Back pain is a remarkably common issue: 80 percent of adults will experience low back pain at some point in their life, according to an April 2021 review in the Journal of Functional Morphology and Kinesiology. The problem is exacerbated by excess sitting and strain put on the neck when staring down at cell phones (referred to as "tech neck").
It can be extra frustrating, then, if you've started a new exercise regimen (say, the popular 12-3-30 workout that calls for walking on a 12 incline at 3 miles per hour for 30 minutes), only to find that walking on the treadmill is causing you back pain, too.
Movement is often prescribed to help with back pain, so what can you do when walking or running on the treadmill seems to be causing the problem?
Causes of Back Pain on the Treadmill
If you're feeling pain in your back after a treadmill workout, it's likely either in the low back or in the neck and shoulders. The low back is supported by the lumbar spine, the curved section above the buttocks. The neck is made up of the cervical spine. Connecting the two is the thoracic spine.
While a lot of the biomechanics of walking on stable ground and walking on a treadmill are similar, it is not entirely the same movement, and working out on the treadmill can reveal weaknesses in the body.
According to the American Academy of Orthopaedic Surgeons, maintaining proper posture while you sit, stand and move is very important in preventing back pain.
Walking on a treadmill with poor posture is going to put pressure on your spine in ways that the body wasn't built for. "What happens is the force from gravity can't be attenuated the same way," Natalie Niemczyk, DPT, doctor of physical therapy, says. "The spine is designed so that it can attenuate the force appropriately that you don't even notice." Poor posture, especially rounded shoulders, causes a lot of that force to be applied on the low back.
Correcting for "good" posture can be hard — be patient and expect that it will take time to fix the issue. "The biggest advice I always give is that it's better to be conservative and start slow, and then introduce some of those little tweaks that might help your natural posture," Niemczyk says.
Some of those little tweaks to think about while on the treadmill:
- Keep a neutral gaze ahead of you and a neutral spine.
- Hold your shoulders slightly back, while keeping your arms loose.
- If you are running or walking on an incline, you'll want to lean forward about 10 degrees in your trunk.
"It's normal to lean forward as you walk uphill or up an incline, but too much may indicate it's too steep or you are going too quickly," Ben Fung, DPT, says.
Weakness in Stabilizing Muscles
Having certain weaknesses in stabilizing muscles like the core and the posterior chain (the muscles that make up your backside like the low back, gluteals and hamstrings) can lead to fatigue, which can affect your posture.
According to the Journal of Functional Morphology and Kinesiology review, core stability exercises can be very effective in improving everyday low back pain that is not caused by a specific trauma.
In order to walk on the moving belt of the treadmill, your body also has to work slightly differently than if you were propelling yourself forward on the stationary ground. It requires more work from the hip flexors, in particular, according to Lauren Shroyer, MS, certified athletic trainer and vice president of product and innovation for the American Council of Exercise.
"The hip flexor muscles are the muscles that will lift your leg up from behind, pull it back forward, so that you can step your foot down again," she says.
That is only compounded when you are walking on a steep incline (anything above a 5 on the treadmill), like what is called for in the 12-3-30 exercise. "We don't tend to have that kind of strength in the hip flexor," Shroyer says.
How to Avoid Back Pain From Treadmill Walking
If posture and muscle strength are some of the main reasons you're experiencing back pain, then you can expect that working on those off of the treadmill will help (see below for some exercises to help). But like with all training, you won't feel those results immediately.
Lower the Intensity
Something you can do right away: pull back. If you're starting to feel sore in your low or upper back on the treadmill, it may be a sign that you're doing too much too soon. Try lowering the incline, slowing down the speed or cutting the amount of time or frequency you're spending on the treadmill.
Holding onto the treadmill will also force you out of that neutral posture, so slowing down or lowering the incline to a setting where you can safely let go and let your arms swing, will help to alleviate the curved upper back.
Diversify Your Workout
"With many things, balance is key," Fung says. In order to mitigate back pain that can occur while walking on a treadmill, he recommends diversifying your workout routine. "The spine doesn't appreciate extreme or repetitive loads," Fung says, which is why sitting for long periods of time can also aggravate your back.
Treadmill exercises involve repetitive forward movements in the sagittal plane. Incorporating exercises in the transverse (cross-body, e.g. dead bugs) and frontal (side to side, e.g. side leg lifts) planes are key to building that balance.
Strength and Posture Training Exercises
The following exercises come from tips from both Shroyer and Niemczyk, with a focus on improving posture and building strength in the core, hips and upper back.
What it's good for: hip flexor strength
- Stand with your legs shoulder distance apart with a neutral spine.
- Lift your right knee into a marching position. Lower it back down.
- Repeat with your left knee.
- Be sure not to arch your back when you lift your legs. Repeat 15 times on each side.
To progress this move, you can add ankle weights or a resistance band to make the move more challenging. To use a resistance band, step onto the bottom of the loop so that one side of the band rests on top of your foot, pulling the band as you raise one leg or the other.
What it's good for: core and shoulder strength
- Get into a high plank with your wrists stacked underneath your shoulders.
- Unlike a regular push-up, you’re going to keep your arms straight the entire time, while dropping your ribs and chest down and pinching your shoulder blades together at the top.
- Raise your spine toward the ceiling while pulling your shoulder blades back down.
- Repeat 8 times.
If holding a plank is too much, you can do scapular retractions while sitting upright in a chair and squeezing your shoulder blades together. Relax and repeat 8 times.
What it's good for: core strength
- Get into tabletop position, with your hands directly under your shoulders and your knees under your hips.
- Reach your left arm straight out in front of you while simultaneously reaching your right leg behind you. Pause for a moment before returning your hand and knee to the ground.
- Repeat 5 times, then switch sides.
What it's good for: hip flexor and core strength
- Lie flat on the ground with your arms at your side. Bend your knees while keeping your feet on the ground, hip distance apart.
- Drive your hips into the air, keeping your shoulders planted on the ground. Hold for a few seconds, engaging your glutes. Then slowly lower back down to the ground.
- Repeat 10 times.
Single-Arm Dumbbell Bent-Over Rows
What it's good for: upper back strength
- Hold a medium-weight dumbbell in your left hand.
- Keeping your left foot firmly planted on the floor, place your right knee on a bench in a kneeling position. Hold onto the bench with your right hand. Keep your back flat and your left arm extended toward the floor.
- Pull the dumbbell up in a rowing motion to rib height, focusing on using your back for the motion. Lower your arm back down toward to floor.
- Repeat 6 times.
- Switch sides and do 6 more repetitions.
When to See a Physical Therapist
Shroyer likes to see people feeling invigorated after a workout and generally feeling better after than they did before. "If you're leaving your workout and your back hurts, or the next day your back hurts more than it did the day before, that's a very strong indicator that you need the support of a professional to really understand how to adapt your exercise so that you're not doing further damage."
According to the American Physical Therapy Association, bed rest or inactivity is not recommended for treating back pain. Instead, they recommend movement. A physical therapist can help you find the type of physical activity that will be best for your sore back.