Low back pain after long runs can be caused by multiple factors. In order to treat and prevent it effectively, you need to determine the exact cause of your symptoms.
Ask yourself: When does my back pain begin? Is it in the beginning of my run and then it goes away? Is it half-way through my run and continues ‘til the end? Or is it after the run is over and it comes on later that day or evening? All three of these scenarios involve the fundamentals of running, and addressing them means taking the proper steps towards safe and pain-free activity.
The first thing to consider is whether you’re performing a complete warm-up routine. A general guideline suggests that one should perform a warm-up to the point of slight perspiration prior to a run. Be sure to include:
Exercises that activate your core (such as front or side planks) and your glutes (such as clam shells or side-lying hip extensions). Activating these muscles will help ensure they are firing at the right time during your stride, which will prevent injury.
Active stretching, such as gentle squats or lunges. Adding arm movements to these exercises can warm up your upper body as well.
Calf and hamstring stretches (such as touching your toes) to reduce the forces pulling on your lower back during your run.
Rotational exercises. Your body goes through rotational patterns while running, not just forward and backward motion.
If your low back pain occurs during your run, then your back may be doing more of the work than your core and legs. To take some of the stress off your back as you run:
Try consciously pulling in your deep core muscles.
Lean your trunk slightly forward.
Maintain proper arm swing and upper trunk rotation.
Breathe properly to ensure proper rib cage expansion, allowing your muscles to work through their entire range of motion.
Pain after the run can be from overuse, implying that one or more muscles are in spasm and unable to turn off. Inadequate core and leg strength, inflexibility, and improper form can place your back at risk. Preventative measures include:
Ensuring proper stride length, trunk rotation, and breathing patterns as you run.
Spending the time to get a good cooldown and stretch. Stretching your calves and hamstrings is especially important. Do not just get into the shower or move on with your day after you run.
Foam rolling your lower and upper back.
If you are experiencing long-lasting low back pain or pain down your legs, and taking the appropriate steps above is not bringing relief, then you should consult with a local physical therapist or medical provider to fully understand the cause of your pain.
Greg Reinhardt is a manager for physical therapy with Hospital for Special Surgery Rehabilitation. He received his Master's Degree in Physical Therapy from the University of Connecticut and his Doctorate from Temple University. Greg has a special interest in hip and spine pathology. He became a certified hip therapist and USGTF-II in 2011. Greg received advanced training in HSS's orthopedic residency program in 2011. Greg's clinical interests include sports medicine, hip pathologies, and rehabilitation of athletes.