Running and Lower Back Tightness

author : AMSSM
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Member Question

I have been training for two months now and I am having problems with my lower back.  As I run, my  lower back gets extremely tight...to the point that I can hardly run.  It seems like it is a stretching issue.  I try to stretch daily and stretch my hamstrings and back before running, but the problem still persists. 

My question is will it get better with time and more stretching?

On a good note, I was able to do five miles today without too much discomfort, but I had to stop a couple of times to grab a lightpole and stretch it out. 

Answer by Andrew Getzin, MD
Member AMSSM

Congratulations on starting to train!  Bummer that your back is not behaving.  Back pain is not uncommon in runners.  The most common cause of back pain is mechanical, which is pain emanating from the joints, ligaments, or muscles.  Other common causes include stress fractures, back joint (called facet joint) arthritis, and disc problems.  With the limited history you provide, it would seem that your back pain stems from a mechanical problem, which tends to resolve quite nicely if handled appropriately.

Injuries occur when the load applied (either acutely from one bout of exercise or from cumulative loading over time) exceeds the body’s ability to sustain the forces resulting in pain and possibly injury.  When assessing your back pain, it is helpful to address both variables.

While I applaud you for running, it seems you are doing too much too soon.  Training adaptations occur over time, and you need to be patient with allowing adequate time to adapt.  Training properly is not just going out and working hard until you can’t push any more.  It involves very gradually increasing your training load while listening to your body to ensure that you are not developing pain.  This is very hard because you may be fit enough to do more but, if you are feeling pain, you are maladapting.

The second variable you can change is how your body handles the load applied.  When you run, you put 3-5x your body weight of force on yourself with each step, and your back must be able to sustain those high loads.  Your core muscles essentially wrap around the back joint and act as shock absorbers.  The stronger your “core” muscles are, the less the load that is transmitted to the other structures in your back.  I look at core work / strength training as setting the table so you can successfully apply a load. 

In the short term, I would not run in pain.  Perhaps your back would be fine biking or swimming.  Running in pain will only exacerbate the problem.  Remember it is not how tough you can be, but more of how can you safely apply a progressive load and successfully adapt. It is funny that most people with back pain seem to want to stretch because they feel tight.  However, the tightness develops in response to an inability to sustain the load applied to the back and the tightness is more of a protective response.  If it makes you feel better to stretch go right ahead, but the key to sustaining the forces of running is to strengthen.  Consider adding planks or stability work at the end of every run to maximize core strength.  I would expect your back to calm down within a few weeks, but, if it does not, I advise seeing a sports medicine doctor for an evaluation to ensure that you don’t have a more significant problem than mechanical lower back pain.

Best of luck for a successful year of training in 2014! 

Andrew Getzin, MD
Clinical Director
Sports Medicine and Athletic Performance
Cayuga Medical Center
Head Team Physician Ithaca College
310 Taughannock Blvd.
Suite 5A
Ithaca, NY 14850
607-252-3580
agetzin@cayugamed.org
www.cayugamed.org/sportsmedicine

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date: January 20, 2014

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AMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

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avatarAMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

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