Running and lower back pain (LBP) don’t have to go hand in hand, but so often, they do. The incidence rate of LBP amongst marathon runners is between 4.8% and 10.3%.
With nearly 80 percent of the population experiencing LBP at some point in their lives, it is important to distinguish whether your LBP is specifically a running-related injury or an injury that running aggravates.
Many people accept LBP as a symptom of life, but it doesn’t have to be that way. Back pain that comes from running often has specific causes that can be remedied, treated, and dealt with.
A common but harmful misconception is that running and exercise, more generally, should be avoided when LPB is present.
Exercise modification is a crucial component of recovering from LBP, and when done correctly can get you back running and prevent you from future injuries.
Our articles are not designed to replace medical advice. If you have an injury we recommend seeing a qualified health professional.
In this article, we will cover:
- Why Does My Lower Back Hurt When I Run?: 5 Common Causes
- Can I Run With Lower Back Pain?
- When To Get Medical Help For Your Lower Back Pain
- How To Effectively Treat Lower Back Pain When Running
- 4 Exercise For Lower Back Pain
Let’s get you back on your feet and running pain-free!
Why Does My Lower Back Hurt When I Run?
LBP, when running, has a number of potential causes. As previously mentioned, it is important to distinguish between running-related LBP and general LBP.
General LBP is a real problem in the wider population; too much desk sitting, driving, and sitting on the couch watching Netflix, coupled with a distinct lack of physical activity, and you have yourself the perfect storm.
Some of the remedies we will look at later will target general LBP too, but for now, let’s focus on running.
Rather than be bad for your back, recent studies have concluded that throughout their lifetimes, runners may actually experience less LBP.
So why does running cause my lower back to hurt?
Here are 5 common causes of lower back pain when running:
Back pain can happen before, during, or after a run. Here are the 5 most common causes:
Overuse is the most common mistake made by runners. It accounts for the vast majority of running-related injuries.
Overuse injuries are relative to the individual. Running for 5 km will be too much for some; running 15 km is nothing for others. Listen to your own body. Overuse results from a mismatch between the resilience of the connective tissue and the physical demands caused by running.
The good news is, overuse related injuries are often completely preventable and treatable.
The key aspects to consider if you are suffering from an overuse injury are:
- Volume: Have you recently increased your running volume? It doesn’t matter if you are a complete newbie or an experienced runner. Not allowing the body adequate time to adapt to your new training volume will cause excessive strain and subsequent inflammation. Do this for too long, and your body will let you know about it.
- Intensity: Have you recently increased your training intensity? Suddenly adding in hill sprints 3 times per week or blasting 5k PR’s again and again will put undue stress on the muscles. Make sure you are including slow, low-effort runs in your training.
- Rest: Avoiding overuse is about finding the right balance between training, adaptation, and rest. Has your rest taken a recent decline? How are you sleeping? Is work stressful? These are all things to consider when assessing how well you a recovering.
#2: Running Gait
Oftentimes, runners with low back pain have a running gait issue, for example, over-striding, excessive pelvic drop, or an upright trunk.
- Excessive pelvic drop can occur during the stance phase of your gait when the hip counter to your stance leg drops lower than the other. On the side which is dropping lower, compression occurs in the lower back, leading to increased loading in the spine along the facet joints. Eventually, this may lead to inflammation and pain.
- Over-striding refers to reaching your lead foot too far out in front of you while running. This is primarily due to low cadence. Over-striding limits sufficient joint flexion at your hips, knees, and ankles, robbing you of your vital shock absorbers. The force is then more likely to be absorbed by the back.
- An upright trunk occurs when we run without a forward lean. Leaning too far back will lead to your glutes not being properly utilized to stabilize the body or absorb impact forces. Instead, your paraspinal muscles are forced to take the load.
If you have the chance, it is recommended to contact a professional who can offer a 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.
Otherwise, we will look at some exercises later that may help correct these gait discrepancies!
#3: Muscle Imbalance
Muscular tightness and imbalance in the hip flexors and glutes can negatively impact muscle activation and force absorption.
For many of us, office work is a fact of life. Unfortunately, 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. This can be a contributing factor to the aforementioned gait errors.
You can test muscular imbalance by doing single-legged exercises or stretches.
#4: Muscle Strain/Weakness
A general lack of strength or capacity in the muscles of the lower back puts you at risk of getting a strained muscle.
Pain in the lower back that occurs from a muscle strain is typically short-lasting and easier to identify. With adequate rest, it should begin to improve in a matter of days.
You can use ice and/or heat alongside gentle stretching to help with the symptoms.
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, and here he tells us about 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.”
An honorable mention is; 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.
Can I run with lower back pain?
Most of the time, you can continue running with lower back pain.
The likelihood is that if you’re suffering from a recent muscular strain or highly acute bout of lower back pain due to overtraining and you feel pain when walking or as soon as you start running, your body could probably do with some rest.
Continuing to run with lower back pain may slow the healing process and prolong the course of the injury. If the symptoms are mild and don’t deteriorate with exercise, then a reduced volume of running is certainly possible.
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.
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.
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.
How To effectively treat Lower Back Pain When Running
There are many techniques that you can implement to your training regime that will help you get back running pain-free and also prevent your lower back injury from re-occurring.
Understandably, there may be a reluctance to exercise out of the fear that any exercises or stretching will aggravate your back pain, but don’t worry; most exercises can be scaled back to suit you in your current state.
It is highly recommended to see a professional personal trainer or physio, as they can offer you a personalized route to recovery.
The key part of a rehabilitation program is activity modification. Rest may be helpful in the first few days or weeks whilst the pain is severe. But the likelihood is that beyond that time frame, you will begin to lose conditioning. Muscles can tighten and get weaker if you leave them for too long.
A prescription of stretching and mobilization alongside a staggered and progressive strengthening program is likely to be highly effective.
Overuse is the most common cause of lower back pain when running. Your best bet, in the long run, is to strengthen the muscles in the lower back, building your load capacity and thus reducing your risk of aggravating them.
As you return to running, slowly increase your running (distance, speed, frequency); 5-10% per week is generally a safe amount.
We’ll provide some example exercises in a moment!
Other tips to help you heal are:
- Soft tissue massage – Getting a massage for your lower back can help ease the tension, which may help reduce the pain and discomfort experienced. Seek out a qualified Sports Massage Therapist local to you.
- Differentiated terrain – If you run on concrete all year round, you may be more prone to lower back pain. Try mixing in softer terrain, such as grass or trails, alongside your road training. This can have a buffering effect on the lower back.
- Crosstraining – The body thrives on variety. Just because you can’t run or can’t run far doesn’t mean you can’t exercise. Exercise modification includes cross-training activities such as swimming, cycling, or hiking. Make sure they don’t aggravate your symptoms.
4 Exercises for lower back pain
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?
As previously mentioned, I highly recommended seeing a professional personal trainer or physio. If any of these exercises cause excessive pain, stop.
All of these exercises can be modified to be made harder or easier, depending on what your body needs.
Exercise 1: Supine Glute Stretch
Begin with holding the stretch for five seconds and gradually progressing over time to 60 seconds.
Repeating for 5 sets of 30-60 seconds.
Exercise 2: Resistance Band Clamshell
A great exercise for promoting glute activation.
Try 3 sets for 15 repetitions.
Exercise 3: Resistance Band Deadlift
This is a great compound exercise that will engage your whole posterior chain. To make it harder, increase the length of time you lower the bands back down. You can eventually move on to dumbbells or barbells.
Try 3 sets for 10 repetitions.
Exercise 4: Bulgarian Split Squats
This will be a real test for your quads and glutes. It’s a great compound movement that will also require proprioception from the other leg.
Try 3 sets of 10 repetitions.
There are plenty more exercises. Take a look at some of our other resources!