in runners. Back pain can be a mysterious thing. Every time your feet hit the ground, the reacting shock is transferred up your legs to your hips and spine, and any biomechanical imbalance can ultimately cause lower back pain.It could be that you have flat feet, and your over-pronation (rolling in of your feet) is causing your back ache. It could be that you have really high-arched, rigid feet and the lack of pronation is causing your back pain. It could be that one of your legs is ever-so-slightly shorter than the other, or that your pelvis is just a tiny bit uneven or tilted. You could have a curve in your spine. More seriously, one of the discs between the vertebrae of your spine could be degenerating or arthritis is setting in.
Back pain can be a tough mystery to solve, but with a little help from your friendly neighborhood sports medicine specialist you should be able to track down the cause. By far the most common diagnosis in patients with low back pain is the lumbar sprain/strain, which accounts for about 75% of all cases of low back pain. While muscle strain is the most common cause of back pain for runners, play it safe and visit a sports medicine orthopedist or a chiropractor to have your spine and vertebrae examined if you are experiencing severe pain.
If you have ruled out all the worrisome spine issue, you may have an uneven pelvis or unequal leg lengths. These conditions are relatively common and can be ascertained with a good biomechanical exam. With either, the muscles on one side are being pulled. They're tense to begin with, and the added stress of running can put them into spasm. Relatively weak abdominal and lower back muscles might also contribute to the problem. Running generally tends to cause strength imbalances between these muscle groups. Add tight hamstrings, another common condition among runners, and you have a nifty recipe for back pain. Core strengthening exercises and a lot of stretching can help.
Finally, the root cause is often in your foot, the last place most people look! Back pain is a common injury associated with flat feet and over-pronation. Likewise, if your feet are rigid and high-arched, their lack of stress relief and under-pronation can cause stress imbalance resulting in back pain.
For immediate relief, cut back on the mileage, moist heating pads, anti-inflammatories like ibuprofen, and a good massage. If the problem is disc deterioration or spinal arthritis, surgery may be necessary, and an adjustment in training is absolutely required. Take this condition seriously, and see a spinal specialist. If your spine is merely out of alignment, manipulation by a chiropractor or physical therapist may help ease your pain. This may also ease your muscle strain.
If your doctor confirms that you have an uneven pelvis or unequal leg lengths, the solution will likely be to try to correct the problem with a heel lift on the short side. This may be as simple as putting a piece of 1/4" foam or cork into the heel of your running shoe. If you don't get any relief at all within a week, go ahead and take the lift out. If it does no good, its better just not to wear one; your body may have adjusted to different leg lengths, and "fixing" it may cause more discomfort. Whatever the case, make sure that the remedy matches the problem; do not use a heel lift if your doctor does not confirm that you have an uneven pelvis or unequal leg lengths, or you may only make your problems worse.
If your problem is in the structure of your foot, your solution may be as simple as wearing different running shoes or adding orthotics to the mix. Shoes have been shown to lose almost 75% of their shock absorption after approximately 500 miles. This appears to be the critical point in which injuries tend to develop as a result of shoe wear. Thus it is important to have a rough idea how many miles are on your shoes and to replace them before soreness begins. If your shoes are not worn out, see your podiatrist for recommendations of shoe types and to see if an orthotic will help decrease the biomechanical strain causing your back pain. . In most cases of lower back pain, you will benefit from exercises to strengthen your back and abdominal muscles.Back pain can be an indicator of a serious problem and can lead to a cascading injury that slows your running to a complete halt! Muscular back pain is the most common and can be annoying and complicated to treat due to the myriad of causes. If you have severe pain, seek medical attention immediately. If your pain is mild and seems to be directly related to your running, look to your feet as a possible contributor to you pain.
Dr Marybeth Crane is a board certified foot and ankle surgeon and a vetran marathon running podiatrist. For a copy of her FREE BOOK or more information on running injuries, she can be reached at her website or peruse her musing on her blog! She also offer doctor-approved foot care products for your health!
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