5 Tips for Writing an Exercise Program for a Client with Low Back Pain

Writing an exercise program for a client with low back pain is a challenge.

People come to me with a history of discogenic problems, retrolisthesis, facet degeneration, endplate fractures, etc.

Each client is unique. And requries a different approach.

The discogenic person tends to have a difficult time with lumbar flexion, whereas the person with facet degeneration has a difficult time with lumbar extension.

On top of that, each clients training goals are different.

Some are looking to move and feel better without having to worry about provoking pain.

Some clients are looking to lose weight.

And some are looking to return to athletics.

All of these variables are taken into account when writing an exercise program. And it creates a challenge for the coach to tailor the best program possible to each client.

With today’s post, I’m going to provide you with “5” tips to help you write an exercise program for clients with low back pain. 

5 Tips to Writing an Exercise Program for a Client with Low Back Pain

1. Assessment: If you’re not assessing a client before putting them into a workout, your asking for trouble. Every client you begin with should go through a detailed assessment to determine what they should and shouldn’t do.

The assessment should involve reviewing the clients’ medical history, posture, movement, and responsiveness to load-bearing positions. And as a general rule, the more extensive the injury history, the more precise the assessment.

2. Exercise Paring: Pairing exercises together is an important consideration when writing a program for a client. The wrong pairing could lead to a catastrophe. For example, paring a fatiguing exercise such as a burpee with a deadlift is not a good idea!

As fatigue develops, it’s harder to maintain technique. And for an exercise that requires a substantial amount of technical steps, it’s easy for things to go wrong. A better solution would be to pair an exercise that induces minimal fatigue such as a Birddog or mini-band side steps with a deadlift. 

3. Exercise Context: Sit-ups shouldn’t be in the program of a flexion-intolerant person. Supermans shouldn’t be in the program of an extension-intolerant person. And heavy squats shouldn’t be in the program of a compression intolerant person. If a client is symptomatic, and you know the specifics of the diagnosis, writing programs can be made simpler.

4. Improve Hip Mobility: The majority of low back pain clients that I work with tend to have stiff hips. Stiff hips lead to more motion at the low back. And more motion at the low back can increase the risk of injury. Improving hip mobility can help spare the low back by reducing the amount of motion the low back needs to achieve a specific position (e.g., lunge).

5. Improve Core Endurance: Spine stabilization exercises are designed to help improve core endurance and improve the capacity of the low back to withstand activities such as standing, sitting, and exercising. Every low back pain client of mine begins their workout with a handful of spine stabilization exercises and then progresses to challenging core training routines through their workout.

Wrap-up

Writing an exercise program for a client with low back pain can be a challenge, but if you follow the steps above — you’ll be in a good position to work with back pain clients.

Salute,

Remi

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