Physiotherapists recommend this exercise for back pain

Back pain affects millions of Americans. About 40% of American adults report experiencing back pain in the past three months, and about 13% have chronic back pain. For many, it becomes an unfortunate part of daily life rather than a one-time injury.

Although there is no shortage of movements claiming to cure or prevent back pain, physical therapists say that compound exercises that develop whole-body functional strength tend to offer more benefits than isolation work targeting just the back.

To find out more, we asked physical therapists which back exercise they wish more people would incorporate into their routines, and they all gave the same answer: the Romanian deadlift (RDL). Here’s why they recommend it, how to perform it correctly, and what else you can do to help build a stronger, more resilient back.

Why the Romanian Dead Lift supports back health

The Romanian deadlift is a compound exercise, meaning it involves multiple joints and engages multiple muscle groups at once. “The RDL engages the entire posterior chain, particularly the hamstrings, glutes, and spinal extensors, while the abdominal and other core muscles help control the spine,” says Alex McRobbie, PT, DPT, OCS. “What makes it particularly useful is that it requires you to generate movement primarily from the hips while maintaining control of your core and spine. This carries over to lifting, bending, and many daily and athletic activities.”

Research shows that strength training exercises can help improve functional strength and manage chronic back pain. The RDL is a great option for building strength in multiple muscle groups.

“Training these muscle groups together helps develop the strength needed to handle the physical demands placed on the spine during daily activities,” says Kaylee LeCavalier, PT, DPT, SCS, CSCS, CAPS. “Supporting the spine does not mean keeping it rigid or preventing normal movement, but rather developing the ability to move comfortably under load.

How to do it

Here is how to perform RDL safely and professionally:

1. Stand with your feet about hip-width apart and your knees slightly bent. Hold a dumbbell in each hand or hold a kettlebell in both hands in front of your thighs.
2. Push your hips back as you lean your upper body forward and down, keeping the weights close to your legs. Imagine pushing your hips toward the wall behind you rather than leaning down.
3. Lower the weights until you feel a stretch in your hamstrings. This usually occurs at or slightly below the knee. You don’t need to lower the weights to the floor. “As you move forward, this stretch should gradually increase, indicating that you are isolating hip flexion rather than getting movement from your spine,” says McRobbie.
4. Press through your feet and move your hips forward to return to a standing position.
5. Perform 2 to 3 sets of 8 to 12 repetitions.

LeCavalier recommends practicing the movement without any weights first, then progressing to light dumbbells or a kettlebell once you’ve mastered the technique. If your flexibility is limited, you can bend your knees slightly or reduce the range of motion. Those with balance issues can practice near a stable surface or use a weight while keeping the other hand supported.

“If you’re a beginner, I’d start with partial range of motion and light weight,” adds McRobbie. “As you become more comfortable with the movement, you can gradually increase the range of motion and resistance.”

Other back exercises to add

The RDL is a foundational exercise, but these other back-strengthening moves can help round out your routine:

bird dog

1. Get on all fours with your wrists under your shoulders and your knees under your hips.
2. Engage your core and simultaneously extend your right arm forward and your left leg back, keeping your hips level and your lower back stable.
3. Hold the position for 2 to 3 seconds, then return to the starting position.
4. Perform 2 to 3 sets of 8 to 12 repetitions per side.

Farmer’s Transport

1. Hold a dumbbell or kettlebell in each hand at your side and walk at a comfortable pace while maintaining an upright posture.
2. Engage your body, keep your shoulders relaxed and avoid leaning to one side or the other.
3. Walk for 20-30 seconds, rest, and repeat for 2-3 sets. If space is limited, walk around the room and turn around to complete each set.

Gluteal bridge

1. Lie on your back with your knees bent and your feet flat on the floor.
2. Press your feet into the floor and lift your hips toward the ceiling, squeezing your glutes at the top of the movement.
3. Hold the position for 1 to 2 seconds, then lower back down.
4. Perform 2 to 3 sets of 10 to 15 repetitions.

Safety and precautions

“You don’t necessarily need authorization before doing an RDL,” says McRobbie. “If you’re new to exercising, you can start without weights and simply practice a bodyweight hip hinge, then slowly add weight over several weeks or months.”

However, LeCavalier advises that “individuals with significant or worsening back pain, radiating leg symptoms, recent spinal surgery or fractures, or conditions affecting bone strength or spinal stability should seek individualized advice from a healthcare professional before performing loaded RDLs.”

Knowing when to stop is just as important as knowing where to start. “You should stop or modify the exercise if you experience back pain during exercise, afterward, or the next day,” says McRobbie. Sharp or worsening pain, numbness, tingling, or weakness are also reasons to stop performing RDL. Some muscle soreness when starting a new exercise is normal, but pain or these other symptoms are sure signs that you need to take a break and reevaluate.

Our expert opinion

The Romanian deadlift is a fundamental compound exercise that physical therapists wish more people would practice to strengthen not only their back, but their entire body. Start with bodyweight to master the movement, build strength gradually, and add complementary exercises like bird dog, farmer’s carry, and glute bridge as your fitness improves. If you are experiencing persistent back pain or are recovering from an injury, consult a physical therapist who can help you determine which exercises are right for your needs.