Squats & Back Pain

You’ve probably heard that you should lift with your legs, not your back, when picking up something heavy. Believe it or not, the research is actually mixed on how much that truly matters. Anecdotally, though, I think most of us can agree it does.

Part of the confusion may come down to form. Many people struggle to perform a squat with proper mechanics. Even if you bend your knees and “squat down,” if you can’t access enough depth or control to truly load your legs, the work can still shift into your back. Form is key.

In some studies, people with low back pain (LBP) were found to activate their back muscles and hip extensors (glutes) differently during a standard squat (not even a deep one). The muscles along the back of the body weren’t working as effectively to support the movement, which shifted more of the load into the quads and knees. In addition, their back muscles tested weaker compared to people without LBP.

It’s a bit of a chicken-and-egg question. Do you change how you squat because you have LBP? Or do you develop LBP because, for whatever reason, your body has never been particularly efficient at squatting?

A squat alone isn’t the magic solution to unraveling low back pain—but it can be part of the answer. Strength-training programs that emphasize posture, quality form, and exercises that often include squats have been shown to improve lower back pain. The basic squat can also serve as a useful test or indicator of back health.

One common reason people struggle with squatting is tight calves or Achilles tendons. If you can’t keep your heels on the floor, it becomes much harder to keep the load in your legs and out of your back and knees. Calf stretching may need to be a regular part of your routine to improve your squat mechanics and potentially reduce LBP. While research is mixed on whether limited ankle mobility is directly linked to low back pain, clinically, it’s hard to ignore the connection.

I’ve worked with people whose back pain made squatting intolerable—and others for whom mastering the squat significantly reduced their discomfort. Every body is different.

For those without back pain, understanding this connection can motivate us to maintain good form and continue squatting well. For those with LBP, it’s an exercise worth exploring. It may not be part of your solution—but if it is, building toward a high-quality squat can be a relatively straightforward and empowering step.

Ultimately, a resilient spine should be able to pick something up by rounding forward or by squatting. Lifting with your back is not a guaranteed injury. Likewise, squatting doesn’t mean you’ll never hurt your back. What matters most is how you move—lifting with strength, control, and awareness.