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Back pain can develop gradually as a result of microtrauma brought about by repetitive activity over time. Because of the slow and progressive onset of this internal injury, the condition is often ignored until the symptoms become acute, often resulting in disabling injury. Acute back injuries can arise from stressful lifting techniques done without adequate recovery, especially when experimenting with more ballistic work, or work where the extensor spinae are stressed during spinal flexion when much of the load is commonly taken up by the slower to heal ligaments which may not adapt progressively to the stress. While the acute injury may seem to be caused by a single well-defined incident, it may have been preventable or lessened if not for the years of injury to the musculoskeletal support mechanism by repetitive microtrauma.