Back Pain Relief for Runners

Back Pain Relief for Runners

80% of Americans will experience low back pain, runners are no exception.

Jill Lohmann PT, MSPT, COMT, CSCS, CEAS
Chicago, IL

KEY POINTS

  • 3 out of 5 Americans will experience lower back pain
  • Running puts a tremendous amount of pressure on the lower back
  • The repetitive motion of running is particularly destructive when there are asymetries in biomechanics
  • Developing your core strength and flexibility will help prevent lower back pain


THE RUN DOWN

An estimated 80% of Americans will experience low back pain and if you’re a runner, you are even more likely to join that group. If your exercise consists of slogging through a run without including core stretching, strength training, and flexibility exercises into your routine, then you’ll find yourself doubled over sooner than you might think.  Just like tennis players are susceptible tendinitis in their elbows or swimmers need to pay special attention to their shoulders, runners’ bodies have needs too.  It’s easy to overlook the back, since we don’t necessarily feel it when we run, but it’s crucial to give it the attention it deserves.


WHY ARE RUNNERS AT RISK

As a runner there are a few things that put added pressure on your back:

  • Range of Impact: When you run you exert a greater range of impact than when you walk.  Your lower (lumbar) spine moves through a larger range of motion (ROM) as you take each stride. This ROM further increased on uphill or downhill slopes (think about the angle of your hip as your run up or downhill, you’re not exactly standing up straight.)
  • Force of Motion: Each time you put your foot down your spine has to absorb three times your normal weight.  You can be light as a feather and still admit that’s a lot of pressure for your spine to handle.  So take the offensive and learn how to give your spine a break—the good kind.
  • Stride Stress:  Structural or stride asymmetries can result in spinal injuries in runners; it might seem like common sense, but the second you start to compromise the integrity of your stride (like by limping) you should stop.  Every time your foot hits the ground you create a chain reaction throughout your body to absorb the impact, so you need to make sure you’re strong enough to withstand it.


RULES FOR RUNNING STRONG

Strengthen for Stability

Weakness in a component of your stride will always be compensated by something else and that something is typically your spine.  The most common weakness develops in your gluteus medius, the muscle that keeps your pelvis level when you run.  If your pelvis tilts then your spine is going to have to handle increased bending with each step.

The strength of this muscle is vital—it controls the extension of your hip, controls the rotation of the spine, and prepares your foot to push off and strike the ground as you move.

You also want to make sure that you’ve got strong and stable transverse abdominus and multifidus muscles, muscles deep within your lower back that help with stability.  These are the muscles that contract when you lie on your back with your knees bent and lift your pelvis off the ground.  Weakness in these muscles will often leave you with an exaggerated arch of your lower back, which can lead to a pronounced forward tilt of the pelvis.  This extreme arching can lead to degenerative injuries over time.

Fine Tune Flexibility

Flexibility can be tough to gauge because on one hand, you don’t want to be so flexible that your muscles are lose and prone to hyperextension, but you do want your muscles and ligaments to be able to stretch comfortably as you move.

Loose hip muscles are particularly important because they have so much to do with maintaining a proper stride.  If your hip flexors are tight then your spine will rotate to compensate for that.  If the muscles in the back of your leg are too tight then your pelvis is pulled into a posterior tilt and your discs and abdominals face added pressure.  Keeping your hips lose helps your body with weight distribution as you move through each stride—and a balanced body runs longer and stronger.

Avoid Asymmetries

Running is a repetitive, symmetrical motion so any asymmetries can lead to injury.  Typical asymmetries include a leg length difference (you can get measured by a profesional), foot structure differences, and pelvic asymmetries.   You can develop hip hiking that then adds pressure to your spinal column as one side compensates for the other.

Most runners have minute discrepancies between the two sides of their bodes that they either ignore or don’t recognize.  Sometimes we fall into the trap of running through the pain.  That determination is admirable, but when you start to hurt, your body starts to compensate for something and distance runners sometimes lose the integrity of their stride as the run wears on.  You might not think you’re running differently, but your body will take the path of least resistance if it starts to ache.  Odd lopes and limps are examples of asymmetries that can cause injuries but are often ignored.  If you start to limp-stop immediately.  You could be developing a bad habit—and bad habits lead to injuries that could keep you out of the game for more than just a training run.

Strengthen for Support

Core strength decreases spinal wear and tear and protects it from injury.  Even if you abhor anatomy, it’s important to know that strong musculature helps support the joints and ligaments they surround.  So if you’re interested in protecting your back, develop strong abs and strength across the pelvic and hip regions—it’s that simple.

Strong abs will help your spine deal with the outrageous compression forces it faces as you take each step. In order to help prevent debilitating back injuries, it is crucial for runners to focus some of their supplemental workout efforts across the core abdominal and hip regions and incorporate some targeted strength and flexibility training.

Your best bet for protecting your lower back is to build muscle, increase flexibility, and ensure that you’re running and walking with proper mechanics.


THE CORE COMPONENTS OF A HEALTHY BACK

Stretching, strength training, and core work can all be seamlessly integrated into your core training to help protect and strengthen your back.  It can be easy to forget about your spine and all the muscles that surround it, but we draw strength from it for everything we do.  Being proactive is the key to ensuring that your back never keeps you from hitting the road, or your stride.

For more information on core health and back pain, as well as examples of exercises check out this article by Moji fitness expert Sean Lee.


REFERENCES

1. Essentials of Musculoskeletal Care 3rd Edition: Ed. Letha Yurko Griffin, MD, PhD

2. Carter JM, Bean WC, McMahan SG, Barr ML, and Brown LE.  The Effects of Stability Ball Training on Spinal Stability in Sedentary Individuals. Journal of Strengthening and Conditioning Research. 2006:20(2): 429-435.

3. Schache AG, Bennell KL, Blanch P, Wrigley TV. The coordinated movement of the lumbo-pelvic-hip complex during running:  a literature review. Gait and Posture.1999.10:30-47.

4. Novacheck TF. The biomechanics of running. Gait and Posture.1998:7:77-95.

5. Schache AG, Blanch PD, Murphy AT. Relation of anterior pelvic tilt during running to clinical and kinematic measures of him extension. British Journal of Sports Medicine. 2000:34:279-283.

6. Levine D, Colston MA, Whittle MW, Pharo EC, and Marcellin DJ. Sagittal Lumbar Spine Position During Standing Walking, and Running at Various Gradients.  Journal of Athletic Training. 2007:42(1):29-34.

7. Skinner, HB. Current Diagnosis and treatment in Orthopedics. Appleton and Lange. 1995.

Jill Lohmann is a Director of Operations for Accelerated Rehabilitation Centers and a certified physical therapist. Accelerated Rehabilitation Centers is a physical therapist owned and operated rehabilitation company with a network of 170 outpatient rehabilitation centers located throughout the Midwest, Arizona and Georgia.

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