Hi, I’m Dr. Molly with Your Goals Physical Therapy. Do you love running but you’re worried about the back pain that you have while you’re running? This is the perfect video for you. Back pain is so common nowadays that people just sort of assume that they should have some level of back pain, which is really unfortunate since pain of any kind is not normal. When your body is giving you the signal that something hurts i.e. pain, that is the signal that something is not working correctly, something is off and it needs to be addressed.
Now, there is a difference between muscle soreness and pain, and sometimes that can get very hard to deal with and to figure out, certainly on your own.
For some people pain and muscle soreness are felt as the same thing. And So, If you’re running and you’re trying to figure out, should I be running with this back pain?
It can be very hard to figure that out. If you love running and you don’t want to stop, but this pain is causing you to have questions like, “is it okay for me to be running with back pain?” or “How intense can the pain get before I need to really stop?” “What could I possibly be doing to harm myself if I continue to run?” That is what I’m going to address. There are some very common reasons and I’m gonna talk about very broad reasons to encompass a lot more things of what can be causing you to be dealing with back pain right now.
The first three things, or the three things I’m gonna talk about in this video are that one of your vertebrae in your spine can be misaligned. So that’s one. The second one, your lower back muscles could be being strained while you’re running. So that’s number two. And the third is just the mechanics of your running or how it is that you’re running could be causing you to have pain. So those are the three big things that I’m going to talk about in this video.
Reason number one, one of your vertebrae could be misaligned. That is sincerely a very large, or broad strokes answer because misaligned could mean that one is slightly tilted, one’s a little rotated, one’s going a little bit further forward in the front or a little bit, down in the back. It can mean all sorts of things, but the details don’t necessarily matter because how you would resolve that is very, very, very similar on the back end.
What it means for you as a runner is essentially the same thing. No matter what the problem is. If one of your vertebrae is misaligned, it’s sort of like having a flat tire. Follow me through this, okay? If one of your vertebrae is slightly off, then it’s going to wear that bone down or it’s going to wear down the cushion that’s between the two bones unevenly much like you would wear down a tire.
If one tire is slightly deflated, the car fully functions and your sensors may not tell you, depending on how much air is being lost, that tire is low on air. You could drive for miles or over years depending on how much you drive.
Especially if you’re a short distance driver, that tire could be fine for a long time, but if you’re somebody who puts a lot of things in their car, maybe you’re moving or maybe you do long distance traveling, that tire is gonna wear out a whole lot faster because it’s not hitting the ground the way that it’s intended. This is where lots of things can go wrong.
This is very similar to what happens with our spine. If things are not aligned exactly the way they’re supposed to and you’re just a normal walk around, get up and do daily activities. You could have that problem for decades without having any inkling that that is an issue for you.
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But if you’re a high intensity athlete and you run, then that force of running, the repetitiveness, all of those things can amplify or quicken how fast and how aware you are that you’re having that problem.
Even something that’s minor, when you’re running can become a little bit bigger or if there is going to be wear and tear depending on how you’re running, it can happen faster. That doesn’t mean that you’ll forever have pain, but it does mean that if something’s misaligned, that could be the cause of what’s going on-that could be the cause of the pain.
Over time that’s where arthritis develops, that’s where bone fractures. You could actually break one of the vertebrae depending on how it’s positioned inside there. So that’s reason number one, that one of your vertebrae is misaligned.
Then for number two, your lower back muscles could be getting strained and that’s what you’re feeling. That sense of fatigue or very tired could be so strained that it’s causing a muscle spasm. That is very common.
People think that low back muscles are the main muscles that keep their upright posture. That they are what help you move around and pick things up, bending, twisting, and turning. But the intention, if you look at the anatomy and how it’s supposed to work, your lower back muscles are actually just supposed to sustain that normal spinal alignment.
In other words, how your lumbar spine is supposed to stack your lower back muscles, assist the ligaments and tendons and all the other things that are in there that help stabilize your spine. They were not designed to pick up your purse five times a day or all the kids’ toys or that stack of tiles or even keep you upright while you’re running. The muscles that are supposed to help you with that are your stomach muscles. That’s really what’s supposed to help you bend forward and resist forces from sideways and forwards.
Then your hip muscles are what’s supposed to help you pick up heavy things.
For instance, if you’re going to bend over to pick something up, your hips should be lifting that heavy load, not your lower back muscles.
Unfortunately, that ‘s not normally what we do. Our bodies are also very smart at saving energy.
It takes a lot less energy for you just to bend forward at your lower back and lift back up than it is to expend all the energy from your large glutes to help you get back to bend down and stand up. So over time there can be some movement patterns that are changed.
If you’re running and you’re getting low back pain, it could be from some imbalances between your stomach muscles, your hips and those low back muscles. Somebody’s doing more work than they really want. What does that mean? Could you push through that?
Certainly, maybe over time everything would balance itself out but if it doesn’t, then what ends up happening is that people run and do so much intense work that they cause really severe muscle spasms. It is not uncommon for people to end up in the hospital for medication to help calm down that muscle spasm.
People will go through X-rays and MRIs and find out that it’s really not a disc problem. It really was muscles cramping up very strongly on them and it can take weeks for that muscle spasm to calm back down.
The third reason is running mechanics. People often assume that if they have knee pain it’s from running. If they have hip problems it’s from running. People don’t necessarily think about having back problems from running, well some people do, but not everybody and it makes sense. The first thing to hit the ground is your foot. The next joint up is your knee and then your hip.
Why would it go any further than that? Really that kind of depends on what part of your back is being strained and how well you absorb impact when you’re running. So depending on how you land, whether you land on your heel or your forefoot, that impact still has to be absorbed by your body.
Depending on how efficient you are at that can vary where that force ends up reverberating. Some people really do land hard enough that their backs end up being injured. The force of landing ends up making a very big compression action at the spine.
Now there are forces that people don’t typically think about; such as, side to side motion and rotational forces. I know that we’ve all seen runners that do a lot of sideway motion or a lot of twisting while they’re running. Those motions may seem minor but over time the strain adds up and can cause your lower back muscle to work overtime trying to keep your spine aligned properly.
Depending on the strength of your spine and how you’re moving, there could be stresses occurring that you wouldn’t have thought about. (Again per reason two your abdominal muscles should be helping stabilize your spine but this very often is not being done efficiently enough to stop muscle strain).
Those are the three broad strokes reasons why you could be having low back problems. If lower back pain while running is something that you’re dealing with but you’re hesitant to get help, thinking, “But it just started” or “it’s not that intense.”
Here’s my general rule of thumb that I think works with any injury. If you’ve had pain for more than one or two weeks, then you should go see somebody because there is something going on. Your body is telling you something is not right.
Go see a movement specialist like a physical therapist, if it’s a movement issue because they’re gonna be able to identify what movement’s causing what irritation.
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If it’s another problem, maybe it’s a different doctor. But in terms of running truly, a movement specialist will be the fastest way to figure out what’s going on with you and your body and where that extra stress is coming from.
Now if the intensity is really low and it’s only intermittent, I can totally see why you would want to try to do a general exercise program and just see if that can help or some stretches and ice.
Basically, I understand wanting to try other things to help calm it down to see if it goes away but if it’s still there or consistently reoccurring. It’s just so much easier to go talk to somebody, find out what’s going on, come up with a plan and be done with it.
No more worrying about surgeries, injections, what this could mean long term. If you see a movement specialist like myself, I very rarely tell somebody that they can never run again. In fact, I really don’t think I’ve ever uttered those words.
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I will hold an asterisk because I work in a field that’s very gray and things happen. There are things that you can work towards to make sure that you’re running safely and that your joints are going to be healthy, and then make sure that you can keep running for decades, not just the next six months but for years.
If you are having back pain and your big fear, that’s stopping you from seeing somebody, is you don’t want them to tell you that you have to rest. Or that running is bad for your joints Or any of the other things that a lot of doctors end up telling you with good faith.
Then worry no more. Those MDs are trying to help you, they’re trying to make sure that you don’t injure yourself.
BUT Running is an amazing sport and when done well you can do this into your eighties. That’s the stance that I start with.
If this is the type of care that you’re looking for, then I will leave a button below that says, “ask about the cost and availability.” You’ll just simply fill out a quick form and then my office will get back with you, answer your questions and possibly schedule depending on what you guys talk about.
Now, if you have tried a bunch of things or you have some very specific questions and you would just like to have a conversation before committing to a full evaluation, that is perfectly fine. I love talking to people, I love answering questions.
So there will be a button below that says, “talk to a PT”. You’ll fill out a quick form so we know when to call you and kind of what the topic will be about. Then we will contact you to set up an appointment time so that we have a good 20 minutes to have that conversation and make sure that all of your questions and concerns are answered.
Until we speak, I hope you’re having a great day.
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