ASK THE PHYSIO Kate Senini opened her own clinic, Pure Physio with colleague Andrew Sargent in the Melbourne CBD, in 2010. A keen runner, Kate’s passion is running specific injuries. She enthusiastically spreads her knowledge through lectures, seminars and freelance writing. Contact Kate on 03 9090 7325 or follow Pure Physio on Facebook.
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Q I get low back pain while running. What should I do?
Low back pain during running is generally attributed to two main elements. Firstly, stiffness and tightness. Secondly, strength and stability.
Stiffness typically manifests in the joints between each vertebra of the upper (thoracic) and lower (lumbar) spine. This presents as a rounded upper back and increased arch of the lower back. Tightness typically manifests in the fronts of the hips (hip flexors) and the muscles of the mid and lower back. This tugs the pelvis into a forward tilted position, further accentuating the lower back curvature. These muscles become very dominant in holding us in an upright posture against gravity.
With the pelvis in a forward tilt and low back overarched, the deep abdominal muscles are in a stretched and inefficient position, making it very difficult for them to be engaged. Equally, the gluteal muscles that stabilise the hip joint and provide power for propulsion are also in an stretched and inefficient position, also failing to fire as well as they should.
The result when running is an overactivity of the low back muscles as they attempt to compensate for poor the deep abdominal muscle firing required for stability. Poor gluteal muscle firing also means the lower back is typically thrust into a greater arch in an attempt to generate power as we push off each leg.
Poor stability through the foot and ankle, and weakness in the calf muscles will also hinder our ability to push off. This is often directly related to gluteal weakness, and can further manifest in overactivity of the low back muscles.
Physiotherapy can be of great benefit in mobilising stiff spinal joints, releasing muscle tension throughout the spine and pelvis/hip region, and providing a specific stretching, foam roller or self-release program for maintenance. Specific retraining of the deep abdominal and gluteal muscles in the correct pelvic position (and single leg exercises) will help improve the brain’s firing patterns to achieve high-level spine and pelvic stabilisation.
Furthermore, the need to arch your back at the time of push off can be eliminated through a strength specific program for gluteal, hamstring and calf power.
