We had physical therapist Dr. Angela come over from OPPT in St. Petersburg and talk to us about low back pain, instability, and teach us methods to use in real time setting. This was created to help Strength Coaches and Personal trainers better understand, identify, and confidently respond to low back pain during training. Whether you are a client watching or a coach looking for more information on back pain, client is recovering from spinal surgery, navigating instability, or afraid of “disc issues,” this session offers practical frameworks and real-time coaching strategies.
Follow along with our document here:
https://madepossiblept.com/wp-content/uploads/2025/07/MPPT-Lumbar-In-service-1.pdf
📚 Key Concepts Covered:
1. Spinal Stability vs. Mobility
Learn how to assess whether a client lacks spinal stability (motor control and sequencing) or mobility (joint motion or segmental movement).
Flat back = lengthened, weak erectors and glutes
Hyperlordosis = compressed lumbar spine, underactive core
2. Posterior Pelvic Tilt & Wall Press Mechanics
Coaching the posterior tilt: watch for over-tucking or forcing flat backs
Cue shoulders down and back, and check if the transverse abdominis (TA) and deep neck flexors are active
Use tactile and visual feedback (like a ball or dowel) to improve proprioception
3. Regression Framework for Back Pain
Start with isometric, then concentric, then eccentric movement strategies
Don’t skip to advanced versions, meet the client where their pain allows
Ex: If extension causes discomfort (e.g. rowing), regress to isometric spinal flexion holds or supported movement drills
4. Range-Specific Training for Painful Patterns
Don’t avoid the painful range, train within it at reduced intensity
Example: For butt wink or lumbar rounding at squat depth, work from that bottom range using tempo or isometric strategies
5. Understanding Pain Cues in Context
Train clients to “talk to” pain but not “sit with” it, short contact with discomfort is okay if it’s not increasing
Use a conversational pain scale or narrative-based feedback over rigid 0–10 scales
6. Common Misconceptions: Tight Hamstrings & MRI Findings
Tight hamstrings may reflect motor control issues, not just tissue length
Teach clients that MRIs show structure, not pain. Many disc bulges are asymptomatic and incidental
Reassure clients that what they do, strength, movement, stability, matters more than what imaging shows
7. When & How Coaches Can Assess Movement
Coaches can safely test/retest hip internal rotation, passive range of motion, and response to drills
Stay within your scope: if it’s not painful and your goal is to inform exercise, it’s appropriate
Table tests can be valuable for identifying joint limitations or asymmetries if pain isn’t present
🧠 Ideal For:
Personal trainers, strength coaches, and rehab-minded professionals working with general population, post-rehab, or aging clients
Anyone looking to better understand the “why” behind common back issues, and how to keep people training safely through them
💬 Note: This is a real, in-gym coaching session with discussion, questions, and some side chatter. Great for learning in context.
Let us know of any questions or comments of the exercise below👇 !
