Q+A: How can I reduce impact on my back?

Our experts answer real-life questions


Posted: 9 September 2000
by Greg Ryan

Q I’m just about to return to running after three months out with a lower-back injury (disc and sacro-iliac joint problems). What sort of training should I do to return to running fitness without risking more injury?

A When returning to training, particularly high-impact training like running, after a back injury, you must tread carefully (no pun intended). Start with a month of low-impact exercise, such as cycling or using an elliptical trainer in the gym, to re-develop your cardiovascular fitness. Using a rowing machine is not advisable due to the strain that it can place on your back if done incorrectly. Think about control and quality in your exercises. Maintain good posture and a stable pelvis throughout your work-out. (Visualise Michael Johnson – the 400m runner keeps his pelvis and torso incredibly still while his legs are pumping away.)

When you start running again, use a treadmill at first. That way you can simply step off the machine if anything goes wrong, rather than having to limp home. Start out by alternating one minute of running with one minute of walking for 10 minutes in total. This will allow you to concentrate on your running without getting too tired or distracted.

Leave a good 48 hours between that first run and your second, to see if there is any reaction from your injury. If everything is okay, you can begin to increase your running time and reduce the number of walking breaks until you’re running for the full 10 minutes. Take this process slowly over a two- to three-week period. This may sound overly cautious and boring, but you’re rehabilitating post-injury and it needs to be done gradually. And, since you’re not running flat out, you can still supplement your running with low-impact exercise.

Greg Ryan, chartered physiotherapist with Medifix Clinics, London


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Ow! Went for a 4.5 mile run yesterday, knew I wasn't in mood for it but got on with things......However after a couple of miles my lower back was killing me, had to stop three times cos of it. Its muscular, so I guess I need to build up my lower back, any good excercise suggestions?

Ta

Russ.
Posted: 11/11/2002 at 14:13

Russ

Actively think about your posture while running – one of the major causes of back pain while running is inappropriate posture – You my find you are either leaning forward whilst running or running with you back slightly twisted
Posted: 11/11/2002 at 14:22

Lie face down. Lift left leg and right arm a few inches off the floor. Hold for a count of ten. Then lower. Then lift right leg and left arm a few inches off floor. Hold for a count of ten. then lower.

It works for me, I used to get lower back pain when I first started out. Now I just ache all over.
Posted: 11/11/2002 at 15:06

Oh yeah! I should have added...repeat a few times. slowly build up length of holds and repetitions.
Posted: 11/11/2002 at 15:07

i take it you've done the basics of checking your shoes - if they're the wrong sort for you or they've done too many miles then that may be the cause. it was for me - i was getting very bad back pain - but since i've got a bad back i just thought i'd have to put up with it. but this weekend i bought a new pair of shoes and now no back pain!! hurrah!
Posted: 12/11/2002 at 08:49

Susannah, bought new shoes from a running shop to make sure they gave me the right ones and I have to say they are much better than my last pair. I think WildWill hit the nail on the head, I do find myself leaning forward so need to correct that. Will also do the excercises as suggested by Dragonbreath.

Thanks guys and girls.
Posted: 12/11/2002 at 10:09

Ooh ooh this I know- everyone else knows about speed and hills and shoes and stuff that I have no idea about , but backs I do, hope this helps...
As oposed to building up your back muscles sounds like theyre already tightening up, work on your stomach muscles, not the outside ones the inside ones- the ones you can feel when you hold your belly button in and tense up.These muscles should be holding your spine stable as you run, but if you dont use them your spine can be instable and your back muscles will tense up to compensate- therefore your back muscles need stretching and your stomach muscles need strengthening. Its called inner core stabilisation. When you do the exercises above hold in your belly button too. Sit ups arent the answere it has to be inner muscles you work.
Try this one- On all fours, pretend you have a tennis ball ( you can use a tennis ball when you get good)balanced on your back just below the waist band sort of on the flat bit of your pelvis. Now relax the shoulders and hold the stomach muscles in really tight. Try to take one hand off the floor, without transfering you weight on to the other arm, you should feel a tightening across the muscles between your hip bones- thats them - the inner core muscles. Do each arm and each leg. Hope it helps I learnt this from Pilates, give it a go.
Posted: 13/11/2002 at 18:23

I had lower back pain on and off for years. Suprisingly enough the thing that got rid of it for me was Squash. I started playing a friend and after a few games i was cured!
I can only suggest it was the range of movements that gave my back some strength.

Now i am not suggesting you go out and do the same as it may do you more harm than good, but it did trick for me.

Hope you get it sorted soon.
Regards
Posted: 13/11/2002 at 19:29


JP
I suffer the same, feels like period pains (sorry russ, not a feminist rant, but only women will obviously have any idea about this, but it's basically low in the back and a dull ache). I have looked at my posture too and I tend to stoop. My ab muscles are resonably firm (shame about the flab round them that's all) so I've put it down posture.
Posted: 22/11/2002 at 18:01

Snap!
I just assumed as I tire I slouch and therefore needed to strenthen my back but what Pars said makes sense .. only can't suss t he exercise bit!
Posted: 24/11/2002 at 20:57

Pull your stomach in when running. It's all about core stabilty...
Posted: 25/11/2002 at 11:19

I have recently been getting treatment from an Alexander Technique therapist and it is starting to pay off. It could work for you but it depends on whether the pain is related to your posture. Mine is not brilliant. Stand up straight and look at yourself in a mirror, sideways on. If your spine isn't straight from bottom to neck you probably could benefit from this treatment. It's not a quick fix but it will help you change the habits of a lifetime.
Posted: 01/10/2003 at 14:20

I just got back from the GP feeling like the whole visit was a waste of time.I have CONSTANT lower back pain,and since I'm running in the FLM next year,and a sports therapist told me that I could permanantly damage my back doing 26 miles if something is trapped,I was understandably a bit worried.He said to go see a chiropractor,so I've asked around(including on here)and also went to my GP.

I was told that there are no chiropractors on the NHS,but they can refer me to physio(which I've had already and did not help at all)which will take nearly a year for an appointment,or they can refer me to a back clinic,which will also take about a year for the appointment to come through.
The doctor says maybe I'm too active,to wwhich I answer I've started training BECAUSE I was a couch potato in pain before,and am now trying to so something about it.I'm a lot fitter already,but the back pain is a big handicap.

I was given a prescription for painkillers.

Marvellous.

Sorry,I'm ranting.Just frustrated that situations like this arise,and seem very hard to solve.I'm going to sulk.

Lovejoy.

www.justgiving.com/Lovejoy

"Sex is a private thing. It should between you and the person you're doing it to."
Martin Crane-1993"Frasier"
Posted: 01/10/2003 at 16:32

Tears of laughter and my greatest of sympathy, I had exactly the same response from the doctor. My back ache eventualy stopped me running, (after putting up with it for far too long). His answer was I needed to do more fitness!!, I said " thats why I'm here, I can't do it!!"

The answer is to see a chiropractor. (Private expense) However, I wasn't allowed to run for close to a year, while the treatment was ongoing. It would only undo the corrections that were being made.

I know that sounds bad , but you will come back better and alot stronger.

I still recieve treatment now, but only every 6 months or so. Meanwhile the pilates classes really do help. You WILL know when you have found your inner core muscles.

You should only start the pilates classes when you are coming 'out the other side'.
Posted: 01/10/2003 at 19:53

"coming out the other side"....

Why do I imagine that being said in a Yoda-like voice?

Have made chiropractor's appt now,hopefully that will stop me moaning :-D

Lovejoy.


www.justgiving.com/Lovejoy

"Sex is a private thing. It should between you and the person you're doing it to."
Martin Crane-1993"Frasier"

Posted: 02/10/2003 at 16:24

The 'other side', I would just say that I on average I visit the doctor every ten years(touch wood). So only when the pain was totally unbearable (you know,the marathon type of pain)it was then that I had to see the doctor.

Re. the chiro' it will depend on the severity of your condition. Grade One (not too bad) to Three (Run no chance!), I was grade three, hence the year off.

Honestly it's not THAT bad going to the gym and getting onto the jogging machine and actually WALKING. Keeping a straight face and looking serious is the hardest part!!
Posted: 03/10/2003 at 21:23

I used to get a lot of lower back pain now cured by vastly improved core stabilty and posture - I do a couple of sessions of pilates a week.

If you realise you are slouching when running thus straining your lower back, slide your shoulder blades down in your back. This will immediately correct your upper body posture. Remember to stay tall and not lean forward too. Good luck!
Posted: 04/12/2003 at 12:45

Pilates has come a very long way now and has been updated by modern day sports science, so try to see a qualified Pilates Trainer who will be able to help. Other than that try reading up on Core Strength, look out for a book by Matt Lawence.
Posted: 04/12/2003 at 18:03


Hi Lovejoy, you might find this of some use.
About a year ago I developed permanent lower back pains. I also went to my GP and he told me their was nothing HE could do so he refered me to a physio, the result was not good the physio did nothing for me at all. Anyway as time went on my back pains persisted, I did'nt know what to do, should I have stopped running?
Well no, the simple answer was that I needed more specialised running trainers.
I don't know what trainers you have but the foot specialised in 'Alexandra Sport' recomended that I had a high stability shoe with dual density mid sole. He said it could take up to 6 months before curing my back pains, but to my supprise after 3 1/2 months of running they rapidly started to dissapear and have been long gone for a long time now!

I recommend you try a RW recommended shoe specialised shop and take all of thier advice into account. I can personaly recommend 'Alexandra Sport' they are fantastic even though I now live in Bristol I still take a day to Portsmouth to visit them every year to do my annual running shop.

I hope this may help you, I know how annoing it is to have a constant back pain, so the sooner you get to 'Alexandra Sport' in Portsmouth the better. (If you descide to go then its by the outdoor Lido, visible from the motorway as you enter Portsmouth. If you would like me to get more specifc details to you e-mail me at

wipper_creeper@yahoo.com
Posted: 07/12/2003 at 20:59

Hi! Used to have dreadful back problems, now I swear by my physio ball, not least because just sitting on it and swaying about whilst I watch tv instead of on the sofa strenthens and loosens my lower back and core. They are fantase. Anyone else tried them?
Posted: 17/12/2003 at 13:24

I am reading all the advice eagerly this morning whilst sitting here with my lower back screaming after a relatively easy paced 5 miler yesterday. I have always had lower back pain from running and the higher the miles the more it aches. Sometimes it goes down the backs of my legs almost like sciatic pain (which I suspect is from tight glutes that never get stretched enough??)

I am loathe to head to my GP for the same reasons that many of you mentioned and don't want to be brushed off with a prescription for pain killers. I know I tend to stoop as I fatigue so hopefully the strength training I've started will pay off. In the meantime, I'm reaching for my brufen.....thanks all for all the posture and core strenght tips.
Posted: 01/11/2004 at 11:13

Don't forget a good bra if you are female. I get lower backpain from a bad sitting position and havy breasts.

Oh and the strechning exercises do work
Posted: 01/11/2004 at 11:20

Back pain could be a sign of problems elsewhere. In my case, my physio reckons the problems are with my glutes and hamstrings. Because they are so tight, my back overcompensates and this causes the irritation.

Plenty of abdominals, and concentrate on stretching your glutes and hamstrings before, and especially after, your run.
Posted: 01/11/2004 at 11:58


D1
If you think it's muscular weakness, Russ, then nothing better than core stability/abs strengthening work using a swiss ball and also Pilates - proper classes with an instructor for both those. Strong abs/core strength will help support & strengthen your back and both Pilates/swiss ball work will help correct your posture/support your running imho.
Posted: 01/11/2004 at 12:11

Kerry pain down the back of your legs after running is quite likely to be caused by a tight piriformis muscle which is affecting the nerve. This can be relieved with stretching exercises (very similar to glut stretches). I am chiropractor and have found that stretching exercises and work on core muscles (e.g. pelvic floor and transversus abdominis) have been useful in preventing and treating some patients back problems
Posted: 01/11/2004 at 15:31

Thanks HVS and everyone for the response. I suspected all along it has to do with my glutes as that's often where I feel tight after running and also with weak core strength, but it's nice to be able to bounce it off a few others to see what you think. I will contiune stretching and "crunching"!
Posted: 02/11/2004 at 11:42

hey did you ever try yoga? it is amazing for strengthening and stretching the back. a lot of runners do it, and there is a special class for runners at the centre where i work. or i could email you some good exercises?
Posted: 12/04/2006 at 12:30

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