Lower Back Pain After Running

Running is a widely popular sport and a recreational activity. It offers a range of benefits, including bone strength, cardiovascular health, and endorphins. However, less popular are the aches and pains that come from running.

A lot of people across the world get injured when running each year. Lower back pain after running is a common issue and can affect runners at all levels. Elite runners and recreational runners alike may experience a dull ache or sharp shooting pain in the lower back after running. These symptoms can interfere with running and all the benefits that come with it.

Our Physical Therapists in San Ramon, CA, are trained in assessing running-related injuries and finding the best solutions for our patients.

What Causes Lower Back Pain After Running?

There are a few reasons why the lower back may be symptomatic after running. This includes:

• Lumbosacral strain: Muscle imbalance, where some muscles are tight and others are weak, can put a disproportionate amount of pressure on the lower back. This can lead to muscle strain, and symptoms of pain especially whilst running.
• Trigger points: Trigger points are areas of tight muscles, or “knots”, which can cause tenderness in the muscles. Therefore, muscle pain may be the cause of lower back pain after running. As running is a high intensity activity, it can cause changes in the muscles. If the muscles do not have adequate time to repair and recover, it can result in symptoms in the lower back.
• Facet joint irritation: The facet joints are the small joints in between the vertebrae (spinal bones) that allow movement and flexibility. However, when these small joints are overloaded or stressed during running, they may spasm or become inflamed. This irritability can result in lower back pain.
• Sacroiliac joint dysfunction: The sacroiliac joint is the joint between the spine and the pelvis. As a lot of load travels through this joint with every step, it is susceptible to injury or pain. In some cases, this can be the cause of lower back pain after running.
• Hamstring strain: The top of the hamstrings is situated near the area of the spine. Therefore, symptoms in the hamstring may actually feel like they are in the lower back. The hamstrings are one of the large muscle groups used in running, therefore this may be the cause of any symptoms of lower back pain during running.
• Tendinopathy: Tendinopathy is an overload injury of the tendon. If tendinopathy is affecting the muscles near or around the spine, such as the gluteal muscles or hamstrings, then it can radiate or cause issues in the spine, contributing to lower back pain.
• Disc herniation: Less common is disc herniation, where the intervertebral discs that are situated between each vertebra are compressed. Part of the disc can protrude into the spine, causing lower back pain and other symptoms – especially during high impact activities like running.

Running may not always be the direct cause of the symptoms. As running increases the load on the body, this may just be the trigger for the symptoms during or after a running session. It’s therefore important to consider all the factors that contribute to running-related lower back pain.

Risk factors for running-related lower back pain

Lower back pain is complex. There are a lot of contributing factors that can result in symptoms in the lower back. Some of the risk factors for developing lower back pain from running include:

• Long running distance every week
• Rapid increases in distance or intensity of running
• Inadequate warm-up or cool down
• Inadequate rest between running sessions
• Muscle weakness or deconditioning
• Lack of flexibility
• Low physical fitness levels
• Poor technique
• Poor biomechanics, including hip and knee alignment
• Past history of injuries
• Unsupportive footwear
• Hard running surface

As there are so many factors that contribute to the risk of developing lower back pain from running, it’s important to get assessed by a trained health provider. A Physical Therapist can assess all the contributing factors to lower back pain, and develop a customised training and treatment plan to help improve symptoms and promote recovery.

When To Consult A Medical Professional

Whilst most cases of lower back pain from running can be explained by mechanical or soft tissue injuries, there are cases when lower back pain is caused by more serious underlying pathology. All cases of lower back pain should be aware of the “red flag” symptoms – that is, the signs and symptoms that are unusual, concerning, or unexpected. This may include pain when coughing or sneezing, persistent or unrelenting pain, sudden loss of muscle movement or sensation, loss of bladder and bowel control, confusion, and more.

If any of these red flags are present, a doctor should be consulted immediately. These signs and symptoms could indicate serious medical conditions such as infection, stress fracture, nerve impingement, and more.

Symptoms Of Lower Back Pain After Running

Running may cause a wide variety of different symptoms in the lower back. This may include muscle aches, a dull tenderness in the lower back or surrounding areas, or pain when standing on one or both legs. It may also affect performance and endurance, and some people may even be fearful of movement and start to avoid running or other activities altogether.

The good news is that lower back pain after running can be effectively treated with the right input and support. Physical therapy is usually a great place to start for managing lower back pain after running.

How Is Lower Back Pain After Running Treated?

The treatment for lower back pain depends on the severity and cause of the symptoms. One of the common treatments for lower back pain is exercise.

Exercises For Lower Back Pain After Running

It might feel like exercise should be avoided during an episode of lower back pain. However, exercise can actually be very beneficial to alleviate and resolve symptoms. This may also help prevent future episodes of lower back pain after running.

Exercises for lower back pain after running will be prescribed by a Physical Therapist. Our Physical Therapists select each exercise to target the specific areas of weakness or dysfunction. As the spine is a complex network of joints, muscles, and other soft tissue, no two cases of lower back pain after running are the same. Therefore, the prescribed exercises are tailored to each individual for the best effect. Some common exercises may include:

• Pelvic tilting
• Lumbar rotations
• Abdominal or deep core muscle activation
• Whole-body movements
• Flexibility and stretching
• Leg muscles

The Physical Therapist will guide you with the dose and the type of exercise, as well as instructing on what sensations should be experienced and when to cease the exercises. If there are any negative symptoms, it’s important to discuss this with the Physical Therapist so they can monitor and make adjustments as needed. The duration of these exercises will depend on the cause of the symptoms and the severity. Most programs last anywhere between 6-12 weeks, with ongoing maintenance exercises thereafter.

Other Treatments For Lower Back Pain After Running

Treatment for lower back pain after running may also include input from a doctor. A doctor may prescribe medications for pain relief or other interventions that can help settle any symptoms and allow better participation in treatments like clinical Pilates classes or rehabilitation classes.

In some cases, a period of rest from running may be required to allow the structures in the spine and surrounding areas to settle. A Physical Therapist can then help guide a return to running program. This may start with walking, then proceeding to hopping and jumping movements, and then a progressive running plan.

How To Stop The Tightness

Whilst not all cases of lower back pain are preventable, there are several strategies that can help reduce the onset of lower back pain after running. These strategies include:

• Completing an adequate warm-up and cool-down
• Avoiding overtraining to help prevent overload and excessive fatigue – a good rule of thumb is to limit increase in distance or intensity to only 5-10% from week to week
• Wearing appropriate footwear – this may include getting a professional fit from a running or footwear store to ensure the right fit and subsequent loads through the foot
• Maintaining a healthy lifestyle, including eating and sleeping well and avoiding prolonged periods of sitting
• Adjusting running form and biomechanical issues to ensure proper alignment and load bearing when running
• Resting adequately between each running session to allow the body time to recover and repair from the load
• Completing a regular exercise routine – consistency is critical, as is working on key muscle groups for running in terms of strength and flexibility
• Shifting to running on softer surfaces, such as rubber running tracks – this can help minimise the forces that travel through the muscles and joints

Run Away From Lower Back Pain 

Lower back pain doesn’t have to slow the body down. Whilst it can be a frustrating thing for runners that experience it, lower back pain can be effectively managed and treated with the right help and treatment. Our San Ramon Physical Therapists are here and ready to help runners at all levels to resolve injuries, improve performance, and help them reach their running goals!

Stride out with Ironhorse Physical Therapy. Contact our experienced team to book an appointment!

Always seek guidance from a medical professional about any specific health questions or issues.

References

Physiopedia. Low back pain. Available from: https://www.physio-pedia.com/Low_Back_Pain

Physiopedia. Low back pain and young athletes. Available from: https://www.physio-pedia.com/Low_Back_Pain_and_Young_Athletes