Lower back pain is a common issue that many individuals, including runners and athletes, may encounter at some point in their lives. When a runner experiences lower back pain, the first question that often arises is whether running is the cause. While it can be challenging for sports medical professionals to provide a definitive answer, this article aims to shed light on one potential reason for the development of lower back pain in runners. Additionally, it will present a set of exercises that can help alleviate the discomfort.
There are numerous factors that can contribute to lower back pain in runners, some of which may have little to do with sports activities. Prolonged sitting or engaging in repetitive tasks involving the lower back can be contributing factors. However, it is essential to consider the role of running posture in exacerbating the issue.
One potential mechanism for lower back pain in runners involves excessive lumbar extension and a forward tilting pelvis. This running posture, characterized by an over-extended lower back and forward pelvic tilt, can place excessive strain on the tissues in the lower back, SI joints, and upper hamstrings.
It is important to note that there is no universally perfect posture or running form. However, during the propulsion phase (pushback) of running, it is normal for the pelvis to tilt forward slightly and for the lumbar spine to extend slightly, allowing for optimal leg extension.
Image: optimal pelvic & lumbar posture whilst running
Self-Assessment: The Bridge
To gauge whether you might be relying too much on lower back extension and forward pelvic tilt, you can perform a simple test at home known as the bridge test.
Lie on your back with your knees bent and your feet resting on a step or chair (around 60cm in height is ideal). Push your hips upward toward the ceiling while paying attention to the areas involved in generating this extension, as well as the posture and movement of your lower back and pelvis. If you notice that your lower back arches significantly and feel excessive strain in the muscles of your lower back, it's likely that you tend to overextend through this region while running.
Image: Bridge Test
If you observe an extended-forward tilt position either during the bridge test or while running, there are two steps you can take:
Firstly, consciously focus on gradually adjusting your position both while running and during exercise. Consider this as improving your motor skills in maintaining a more optimal posture.
Secondly, target the muscles that are typically weaker in runners and can contribute to the lower back and pelvis assuming this posture—the abdominals and hamstrings.
Keep in mind that your hamstrings and abdominals can never be too strong.
Here are five recommended exercises to help you cultivate a strong, stable, and efficient running posture.
Exercise 1: Nordic Hamstring Curls
Image: Nordic Hamstring Curl
Begin with your shoulder, hips and knees in a straight line. As you slowly lean forward you will feel your hamstrings activate and your pelvis wanting to tilt forward and your lower back extend. Focus on using your hamstrings to prevent your pelvis from tilting forward and use them to control the loading in your lower back.
Exercise 2: Jack Knifes
Image: Jack Knife
The focus should be on engaging your abdominals to prevent and resist excessive lumbar extension (don't let your back sag toward the ground) especially whilst returning to the start position (straightening your legs).
Exercise 3: Abdominal Roll Out
Image: Abdominal Roll Out
Begin in kneeling position. Roll outwards using your shoulders and lowering your hips towards the ground. Ensure your shoulders, hips and knees stay in a straight line. As you move the wheel away from your body you will feel your back starting to arch. Use your abdominals to resistance and control this extension. Go out only as far as your abdominals can control loading through your lower back. Pull back to the start position.
Exercise 4: Leg Lowers
Image: Leg Lowers
Begin with your legs at the top position (hip 900, legs towards the ceiling) and lower back relaxed against the floor. Slowly lower your legs towards the floor until you feel your pelvis tilting forward and your back lifting off the floor. Focus on using your lower abdominals to resist and control this. Return to the start.
Ensure you do not lower your legs so far down that you have excessive movement in your lower back. This can be a major reason why this exercise may give you lower back pain.
Exercise 5: Swiss Ball Push Backs
Image: Push Backs
Start in a press-up position with your feet on the Swiss ball. If this is too hard – place your shins on the ball to make it easier. Keep your shoulders, hips and ankles all in alignment. Push back off both your shoulders, extending your arms and pushing the ball backwards. The spine will want to sag into extension, ensure your abdominals are active to prevent this (resisting extension). Pull yourself back to the start position using your shoulders keeping your shoulders, hips and ankles all in alignment at all times.
There can be other reasons for an anterior pelvic tilt and extended lumbar spine, so I always recommend getting a qualified health professional to assist with your conditioning and any injury management.