Get Relief From Lower Back Pain When Squatting With Tips and Exercises From Physical Therapists

Your back is involved in almost everything you do, from simple things like looking behind you to squatting to pick something up. “We squat a lot in our daily lives without even noticing — like when we sit down or stand up,” says Katie Schaner, PT, DPT, a physical therapist at Hinge Health. “It's a basic activity that humans are meant to do. In many places in the world, people even squat for things like eating and chatting." 

But what if you begin to notice back pain when squatting? You may be concerned and begin to shy away from movements that exacerbate your pain. Know this: Avoiding squats because they cause back pain can actually make the problem worse. The solution? “You want to experiment and find a way to squat that feels good for you. And you also need to strengthen and stretch your lower back,” explains Dr. Schaner. Targeted exercises and physical therapy help make your back more resilient to the movements you do everyday, including squatting.  

Read on for more on how to treat lower back pain when squatting, including exercises recommended by Hinge Health physical therapists.

What Causes Lower Back Pain When Squatting?

Below are a few reasons you may notice some aches and pains when you squat. But no matter the primary cause of lower back pain when squatting, movement and targeted exercises are usually the first-line treatment. They’ll strengthen your lower back to reduce pain and stretch out your muscles to reduce tightness.

• Going beyond your body’s movement sweet spot. If you’ve just started to lift weights, or you’ve recently ramped up your resistance training routine, you may have done something to cause pain in your lower back. “Squatting is a great addition to a movement routine, and it’s great to squat with weights. But you need to gradually work up to that,” says Dr. Schaner. Start by doing bodyweight squats, or even mini squats, and slowly add weight. 

• Weak core muscles. Your body relies on your glutes and core to help you sink down into a squat, explains Dr. Schaner. If those muscle groups aren’t strong enough, your body may shift the work to your lower back to compensate, which can contribute to pain over time. Tight ankles can contribute too — one study found that people with poor ankle mobility leaned forward as they squatted, which might put more pressure on your lower back. 

• Tight hips. This can be an issue especially if you spend a lot of time sitting, says Dr. Schaner. “If your hips are tight, it’s harder to lower into a squat so you end up putting more pressure on your lower back as a result,” she explains. 

• Past injuries. If you’ve strained your back before, it’s possible that you’ll adopt a more guarded squat technique in an effort to prevent future injuries. But an awkward technique can actually contribute to back discomfort for some people.  

• Your job. If you work in a field where you need to be in a deep squat position for an extended period of time — think construction workers, delivery workers, and firefighters — research suggests you may be more likely to develop back pain, especially while squatting.

Squatting and Lower Back Pain: A Hinge Health Perspective

Here’s some good news: Squatting won’t make your back pain worse. “In fact, squatting will help low back pain,” says Dr. Schaner. “If you pull back from movement when something hurts, it tends to get worse.” Here’s why: “Movement helps your muscles and tendons contract and relax, and it also helps to improve blood flow,” she explains. “Our bodies are designed for movement. So when you pull back on activity because it hurts, that usually just makes you hurt more.” 

If your lower back is very painful, Dr. Schaner recommends that you begin with a mini squat. “This way, you’re still working your core and hip muscles, which you need to squat, but you give your back a little break,” says Dr. Schaner. It will also help your body get stronger, and teach an oversensitive pain system that your body, particularly your lower back, is strong and capable.

Exercises that stretch and strengthen your back and core muscles are very effective to help treat and prevent lower back pain when you squat. The above are some of the best exercises recommended by Hinge Health physical therapists.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatment Options for Lower Back Pain When Squatting

The following tips and techniques are recommended by Hinge Health physical therapists to treat lower back pain when squatting.

• Do physical therapy. The best way to handle lower back pain when squatting is to keep moving, advises Dr. Schaner. The exercise recommendations in the previous section are a good place to start. But a physical therapist can show you additional exercises tailored to your needs. A 2021 review of 249 studies found that exercise therapy was an effective way to treat lower back pain, including lower back pain when squatting. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• Start your workout with squats. If you do squats as part of your workout, consider doing them at the beginning of your workout, not at the end. “This way, your core, glute, and hip muscles are less fatigued and better able to support your lower back,” notes Dr. Schaner.

• Stay shallow. If your lower back hurts when you do a deep squat, then start with mini squats or a shallower squat and gradually build up to deeper squats, advises Dr. Schaner. Remember, there’s no such thing as a “perfect” squat. Listen to what your body tells you, so you can adapt your squat to meet your own unique needs. 

• Tweak your technique. If you need to reach something on the floor and you’re navigating a bad pain flare, consider adopting a golfer’s lift where you hold onto something stable, like a counter, stand on one leg, then tip yourself all the way forward. “You don’t want to do this forever, but if you just pulled a muscle and are having spasms, this will give your tissues a chance to calm down,” explains Dr. Shaner.

• Get a squat assessment. “There’s never a one-size-fits-all solution for squatting,” says Dr. Schaner, so you don’t need to get too prescriptive when it comes to squatting technique. But if you’ve struggled with back pain related to squatting for a long time, a physical therapist can review your squat technique and develop a tailored strengthening  and stretching plan that will help you move in a way that works for you, says Dr. Schaner. 

• Take a deep breath. Breathing helps to prime your lower back muscles for movement, says Dr. Schaner. “You want your diaphragm and pelvic floor muscles to contract and relax without guarding or restricting,” she explains. “Oftentimes people hold their breath while they stand up, which just tenses those muscles.” Try to inhale as you lower down, then exhale as you stand back up again.

How to Prevent Lower Back Pain When Squatting

Put simply: Motion is lotion. To keep your back healthy and strong for life, the key is to stay active in whatever way works for you. And that may involve tweaking how you squat to find a technique that works for your body. Here are a few tips you can try to make sure your physical activity nurtures a strong, resilient back so you can better prevent lower back pain when squatting. 

• Keep your feet flat on the ground. Think about the inside and outside balls of your foot and your heel — try to keep all three on the ground. 

• Stand with your feet hip-width apart. Your knees will be in line with your feet. As you squat, move your hips back, as if you’re about to sit on a chair behind you. This will help keep stress off of your lower back.

• Tighten your tummy. As you squat, squeeze your stomach muscles as if you’re “hugging” your stomach. This activates your core to reduce how hard your back has to work.

• Lighten your load. “Be mindful of how much weight you add to your squats — you don’t want to add too much too quickly,” says Dr. Schaner. “There’s nothing wrong with sticking to bodyweight squats until you master a technique that works for you.”

PT Tip: Keep Moving During Pain Upticks

When you experience an uptick in back pain, you want to find ways to stay active. “Find activities you enjoy — whether it’s pool aerobics, hiking, or walking the dog — and stick with it,” says Dr. Schaner. “The more you move, the more you’ll work on your mobility and the faster you’ll regain your ability to squat without pain.”

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. 

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Zawadka, M., Smołka, J., Skublewska-Paszkowska, M., Łukasik, E., Zieliński, G., Byś, A., & Gawda, P. (2020). Altered squat movement pattern in patients with chronic low back pain. Annals of Agricultural and Environmental Medicine, 28(1). doi:10.26444/aaem/117708

2. Zawadka, M., Smolka, J., Skublewska-Paszkowska, M., Lukasik, E., & Gawda, P. (2020). How Are Squat Timing and Kinematics in The Sagittal Plane Related to Squat Depth? Journal of Sports Science & Medicine, 19(3), 500–507. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429430/

3. Lui, T. K. S., Sharon M.H. Tsang, & Kwok, A. (2018). Changes in Lumbopelvic Movement and Muscle Recruitment Associated with Prolonged Deep Squatting: A Pilot Study. International Journal of Environmental Research and Public Health, 15(5), 1001–1001. doi:10.3390/ijerph15051001

4. Fuglsang, E. I., Telling, A. S., & Sørensen, H. (2017). Effect of Ankle Mobility and Segment Ratios on Trunk Lean in the Barbell Back Squat. Journal of Strength and Conditioning Research, 31(11), 3024–3033. doi:10.1519/jsc.0000000000001872

5. Gordon, R., & Bloxham, S. (2016). A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare, 4(2), 22. doi:10.3390/healthcare4020022

6. Saper, R. B., Lemaster, C., Delitto, A., Sherman, K. J., Herman, P. M., Sadikova, E., Stevans, J., Keosaian, J. E., Cerrada, C. J., Femia, A. L., Roseen, E. J., Gardiner, P., Gergen Barnett, K., Faulkner, C., & Weinberg, J. (2017). Yoga, Physical Therapy, or Education for Chronic Low Back Pain. Annals of Internal Medicine, 167(2), 85. doi:10.7326/m16-2579