“Please help! I’ve got lower back pain. I’m not sure what’s caused it, but its stopping me from running!!”
This is one of the most common phrases that therapists like osteos and physios hear from their running patients.
But there is one very big error in the above phrase. Can you guess what it might be?
Whereas we think of injuries to our feet, legs, knees and hips as being ‘running injuries’, we think of back pain not as a running injury, per se, but more as a nuisance that just happens to interfere with our running.
You may ask ‘so what?’, why does that matter? It matters because if you consider your back pain as a running injury, then you can adjust your running frequency, duration, intensity and style to help your back pain heal quicker.
What is Runners’ Low Back Syndrome?
Runners’ Low Back Syndrome (RLBS) is not a medical term. It is a term that I tend to use to group together the four most common causes of lower back pain from running.
Despite being distinctly different conditions, I group these back injuries together purely because they often occur simultaneously, and the self help treatment I recommend covers all four conditions at once, and can sometimes bring about effective relief from the pain, whichever problem is present.
These four conditions are :
1) Facet Joint Irritation
The spine is made up of building blocks called vertebrae. These vertebrae are connected to each other by discs at the front (you know, the ones that slip!) and by joints at the back. If you have a rather large hollow in your lower back (like a dancer or gymnast) and have weak abdominal muscles for example, these joints can become irritated and inflamed, and be painful during running.
2) Sacroiliac joint dysfunction
The Sacroiliac joints are two joints which sit either side of the lowest part of the back above your buttocks. They’re easy to find, as they lie next to the two knobbly bits of bone in your lower back. There are also two dimples in the skin overlying the joints, called the ‘Dimples of Venus’ (google it if you dont believe me!). If we land harder on one foot than the other while running, excessive pressure can be put through one of the sacroiliac joints (very rarely through both joints at the same time), and can irritate the joint and make it inflamed and painful.
3) Weak back
This is just what it says. Well, actually, maybe its not exactly what it says. It’s a weakness of the lower back muscles leading to a loss of control while running, but it is also a weakness in the abdominal muscles. These two weaknesses create a global vulnerability in the lower back that means that as we tire through a run, the muscles cannot control movement, leading to stress on the spine, and pain as a consequence.
4) Myofascial trigger points in the lower back muscles
Weak muscles tend to do two things in response to stress on them. Either they cramp up completely, or small parts of the muscles cramp up, resulting in little knots of very tight muscle which we call trigger points. These two responses tend to occur near the end of really important races (following ‘McCarthey’s law’, which states that Sod’s law is far too optimistic!). The result is that we develop a moderate to severe pain while running, that can’t seem to be stretched out easily.
Click Next Page for tips to identify RLBS