If you've had chronic low back pain for more than a year, you've already done physical therapy. Probably twice. You've stretched, foam-rolled, maybe done dry needling, maybe gotten an MRI that showed "moderate disc bulging at L4-L5" and walked out with no real plan.
What most people in this situation actually need is not more rehab. It's a strength program built around the back they have, not the back they wish they had. That's the work.
What "back pain training" actually looks like
People hear "back pain" and assume the answer is to avoid deadlifts. It's almost always the opposite. The deadlift — done at the right load, with the right setup, at the right tempo — is one of the most therapeutic exercises in the room for a chronically irritated lower back. The catch is that the version of the deadlift you can do today is probably not the version you've been doing.
The work usually starts with three things:
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Position before load. Most chronic back pain training failures come from skipping the position work and going straight to heavier weight. We spend the first few weeks rebuilding the bracing pattern — how you get tension before the bar leaves the floor — and we don't add load until the position holds.
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Carries. Loaded carries (farmer's walks, suitcase carries, front-rack carries) are probably the single most underused exercise in chronic-back-pain rehab. They build the kind of stiffness you actually want in the trunk without the spinal compression of heavy compounds.
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The hip hinge, isolated. Romanian deadlifts at light weight, slow tempo, owned position. The hinge is the movement the spine has to outsource to. Most chronic back pain in lifters is a hinge that's been outsourced to the lumbar spine instead of the hips.
What this isn't
This isn't physical therapy. I'm not a PT. If you have a recent injury — within the last 6-8 weeks — see a physical therapist first. If you've had imaging that suggests something structurally specific (active disc herniation, spondylolisthesis, fractures), that's a PT conversation, not mine.
What I do is the part that comes after PT. The "you're cleared, now what?" phase that nobody really has a plan for. The clinical world hands you off and the gym world hands you a program written for a 22-year-old. This is the middle.
Who this works for
The clients I've taken through this typically share three things:
- They've been dealing with the same pain pattern for at least a year
- They've done some form of rehab and gotten partial improvement
- They want to keep training — they're not trying to "be careful," they're trying to be strong
If that's you, the 12-week consult is where we start. It's free, it's a real conversation, and if I think your situation needs more rehab before strength, I'll say so.
FAQ
Will I be able to deadlift again? Almost always, yes — but the version of the deadlift you do might look different from the version you used to do. Sumo instead of conventional, trap bar instead of straight bar, top-down setup instead of bottom-up. The deadlift is a category, not a single exercise.
Do you work with people who've had back surgery? Yes, post-clearance. Usually I want at least six months out from surgery and a clean handoff from the surgeon and PT.
Where are you located? Private training space in Palo Alto. Clients come in from across the Peninsula.
The next step is the consult. Thirty minutes, in person. Bring your imaging if you have it.