Lower Back Pain: 8 Step Checklist to Eliminate Pain When You Are Training

Women are back pain. Used hand support at waist. Symptoms of Office Syndrome. Healthcare background. Black and white color theme with red color effect.

Women are back pain. Used hand support at waist. Symptoms of Office Syndrome. Healthcare background. Black and white color theme with red color effect.

Lower back pain is proof that your strength, speed, and power is built on a faulty foundation. There is no amount of foam rolling and mobilizing that can save you. The problem goes deeper, beyond soft tissues and joints, and into the nervous system affecting the way your brain communicates with your body.

If you are in chronic pain, it is going to get worse. Your brain recognizes any load on your spine, including bodyweight, as a threat. To eliminate that threat, it signals pain to your low back to stop you from further harm.

Dr. Theresa Larson, DPT and Anders Varner have taught movement principles to thousands of trainers and health practitioners on 4 continents, and have coached and treated over 100 CrossFit Regionals, WWE, NFL, and MLB athletes. Through their combined 20 years of movement expertise they’ve witnessed that lower back pain is the most common and debilitating injury you can experience.

Lower back pain is a symptom of problems that you can control. It starts with the breath, developing core stability and down regulating the nervous system. This allows you to create balance amidst external stress and structural balance in your body. Practicing these principles creates behavioral changes that help you build a foundation that moves you from pain to performance.

Your breath, balance, and behavior: A simple recipe to a complex problem.


The way you breathe is the single most important aspect to understanding lower back pain, movement mechanics, and rehabilitation.

It starts with being still. Through stillness, you will find the breath. The breath has two major roles in eliminating lower back pain: down regulation and core stability.

You have heard of the “Fight or Flight” response. This is the body’s natural reaction to stress — controlled by the sympathetic nervous system. Any time you feel stress, this system is working overtime. Emotional, mental, and physical stress are stored in the body’s tissues leading to tight muscles, decreased ROM, and tension in the connective tissues.

The opposite of “Fight or Flight” is “Rest and Digest.” “Rest and Digest” is the body’s down regulatory system, the parasympathetic nervous system. This system is responsible for flushing stress out of the body.

The breath gives your brain the chance to stop processing external threats, restore function, and heal itself.

The Stress Breathing Checklist

  1. Take a deep breath, did your belly rise before your chest? Yes / No
  2. Take a deep breath, was your mouth open? Yes / No

Your thoracic spine is protected and supported by a massive bone structure, the rib cage. Below the ribs, however, in your lumbar spine, there is no such structure. Instead, you have to create this structure, using your core to stabilize your lower spine.

Turns out, the six abs you work so hard on are the least important muscles in your body when it comes to low back health. The multifidus is the deepest core muscle. Attached to the spine, the multifidus assists in vertebral stability and function. The transverse abdominis, responsible for lateral expansion of rib, provides stability to the spine by connecting the rib cage to the pelvis.

The only way to train these deep core muscles is through diaphragmatic breathing, deep into the belly.

Core Stability Checklist

  1. With straight legs, can you bend over to touch your toes? Yes / No
  2. Can you rotate and look behind you, pain free, with equal rotation on each side? Yes / No


It is ok to admit your life is stressful. From the time you wake up you are rushed, stuck at a stressful workplace, and bookend your day sitting in rush hour traffic. The first time you think about quality movement is walking into the gym. Sitting in traffic and meetings all day is not the ideal way to prepare for a workout with 45 deadlifts and pull ups for time.   Balance is divided into two categories, “global” and “local.”   On a global level, analyzing general stress brings awareness to the energy you are bringing into the gym. Sleeping 6 hours, multiple deadlines at work, plus a long commute is the triple threat of general, long duration stress on your body. Throwing in a high intensity workout does nothing but compound the stress and fatigue your body is combatting.   This stress is stored in the tissues and nervous system. Despite your intuition, you do not need to stretch your hamstrings. General, long duration stress creates inflammation in the body. This inflammation is stored in the tissues. The brain communicates with the body through a complex system of nerves passing over and through joints. Increased inflammation in the tissue compresses these nerves and signals to the brain that there is a problem. The tension you feel in your hamstrings has nothing to do with the length of the tissues. What you feel is adverse neural tension that cannot be stretched, foam rolled, or mashed with a barbell. It can only be fixed by reducing stress and inflammation in the body through the breath.  

Global Balance Checklist

  1. Did you get 8 hours of sleep? Yes / No
  2. Was your total work day (including commute) less than 10 hours? Yes / No

Local balance references the asymmetries you have developed through poor movement mechanics and lifestyle choices. When you squat, your right leg is a little stronger and at higher percentages you start to develop a tiny hip shift. Setting PR’s is great, you earned it, but you also are earning the pelvic imbalances that lead to lower back pain.   Your body loves these asymmetries. Your brain does not know back squatting is cool. It recognizes a gigantic weight on your back that is about to crush you. Your brain is going to use every resource and advantage it has to stand that weight up. Your strong leg is going to bear the brunt of that load because your brain knows your weak leg is going to fail.   Over time, asymmetries develop, imbalances shift your pelvis effecting the way you walk, sit, and train leading to chronic pain.  

Local Balance Checklist

  1. Can you stand on one leg for 30 seconds? Yes / No
  2. Can you stand on one leg with your eyes closed for 30 seconds? Yes / No


Lower back pain is not something that happened to you. Lower back pain is the symptom of the default behaviors you have adopted over the years.

Default behavior patterns are hard wired into your daily life. The way you brush your teeth and drive to work are practiced so frequently that they become automatic. Lower back pain is no different. Your default behaviors, stress management and movement patterns are so automatic that you do not think about their downstream, negative consequences.

By changing your behavior patterns, you can change the outcomes.

The first action is always to find stillness and focus on the breath. Once you have established this baseline, then you have the chance to properly layer in mobility, stability, strength, and conditioning.

Did You Pass?

In the 8-step checklist, how many Yes’s did you have? How many No’s?

If eight of your answers were “Yes” — Congrats! You get it and have your low back health dialed in.

If six of your answers were “Yes” — Your risk for low back pain and injury increases.

If you had less than six “Yes” responses — Unfortunately you need to take action today. The luxury of time is not on your side.

Thanks for reading!

Begin your journey towards eliminating lower back pain and developing a stronger foundation to your fitness by downloading your free copy of The Low Back Fix eBook now.

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