Can Running Cause Lower Back Pain? (Plus: The Solution If It Does)
Why Does My Lower Back Hurt When I Run?
You’re not alone if you suffer from lower back pain: Studies show that more than 80% of us will deal with it at some point in our lives.
And if you’re a runner? While the prevalence of lower back pain in runners is actually less than in the general population (in fact, running can even help protect your discs from injury), the repetitive stress of running can amplify the effects of structural asymmetries, joint dysfunction, or muscle imbalances that are already present. It’s something I work with my patients on every single day as a chiropractor in Brookfield, WI.
In other words, whatever weakness or biomechanical dysfunction you have that’s leading to lower back pain probably isn’t caused by running – but the impact your body absorbs while running is making you notice it much more than you would otherwise.
Fortunately, the types of back pain associated with running usually have specific causes that are readily treatable – or avoidable altogether with simple modifications to your training routine. And even more importantly, you can reduce the likelihood of more serious injuries in the future by addressing these problems early on.
So if you’re one of the unlucky runners dealing with back pain, we’re going to explain what’s most likely to blame for your lower back pain along with the form modifications, exercises and stretches you need to be doing to get back to running pain-free again.
Where is the pain coming from?
There are a huge number of possible sources of lower back pain; in fact, there are over 150 different structures that are known to cause lower back pain. So instead of listing them all, we’re going focus on the four most common causes of lower back pain symptoms that can be aggravated by running.
- Anterior Pelvic Tilt & Lack of Dynamic Pelvic Control
- Muscle Imbalances in the Hips, Pelvis & Lower Back
- Lack of Thoracic Spine Mobility
- Poor Running Form/Technique
1. Anterior Pelvic Tilt & Lack of Dynamic Pelvic Control
Whether you’re brand-new to running or have been doing it for years, you’ve probably heard the term anterior pelvic tilt. A host of running problems – including an altered stride, back pain and tight hips – can all often be attributed to the mysterious anterior pelvic tilt.
Anterior pelvic tilt (in which your “hip” bones tip forward and your tailbone tilts up and back) is, at its root, a muscle imbalance issue. Although the imbalance can be due to training incorrectly, it’s usually what you’re doing during the rest of the day that causes it in the first place.
It’s no secret that we’re all spending more time on our butts than we used to — and that’s causing major postural problems.
If you’re spending 8 hours every day in a seated position and don’t actively pay attention to your posture, you likely have inactive gluteus and core musculature, tight lower back muscles, and tight hip flexors, all of which combine to create the muscle imbalance that causes your pelvis to tilt forward.
Running then tends to magnify whatever pelvic tilt was already occurring.
How does it impact your running?
Tight hip flexors (the muscles directly to the left and right of your groin) mean you’re bending forward at the waist, leading to reduced hip extension and an overemphasis on hip flexion. Runners who lack range of motion at the hips consequently find themselves compensating by putting excessive arch into their lower back. This exaggerated backward curve is known as lumbar hyperlordosis.
If your facet joints (the joints where your vertebrae meet in the back of your spinal column) are already being jammed together due to an anteriorly tilted pelvis, it’s no surprise that subjecting them to compressive forces a few thousand times over the course of a 5k will lead to lower back pain.
Muscle-wise, not only does this anterior pelvic tilt and hyperlordosis make it difficult to engage your glutes, but it also places more demand on the muscles of your lower back – specifically your quadratus lumborum and erector spinae muscles.
Over time that’ll inevitably cause these lower back muscles to become overworked, tight and painful.
What’s more, studies show anterior pelvic tilt can be blamed for runner’s knee, IT band syndrome, patellar tendonitis and a host of other knee problems.
What can you do?
Obviously, finding ways to work movement and standing into your day so you aren’t sitting so much is an important part of preventing anterior pelvic tilt. But what if you’re already past the prevention stage?
Reversing anterior pelvic tilt requires a three-part approach.
First, you need to find a chiropractor who can fix any joint mobility issues in your pelvis that will keep you stuck in anterior pelvic tilt – specifically, you want to make sure your SI and lumbosacral joints are moving like they’re designed to.
Second, you’ll need to loosen the muscles that are tight and shortened – your lumbar extensors and hip flexors. You can achieve this with myofascial release techniques (foam rolling, IASTM, etc.) or with active release therapy by a pro.
Finally, you’ll need to strengthen the muscles that counteract those tight muscles, which include the hamstrings, glutes and core musculature.
Make sure you’re including these in your workouts:
- Lower ab and external oblique work: Planks, side planks and dead bug progressions will do the job.
- Hip extension/hip hyperextension work: This includes hip bridges, lunges and front squats. These all help you reach complete hip extension.
- Stabilization work: Anything that forces your body to stabilize through the torso (planks, pallof presses, and unilateral work) are all good choices.
2. Muscle Imbalances in the Hips, Pelvis & Lower Back
Of course, that’s not the only muscle imbalance that can cause problems for runners. Your hips, pelvis, and lower back are a crossroads in the body, where a ton of important muscle groups come together to work in harmony.
For us to move properly as we run, we need to achieve and maintain a balance between the actions of the various different muscle groups in this area. These muscles are also essential for providing stability around each joint.
When an imbalance is created, whether due to myofascial restrictions, joint hyper- or hypo-mobility, or weakness/inhibition of a muscle group, our bodies are great at compensating and simply getting the job done.
Unfortunately, this ability to compensate for muscle imbalances short-term can cause real long-term problems.
For example, weakness or inhibition of the hip abductor muscles (the gluteus medius and minimus) can majorly interfere with your running form and lead to SI joint injuries, piriformis syndrome and groin pain.
What can you do?
Unfortunately, if muscle imbalance issues are to blame for your running problems, it can be tough to identify the underlying cause of the dysfunction – on your own, anyway. That’s where a physical therapist or sports chiropractor comes in. They can determine where the breakdown is happening.
3. Lack of Thoracic Spine Mobility
Running is obviously a lower-body dominant activity, but it’s definitely not an exclusively lower-body exercise. Running really depends on proper movement throughout your entire skeleton allowing you to generate force and absorb impact efficiently.
Dysfunction in one area will inevitably cause problems elsewhere. This is especially true in your thoracic spine – the 12 vertebrae between your neck and lumbar spine that make up your mid-back.
Your thoracic spine needs to be able to move freely in flexion/extension and rotation when you run. If it doesn’t, then that motion will come predominantly from the lower back instead. This is especially common in the many ‘office-based athletes’ who suffer from lower back pain while running.
How does it impact your running?
A ‘stuck’ thoracic spine prevents full rotation: This in turn forces other muscles to work overtime and puts you at a much greater risk for injury. Plus, inefficient biomechanics lead to unnecessary energy expenditure – energy you could be using to propel your way to faster 5k times.
Tightness in your thoracic spine affects your arm swing: And as my high school track coach taught me, arm drive is actually a pretty important piece of the running puzzle. An immobile thoracic spine compromises the “lever” function of the arms during running, making you less energy efficient. The result: you run slower.
You need full motion of your thoracic spine to benefit from core strength: In other words, no matter how many planks you do, you’ll never reap the full benefits of your labor if a rigid thoracic spine is preventing you from moving in a way that puts those muscles to work.
What can you do?
Stop slouching: The biggest culprit for T-spine woes is today’s modern lifestyle, in which slouching and poor posture are rampant. We simply sit too much without paying attention to how we’re sitting. Even those at standing desks often find themselves hunched over their workstation.
Stress is also a huge contributor, as many of us hold extra tension in our traps and upper back muscles.
Do thoracic spine mobility work on your own, and find a chiropractor to take care of what you can’t do by yourself: Stretch, get to know your foam roller more intimately, and then get adjusted regularly.
4. Poor Running Technique
All of the factors described above will be magnified by running with poor form. Running with a focus on your technique allows your body to distribute the impact caused by running and helps you maintain better control of the lumbopelvic region.
The basics of good running form are all important here:
- Keep your core and glutes engaged.
- Look straight ahead. Avoid tilting your head down and slumping your shoulders.
- Puff your chest out, and keep your shoulders down and back.
- Keep your hands loose, and use a relaxed arm swing. Avoid crossing your arms in front of your body.
The easiest, most effective change you can make to your running form to protect your lower back? Shorten up your stride.
Heel strikers sustain more impact injuries to their feet, ankles, knees and lower back than those who land on their mid or forefoot and allow their arches to act as natural shock absorbers. The most efficient and least injury-prone runners shorten their stride, land on the midfoot, and keep the running motion smooth, light and flowing.
5. Everything Else
Of course, this is far from a comprehensive list. Here are a few other common causes of lower back pain associated with running.
You’re dehydrated (or low on electrolytes): If you didn’t hydrate properly before or during your run, or if it’s a particularly hot day out, dehydration and a lack of electrolytes can actually cause the muscles in your lower back to spasm. In fact, when you ‘hit the wall’ on a run, it’s far more likely because you’re dehydrated and low on sodium, not because you didn’t eat enough carbs. Make sure you’re getting enough water (and salt) before a run.
Overuse: Taking on too many miles too fast without giving your body ample time to adapt and recover can lead to muscle strain. The good news is that this type of back pain is typically short-lasting and relieved with a few days of rest, ice and/or heat therapy, and gentle stretching.
Your footwear isn’t supporting your body: Wearing unsupportive running shoes can cause abnormal running form, which then causes jarring in the structures of the lower back. People often associate foot injuries with poor footwear choices, but they can cause knee, hip and back injuries too! We’re huge fans of FootLevelers XP3+ custom orthotics, which are specifically designed for runners. They’re a great investment if you’re serious about running, since they’re custom-made to give your feet, legs, and back exactly the support they need.
Got Back Pain?
Remember, running shouldn’t be painful – pain isn’t normal! And whether you’re training for ultramarathons or just hitting 5ks on the weekends, study after study shows that regular chiropractic care is an essential part of reaching your full potential as a runner.
Ready to perform at your peak and need a Brookfield chiropractor? If you’re reading this, you probably already know that the results we get at Ascent Chiropractic are second to none. To make an appointment at Ascent Chiropractic, call 262-345-4166 or schedule an appointment with our online scheduling app.