A common complaint for runners
Low back can be a common complaint for runners and one that we treat a lot a my clinic.
It can make running very uncomfortable and it can really get in the way of you doing those long runs at the weekend.
The first thing that I like to find out from a runner (or anybody) when they come to see me in the clinic is their story of how their pain came about. This is key, as everyone is different and everyone will have different events in their lives that will have led to them experiencing this pain. Understanding someones story is the first step in our six step treatment process.
But, for the purpose of this article, I’m going to group the most reasons that I see for runners experiencing back pain.
1 – Stiffness through the ribcage.
The ribcage has such an important roll to play in back pain and with movement through the rest of the body. In order to run ‘freely’ (if that is even a word), the ribcage and the muscles that surround the ribcage need to be able to move well.
Stiffness around the ribs can have two big impacts on runners.
Firstly, if they are elevated too much and are not able to depress properly, then this will cause an excessive curve in your lower back causing a shortening of the low back muscles. If your low back muscles are constantly in a shortened position, then they will get stiff, grumpy and get sore.
An elevated ribcage will often couple with a anterior pelvic which I will discuss later.
The second reason a stiff ribcage can lead to problems when running is due to the rotation movement that is required when running. When your foot travels forward the same side ribs travel backwards. If this cannot happen it will affect the efficiency of your running and you will be taking advantage of the natural elastic energy that occurs when muscles are lengthened.
2 – Running with an extended back or too upright
A lot of runners will have been told to run with an “upright posture” or keep “your shoulders back”. ….
..and this may have been good advice if that person was very slouched or too hunched over.
But, it can have the opposite effect if it people take it too seriously.
As discussed above, if someone is running with a back that is too straight, they will more that likely have an excessive curve in their back , which will cause shortening of the low back muscles and can lead to back pain.
Having a slight forward lean also has other benefits. It will help you land on your forefoot more, rather than your heels.
It will give you forward momentum and it will also put you glutes in more advantages position to work effectively.
But, only a slight lean of around 8 – 10 degrees is necessary.
3 – A Pelvic Drop
A pelvic drop is where the gluteal muscles of the standing leg cannot fully support the weight of the other side of the body, and the opposite side drops.
As running is pretty much a single leg sport where you go form one leg to the other, so if this is happening every strife or two, then problems can occur.
Pelvic drop on one side can also lead to other problems such as hip and knee pain but lets just focus on how it can affect the back for now.
As the hip on one side drops your back will have to compensate by bending further up, in other to keep you upright and keep your head level.
This can lead to muscles having to work constantly to maintain this position and they will get tired and grumpy. It may also cause some facet irritation at the spine.
Again, as with the other two points above, some muscles will be working harder to compensate, which will lead to fatigue, which will lead to stiffness and pain.
Meaning, your running will not be as enjoyable as it should be.
4 – Tight Hip Flexors
… which will lead to limited hip extension.
..which will lead to an anterior pelvic tilt.
… which may lead to back pain.
As in point number 1, tight hip flexors will lead to an anterior tilt when running, which will shorten your low back muscles (thereby working them harder than they need to during the course of your run.
Again, your will be as efficient a runner because tight hip flexors will not allow your calf, hamstring and glute to get into the adequate position to work and you will not be taking advantage of free ‘elastic’ energy that allows good long distance runners to glide along.
5 – Over Striding
Over-striding is where your heel lands too far out in front of your body when running.
When over-striding occurs it can cause more pressure on your joints as the force form the ground is not absorbed as well through your calf, hamstring, quad and glutes.
Instead, more force will travel up more through your knee joint pelvis and spine.
Over-striding is something that can be helped by taking more steps, which will shorten the length of your step.
Running should be free and natural
You can get very technical about running and go into great detail on running technique, but I far from an expert on that and do not want to go down that route.
What I aim to do, is to try and explain problems and injuries that people have in a simple and easy to understand way.
Running should be a natural thing to do and I think runners should run without thinking about their techniques too much, so long as they have no major postural flaws.
However, as you can see form the 5 points above, imbalances can and will lead to problems and pain for runners and these can carry on for a while, if not addressed properly.
At Midlands Physical Therapy we take runners through a step by step program that loads and exposes them to the right movements and ensures that they can go back running with the problem reoccuring.
If you are a runner who is struggling with back pain then you can apply for a free 20 minute discovery visit to see how we can help you first.
Or if you wan to bypass that you can book an appointment by calling the clinic on 09064 66761.