First: when not to see a trainer
Almost all back pain is what clinicians call non-specific — no single identifiable structure at fault, and a good prognosis. A small minority isn't. Book a doctor rather than a coach if you have numbness or pins and needles down a leg, weakness in a foot or ankle, any change in bladder or bowel control, unexplained weight loss, fever, or pain that consistently wakes you at night. We will not train around those, and any coach who offers to should be avoided.
Why rest usually makes it worse
Bed rest was standard advice a generation ago and has since been reversed: prolonged rest deconditions the muscles that support the spine, stiffens the hips, and — because pain that persists starts to feel threatening — makes the nervous system more protective, not less. Current guidance is to stay as active as symptoms allow and to return to normal loading progressively.
The order to rebuild in
| Stage | Focus | Examples |
|---|---|---|
| Settle | Breathing, gentle movement, walking | Diaphragmatic breathing, cat-camel, short frequent walks |
| Brace | Trunk control without loading the spine | Dead bug, bird dog, pallof press, side plank |
| Hinge | Teaching the hips to do the work | Hip thrust, glute bridge, RDL from a high start |
| Load | Progressive carries and pulls | Farmer's carry, suitcase carry, rows, trap-bar work |
| Return | Back to your normal programme | Squat and deadlift patterns, rebuilt from the bottom |
It's usually the hips
The pattern we see most often in desk-based clients isn't a weak back — it's hips that have stopped contributing. When the glutes don't fire and the hips don't hinge, the lumbar spine picks up movement it was never meant to do, rep after rep, every time you pick something up. Teaching the hinge is frequently the single change that settles things.
Want this planned for you?
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Why home training suits this
Early-stage back rehab is unglamorous: floor work, breathing drills, banded work, carries up and down a corridor. None of it needs a gym, and doing it at home removes the temptation to test yourself against whatever is loaded on the bar next to you. See injury rehab coaching for how we structure it, and home training for how sessions run.
Working alongside a physiotherapist
If you're already seeing a physio, we coach inside their plan — they own the diagnosis and the clinical decisions, we own progressive loading once you're cleared for it. Tell us what they've said and we'll work to it. If you aren't seeing one and your pain has persisted beyond a few weeks, get assessed before adding load.