Running related back pain is pain that comes on with one or more of the following:
1. A pain in the lower back while running, which comes on during the run, normally after 10-15 minutes into the run.
2. A pain that may refer into the buttocks, but not below the knee, and not with tingling or numbness in the legs.
3. A pain and tenderness, while running, located at the very bottom of the lower back. (the Dimples of Venus).
4. Pain generally worsened by leaning backwards or sideways, although it can also render it difficult to put shoes on when sitting down.
5. Your back often feels stiff and vulnerable, especially but not exclusively when running.
6. The pain comes on for no apparent reason. No apparent injury has occurred.
What causes running related back pain and how to prevent it:
Sharp increase in training. By this I mean a change to length, speed or volume of running. Every run will create a little irritation in all joints, which the body then heals and is stronger for it. But an increase in training that you are not used to (and possibly too quickly) can result in your body simply not having the time to heal the irritation before the next time you run. If this happens a few times you will inevitably start to hurt.
What to do?
Manage your training volume. The 10% rule is popular among the running world whereby you don’t increase your weekly distance by more than 10% each week. For example, if you run two 5km in week one, that gives a weekly total of 10km. Therefore in week two, you should not run more than 11km total. Be weary when adding in additional runs during the week that you are not going over this weekly total.
Weak muscles and core strength. Have you been incorporating strength training into your weekly schedule? The muscles around the trunk provide a secure belt or corset that increases the stability of the lower back under the stress of running, and reduces vulnerability in the spine. The exercises that develop core strength can easily be learned from Pilates classes or personal training in a gym.
What to do?
Strength training should take place at least twice weekly. In the clinic we often use the Bunkie test bundle to assess a patient’s core strength. See video below.
Old injuries. Have you had in the last year or so an injury to your feet, knees, or hips that could have a knock on effect on your lower back? The leg bone connects to the hip bone, which is connected to the pelvis which is connected to the lower back.
What to do?
Get a physio to assess an injury sooner rather than later. This results in a faster and better recovery and prevents too many compensatory patterns from setting in.
Posture. Often people have a very stiff running posture and keep their lower back in a hyper extended position and shallow breathe while running.. This can lead to stress in their lower back and stiffness between the facet joints. Similarly, a lot of people can develop stress in their lower back from being unaware of keeping their core strong as they run up and downhill. Holding your stomach in as you go down steep hills can take a lot of pressure off your lower back.
What to do?
Ensure correct breathing when running. See our previous blog on “Running Part I: Breathing - We’re Doing It All Wrong” for more information on this topic, it details how to engage your core and prevent anterior pelvic tilt when running through correct breathing techniques.
Incorrect footwear. Are your running shoes giving enough support or cushioning to your foot or indeed are they worn out? It is important to get the right shoe, and to replace shoes BEFORE they wear out. The cushioning of good new running shoes helps reduce the shock of foot impact reaching the lower back.
What do do?
Check footwear and if you are unsure get a foot assessment by a chartered physiotherapist. See our blog “Running Part II: Choosing the Correct Footwear” for more information.
To learn more, or speak to one of our physiotherapists email physio@reflexphysiotherapy.ie or call 087-6156270. We offer video running assessments in the clinic which includes foot assessment and posture analysis where compensatory patterns are measured.
Stay tuned for our upcoming running blog on Running Related Injuries Part II.