lohne-Seiler, H., Hetlelid, K., Paulsen, G. and Berntsen, S., 2017. Changes in health-related quality of life in elderly men after 12 weeks of strength training. European Review of Aging and Physical Activity, 14(1).
Afonso, J., Ramirez-Campillo, R., Moscão, J., Rocha, T., Zacca, R., Martins, A., Milheiro, A., Ferreira, J., Sarmento, H. and Clemente, F., 2021. Strength Training versus Stretching for Improving Range of Motion: A Systematic Review and Meta-Analysis. Healthcare, 9(4), p.427.
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