What should I do if I run and I am getting back pain?

Running is one of the most effective ways to improve cardiovascular fitness and burn calories. The issue for most people is how challenging running is on the body, especially if you are predisposed to back pain. 

In this article we will break it down into different sections to best guide people concerned about their back yet are keen to achieve or maintain the great benefits running provides. Please read through the different segments and establish which scenario best describes your situation. 

New to running, starting to get back pain? 

Running requires both core (trunk) and gluteal (gluteus maximus) strength and conditioning. For many people their reason for getting into running in the first place is due to carrying excessive weight and or being unfit. It is fair to say that the majority of people with the goal to lose weight and get fit have a very weak core and very weak gluteal muscles.  This leads to problems, and most often the back becomes one of these problems for new runners. If the running technique is not supported by the trunk and gluteal muscles, the back becomes overloaded, fatigued and tight which in turn causes pain either during or after running. This is not a major concern in the sense that any damage is being done, however it is significant enough to end the newfound goal of running to lose weight and get fit. 

Below are some tips to guide you in the right direction. 

• Try to reduce the distance you are running. Most people feel fine for the first 5 mins or 1-2 km of running, with back pain commencing post this. Start off with shorter runs, and work on getting faster over that speed before you increase the distance. 
• Commence exercises such as squats and deadlifts to strengthen the muscles that support the lower back when running 
• Commence sprint training to strengthen the muscles that support good posture and running.

Haven't ran for a prolonged period, starting to get back into running and experiencing back pain?

Most likely the muscles that were once strong and conditioned when you were constantly running have atrophied during your hiatus. You will still be able to run quicker and longer than a new time runner, which places even more load on your back, due to the lack of support from your once conditioned trunk and gluteal muscles. No different to new time runners, you need to re-condition yourself first and gently build up to what you were once able to achieve. 

Below are some tips to guide you in the right direction. 

• Try to reduce the distance you are running. Most people feel fine for the first 5 mins or 1-2 km of running, with back pain commencing post this. Start off with shorter runs, and work on getting faster over that speed before you increase the distance. 
• Commence exercises such as squats and deadlifts to strengthen the muscles that support the lower back when running 
• Commence sprint training to strengthen the muscles that support good posture and running (refer articles on this site).

You are a seasoned runner and have started experiencing back pain

Of the 3 scenarios this is the one we tend to take more seriously. For new runners your back is not supported due to prolonged periods of inactivity that leads to postural weaknesses.

If you are and seasoned runner and you have only just experienced back-pain, we suggest that you seek quality physical therapy and/or massage therapy) to work deeply through the muscles of the hips and lower back. For some runners, tightness can occur in the muscles of the lower back and hips either over a period of time or from slight overtraining. For many seasoned runners experiencing back pain, a series of treatments resolves the issues and myotherapy becomes a maintenance strategy against recurrence.   

For the seasoned runners experiencing back pain who are not getting relief from treatment then another approach needs to be taken. 

Over time a runner's posture can change, weaknesses can set into the posterior muscles (gluteus maximus, hamstring, adductors), which in turn places a greater load (especially when running) onto the anterior muscles (hip flexors). This muscular imbalance causes the pelvis to anteriorly tilt, which creates an excessive curve in the lumbar spine (hyper lordosis). The excessive curve shortens and compresses the structures of the lower back. The major gluteal muscles and posterior muscles not only support the lower back when running, the act as a cushioning or a shock absorption for the spine and lower back structures. So, with the lower back structures already compromised and the cushioning removed with each step of running pain sets in very quick for the runner. 

Below are some tips to guide you in the right direction. 

• As best as possible rest/ or reduce running load to allow back to settle down
• Seek quality treatment to free up the structures of the lower back 
• Commence rehabilitative program to elongate the anterior muscles and the strengthen the posterior muscles 
• As you commence running, shorten the distance and work on speed/ not endurance. The faster you run, the more the posterior muscles need to work, so this will complement your rehabilitation progress.
• Commence sprint training to strengthen the muscles that support good posture and running (refer articles on this site).