Back Injury Prevention in the Gym


Low back complaints seen in the office are often related to a patient’s well-intentioned attempts to improve fitness by training at the local gym.  The problem is that modern clinical exercise science has generally not found its way into the gym.  People rely on out-dated and often hazardous exercise methods. Here are some tips for injury prevention at the gym


Stretching is not a warm-up.  Initial static stretching can actually decrease coordination by altering information from the nerve endings that communicate joint position and movement to the nervous system.  This is particularly true of back stretches. A warm-up is cardiovascular exercise such as a brisk walk with arm movement. This improves blood flow and stimulates spinal stabilization mechanisms.

Training with weight machines

Weight machines offer resistance training that is “non-functional”.  That is, training a body part in isolation with a machine diminishes the need to balance, stabilize and coordinate movement at multiple joints.  Consider the bicep curl machine versus lifting a laundry basket from a counter top.  Lifting the laundry basket requires the coordinated activation of the entire musculoskeletal system from the hands through the arms, shoulders, abdomen, back, hips, legs and feet.  The use of body weight, free weights, cable systems, resistance bands and balls offers much more functional training than machines.  Machines that require seated posture increase the risk of injury to the back.  The seated leg press machine, for example, can force the lumbar spine into flexion under a load and has been shown to cause disc herniations.  The bottom line is “train the motion, not the muscle.”

Questionable activities

  • Seated leg press machines can create high knee and lumbar stresses.
  • Seated spinal extension and abdominal flexion machines create repetitive trunk flexion under a load and produce disc herniations.
  • Trunk rotation machines cause twisting under a load which can lead to back injury.
  • Leg curl machines produce unnatural stresses and loads on the knee cap.
  • Seated overhead press places spinal joints into weak and vulnerable positions.
  • “Crunches” on a gym ball dramatically increase compression loading of the intervertebral discs which in turn can cause disc herniations. Novice exercisers or those with disc injuries should avoid this activity.

If you have questions about your exercise routine, please ask your doctor.  If you are experiencing pain with any exercise, discontinue. Even good exercises can cause injury if they are done with improper technique. Here are tips from the military about proper technique and exercises. You can also read about going back to the gym after a low back injury.