Health&Nutrition

Injury Prevention - Back Problems: Tough to Get Straight

June 21, 2011
By Rebecca Gardiner

Jen Randy remembers when she couldn’t run without suffering serious back-pain. “I would run and immediately after, my back would seize up,” the 36-year-old mom and runner recalls. “The following day I would be almost unable to sit at my desk at work because my lower back would hurt so badly.”

Back problems also plagued 34-year-old Kris Kernohan. For her, it started in 2005 after a hard hit in a hockey game, but after running a half-marathon last year, her lower back seized up so badly that she spent two weeks lying on the floor of her family cottage. “I couldn’t do anything,” she says. “I’ve broken bones, I’ve torn things in my body, but nothing has been as heartbreaking as screwing up my back.”

Kernohan and Randy aren’t alone. Run for long enough and if you don’t encounter a back problem yourself, one of your running partners will.

Just about anything can cause the problem including tight hamstrings, poor pelvis rotation, a weak core, or inadequate foot support. The back is fundamental to the biomechanics of running but it’s often hard to tell if running causes back pain or simply aggravates it.

“There is still so much that we do not understand regarding the actual cause of back pain in most people,” says Dr. Karen Murtaugh, a sports medicine specialist in Burlington, Ont. “I think as humans we are just predisposed to it. It’s not about blaming the back pain on the running, but treating back pain as a runner should.”

Carla Brash agrees. A runner and certified athletic therapist in Kingston, Ont., Brash treats many runners in her clinic. The number one cause of their back pain is not the spine itself, she says, but biomechanics.

For example, if a runner’s right hip isn’t flexing properly (knee to chest), the back compensates by contracting the muscles that run up and down both sides of the spine to help lift the hip. In turn, the lower back hurts because the muscles are overworked.

Surprisingly, lower back pain in runners is a relatively untouched field of study. A rare study in 2009, from the University of Massachusetts - Amherst, found that runners who have stiff knees don’t absorb shock very well and are more likely to end up with lower back pain.

Experts agree that having a strong core is crucial to preventing and treating lower back injuries. If your abdominal muscles aren’t strong, your back is forced to work harder. “The biggest problem with runners, especially the marathon distance and above, is it leaves little time to do anything else,” Murtaugh says. “Core strength and stability often get left behind.”

Make sure you’re running with the right equipment. Stephen Connor, a chiropractor and coach in Oakville, Ont., says shoes are the first thing he looks at when a runner comes to his clinic. A marathon runner and Ironman triathlete, Connor coaches a group of about 70 runners and says many are often unaware that their shoes aren’t a good match for their build. “Too many people run in a shoe that doesn’t have the right amount of support and stability,” he says. “They choose a shoe for price or colour and it can create problems.”

Increasing balance training, hip abductor strength and even altering running technique can also be helpful. Most importantly, if you can, stay active. “Ten or 15 years ago if you had back problems the first course of action was bed rest,” says Connor. “Now we’re saying activity is good. Action is good.”

While specialists are crucial to recovery, don’t be overwhelmed by the process or intimidated by the idea of costly weekly visits. Depending on your injury, many practitioners can teach you various exercises you can do on your own in only two or three visits. “It’s not rocket science,” says Brash. “A lot of my clients just aren’t aware of their bodies. I give them exercises and send them on their way.”

Of course, an ideal scenario is no back pain to begin with. And there are a few things everyone can do to prevent it from happening. Any running program should include core-strengthening exercises.

It’s important to look beyond running - fix your biomechanics in the way you walk and improve your sitting posture.

As for Randy and Kernohan, both women followed the same prescription: they found specialists who prescribed specific exercises for their biomechanical issues and stuck with the plan. While they both occasionally still have back twinges, their debilitating pain is gone.

“I’m aware of my body now,” says Kernohan. “So if I feel something, I know how to fix it.”

Rebecca Gardiner writes a blog for runningmagazine.ca called “Couch to Kenyan”

Back-fixing Tips:

Treatments will vary depending on your lower back injury. Carla Brash, an athletic therapist in Kingston, Ont., recommends the following stretches and exercises to keep your back, hips and legs strong to prevent injuries:

Glute stretch - While sitting on the ground, bend your legs and cross one leg over the other at the thigh with a bent knee. Bring the bottom leg towards your chest.

Hamstring stretch - Straighten one leg while standing, elevate the foot (using a step for support) and point your toes up. Lean forward at your hips and reach towards your foot. Keep your back straight.

Psoas stretch/Superman - In the lunge position, while keeping your back straight, lean forward with your hips towards the front leg. Raise your arm in the air (same arm as the back leg)

Monster Walk - Put a band around your legs, above your knees. With your knees bent, rotate your foot out and step to the side. Bring your legs back together slowly. Put a med ball in your hand to make it harder.

Quad Stretch - Standing straight, pull one foot to your bum. Keep your knee in line with your body and push your pelvis forward.

Alternate quad stretch - Elevate your back leg on a step or bench. Bend your front knee and push your back knee to the ground keeping your pelvis and back straight.

Cat stretch - On your hands and knees; arch your back and tuck your chin into your chest.

Camel stretch - On your hands and knees; keep your arms straight, drop your stomach to the ground, putting a curve (opposite of cat stretch) in your back. Extend your head.

Upper Back Stretch - While sitting, hug your knees. Round out your back and tuck your chin into your chest.