Physical Therapists Wish More People Did This Exercise to Alleviate Back Pain

Physical therapists say this one exercise builds the strength your back needs for daily mobility.

Reviewed by Dietitian Katey Davidson, M.Sc.FN, RD, CPT

Key Points

• Romanian dead lifts strengthen your back, glutes and hamstrings to support everyday movement.
• Start with body weight and build up gradually as your strength and technique improve.
• Bird dogs, farmer’s carries and glute bridges complement your back-strengthening routine.

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

While there’s no shortage of movements claiming to fix or prevent back pain, physical therapists say compound exercises that build full-body functional strength tend to offer more benefits than isolation work targeting the back alone.

To learn more, we asked physical therapists which back exercise they wish more people incorporated into their routines, and they all gave the same answer: the Romanian dead lift (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 dead lift is a compound exercise, meaning it involves multiple joints and engages several muscle groups at once. “The RDL engages the entire posterior chain, particularly the hamstrings, glutes and spinal extensors, while the abdominal and other trunk muscles help control the spine,” says Alex McRobbie, PT, D.P.T., OCS. “What makes it especially useful is that it requires you to generate movement primarily from the hips while maintaining control of your trunk and spine. This carries over to lifting, bending and many everyday 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 across multiple muscle groups.

“Training these muscle groups together helps build the strength needed to manage the physical demands placed on the spine during everyday activities,” explains Kaylee LeCavalier, PT, D.P.T., SCS, CSCS, CAPS. “Supporting the spine doesn’t mean keeping it rigid or preventing normal movement, but rather developing the capacity to move comfortably under load.”

How to Do It

Here’s how to perform the RDL safely and with proper form:

1. Stand with your feet roughly hip-width apart and your knees slightly bent. Hold a dumbbell in each hand or hold a kettlebell with both hands in front of your thighs.
2. Push your hips backward 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 bending straight down.
3. Lower the weights until you feel a stretch in your hamstrings. This typically occurs around knee level or slightly below. You don’t need to lower the weights all the way to the ground. “As you go farther, that stretch should gradually increase, which helps indicate that you’re isolating hip flexion rather than getting the movement from your spine,” says McRobbie.
4. Press through your feet and drive your hips forward to return to a standing position.
5. Perform 2 to 3 sets of 8 to 12 reps.

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

“If you’re a beginner, I would start with a 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 Worth Adding

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

Bird Dog

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

Farmer’s Carry

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

Glute Bridge

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

Safety & Precautions

“You don’t necessarily need clearance before doing an RDL,” says McRobbie. “If you’re new to the exercise, you can start without weight and simply practice a body-weight hip hinge, then slowly add weight over the course of several weeks or months.”

However, LeCavalier advises that “people 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 guidance from a health care professional before performing loaded RDLs.”

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

Our Expert Take

The Romanian dead lift is a foundational compound exercise that physical therapists wish more people did for strengthening not only their backs, but their entire bodies. Start with body weight to master the movement, build strength gradually and add complementary exercises like the bird dog, farmer’s carry and glute bridge as your fitness improves. If you experience persistent back pain or are recovering from an injury, consult a physical therapist who can help determine which exercises are appropriate for your needs.