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Lower Back Pain When Running

A lady with lower back pain when running

This article provides all the information you need to know about the common causes of lower back pain when running and the best ways to treat it. Chronic low back pain is a highly prevalent pain disorder that affects millions across the globe. It is due to back pain that most days are missed from the office. The pain arising in your back can be of different types and intensities.

The prevalence of low back pain was found to be around 4.2% in the young population while it increased to values greater than 20% in the older population. When compared to other sports-related injuries, the incidence of lower back pain from running among runners is low. The most evident risk factors for pain include:

  • Lack of aerobics activity
  • Restricted range of hip motion
  • Poor hamstrings
  • Poor back flexibility

In this article, we will be discussing the reasons for lower back pain when running.

Common Causes Of Lower Back Pain When Running

Back pain from running can interfere with your everyday routine and limit the performance of professional athelets. If you feel uneasy or achy when running, following conditions could be the reasons:

1. Muscle Sprains/Strains And Overuse Injuries

Muscle sprain and strains are common in athletes involved in strength training. Cross-training is a hectic type of sports training readily adopted by enthusiastic runners.

Excessive exercise, however, can be troublesome for athletes. Too much stretching can lead to the development of:

  • Pain
  • Stiffness (reduced hip mobility)
  • Muscle spasms

A study pointed out paraspinous muscle spasms to be the cause of low back pain and highlighted the importance of early treatment.

Another reason for low back pain in running is an overuse injury. Overuse and running injuries are common in those putting carry excessive weights on the back while running. These injuries

2. Hamstring injury as a cause of lower back pain when running

Hamstring injury mostly causes pain in the posterior knee, however, the trica of muscles forming the hamstring can lead to a belt-line like feel in the back.

Research shows that individuals having chronic low back pain have reduced flexibility of hamstrings indicating that hamstring strength is good for back muscle strength.

It is important to keep your glutes and hamstrings strong to keep backache at bay.

3. Stress Fracture

Though rare, stress fractures of the bones in the lower back can cause lower back pain while running. These types of fractures result from repetitive stress on the joint.

In a case study, a 16-year old volleyball player reported low back pain. Detailed investigation revealed an underlying sacral stress fracture to be the cause of pain.

In most cases, stress fractures are identified on the basis of associated inflammation, soreness and tenderness in the region.

4. Sacroiliac Joint Dysfunction

The sacroiliac joint is an important joint that provides support to the back as you carry out different activities. Around 15 to 25% of all patients suffering from low back pain have an SI joint disorder too.

The joint is a major shock absorber (cushioning effect) too, therefore, dysfunction of the joint is most noticeable when moving your body.

There can be damage to the soft tissues or the hard tissues. In some cases, the cartilage or the ligament that provides a protective layer gets damaged while in other cases the SI joint itself goes out of alignment.

SI dysfunction can be the outcome of long-standing osteoarthritis or other joint inflammatory conditions such as ankylosing spondylitis and gout. Trauma/injury to the joint while running can also trigger SI joint imbalance and consequent lower back pain.

Inflammatory arthritis and pregnancy may also contribute to abruptions in the SI joint. Studies have found back pain and sacroiliac joint dysfunction to be a two-way link as people with back pain have a greater chance of developing SI dysfunction (if not present already).

5. Facet joint irritation as a cause of  lower back pain when running

Training for long periods can have a negative impact on the body. The spine is composed of small yet highly efficient bones called vertebrae. The vertebrae are connected to each other via facet joints.

Individuals having weak abdominal muscles (like dancers) are prone to irritating the facet joints which can ultimately lead to pain in the back when running. Patients of degenerative disc disease undergo joint and vertebral disintegration. This disruption of the bones in the lumbar spine makes their bones and facets more prone to irritation.

6. Weak Core Muscles Of The Back

A major reason for low back pain when running is weak core muscles of the back. The lower back muscles are crucial in keeping your body weight evenly distributed and safe from muscular imbalance.

There is strong evidence which suggests that weakness of the glutes (gluteus medius) paired with the tenderness of the muscle can cause chronic non-specific lower back pain.

Another study found that an imbalance in muscle strength of the trunk (lower extensor muscle) can be a perpetuating factor for low back pain while running.

Back muscle weakness, in some cases, makes the patient follow a “swayback” posture that involves abnormal positioning of the hip flexors, knee and ankle. These structures then try to compensate for the weak abdominal and back core muscles which leads to low back pain.

7. Poor Posture And Training Plans

Running is best for your health but only when done in the right manner. There are a lot of aspects that should be followed when making running a part of your routine.

To begin with, you should follow training plans made by professionals in the field. Running abruptly and more than your limit increases the chances of falling prey to low back pain.

Back pain is often experienced by runners who do not give attention to the biomechanics of the body and start off without a warm-up.

Running with improper postures shifts the body weight to one side, increasing the chances of muscle sprains.

8. Sciatica

Sciatic nerve impingement in the buttocks can give sleepless nights. Sciatica (sciatic nerve inflammation) is characterized by severe, stabbing or radiating pain accompanied by numbness, tingling or burning sensations.

This condition, again, is due to muscle imbalances present in the buttock and back region. The sciatic nerve is a large nerve that innervates the back, legs, thighs, and buttocks region. People prone to sciatica usually get a pain episode on running or jogging.

9. Obesity And Wrong Shoe Wear

Shoe wear selection might not seem like an important issue but it can be the sole cause of back pain while running in runners.

As per the Cooper river bridge run study, low back pain was more frequently experienced by obese runners and those individuals who reported specific patterns of shoe wear.

Thus, if you are a regular runner, you must be very careful when selecting shoe wear and consult a podiatrist. Runners must be very careful in selecting running shoes.

Treatment options for lower back pain when running

Getting pain-free is not very difficult in cases of muscle sprains. All you have to do is allow the muscles to rest. You can take help from over-the-counter pain killers to relieve the pain.

Physical therapy

To get muscles in a better condition, it is advised to get a physical therapy session. The hands of a physio can rejuvenate the blood supply of your back muscles and increase hip mobility while alleviating pain.

Studies suggest that physical therapy exercise be adopted as the first line of healthcare treatment in the management of low back pain.

Core Muscle Strengthening

A major triggering point for low back pain on running is weak core muscles (of the back and the abdomen). Thus, to get rid of this gnawing pain you must undergo muscle strengthening exercises.

You can adopt core strength training to make your trunk muscles strong enough to bear the weight of the body when running.

Core exercises have shown to be more effective in decreasing low back pain as compared to general exercise.

Attention To Biomechanics

Following these steps can help restore the balance of the muscles and make you robust against injuries:

  • Always warm-up before running.
  • Follow a coach-guided fitness and running plan based on your running technique and running form.
  • Do not overdo exercise.

Conclusion

Low back pain on running is usually the consequence of over-exercising and running with improper postures. Facet joint irritation and muscle sprains can cause low back pain on running. SI joint dysfunction and stress sacral fractures can also trigger pain. Weakness of the core muscles (of the trunk and abdomen) and sciatic nerve impingement is also responsible for gnawing back pain. Effective ways of achieving pain relief include rest, painkiller medications, physical therapy and following proper biomechanics during running. Individuals having weak core muscles must follow strength training exercises under the supervision of a professional coach.

FAQs

Q1. Is Back Pain During Running Normal?

A. No, running is a good exercise for your joint and muscles. While you may feel stretching and tiredness in the back, low back pain during running is not a normal phenomenon.

Q2. How To Prevent Low Back Pain When Running?

A. You can follow these steps to prevent low back pain on activity:

  1. Always do a warm-up before sprinting and running.
  2. Stretch the hamstring muscles on daily basis to strengthen them.
  3. Add core muscle strengthening exercises to routine.

Q3. How Can I Strengthen My Lower Back?

A. You can strengthen your core muscles by carrying out some strength exercises such as plank, high plank leg lifts, squats and superman pulls etc.

References

  1. Meucci, Rodrigo Dalke, Anaclaudia Gastal Fassa, and Neice Muller Xavier Faria. “Prevalence of chronic low back pain: systematic review.” Revista de saude publica 49 (2015): 73.
  2. Maselli, Filippo, et al. “Prevalence and incidence of low back pain among runners: a systematic review.” BMC musculoskeletal disorders 21.1 (2020): 1-25.
  3. McCarberg, Bill H., et al. “Diagnosis and Treatment of Low‐Back Pain Because of Paraspinous Muscle Spasm: A Physician Roundtable.” Pain Medicine 12 (2011): S119-S127.
  4. Mistry, Gopi S., Neeta J. Vyas, and Megha S. Sheth. “Comparison of hamstrings flexibility in subjects with chronic low back pain versus normal individuals.” J Clin Exp Res 2.1 (2014): 85.
  5. Shah, Mrugeshkumar K., and Gregory W. Stewart. “Sacral stress fractures: an unusual cause of low back pain in an athlete.” Spine 27.4 (2002): E104-E108.
  6. Cohen, Steven P. “Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment.” Anesthesia & Analgesia 101.5 (2005): 1440-1453.
  7. Cohen, Steven P., Yian Chen, and Nathan J. Neufeld. “Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment.” Expert review of neurotherapeutics 13.1 (2013): 99-116.
  8. Barros, Guilherme, Lynn McGrath, and Mikhail Gelfenbeyn. “Sacroiliac joint dysfunction in patients with low back pain.” Federal practitioner 36.8 (2019): 370.
  9. Cooper, Nicholas A., et al. “Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls.” European Spine Journal 25.4 (2016): 1258-1265.
  10. Lee, Joon-Hee, et al. “Trunk muscle weakness as a risk factor for low back pain: a 5-year prospective study.” Spine 24.1 (1999): 54-57.
  11. McGregor, A. H., and D. W. L. Hukins. “Lower limb involvement in spinal function and low back pain.” Journal of back and musculoskeletal rehabilitation 22.4 (2009): 219-222.
  12. Stafford, M. A., P. Peng, and D. A. Hill. “Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management.” British journal of anaesthesia 99.4 (2007): 461-473.
  13. Woolf, Shane K., et al. “The Cooper River Bridge Run Study of low back pain in runners and walkers.” Journal of the Southern Orthopaedic Association 11.3 (2002): 136-143.
  14. Shipton, Edward A. “Physical therapy approaches in the treatment of low back pain.” Pain and therapy 7.2 (2018): 127-137.
  15. Coulombe, Brian J., et al. “Core stability exercise versus general exercise for chronic low back pain.” Journal of athletic training 52.1 (2017): 71-72.

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