Two Causes Of Low Back Pain While Running

Is your lower back bothering you while you run? Is your lower back cramping up or just causing severe pain, which is hindering either the distance that you're able to run or just being able to run in general. This video is perfect for you. My name is Dr. Molly, with Your Goals Physical Therapy, and I absolutely love treating runners. Unfortunately, running does come with injuries and over the course of my practice, I have noticed that there are two big things that cause people to have lower back pain while they run.

The first one would be just from the force of hitting the ground. Some people end up with lower back pain, and that ends up being the thing that a lot of doctors tell you, “Hey, you just shouldn't run at all.” And, I have a little bit different take, so stay tuned.

Then the other one is when your lower back muscles are doing too much work, they are so strong that they are taking over and they are cramping. They're just so tight and constricted that it's causing you pain. 

Now. I actually have worked with many people over the years, so I'm going to highlight two people today. So Susie, when she came to me, she was 38. She had two kids that were in middle school and she used to run before she had kids, it was her like mental escape.  Once her kids were independent, she basically was like, “well, I have no more excuses. I can literally run in the morning before they go to school and get them off and everybody will be fine to go to work, but I do have to do it in the morning.” So she had to renegotiate some things, but she realized that now that her kids were independent, running could be a priority again.  She started running and she was doing so well at the beginning. Then all of a sudden her low back was nagging at the end of her runs. That nag became a little bit more intense slowly over time. It was taking away her ability to run and anybody who likes to run knows that is just not okay. It's like taking away your best friend.She used her runs as a decompression time. Without being able to run it was really making her moody. She noticed that her morning routine wasn't as smooth.  She was a lot more jittery and sharp with her kids. When she came to me, she was looking for not only peace from the low back pain, which was interrupting, sleep and messing with her at work. But it was also just not making her a very nice person because running really was her form of meditation. She wanted to get that back more than anything. 

Then there's mark. Mark was 45 and forever in a competition with himself. He's read so many things that tell him eventually he won't be able to run as fast or as long as he ages.  So right now he feels like this is his time, right? 45. I should be able to do everything I want. So instead of running half marathons and marathons, he decided he wanted to break into ultra marathon running.

Those really long runs where 10 miles is like the warmup. And so he was just very excited. But what he found is that he'd always had a little bit of discomfort when he was running at the end of his runs in his lower back. But now that he was doing those ultra long runs, he was having a whole lot of discomfort, and it was just stopping him from being able to achieve the goal of running these really long races. He came to me because he didn't want to feel like he was old and wasn't able to challenge himself like he was up until this point. 

Those are my two people, Mark and Sue. Let's talk about what happened with Sue? So Sue came in for her evaluation and I looked at posture, muscle tone, flexibility, and watched how she ran on the treadmill. And one thing that I noticed that was very obvious with Sue is that when she started off running, everything looked normal and good, but as she started to run, her lower back would actually arch. She would get more of a curve in her lower back. You're supposed to have this little curve in your low back while she started off normal and then it would get more extreme by the end. And with her range of motion, you just notice how tight those lower back muscles were. When she was getting some distance on her run, those muscles were tightening up even more. They were just really clamping down until eventually they stopped realizing how to relax. And so that's why she was coming in with me. Those muscles were just so used to being tight and stiff that at any point, if they were stretched or loosened up, they just really spasmed on her. 

With Sue, we talked about how to make that more balanced. How’d we balance out the strength of her low back muscles with abdominal muscles and hip muscles. How do we improve her flexibility? How do we get all of that to work together while she's running? So those were the highlights of what we did with Sue. 

Now for Mark. Mark looked amazing running, for the first several miles, but then you started to hear how loud his footsteps got and the longer he ran, the louder those footsteps got. He also has the standard guy runner muscle stiffness, if we're going to pick on men that run as a group they're typically very stiff.  So his muscles were very short in every direction, just very, very tight. There were some other things, but what that meant was that while he was running, when he got to the 10 mile mark, he was just pounding on those bones and it was going from his foot to his knee, to his hip, to his lower back.  When asked he did acknowledge he had knee pain and a little hip pain he also runs really far. He just associated all of those little aches and pains with part of his training. He kind of brushed them off and didn't pay any attention. He stated, “I know I'm stiff” and made jokes because everybody who's stiff jokes about that. He was able to ignore these other joint pain but the buck stopped with his lower back.

Not only is the back the top spot that compression force ends up at but when your back hurts, that's a lot scarier for most people than when your hip hurts. If you're going to have back pain, most people just want to stop whatever that is because having back pain is very, very scary. And that's what brought him in for an evaluation.  

We came up with a nice plan to improve his overall flexibility because stretching was just not doing it for him. We come up with other things that would help him get past his ligaments and his muscles being so stiff and then work on his endurance at the higher distances. Because you're not just talking about running five or 10 miles, he’s talking about running really far. So your muscles have to have a whole lot of endurance and a whole lot of muscle strength. And finally we need him to be able to know how to land softly. That's a little bit of coordination and some other things that just need to be honed, just like any other skill, you just have to learn how to practice that. 

Those are the two big things that cause low back pain while running, overactive lower back muscles and compression forces. 


It's very rare that people have weak backs. It's much more common that people have overly strong lower back muscles. And the compression forces  from hitting the ground again. Which is what many people believe is the bad thing about running over time. And all be at that isn't inaccurate. But if your body is trained to absorb that impact, and the muscles are able to help you do that, then the bones don't take as much of that impact as people like to imply. It just takes a little bit of training to get your muscles to absorb the impact of running. Then you can run well into your sixties if that's what you want to do. 

Those are my two people that I wanted to highlight today because now they're off doing their favorite thing. They're back to running. Mark is challenging himself all the time to run better and faster and he's still on that goal. And Ms Sue, she is able to decompress so that she can come back in and deal with all the stresses of being a mom, between working and kids. It just can be a lot. 

If this is the type of thing that you're looking for, if you're suffering from lower back pain while you're running, and you're trying to find a remedy that doesn't involve giving up running, injections, or surgeries. 

Then feel free to contact me.  At the bottom of this video, I'm going to leave a couple of ways to get a hold of me. You can just pick which one works the best for you. I hope that you're having a great day.

Looking for more information check out one of these blog posts: 
runners-knee.html
what-is-the-best-running-shoe.html
5-common-running-injuries.html

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