Back Pain While Running

• Do you have back pain while running?
• Lower back tightness while running?
• Does the pain last for a day after?

If you’re anything like me, you have had back pain. Maybe not from an “injury” but from overuse that developed over the course of a week.

My reason for back pain was a small disc herniation (3mm), which is not large in the grand scheme of things, but it was enough to kept me from doing what I wanted for about 6 months.

During the first few months I was really afraid of throwing it out again it will simple movements, bending over, getting out of my car and putting on my shoes. Running, lifting and even sneezing set me off for sure! My back felt weak, vulnerable and effected my athletics.

Hi, I’m Dr. Sebastian Gonzales. I own/ operate a rehab clinic in Huntington Beach, CA where we specialize in getting active people active again.

I’ve run many races from 5k’s to 1/2 Irons. I’ve experienced low back pain, just as you have, yet I’ve been fortunate to have a sports medicine educational background to trouble-shoot “what works and what doesn’t work” to heal many conditions like disc herniation, degeneration and pinched nerves.

Today I can say with confidence that I have full ability to run and lift without back pain. I even wrote a book about my story!

How long does it take to recover?

Everyone is a little different but if I had to estimate:

• 1/3 of the people I see feel 50% better within a matter of 30 minutes and are able to keep milage up, with slight suggestions.
• 1/3 take roughly a month to get back into their desired milage, with a more focal warm-up/ cool down.
• A very small fraction are more complex cases and can take months and often times have a chronic issue.

Don’t get me wrong, the complicated ones aren’t broken. I still have them train in some way, shape or form within the first week. Typically, I start them with resistance training and walking.

If you want these same results, I’m here to guide you. If you have been told your back pain is from spinal or disc degeneration, arthrits or old age, you can still get better within the same time frame I mentioned above.

Take a look through the article below to get a feel of what I can offer.

Some of you may feel better from the tips within this article even, but if you’re not don’t fret. You probably just need a little one on one direction is all.

There’s no substitution for one on one help.

I could write an article telling you how to fix your care, or I could just come over and show you how!

On that note, if you’re in the Southern CA area, book a time with me. The proof is in the pudding and it’s faster to make pudding when you can use your hands.

People recover from back pain everyday… and yes they are able to run again. Often times faster and further than before! All you need to do is duplicate what works.

If you need my help just book an appointment with me HERE.

How can you prevent lower back pain when running?

Depends on what areas of strength, flexibility and coordination you are lacking.

How can you rehab a back injury from running?

Depends on what the exact injury is…all of them respond to different treatment and strengthening plans.

Below are the top four reasons for back pain while running:

• Facet Syndrome
• Disc Herniation
• Sacroiliac Joint Sprain
• Muscle Spasm

In this article, I will go over each injury.

By the end, you will have learned what they are, why they occur, how we strengthen them and how they are treated.

FACET SYNDROME

What is Facet Syndrome?

The facets are small joints of the back. Each segment of the back is directly connected to four facets (two on each side).

When they become jammed, they often hurt too. Compaction is the mechanism of injury in Facet Syndrome.

What causes Facet Syndrome back pain when running?

Compaction or jamming of the small joints of the back happens with repeated and prolonged extension.

Extension of the back (bending backward) often occurs over and over again if you run with a swayback.

What is a swayback?

A forward-tilting pelvis (imagine a swaybacked horse) jams the back by changing its base, which is the sacrum.

Lower Cross Syndrome is the term that’s often used to describe what is going on in the area with regard to muscular imbalances, spinal posture and what is optimal.

This is actually very common in cases of back pain while running. Treatment, rehab and therapy revolves around the idea of strengthening what is weak, stretching what is tight and being able to keep correct posture while running.

Facet Syndrome Rehab

To control Facet Syndrome, we need to obtain a “softer jamming.”

Why don’t we get rid of the lumbar extension causing the jamming altogether?

It’s kind of like when you are walking to the edge of a cliff; you want to get close, but not too close.

Low back extension is a normal motion. We just need to make sure it is not too extreme or under low control.

How can we do this?

The anterior abdominal wall resists extension and needs to be trained to work better while running.

I’ll say that another way: we need to get better at “anti-extension”.

Actually, we have a whole online program coming on this theory, but here are a few starting points that I can share.

To relieve pain, we often start with bouts of decompressing stretches.

Stretches

To control excessive motion of the trunk, Pallof Press variations are a good go-to. I apologize, as this is not the exact video I wanted. We haven’t filmed it yet.

But this is an Anti-rotational Pallof Press we use to combat back pain when running.

Facet Syndrome Treatment Options

Hands-on treatment often cannot train the body to resist extension, but they can help to decompress the area.

• Stretching
• Chiropractic adjustments
• Hip mobilization
• Thoracic spine mobilization
• Deep tissue work
• Active Release Technique
• Traction
• Acupuncture
• Injections
• Oral medication

DISC HERNIATION

• Unbearable pain getting out of bed?
• Can’t bend over to tie your shoes?
• Loss of sensation in your hip, thigh, calf or foot?

If you have any of these, you could possibly have a disc injury and/or possible nerve root irritation.

Disc injuries can be extremely painful. They can take a long time to get better (months even) if you don’t get on them fast.

Disc injuries can get worse, and the loss of sensation can get worse as well.

Read through this article and understand this injury.

What Is Disc Herniation?

A spinal disc is a cartilage-based “jelly donut” located between the vertebrae of the back.

They are softer than bone, and as such, can be ripped resulting in pain.

Disc injuries come in four types (best to worst):

• Protrusion
• Prolapse
• Extrusion
• Sequestration

If we say “herniation”, we are talking about extrusion where there is a “disruption of the annular fibers” of the disc. An analogy would be the “jelly” coming out of the “donut”.

If you deteriorate to a prolapse, you become a surgical case, so it’s best to deal with it sooner rather than later.

What Causes Disc Herniation?

Disc injuries occur with and without major trauma. You don’t have to be in a car accident or fall off a roof to have a disc injury.

A majority of them happen over time due to poor mechanics and posture.

The spine is designed to take a compressive load well, but it does not take shear. Here’s a picture to better understand.

Disc injuries happen when the spine is subjected to a load under flexion and rotation.

In the case of running, it is a repetitive insult to the area. Most runners I see tend to extend in the low back, and while this in and off itself doesn’t directly lead to a disc injury, it can cause some strange things. Let me tell you, I’ve seen some odd postures at the end of some runs, especially when someone is going for time.

People are flexed, rotated, dragging legs, you name it. Anything to be under the hour mark right!?

Do this over and over again without the supporting protection of the hips, pelvis, and trunk, and the disc will become damaged.

Disc Herniation Rehab

The first thing we have to do is take the pressure off of the disc and allow it to “center.”

The McKenzie Protocol is a great one to use to do this.

McKenzie Extension

Normally, if it is a disc injury, this will feel good and take the person out of pain…until they bend forward again.

Bending forward will re-aggravate it, or as I like to describe it: “ripping off the scab.”

Also long as you keep ripping off the scab, it will never heal.

How can we stop the scab from reinjuring?

Don’t bend forward from the back. Learn to move your hips. Hip hinging and strengthening the muscles used in hip hinging assist in protecting the back from flexing forward.

Don’t believe me?

If you have back pain similar to this, just stand up tall and contract your glutes together like your attempting to break a quarter into five nickels.

Hold it for 30 seconds.

Does your back feel better?

The glute muscles assist in the hip hinge pattern. Actually, the hamstrings do too.

Here’s a good exercise we use to create a rigid trunk to combat back pain when running.

The Lewit Exercise

Disc Herniation Treatment Options

I prefer to work on stabilization of the trunk with my clients with disc injuries. I don’t even adjust them and I am a chiropractor by education. Stabilization and modification of daily activities seems to greatly assist in pain.

Here are some other treatments you can try out for pain:

• Stretching
• Chiropractic adjustments
• Hip mobilization
• Thoracic spine mobilization
• Deep tissue work
• Active Release Technique
• Traction
• Acupuncture
• Injections
• Oral medication

SI JOINT SPRAIN (SACROILIAC JOINT)

• Low back pain?
• Extending to the buttocks?
• Down the thigh, but not past the knee?
• Worse with sitting?

I know this sounds like the other injuries in this section, right?

A Sacroiliac Joint Sprain is often missed when you go see your doctor. Many physicians (myself included) believe the cause of your back pain is more likely to be from disc injury or facet compression before a SI Joint Sprain.

Before you assume you have a Sacroiliac Joint Sprain, you should be examined to rule out the other conditions…seriously. This is not one you should attempt to budget on.

When diagnosed correctly, rehab can actually go very quickly, so you’re in luck!

What Is A Sacroiliac Joint Sprain?

The sacroiliac joint is actually a paired joint at the base of the back where your low back and pelvis come together.

The joints are held together by and function with healthy bony structure, cartilage, ligaments, tendons and muscles.

Sprain equals an injury to a ligament.

Sacroiliac Joint Sprain Causes

Your SI joint doesn’t normally get sprained with trauma (i.e. slip and fall). Like most running injuries, it happens over time. It too, more often than not, is a repetitive stress injury.

After a sprain, the joint can become chronically irritated, and if too much rest is taken, then it can become “loose.”

Sacroiliac Joint Sprain Rehab

Our treatment plans for SI Joint Sprain center around two goals:

• Decreasing pain
• Increasing strength in the regions around the joint (hip, pelvis, core)

To decrease pain, we often use passive therapies (ice, heat, massage etc.) that I will list in the next section.

As for stabilization of the joint, this can be done with core work, pelvic strengthening and posture exercises.

Here’s an exercise we like to start our runners on.

Sacroiliac Joint Sprain Treatment Options

• Active Release Technique
• Stretching
• Chiropractic adjustments
• Hip mobilization
• Acupuncture
• Oral medication
• Injections
• Thoracic spine mobilization
• Deep tissue work
• Traction

MUSCLE SPASM

• Stabbing back pain?
• No leg or buttock pain?
• Does it get better after massage?

This type of back pain could just be a muscle spasm.

Muscles spasms can be extremely painful, and they are extremely common either as a primary or secondary injury.

Primary injuries are the main cause of pain and disability.

Secondary injuries are ones that present themselves because of another larger injury (i.e. a disc herniation).

When it is truly a primary muscle spasm, they are very easily treated.

If you have a muscle spasm, you could be running pain-free within a week if you do things right.

What is a muscle spasm?

A muscle spasm is when a muscle becomes tight or hypertonic.

Muscles spasms are minor, Grade I tears of the muscle, and the spasm is a protective mechanism for the tear. Oftentimes, there’s a residual tightness, even months after the initial tear, as denser tissue (or scar tissue) has developed/hardened.

This scar tissue can become a chronic injury if left untreated as the scar develops over the next year.

Muscle Spasm Causes

Muscles and joints have receptors.

These receptors are like switches telling your muscle/joint complex to protect itself, amongst other actions that we will not go into at this point.

One function of these receptors is to tell the muscle to contract if it’s have been stimulated by a stretch or chemical response (inflammation).

For this reason, it is not always a good idea to attempt to get rid of a new muscle spasm… it could be protecting you from further damage.

However, if this injury is purely a muscle spasm, stretching it will produce profound results.

Muscle Spasm Rehab

When muscle spasms become chronic (longer than 3 months), they can be addressed safely without risking further damage to what they initially were protecting.

Wondering if they could be treated sooner?

In my office, we do a thorough exam to make sure there is no other major injury we need to know about first, but if the exam looks good, we start our runners in therapy as soon as one week of their injury.

Wonder what we do?

Here’s an activity we have our athletes do for a primary muscle spasm.

Lacrosse Ball for Low Back Pain

Early in the injury, we often recommend trunk stabilization exercise under light load. The Lewit exercise was mentioned earlier. It is just one of our go-to exercises in this scenario.

Muscle Spasm Treatment Options

• Active Release Technique
• Stretching
• Deep tissue work
• Traction
• Chiropractic adjustments
• Hip mobilization
• Thoracic spine mobilization
• Injections
• Oral medication
• Acupuncture