Do you struggle with low back pain while running?
If so, you’re not alone.
40 million Americans regularly run, and thousands have to stop running every year due to pain and injuries.
If you’re thinking about giving up running because of your lower back pain, don’t.
Read this article first!
Running isn’t the first thing that comes to mind for most people when they think about back pain, but it’s incredibly common.
Why is that?
Running is supposed to be the thing that everyone can do if they want to stay fit, right?
If that’s the case, then why is back pain so common in runners?
There are many possibilities, but here is one of the most common; it’s called extension intolerance.
Extension intolerance sounds scary, but it’s really not, and it’s relatively simple to address. So, what is it?
Extension intolerance is when the tissues surrounding the back side of the spine become sensitive and painful due to compression, which happens when the spine is in an extended position.
The main culprit for this pain is typically the facet joints, the small joints between the vertebrae.
Over time, if these joints stay compressed, they get very angry.
So the question is, how does this apply to runners?
The short answer is strength balance, specifically strength balance of the muscles that flex and extend the lower spine and the mobility of the hip flexors.
In a nutshell, strength balance is the balance between forces on either side of a joint. If you have significantly more strength on one side of the joint, everything gets pulled in that direction. In this case, we’re talking about the muscles of the anterior trunk that flex the lower spine, think the abdominals.
If the abdominal muscles are relatively weak compared to the spinal extensors, the resting position of the spine becomes biased even more toward extension than it naturally already is.
The simple solution is to strengthen the core musculature, which can be done in many ways, but we prefer unilateral carries such as single-arm farmer carries and crawling variations. We prefer these types of exercises because they keep the movement of the spine dynamic and easily transferable to real-life activities, like running.
Another variable to consider is the hip flexors.
When we run, the back leg is in a position of hip extension and knee flexion, like in this photo.
This position puts the hip flexors on maximum tension, and if you don’t have sufficient hip flexor mobility, this is a problem.
When your hip flexors don’t have enough mobility to facilitate a specific movement, the lack of mobility has to be made up from somewhere.
That somewhere is your lower back because your hip flexors attach to the front of your pelvis, and the momentum of your legs swinging backward thousands of times every time you go for a run pushes your lower back into an increasingly irritated extension position. Image link
So, the solution here is to increase hip flexor mobility. HOWEVER, the best route for doing so isn’t stretching.
Most people have chronically weak hip flexors, which is why they constantly complain about feeling tight.
The feeling of tightness isn’t a cue that they need to stretch; it’s a cue that those muscles are weak and need attention because they feel vulnerable.
Again, there are near-infinite ways to strengthen your hip flexors, but we’ve found great success using banded hip flexion exercises as they’re easy to load hip flexion through the full range of motion.
Here is an example of an exercise we often use with clients who have back pain while running.