Do you suffer from lower back pain while running?
Lower back pain is a frustrating problem that affects many runners.
While active adults are thought to be less likely to suffer from chronic lower back pain, runners like you and I still often complain of lower back pain when running, or even after running.
In fact, the repetitive nature of running gait can greatly amplify the cumulative effects of existing soft tissue imbalances, movement dysfunctions or structural asymmetries which can lead to back pain.
Whether caused, by a structural asymmetry (such as a leg length discrepancy) movement dysfunction (at the sacroiliac joint for example), or soft tissue imbalances around the hips; lower back pain while running can be both incredibly frustrating and debilitating.
In this article, I’m going to explore four of the most common reasons why some people experience lower back pain from running and look at some simple exercises you can use to fix the underlying causes
Four Common Causes of Lower Back Pain when Running
There are numerous potential reasons for you to experience running-related lower back pain; too many to list in this article. Instead, I’m going to focus on the four most common situations I’ve seen when treating runners with lower back pain symptoms, aggravated by running.
Please do bear in mind that this is far from an exhaustive list. If you’re in doubt, please consult your physio.
1. Hyperlordosis & Poor Dynamic Control of the Lumbro-Pelvic Region
With every running stride, your body moves through the various phases of running gait. By its very nature, your gait pattern is both cyclical and repetitive.
As our legs swing forward and back through the swing and stance phases of running gait, a great deal of the movement that allows us to create the required stride length for the given pace comes from the hips.
However, to create efficient movement from the hips you need both adequate hip mobility and stability at the pelvis, which should provide a stable base.
Runners who either lack range of motion at the hips, or dynamic control of pelvic position (or often both!), frequently find themselves compensating by extending excessively through the lumbar spine (creating a hyperlordosis) as the pelvis rotates forward into an anteriorly tilted position.
Not only does this anterior pelvic tilt and hyperlordosis make it difficult for you to engage your glutes, but it also places more demand on the muscles of your lower back.
Over time these muscles, such as quadratus lumborum can become tight and painful.
Here’s a great video to demonstrate what you can do about this common problem…
2. Muscular Imbalances Around the Hips, Pelvis & Lower Back
The hip, pelvis and lower back region create a real cross-roads in the body.
For us to move properly as we run, we need to achieve and maintain a balance between the actions of the various different muscle groups in this area. It’s also important to provide both adequate mobility and stability around each joint.
When an imbalance is created, through soft tissue tightness, weakness (relative or positional) or inhibition of a muscle group, our bodies are great at compensating and “getting the job done”.
Unfortunately, these compensation strategies often come at our own long-term detriment!
As an example, weakness or inhibition of the gluteal muscles often results in runners overusing their lower back muscles, as well as potentially their hamstrings and calf muscles.
3. Reduced Thoracic Spine Mobility
This is especially common in the many ‘office-based athletes’ I meet who present with low back pain while running.
I find that these runners frequently lack the ability to comfortably extend and rotate properly through their thoracic spine.
This video analysis of elite marathon runner Shalane Flanagan demonstrates the importance of extension and rotation of the torso in running gait.
Picture the spine as a segmental unit, achieving motion in all planes as a net result of all the individual segmental motions.
If a number of segments are restricted in the desired motion (the thoracic spine in this example), then the overall spinal extension and rotation needed in running will come predominantly from the lumbar spine.
This type of compensation results in undue demand on the region by placing the lower back in the hyperlordotic position described in the first point above.
Here’s a great exercise you can use to improve thoracic spine mobility.
4. Lower Back Pain Due to Poor Running Technique
All of the factors described above, and many that I haven’t covered, will all be exacerbated by running with poor form.
Running with proper technique will help you reduce the undue impact on your body, which is always a great thing!
However, and potentially more importantly in this context, running with a focus on your technique will help you maintain good running posture and control of the lumbro-pelvic region.
Here’s a great video you can use as a start point for working on running form:
What About The Role of Core Strength & Stability in Running With Back Pain?
Firstly we need to define what is meant by core strength and core stability.
There are many definitions out there for these generic terms, many of which speak of providing stability to the lumbar spine through strengthening the deep and superficial abdominal muscles.
Consider the fact that the bony and ligamentous architecture of the lumbar spinal segments gives them a good level of inherent stability…
If your back pain stems from having truly unstable spinal vertebrae, being able to run is probably the least of your problems.
What we should instead be considering in terms of core strength and stability is this:
The ability to maintain good pelvic (and therefore lumbar spine) posture throughout the functional movements for our sport…
Strength, stability and mobility, all in the right areas will allow your ‘core’ to maintain a neutral lumbro-pelvic posture.
in addition, having adequate thoracic motion is going to also be a factor in enabling you to be more effective in keeping the lumbar spine in a neutral position through the motion of running.
While typical ‘core’ activities such as floor-based pilates will be great for getting a ‘feel’ for the activation of the correct core muscle groups, the real focus for a runner should be to train these muscles to provide pelvic control through functional ranges of motion in load-bearing positions.
Here’s a good example of a floor-based exercise which will help you develop the kinaesthetic awareness and neuromuscular control required to then move on to more functional exercises:
In terms of load-bearing exercises, I’m a big fan of various plan variations when it comes to building core strength in runners:
N.B. For specific diagnosis and identification of root causes for your back pain symptoms, I strongly suggest a visit to a sports physio or doctor with a solid knowledge of running biomechanics in particular.
As with all exercises shared on this website, if it hurts, stop!
Don’t Ignore Your Lower Back Pain When Running
In the vast majority of cases, this type of lower back pain isn’t something you simply have to accept and put-up with. An appropriate rehab and strengthening plan, alongside your running, will help you run pain-free.
I previously stated that there are many different types and causes of back pain in runners. Not all of the exercises above will be appropriate in every case.
Please do seek the help of a good physio or doctor to get specific advice for your injury.