Tips for Fixing Lower Back Pain in Ultrarunners

Back pain is a common complaint among all adults. Although active individuals (including runners) are less likely to experience lower back pain than the sedentary population, plenty of athletes and runners suffer from low back pain on a regular basis. Some of the causes relate to our activities of daily living (or lack thereof), but running posture can contribute as well. Here is how you can keep your back happy as a runner.

The trouble with too much sitting

Many people in our modern world spend a great deal of time sitting, which is a hip flexed position. As a result, the hip flexor muscles on the front of the hip shorten and tighten. This tightness doesn’t just go away when you stand up. Instead, tight hip flexors often pull the pelvis into a forward tilting position. Normally, the lumbar portion of your spine has a gentle curve inward (toward the front of the body), as opposed to the gentle outward curve of the thoracic spine.

When overly tight hip flexors pull the pelvis into a forward tilting position, this creates excessive curvature in the lumbar spine. This arched-back position is clinically called lumbar hyperlordosis. The spine provides support to humans’ upright posture, and in its natural state it does a great job dissipating impact. In a person with hyperlordosis, however, forces are applied to parts of the spine that aren’t equipped to handle them. This leads to pain, pinched nerves, ruptured disks, etc.

Running can exacerbate the sitting problem

Running requires hip flexion (knee comes up in front of the body) and hip extension (leg pushes off the ground behind the body). In cases where hip flexor muscles are tight, hip extension can be limited. In many cases, runners’ compensate for limited hip extension by arching (hyperextending) the lower back even more as they run.

Running adjustments for a happy lower back

Ultrarunners are on their feet for a long time (often wearing a hydration pack!) in training and racing. With normal spinal alignment, you may not experience low back pain. However, poor lumbar posture often leads to discomfort. Luckily, there are a number of simple ways to prevent or minimize low back pain:

• Stand up and move around regularly throughout the day.

  Avoid extended periods of sitting. A stand-up workstation can help, but a workstation you can adjust to use standing and sitting allows for greater flexibility. If that’s not an option, make sure you stand up and walk around every few hours.

• Stretch your hip flexors and quadriceps regularly.

  Hold a stretch on each side for 2 minutes. I like the Couch Stretch or Lunge Stretch. Make sure you are not arching your back while stretching. Focus on keeping your pelvis in a neutral position instead of arching your lower back. This article contains a list (including videos) of useful hip mobility stretches and exercises.

• Strengthen and engage your transverse abdominis.

  Planks are a simple exercise, but one that is often performed incorrectly. In order to benefit from planks you must practice planking in proper posture. Too many people plank with a lordotic lumbar spine. When planking, focus on drawing your belly button in towards your spine and think about shortening the distance from your bottom rib to your pelvis, but not so much as to tilt your pelvis. There are exercise examples in this article from CTS Strength Training Coach Sarah Scozzaro.

• Ensure that you aren’t running with an excessively upright posture.

  Running too upright exacerbates the stress placed on the lower back

Be patient with the stretches and core strength work. You didn’t get tight hip flexors overnight and it will take some time for them to loosen up. Consistency is the key, not intensity. Doing a little bit of work each day will do you more good than intense stretching or strengthening more sporadically (or only when your back hurts).