While many runners are always on the lookout to prevent running injuries, lower back pain when running sometimes gets ignored.
Back pain is an all too frequent symptom that so many people accept as a part of life – a downside of getting older, a negative consequence of sitting at a desk all day…etc.
But back pain from running comes from very specific causes that can be remedied, treated, dealt with relatively easily.
Furthermore, by tackling the issue early on, you can minimize the risk of future back injuries.
This article outlines the causes of lower back pain when running, along with what you can do to prevent and fix it, so that you can get back on your feet and running pain-free.
Why does my lower back hurt when I run?
If you were already thinking along the lines of too much desk sitting, you’re not far from the truth.
For the average person, the back is kept in a resting position throughout most of the day (sitting on the couch, sitting at a desk, bending over while eating…). Thus, there aren’t too many opportunities to force the back to hold an upright position that’s good for the posture.
When combined with a relatively high-impact sport such as running, this means that a majority of patients in chiropractic clinics, physio centers, and doctor’s offices are runners. We’ve interviewed some of these experts in an effort to get to the real reason behind back pain when running.
Dr. William Brady, director of the Brady Back Institute near Boston, MA.has over 23 years in practice. He’s seen many different back injuries come and go, but here are the causes of lower back pain in runners.
“There are over 150 different structures that can cause low back pain. One of the most common and most often missed by doctors is sciatic nerve entrapment in the hip. With overuse, adhesion (think sticky glue) forms between the sciatic nerve and piriformis muscle in the back of the hip. This causes pain and inflammation during or after running. Or worse, can cause a pulled hamstring muscle because it overworks to protect the nerve.”
Dr. Jerry Yoo is a doctor of physiotherapy with over 20 years of specializing in working with endurance athletes. He is also a running technique coach and a triathlete himself.
“Before we explain why runners may experience low back pain during or after their run, we first have to rule out the reasons.
Medically speaking, kidney stones and GI tract issues can refer to the low back. Prostate and pelvic floor issues in men and women can also refer to the low back. A skilled physio will need to rule these out before moving on to the musculoskeletal causes.
Oftentimes, runners with low back pain have a running gait issue (overstrider, “stomper,” or collapser, for example) or poor core activation. We always recommend a 3D or at the very least a 2D running gait analysis to determine if the running technique needs to be modified or if specific exercises need to be implemented to improve weakness contributing to poor form.
Running is one of THE most core engaged activities we can do. We’re not talking about the six-pack when we talk about the core; rather, the muscles that envelope the entire trunk (which includes the pelvic floor and the glutes).
When you add distance or intensity over time, poor core activation/endurance can lead to a breakdown in trunk stability, especially as fatigue sets in. As a result, the lumbar spine and pelvis take on more ground reaction force than needed, which can cause an achy low back.”
Runners with lower back pain get treated daily at Thrive Physio Plus, a physiotherapy clinic in Adelaide, Australia. The owner, Giancarlo, gives the top 2 causes that he sees on a regular basis.
“Lower back pain when running is generally caused by:
1) A lack of strength/capacity in the lower back surrounding muscles to deal with their running loads,
2) A runner doing too much too soon and overloading their lower back.”
What Causes Lower Back Pain After Running?
Maybe you don’t actually feel any pain during your run, but once you’re at home recovering…that’s when the pain kicks in.
Back pain before and after running has many of the same causes, but here are a few reasons you might be feeling it after the run.
- You might be dehydrated: If you didn’t hydrate properly before or during your run, or if it’s a particularly hot day out, dehydration can cause muscle spasms that you would feel in your lower back. Adjust your drinking habits and rule out dehydration before moving on to other causes.
- Overuse: If you took on too many miles too fast without giving your body ample time to recover from the repetitive stress, it could cause the back pain you’re feeling.
- Your hamstrings could be too tight: The hamstrings and glutes are directly connected to your lower back. Make sure you’re stretching properly before a run to make sure your hamstrings are loose and warmed up.
- Muscular imbalance in the hip flexors and core muscles: When we spend all day sitting down, the glutes are relaxed and the quadriceps muscles at the front of the thighs will often be overly tight, negatively affecting the lower back muscles and spine. This can be prevented by strengthening the glutes, hip flexors, lower back, and abs.
- Asymmetric muscle tightness in the hip flexors and core: You can determine if this is the cause of your back pain by stretching out your hip muscles and core, and noticing if one side feels tighter than the other. If so, spend longer stretching the tighter side when you warm up before each run.
- Your shoes are too old: Wearing worn-out running shoes can cause you to run with a flat foot, which then causes jarring in the bones of the spine. People often associate foot injuries with bad footwear, but those old shoes can cause injuries throughout the body!
Related: Running Shoes Guide
How to Prevent Lower Back Pain When Running
To prevent lower back pain before it happens (or before it gets worse), there are some techniques you can do before and during the run to get rid of the pain (and the long-term consequences that might come from ignoring the pain).
Dr. Brady offers some exercises to perform before you start running.
“This [pulled hamstring muscles] can be prevented by consistently mobilizing the nerve. Before each run, do a standing toe touch stretch, but instead of holding and stretching for 30-60 seconds, perform three sets of 15 reps holding the bottom position only for a second or two.”
Dr. Yoo points out that where you run can affect your lower back and help you avoid pain.
“Runners who only run on asphalt or concrete all year round are also more prone to low back pain during or after running.
I often recommend cross-training on softer terrain – trails and track mixed in with road training can have a buffering effect on the low back and all the structures down the chain.”
Giancarlo provides his 2 best tips to counteract the 2 main causes of lower back pain.
“It can be prevented by:
1) Slowly increasing your running (distance, speed, frequency) slowly; 5-10% per week is generally a safe amount.
2) Performing strengthening exercises for the lower back and gluteus muscles 2-3 times per week.
Furthermore, overuse injuries when running, such as lower back pain, can be reduced by up to 50% with adequate strength training.”
In addition to these tips, one of the best ways to make sure your back is healthy and in shape during your run is to work on your running form. It’s easy to fall into whatever feels natural and most comfortable while you’re on the trail.
But learning – and consistently using – proper running form is the best way to avoid back pain and other running injuries at the same time.
As previously mentioned, running can strengthen your core muscles, so if you are able to correct your posture you may see some improvements as you run more and further develop core strength.
When to Get Medical Help for Your Back Pain
If you’ve followed these techniques but your back pain still persists, don’t let it go too far without professional medical advice, as physical therapy or further medical treatment may be required.
As Dr. Yoo pointed out, there could be underlying physical issues causing the back pain, rather than simple fixes like running form and strength training. He recommends seeking medical help if the pain is severe, unrelenting, or if it persists for several weeks.
Giancarlo notes another sign that indicates you should see a medical professional: if the symptoms persist for longer than 8 weeks, don’t improve with stretching, or the pain spreads to the calf or foot.
Strength Training Exercises for Runners
You may have gotten to this point in the article and are thinking, it’s all well and good to recommend strength training exercises, but what are some tangible ways I can make that happen?
Here are some of our top strength-building workouts for runners.
With these, you really can target and strengthen the deep core muscles, hip muscles, and other areas of the lower body that maybe be causing your lower back pain, ensuring that you can get back to running pain-free.
Our half marathon training plans all include cross-training days to make sure you fit that crucial strength training into your weekly running schedule!
Take Your Running Further With Our Resources...
Half Marathon Resources
Marathon Training Resources
Ultramarathon Training Resources