1/4 Hour Neuro #33: "When I Deadlift or Squat, My Back Hurts. What Should I Do?"

Introduction

Back pain during deadlifts or squats is a common issue that many athletes face. This article offers an in-depth exploration of the potential causes of this pain, ranging from imbalances related to immature primitive reflexes to muscle engagement issues. We will also discuss concrete solutions to improve your technique, adjust exercise complexity, and ultimately preserve your physical integrity.

Whether you are an experienced athlete or a beginner, understanding the underlying mechanisms of this pain is essential for progressing safely and optimizing your performance. We will see how a holistic approach, sometimes involving a return to basics, can make all the difference.

Eliminating Medical Causes and Understanding the Role of Primitive Reflexes

The first step when experiencing regular pain is to consult a healthcare professional, such as a doctor or physical therapist, to rule out any underlying pathology. Once this step is validated, it is important to consider the impact of primitive reflexes on your posture and movement.

An immaturity of certain reflexes, particularly plantar reflexes, can affect your foot usage and create tension in your back. The posterior chain, which originates from the foot, is directly impacted by poor contact with the ground. If the proprioception of the arch of the foot is deficient, the posterior chain cannot be activated properly, leading to compensations and pain.

Impact of Plantar Reflexes on Stability and Posture

Consider the Babinski reflex. If it is not well developed, it may be difficult to anchor your toes correctly to the ground, particularly the big toe. This disrupts the engagement of the muscle chains necessary during a deadlift or squat.

An inward collapse of the foot (excessive pronation) can cause rotation at the knee and hip, creating twists at the pelvis and, by extension, the back. If this phenomenon is bilateral or if one foot collapses inward and the other outward, it can create a twist in the pelvis, increasing spinal stress.

Reflexes such as the cross-extensor reflex or the crawling reflex, if immature, can also influence foot function, hip function, and overall posture.

Adapting Exercise Complexity and Proper Muscle Engagement

Beyond reflexes, a common issue is insufficient or inappropriate muscle engagement. It is crucial to adapt the complexity of the exercise to your actual capabilities. For example, with squats, a back squat is an advanced version. It is often wiser to start with simpler exercises like the goblet squat and progress gradually.

If you experience pain, do not hesitate to reduce the complexity of the exercise. If the pain persists, it may indicate that you are working beyond your capabilities and that a focus on coordination and reflexes is necessary.

The RPR Hip Extension Test (Reflexive Performance Reset)

The RPR method offers an interesting approach to assess muscle engagement. During a hip extension (lying on your stomach), you can evaluate the correct recruitment of muscles. Place one finger on the athlete's glute, your thumb on the lower back, and touch the hamstring on the same side. Ask the athlete to perform a hip extension.

Optimal recruitment involves a contraction of the glute first, then the hamstring, without excessive activation of the lower back (quadratus lumborum) on the opposite side. A strategy where the lower back activates first may indicate a problem with the timing and coordination of the movement, which can be corrected through RPR sequences or technical work.

Improving Proprioception and Neuromuscular Connection

Muscle quality, or the "mind-muscle connection," is often more deficient than the quantity of muscle. Many people do not know how to correctly engage their muscles at the right time. Sensory work focused on proprioception can be very beneficial.

Tools and Exercises for Proprioceptive Stimulation

Tools like sensory cones or proprioceptive mats (like "acupressure mats") can be used to stimulate the central nervous system through touch. Walking barefoot on these surfaces helps reactivate the sensory receptors under the feet, thereby improving the connection with the brain. This can be integrated during rest periods between exercises.

To enhance the "mind-muscle connection" during a deadlift, it is recommended to focus on anchoring your feet to the ground, imagining that you want to bring your feet closer together without moving them (creating "internal torque") and planting your big toes. This action immediately activates the posterior chain (calves, hamstrings, glutes).

If you struggle with squats, exercises like step-ups are valuable. The step-up is known for heavily recruiting the glutes. By working unilaterally, you can precisely target muscle engagement and recreate the correct connections before returning to simpler bilateral squats (goblet squat) and progressing to more complex variations like a higher-quality back squat.

Balancing Physical Qualities for Optimal Performance

Performance does not depend on a single quality, but rather on a balance between multiple factors. To understand this, one can refer to the "StrongFit" model which assesses different physical qualities (e.g., muscle quantity, muscle quality, etc.) to identify imbalances.

It may happen that a person has a lot of muscle (muscle quantity) but a low capacity to engage it correctly (muscle quality). The goal is to balance these qualities so that the "performance box" is harmonious and allows for optimal performance on a given exercise.

Practical Tips and Conclusion

In summary, here are some key tips:

• Consult a healthcare professional for persistent pain.
• Do not underestimate the impact of primitive reflexes and work on their integration if necessary.
• Adapt the load and complexity of exercises to your capabilities. Returning to simpler variations is not a failure but a step toward better progress.
• Improve your "mind-muscle connection" through proprioceptive exercises and active focus.
• Record yourself during training sessions and, if possible, work with a qualified coach to receive precise feedback on your technique.

By considering these various aspects, you can not only reduce your back pain during deadlifts and squats but also improve your technique, strength, and overall well-being. Muscle quality and movement mastery will always be valuable assets.