Lower Back Pain When Running? Here’s Why (and How to Find Relief)
Medically reviewed by Theresa Marko, PT, DPT, MS
Lower back pain while running affects between 0.7% and 20.2% of runners and is the leading cause of disability worldwide. Lower back pain while running could result from a new injury or be a symptom of a pre-existing issue.
This article covers the reasons you may have low back pain during or related to running, as well as ways to find relief and tips for prevention.
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What Causes Lower Back Pain When Running?
Pain between the buttocks and lower ribs is lower back pain. Some people notice that running aggravates pain in this area. Below are some possible causes of lower back pain during running that might be relevant to you.
Overuse
Overuse injuries are when you repeatedly use the same body part, leading to micro-traumas in the muscle, bone, or connective tissues. Running is a repetitive movement, particularly at long distances, which can lead to lower back pain. Long-term running, especially for six or more years, increases the risk of lower back pain.
Muscle Sprains and Strains
Injury, including muscle sprains and strains, is a leading cause of lower back pain among runners. You may experience a sprain or strain if you:
Don't cross-train
Don't have core-stability exercises in your routine
Don't warm up
Don't wear proper footwear
Increase your speed or distance too quickly
Run with improper form
Muscle Imbalances
Muscle strength or position imbalance while running can lead to injuries, including lower back pain. In particular, poor flexibility in the hamstrings and back and lack of hip flexion range of motion are risk factors for lower back pain among runners.
Disc and Joint Stress
Running can put a lot of stress on your joints and the discs in your spine when running on hard surfaces like roads, sidewalks, and tracks. This is particularly true if you do not warm up properly, push yourself to run too far for your fitness, or are overweight. With time, this pressure and stress on the joints in your lower back can lead to pain.
Risk Factors for Low Back Pain in Runners
A 2020 systematic review found that risk factors for lower back pain among runners included:
Body mass index (BMI) greater than 24
Leg length differences
Not doing aerobic activity weekly
Poor back flexibility
Poor hamstring flexibility
Restricted range of motion in hip flexion
Running for more than six years
Taller height
How to Find Relief From Lower Back Pain When Running
Below are some tips on relieving lower back pain if you experience it before, during, or after running.
Stay Active
Staying active is one of the best ways to manage lower back pain. While this may seem counterintuitive, immobilizing for over two days can cause more harm than good.
It is crucial to keep moving, even if you're moving differently. Focus on gentle stretching, core strengthening, or physical therapy exercises instead of running your usual distances for a while.
Heat Therapy
Applying a heating pad or hot compress to your lower back may help relieve some initial pain. A warm bath or sitting in a hot tub or sauna may help ease soreness.
OTC Pain Relievers
If your lower back pain affects your ability to get things done, take an over-the-counter (OTC) pain reliever like Advil (ibuprofen), Tylenol (acetaminophen), Aleve (naproxen), or Bayer (aspirin).
Physical Therapy
Physical therapists (PTs) specialize in biomechanical issues and can thoroughly analyze your lower back pain and prescribe you a personalized exercise plan. If you have a primary care provider, ask if they can recommend a physical therapist. However, you don't need an official referral to see a PT; you can go directly to a doctor of physical therapy for treatment.
How to Prevent Lower Back Pain From Running
The primary prevention for lower back pain from running is to see a doctor of physical therapy for joint alignment and mobility, muscle strength and flexibility, and stability assessment. They can help you identify areas of your body that might need support.
Stop lower back pain from running before it starts using the prevention methods below.
Stretch
Stretching is an essential step for preventing lower back pain from running. Poor flexibility, particularly in the hamstrings and back, is a risk factor for lower back pain in runners. Research shows that improving flexibility in the back can increase your range of motion and improve functional movement patterns.
Warm Up
Be sure to properly warm up each time you run to prevent lower back pain and other injuries. Among marathon runners, lower back pain has been linked to insufficient warm-ups.
Consider a short, slow-paced jog to warm up and stretch your hips, back, and legs. Once warmed up for five to 10 minutes, proceed to your usual workout.
Stay Hydrated
Stay hydrated while you're exercising. Our body's connective tissues and the discs between the vertebrae in the lower back are all made up of a significant amount of water. Keep these tissues healthy by drinking water.
Adjust Your Running Form
Running with poor alignment or an inefficient gait pattern can increase your risk of lower back pain and other injuries. One study found poor running form was a risk factor for low back pain among half-marathon and marathon runners.
Adjusting your running form can prevent low back pain. Visit a local sports shop or physical therapist for a running gait analysis.
In general, try to:
Engage your core
Keep your head neutral with a forward gaze
Lift your chest
Keep your shoulders back and down
Keep your hands loose
Keep your arms on a forward (not crossing) swing pattern
Avoid heel striking
Hit the ground mid-foot
Change Your Running Surface
Changing your running surface may help you avoid lower back pain and other injuries. Running on hard surfaces like concrete puts the most stress on the body.
You might think that trail running would present a risk of injury due to obstacles like tree roots or terrain changes. However, research indicates that trail runners have a lower risk of injury due to slowing their pace when faced with these obstacles.
Likewise, running on a treadmill surface also puts less stress on the joints due to some kinetic differences, like a shorter step length and increased cadence (number of steps per minute), which can lead to a lower risk of injury than overground running.
Strengthen Your Core
Increasing your core strength can provide more support for your lumbar (lower) spine and decrease your risk of lower back pain.
Adjust Your Footwear
Sometimes, lower back pain can result from faulty footwear. Perhaps your shoes don't fit well, or maybe they aren't suitable for your running style (for example, people with lower back pain might need more cushioning at the heel for stability or a higher arch support).
Consider a consultation at your local sports store before buying your next pair of running shoes.
Try Cross Training
Cross-training—doing another type of aerobic activity that uses different movement patterns, like cycling or strength training—can be beneficial for runners in preventing lower back pain from overuse injuries.
In general, research shows that aerobic exercise is helpful for lower back pain recovery because it increases blood flow and delivers essential nutrients to the soft tissues in the lower back. This can speed up the healing process.
Avoid Overtraining
Try to avoid overtraining. Running is a repetitive movement that can stress the joints and muscles. Be sure to give your body rest days to recover and build muscle.
Should I Continue Running If My Lower Back Hurts?
In general, pain is a sign of something wrong in the body. It may be okay to continue running if you have mild soreness in your back, but anything worse than that could be a sign of a sprain, strain, or injury.
Take a few days off running, switch to gentle stretching and strengthening, and see if that helps. Your back may be inflamed and need some rest from overuse. If the pain continues, consider changing your training plan, cross-training, getting a gait analysis, adjusting your footwear, or consulting a healthcare professional.
When to Contact a Healthcare Provider
Talk to a physical therapist if your lower back pain doesn't go away within a few days, gets worse with running, isn't relieved by stretching or reducing your training, or isn't helped by over-the-counter pain relievers. Treating your pain before it becomes a more severe injury could be the difference between your ability to continue running or not.
Summary
Lower back pain is a significant issue and the leading cause of disability worldwide. Runners can experience lower back pain due to an injury or the aggravation of a previous injury. If you're a runner, take steps to prevent lower back pain by warming up properly, stretching, cross-training, and more. Consult a healthcare provider if you experience lower back pain that doesn't improve with rest or medication.
Read the original article on Verywell Health.
