How to FIX Your Back Pain: Why Athletes Need A Different Approach

Dr. Michael Blanco PT, DPT
Oct 15, 2025
4 min read

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If you’re an active adult, runner, or even a D1 athlete who’s been sidelined by back pain, you’ve probably heard all the same: “Just rest,” “don’t lift heavy,” “you need surgery,” or “your MRI says… therefore you can never ______ again”

At Rival Physical Therapy, we hear this story all the time and we want you to know that back pain doesn’t mean your athletic career or active lifestyle is over. In fact, most cases of back pain can be treated without surgery, imaging, or long-term rest.

That’s why we created the Fix Your Back Pain E-Book, a simple, research-based guide to help you understand your pain, identify what’s causing it, and start moving safely again.

Why Back Pain Happens

Back pain can come from many sources, but for most athletes, it’s a combination of:

Repeated poor movement mechanics
Muscle imbalances or stiffness
Weakness in key stabilizers (like the core or hips) leading to compensatory movements
Training volume or load errors

In other words, your body starts to move inefficiently over time. Small movement compensations build up, mobility decreases, and eventually you reach a breaking point… the “I tweaked my back” while deadlifting/picking something up/getting out of bed moment.

***Research shows that most low back pain in athletes is mechanical in nature and not caused by structural damage (Maher et al., 2017, The Lancet).

Understanding the Two Common Types of Back Pain

Our e-book breaks back pain into two main categories, because treating them the same way doesn’t work. There are other types, however for this post we will be focusing on these 2 main circumstances.

1. Low Back Pain with Mobility Deficits

Feels like stiffness, tightness, or restriction
Usually linked to decreased movement at one or more spinal segments
Muscles around the low back, hips, or glutes often “guard” or spasm

Rehab focus: Restoring motion and flexibility with controlled mobility exercises like:

Cat-Camel Stretch
Thread the Needle
Kettlebell Weight Shifts

These drills reduce stiffness, improve movement tolerance, and reintroduce load safely.

2. Low Back Pain with Movement Coordination Impairments

Feels like weakness or instability
Pain may come and go (episodic)
Often seen in athletes with hypermobility or poor core control

Rehab focus: Building stability and motor control with targeted strength training like:

Pallof Presses
Side Plank Clamshells
Bridges with Banded Abduction

These exercises retrain your body to move as a unit, strengthening your core, hips, and stabilizers without overloading your spine.

Red Flags: When to Seek Immediate Help

While most back pain is mechanical and treatable with movement, some symptoms can indicate a more serious issue. If you experience any of the following, stop exercising and see a healthcare provider immediately:

🚨 Red Flag Symptoms:

Unexplained weight loss or gain
Fever or chills (possible infection)
Night pain that wakes you from sleep
Incontinence or loss of bladder/bowel control
Numbness, tingling, or weakness in both legs
Pain after trauma (fall or accident)

These symptoms could signal an underlying condition like a stress fracture, infection, central disc herniation, or spinal cord compression, and require further evaluation.

Story-time — when I was doing my clinical rotations at University of Michigan I was treating a 36 year old man for about 3-4 weeks with “hip pain”. During one visit he goes “hey Mike, I’ve been embarrassed to say this but is it normal to lose control of bowel and bladder control?” … I told him that he needed to go to emergency room (which he did) and he was found to have a tumor on his spinal cord. PLEASE PLEASE PLEASE do not feel embarrassed to tell a health care provider! We are here for a reason.

Why Athletes Need a Different Approach

Athletes aren’t 80-year-old sedentary patients, yet many are still treated that way. Active people need a plan that keeps them moving and addresses the true root cause of pain, not just the symptoms.

At Rival Physical Therapy, we treat athletes differently because we know:

Your pain tolerance is higher, but so are your demands.
You don’t just want to be “pain-free”; you want to train and perform again.
Loading the spine appropriately, not avoiding it is the key to long-term recovery.

Our Fix Your Back Pain E-Book walks you through this exact mindset — how to restore mobility, retrain movement, and rebuild your confidence under load.

How to Start Rehabbing Your Back

Here’s what you can do today:

✅ Identify your back pain type (mobility deficit or coordination issue)

✅ Start with gentle, controlled movement. Not ice or total rest

✅ Build strength in your core and hips through consistent loading

✅ Reassess every few weeks. Your back will adapt over time

Remember: most athletes start feeling stronger and more stable within 4–6 weeks of consistent movement-based rehab.

The Bottom Line

Back pain doesn’t have to end your training, your sport, or your lifestyle. With the right approach, one that focuses on movement, not fear - you can rebuild strength, mobility, and confidence.

Our Fix Your Back Pain E-Book is designed to guide you through that process, step-by-step, with clear explanations, safe exercises, and red flag awareness to know when to seek help.