21 Jan Should Bodybuilding Be A Part Of Your Rehab?
Article Rundown
- Bodybuilding for rehab: Good or Bad?
- “Type A” Personalities
- Shoulder/Knee Injuries
- Back Injuries
- Summary
Bodybuilding for Rehab: Good or Bad?
In this video, I cover the topic of bodybuilding and rehabilitation, specifically why bodybuilders are some of the most challenging individuals to work with when rehabbing a back injury. When people suffer from lumbar back pain, discogenic back pain, or facetogenic back pain, I always recommend avoiding bodybuilding. This advice applies to other areas of the body as well, including the shoulders, knees, and hips. To explain, I’ll first provide an overarching theme and then focus on back pain specifically.
What is a “Type A” Personality?
Over the years, I’ve worked with many bodybuilders, and they are among the most difficult clients to coach, much like powerlifters. Why is this? Both bodybuilding and powerlifting tend to attract what is known as a “Type A personality.” A Type A personality describes someone who is often addicted to training and obsessed with seeing results in the mirror. These individuals are highly driven, constantly seeking growth, and are often determined and headstrong. For bodybuilders, training, competing, and showcasing results—often on social media—become central to their identity. This mindset makes them some of the hardest people to coach.
Bodybuilding Rehab for Shoulders and Knees?
When it comes to shoulder and knee injuries, some bodybuilding practices might seem beneficial. However, the effectiveness depends on the specific injury. For instance, while overhead presses and lateral raises might help strengthen the shoulder in some cases, they could exacerbate the issue in others. Instead of relying solely on generic bodybuilding exercises, it’s crucial to adopt a more targeted approach. For example, the shoulder “Big 3” exercises from Dr. Andrew Lock, along with thoracic extension drills, can improve t-spine mobility and ensure proper shoulder function. Addressing weak points from multiple angles helps tackle the root cause of the injury rather than aggravating it. In some cases, further diagnostic steps, such as an MRI or a consultation with a specialist like Dr. Andrew Lock, may be necessary.
It’s important to remember that bodybuilding’s primary goal is hypertrophy—building bigger muscles—rather than improving strength, stability, or multi-joint movement patterns. Some of the bodybuilders with the most impressive physiques have incredibly unstable spines. They are, as the saying goes, “all show and no go.” While exceptions like Ronnie Coleman and Dexter Jackson demonstrate immense strength, most bodybuilders focus exclusively on muscle growth.
Bodybuilding Rehab for Back Pain?
When dealing with back pain, a common mistake is substituting barbell and dumbbell movements with machine exercises, thinking it will alleviate pain. For instance, replacing back squats with machine hack squats or leg presses often worsens the problem. These movements still load the spine, causing compression, flexion, and extension—the very pain generators that need addressing. Using machines like the Smith machine for squats or even leg extensions can exacerbate the issue, particularly if neural tension or drag is present. Such exercises can continue to “pick the scab” and hinder recovery. Bodybuilding is not the right approach to rehabilitate the spine.
Many exercises thought to be spine-sparing or spine-friendly are actually detrimental. In most cases, all lifting should be paused. Begin by identifying the underlying cause of the pain, such as ligament, facet, disc, or nerve issues, or a combination thereof. Resources like “Back Mechanic” and “Gift of Injury” provide valuable guidance on how to rebuild correctly. Starting with foundational exercises like the McGill Big 3 and progressing gradually is essential. For instance, sled drags can be a safer and more effective option for quad development compared to leg extensions or curls, allowing for easy progression and regression based on individual needs.
Conclusion
In conclusion, don’t deceive yourself. If you’re still using gym machines while experiencing back pain, it’s time to reevaluate your approach. Determine the type of back pain you’re dealing with, and if necessary, shut down your gym activities entirely. Return to the basics and rebuild your strength and stability correctly. While certain injuries can benefit from bodybuilding’s ability to pump blood to the affected area, this approach is unsuitable for the spine. Exercises like back extensions and reverse hypers can exacerbate discogenic pain if they repeatedly trigger pain generators.
If you’re dealing with back pain and need help, I offer both virtual and in-person assessments to guide you toward a stronger, healthier recovery. Learn more about my services [HERE].

Brian Carroll

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