You've been waiting to log your miles all day. But instead of finishing with a sense of accomplishment, you feel a twinge in your lower back. Surprised? Don't be. Back pain, which the National Institute of Neurological Disorders and Stroke says 80 percent of American adults will experience, is common among runners.
"Our back is the center of our body, and its role includes providing a strong base for our limbs to work more effectively and efficiently," says Martin Ridley, a physical therapist at Tru Whole Care in New York City. "If our back is compromised during running, our limbs often times won't be able to generate enough strength or have to compensate by working harder, which can lead to over-use injuries."
Back pain, though, can be caused by a number of reasons, including weak muscles, lack of mobility, postural misalignments and deviations, and even disc dysfunctions, says Miriam Alicea, a NASM-certified trainer with a specialization in corrective exercise. That's why identifying and targeting the causes and triggers of the pain — not just the symptoms — is key in long-term relief and prevention.
Read more: 12 Running Mistakes You Could Be Making
First, Assess Your Situation
To start, a simple movement screening, which a physical therapist (or a personal trainer who has a Functional Movement Screen certification) can administer, can help pinpoint areas of the body that may be contributing to the tightness in your back. Based on that, they can prescribe corrective exercises tailored to your unique situation.
In general, though, stretches such as Cat pose (arching your back up while on your hands and knees) or Child's pose can help the muscles slowly relax, says Carly Graham, DPT, a physical therapist at Finish Line Physical Therapy in New York City, who is also a certified running coach.
If your pain doesn't improve with simple soft tissue maintenance, such as foam rolling and gentle massage, or with heat, which should help loosen up the tissue, Graham recommends seeking medical attention.
Here's why: Chronic pain, which typically last longer than three months, can create other changes to our body because of compensation. "This can lead to increased pain or having pain elsewhere along the body, thus making the pain more complex," Ridley says. "The longer you have an issue, the longer it may take to fix it, and the more likely you are to injure other body parts."
That said, here are five common reasons you are experiencing running-related back pain, and what you can do to about it.
1. Your Form Is Failing You
Whether you're pounding the pavement or just strolling around town, a tight body (think hunched shoulders) can wreak havoc on your running. Learn to loosen up and breathe.
"Keeping the shoulders relaxed and ribs dropped down into the belly can help keep the spine in its more neutral state," says Graham, who notes that often our natural reaction is to stiffen and protect when the back might be hurt. "Letting go of tension helps allow the normal movement and rotation that needs to occur to function and run normal." Also, be mindful of pulling shoulders down and back.
Pay attention to your head position as well, aligning your head and neck above your shoulders. For each inch your head, which is 10 percent of your body weight, is moved forward out of alignment, there's an extra 10 pounds of force on your posterior chain, says David Reavy, performance therapy expert and founder of React Physical Therapy in Chicago. This extra pressure increases the stress at your lower back.
Your foot strike also plays a role. Walking or running on the outside of your foot limits the power you can generate by using your entire foot evenly. "You don't use your sessions bones, which act as a rocking chair, a significant mechanical advantage that allows your glutes to fire when you push off," Reavy says.
So if you're a supinator, consider running sneakers with extra cushioning that are specifically designed with your foot type in mind — and remember to replace shoes before they wear out.
2. You're Overtraining
Like most common running-related issues, sudden changes in your training regimen, such as distance, intensity or speed, are often to blame. That's because these shifts place a bigger demand on the body.
"Our body needs to be trained properly for running longer distance or for running faster," Ridley says. "[It also] needs a gradual progression in loading to be able to handle increased intensity."
In other words, doing too much too soon doesn't give your bones, muscles and tendons — this includes your core's ability to keep your torso upright — time to adapt. A good rule of thumb according to Ridley: Don't increase your weekly mileage by more than 10 percent each week.
3. Your Glutes Need Work
Your strength — or lack thereof — could also be a culprit, especially when it comes to the trio of muscles in your butt — the gluteus maximus, gluteus medius and gluteus minimus. These big three (thanks This is Us!) are a source of strength for runners.
But when weak, "they may cause other muscles, like the back muscles, to become overactive or tight in order to provide stability through the trunk, core and pelvis," Alicea says. Her recommendation for shoring up your rear-end strength: squats and deadlifts.
4. You Don't Carve Out Time for Your Core
Your glutes aren't the only muscle that need attention. According to a January 2018 study published in the Journal of Biomechanics, runners with weak deep core muscles are at higher risk of developing lower back pain because it forces more superficial muscles like the abs to work harder, which results in an increased load on the spine.
To avoid this, steer clear of exercises such as sit-ups and Russian twists, Alecia says, which do very little for increasing stability. Instead, opt for moves like plank or bird-dog that involve isometric contractions that focus on neuromuscular control and the development of stability.
5. You’re Sitting Too Much
We all know your health takes a hit when you sit too much. (Psst! Research in the March 2019 Journal of Epidemiology found that replacing 30 minutes of sitting with any movement can lower your risk of death by 17 percent!)
But sitting also "causes your hip flexors to tighten, which then causes your pelvis to come out of alignment," Reavy says. "This causes an anterior tilt in the pelvis, which shuts down the abdominals and glutes." That results in a pulling on the lower back.
Not only is pain inevitable, but when hip flexors lose mobility, it can really mess with your running mechanics. Loosen them up by heading to your yoga mat (a June 2017 study published in the Annals of Internal Medicine found that getting bendy was just as effective as physical therapy) for Pigeon pose or Malasana (a yogi squat). Your back will thank you!
- National Institute of Neurological Disorders and Stroke: Low Back Pain Fact Sheet
- Journal of Biomechanics: Biomechanical consequences of running with deep core muscle weakness.
- Journal of Epidemiology: Potential Effects on Mortality of Replacing Sedentary Time With Short Sedentary Bouts or Physical Activity: A National Cohort Study
- Annals of Internal Medicine: Yoga, Physical Therapy, or Education for Chronic Low Back Pain