running Many Americans exercise routinely by running. Running is a great way to burn calories, exercise the heart, and relax the mind. I recently have been seeing patients who feel that running may increase their low back pain (LBP). Is it possible that running for exercise can cause pain or aggravate your low back?

Starting from Anatomy 101

The Discs (the soft stuff between the spine bones) act as shock absorbers. As we get older, the discs naturally dehydrate and stiffen. This process called degenerative disc disease may cause LBP with activities that load the discs (sitting on a hard surface, leaning forward, bending down and lifting). Facet joints are actual joints (like a knee) that connect the spine bones behind the spinal canal. These joints can become arthritic and potentially cause pain with activities that involve twisting or leaning backwards (going downhill, sweeping, or mopping). Last but not least, Spinal Stenosis (pinched nerves) can happen with these normal wear and tear changes described above which may cause buttock or leg pain.

Enough anatomy, what about running?

An English Study by Garbutt et al in 1990 looked at the size of discs after running. They found that people who run shrink! The more you run the shorter you get. The good news is that the discs will go back to their original size after you stop but it shows that when you run there is significant stress and loads placed on our shock absorbers. Is shrinkage bad? On average, athletes and runners have less LBP complaints compared to the normal population. So being active is good.

What about if I already have back issues and running seems to make those symptoms worse?

The general consensus is that strengthening the CORE muscles (the muscles that support your Low Back and Pelvis) will help runners maintain better posture during the run and hopefully decrease your risk of LBP.

Another potential abnormality could be your leg flexibility. Tight hamstrings or tight hip flexors (the muscles don’t want to stretch) can alter your pelvic tilt (position of your Pelvis in space) and place extra loads onto your spine which could mean pain.

If you are one of the unlucky runners who notices pain with running; what can you do?

Normally, I recommend Physical Therapy (PT) to focus on CORE strengthening and lower extremity flexibility to include hip flexors (Iliopsoas muscle) and hamstring stretching. Secondly, buy yourself a good pair of running shoes. Worn out running shoes can increase the impact of running on your low back. Lastly, practice some common sense. If you have not run for some time, don’t run 5 miles right away! Work your way up by building endurance. Start at running 1 mile and gradually build your distance. On the other hand, if running is causing you severe discomfort; do not ignore the pain! Evaluation by a Spine specialist can be helpful in figuring out why you hurt and hopefully getting you out back running.

-Dr. Paul Saiz
Las Cruces, New Mexico

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