Running with Back Pain | Total Performance Physical Therapy

Running with Back Pain

May 29, 2020

Running with back pain? It sounds weird to even ask such a question. Most people would think, who would run with back pain? But runners get it. People who love to run will run with back pain, hip pain, knee pain, it doesn’t matter, they just want to run. And most runners (well not even just runners) do not go to get the back pain treated because they do not want to be told not to run. They are afraid that the diagnosis will be bad, requiring medications, injections or even surgery and they will be told not to run.

Why do people continue to run with back pain?

Fear of the unknown, fear of not understanding, keeps people from getting their back pain diagnosed and treated. The truth is you don’t have to stop running. That is the easy answer. Just quit than your back won’t hurt. But if you love running, you don’t want to quit, and you don’t have to. But you cannot just ignore it and expect it to go away.

You cannot just take 2 weeks off and expect it to go away. This is a popular method for dealing with pain. Just stop for 2 weeks and the pain will go away. And it will but it will also come back and most times it comes back even worse than before.

Taking 2 weeks off and doing nothing to determine the cause of the pain or how to eliminate the pain does nothing. Taking 2 weeks off is pointless unless you want to take the 2 weeks off to address the pain and work to find the cause and eliminate it.

Usually people don’t chose to deal with it until they cannot take one step running because the pain is too great. That is when they come hobbling into my office bent over and frustrated because every step is painful.

But when should you get help?

Yes, let’s face it. Most of us wake up with pain on occasion and we are not going to run to the doctor with every little ache and pain. The rule is 2 weeks. If you feel the same pain for 2 weeks, it is not going away on its own. And if it does, you just compensated to fix it, you didn’t actually fix it.

Pain that goes away in the middle of a run is pain that was compensated for. You changed how you run, you didn’t realize it but you did. This causes a much bigger issue.

So what should you do if you run with back pain?

1. Don’t stop running!

This does not mean push through the pain at all cost. This means address the pain, find out what is the cause of the pain and get it treated. Continue to run, but address why you have the pain and fix it.

2. Determine the root cause of the pain

Most back pain that develops with running does not start as back pain. There is often a sore knee, ankle issue, hip pain that happens days, months, years earlier and because that pain was never addressed the body compensated with the low back.

That is why many treatments fail and become discouraging because in order to have successful treatment you have to determine all the possible causes of the back pain and it is usually in response to something else hurting.

3. Improper running form

This is the biggest cause of back pain with running. And it is the hardest to fix. Now just by reading that you automatically want to change your running form. It is NOT that easy. You have muscles that certain lengths and strengths. You can’t just tomorrow go from being a heel striker to a mid foot striker without injuring yourself. Your muscles are not ready for that.

Changing running form means changing how your muscles work together. This is a process, not an overnight fix however fixing you stride can allow you to run pain free if you do it correctly and invest the time to do it.

For example if you are a heel striker, you literally are putting on the brakes every time your foot hits the ground. This is putting tremendous stress on the hamstrings that affect the low back and could be causing you tremendous pain.

4. Stop Running with people

The least popular of all the advice. But when you run with someone you change your running mechanics. This change in running mechanics affects your muscles. Even trying to run with someone 5 seconds slower or faster can cause you to alter how you run, how you use your muscles and cause your back to react differently causing you pain.

Try running the same distance as someone but be sure to run your own pace and see them at the finish line.

5. You don’t have a strong core

Most runners hate strength training. This is not a secret and it is not done because they don’t want to go to the gym and do anything. But what happens when you do not have strong abdominals is that your spine is left to flop around, it has no support. Therefore with no abdominals to support the spine, the lower back muscles start to work overtime to help stabilize the spine, causing overuse and pain.

6. You don’t recover

Recovery does not mean sitting on the couch after a long run. You need to actively recover. Foam rolling is an excellent way to actively recover. 10 minutes a day, that can be broken up into 1 minutes segments 10 times throughout the day is the best way to recover. Check out our YouTube page, Total Performance Physical Therapy to see how to foam roll.

Running with back pain is not normal and should be something that you address sooner rather than later. The sooner you deal with it and have it fixed the sooner you can be back to running pain free. If you are experiencing back pain with running and want a free consultation with a Doctor of Physical Therapy call 215-997-9898 and get guaranteed answers on your first visit!