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

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