Running and back pain?

Oh, the impact! Actually a very small percentage of impact from running should even reach your back. Often, lower back pain during running comes from hyperextension of the back due to tightness primarily in the hip flexors (iliopsoas muscle) when the leg extends back.
Note: There are other conditions that should be examined more carefully by a Medical Doctor or Chiropractor if symptoms do not improve or worsen.

The discs in your back have an incredible ability to tolerate a compressive load as long as the disc is in a neutral position. For example the 500 kg (1100 lb) deadlift has recently been accomplished. Astounding!  The man who did it happened to weigh 400+ lbs (so please don’t try this at home), but his discs were still relatively small. It is repetitive flexion, rotation, hyperextension and shearing loads that the disc and back in general do not tolerate nearly as well as direct compression.

With proper upright running technique where you are landing under (or close to under) your hip and center or gravity, you have very effective built in shock absorbers around your feet (plantar fascia, muscles, tendons), ankle (calf, Achilles) knee (quad, ITBand), hip (glutes, ITBand) that can dissipate and store potential energy for a spring-like (plyometric) effect to capture these ‘impact’ forces and send you on your way (horizontal, smooth running for less impact on the next step).

So how can we apply less impact and pulling forces on our back when running?
• Incorporate good technique as mentioned about and land under your hips and run tall to give your muscles a mechanical advantage for shock absorption. Ways to help this landing are increasing your cadence (steps/minute). Research has demonstrated that increasing cadence 5%, you can decrease impact forces by 20%. Other useful analogies are letting gravity place your foot underneath you or trying pulling the ground underneath you as you footstrike.  These 2 goals will make it less likely that you will overstrike or overstride out in front of you body causing braking and increased impact.
• Stretch and release your hip flexors. Tight hip flexors from sitting/life will directly compress and tilt your lower back (iliopsoas muscle attaches from the leg/hip into the entire lower/lumbar spine).  As your leg goes back during your running stride, it tightens and pulls forwards and downwards on your lower back.

The combination of tight hip flexors and extending your leg when running can aggravate your lower back. Leg swings prior to running and picking up your foot more quickly after foot strike will help alleviate this extra strain on your lower back. Research indicates that efficient runners have 10 degrees LESS ankle plantar flexion (push-off bending of the ankle) than inefficient runners. This suggests that they pick up their foot more quickly and instead use more range of motion in their hips, glutes and upper legs for soother running. The ankle, calf and Achilles should be used more as a spring with less range of motion to assist in propulsion at the end of the stride.

• Stretch and strengthen your quads. Stretch by squeezing your glutes and gently pushing your hips forwards as you flex your knee (standing or side-lying) because one of the quad muscles crosses the hip and will decrease your ability to extend your leg, especially with a bent (flexed) knee. This can cause hyperextension of your back in compensation.  Squats and single leg squats are a great way to strengthen your quads for shock absorption when running.

• Run downhill, but be careful and not steep!  Add very gradually slightly downhill slopes to do some of your easy, then tempo or faster intervals. More muscle damage occurs on the downhill due to eccentric (lengthening under a load) muscle contraction and more recovery is required between these sessions (ideally once a week max.)

• Strengthen our glutes.  Your glute maximus acts as a force closure around your main joints connecting your lower body to your torso, also know as your Sacro-Iliac (SI) joints. Glutes (maximus) can be worked effectively with bridging exercises and a variety of lunges. Your glutes medius and medius help prevent your hip from popping out when running causing your lower back to compensate and tilt to the weak side causing an extra compression or pinching on that side and a strain or pulling on the other side of your back, and/or just excessive side to side motion when running which can aggravate your back.  These can be strengthen with a band around your ankles or above your knee and doing lateral movement or squatting/bridging exercises.

• Strengthen your core with planking variations (side/front) and add an anti-torsional component, by using cables for rotation or simply lifting an arm or leg for a few seconds during a front plank (from knees or toes).

• Treatment first? Occasionally I use a combination of ART, Chiropractic and Shockwave Therapy to first remove scar tissue, adhesions, restrictions in muscles, tendons, fascia or joints affecting alignment.  These restrictions can be from old injuries or overuse postural strains.  Treatment is sometimes required before implementing an exercise program targeted at stabilizing the back and hips and other potential sources of weakness (foot, knee etc.).

In summary, don’t just avoid running unless pain or specific diagnosis prevents you from doing so. Ideally go to a practitioner if necessary who runs. They tend to have more knowledge, interest and insight about the implications of running with back pain. Remember to gradually incorporate the above recommendations and if any of them cause any aggravation, stop and purpose a more specific diagnosis.
You need to give your body at least a chance to become a smoother runner. Many runners including myself find that running 50+ km per week improves their back pain.

Again, if pain persists, go see your Medical Doctor or Chiropractor/Therapist for a specific diagnosis and potential solution.