Running Related Low Back Pain

February 7, 2019

 Low back during or after running is a common issue affecting runners.

 

Low back pain is a hugely complicated, multifactorial, individual experience and it is therefore impossible to provide advice that is suitable for everyone. This post does not represent medical advice and it is always important to see a healthcare professional if you have persistent or worsening symptoms. This blog is also not aimed at those who regularly have low back pain that is not related to their running or those who have associated symptoms into the legs such as pain, pins and needles or numbness and I would strongly advise seeing someone if you have these symptoms.

 

This blog is aimed at those who experience pain in the lower back when running or immediately after running, the pain will often come on towards the end of a run and be associated with increased distance or time on feet. Often, the pain is described as an ache and /or tightness that builds during the run, it can linger for a while after running but will usually settle relatively quickly and the person presenting with this type of pain often describes liking to sit or bend forward to alleviate the symptoms either during the run or when finished.

 

As with all injuries there are a large number of factors that could contribute to developing pain when running but I am going to focus this post on two areas - technique and strength/control.

 

Runners getting low back pain when running often have an increase in anterior pelvic tilt and lumbar lordosis when running (see picture). I’ll make it clear immediately that this is NOT A BAD posture, there is no good evidence that shows posture causes low back pain. However, prolonged running in this position with limited variability (moving out of this position) has the potential to overload various structures in the lower back and lead the runner to experience pain.

 

Possible reasons for adopting this position when running could be:

 

- Habit - it is just how you have developed your running style

 

- Technique - trying to stay up tall or trying to lean forward slightly but remaining flexed through the hips and therefore needing to compensate through the lumbar spine (see picture)

 

- Sub-Optimal Strength - particularly in the lower abdominals and obliques, and potentially the gluteal muscles

 

- Fatigue - as we get tired we may lose the ability to maintain the pelvis in a more neutral position.

 

Ideally, it would be best to have the problem assessed and that would include a look at running technique both when fresh and when fatigued. However, here are some things you can try if this is a problem you are suffering with.

 

Mobility:

 

The first video attached to this blog shows some simple mobility drills that can help improve lower back and pelvis mobility and also awareness of pelvic and lumbar spine position. These exercises can be useful before and after a run.

 

Strength:

 

The second video shows some simple strength exercises for the abdominal and gluteal muscles and a step exercise focusing on keeping the pelvis in a more neutral position.

 

These exercises can be progressed in many ways once they feel relatively easy.

 

Technique

 

This is trickier to offer advice on as everyone runs and learns differently but one cue I use is to imagine you are being gently pulled upwards by your hair when running to make yourself feel lighter and taller. Others benefit by initiating this upward movement from the hips or pelvis.

 

As always I hope you’ve found this useful and feel free to contact me with feedback and questions at alexquinnphysio@gmail.com or on twitter @quinnphysio 

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