Why Does My Back Hurt When I Run?
Updated: Sep 14
Unfortunately, the answer to this frequently asked question is “it depends”.
Patients with low back pain while running typically have one or a few of the following conditions going on:
Facet Joint Irritation: The spine is made up of vertebrae (the bones in your spine). In between each vertebrae is a fluid filled disc (you know the ones that “slip”… they really don’t, but more on that later). If you have a large lordosis (curve in your low back), think dancers, gymnasts, pregnant women, and have weak abdominal muscles that are unable to stabilize these joints while running, the facet joints can become irritated, inflamed and painful while running.
Sacroiliac joint dysfunction: The Sacroiliac joints (SIJ) are two joints which sit on either side of the lowest part of your back above your buttocks (you have two dimples where these joints live). If we land harder on one foot than the other while running, jumping, dressing this can cause excessive pressure in that joint resulting in irritation, inflammation and pain at the SIJ.
Poor stabilization and hip weakness: The stabilization system of our body is one of the most fascinating things I have ever learned. We have an in inner stabilization system made up of the diaphragm, pelvic floor muscles, multifidus (surrounds our vertebrae) and transverse abdominus (imagine a corset- that is how it works). On top of that inner stabilization system we have the outer abdominal muscles (the pretty muscles that result in a 6 pack) that offer support to our spine as well. If there is a weakness in any of these muscles and you try to power through a long run you know how that is going to end… pain, irritation, poor run times. Now, our core muscles, when working correctly, offer great support to our spine, but as we all know, our spine connects to our hip and pelvis so not only is core stabilization important, but hip strength is equally important. If our hips are not working (AKA they are weak) our spine is going to take up the slack for the hip weakness resulting in low back pain and irritation.
Muscle imbalances: Let me paint a picture in your head. Imagine your hip flexors (the muscles on the front of your hips) are very tight. They pull you forward into a slightly bent position (so slight that you might not notice it). This slightly bent position causes your posterior hip muscles (buttock muscles/gluteals) and back stabilization muscles to become stretched and weak. Over time, this sustained tightness of the hip flexors (front muscles which are tight from sitting all day long or overuse from running) and stretch on the hip extensors (buttock muscles) results in poor running mechanics, poor spine stabilization and poor hip strength.
Ask yourself the following questions.
Do you have a pain in your lower back while running, which comes on during the run after about 10-15 minutes into the run?
Do you have a pain and tenderness, while running, over or around the dimples in your low back? Go ahead and find those dimples while you are reading this. Secondly, go find a flight of stairs. Does it hurt to go up and down stairs? How about standing on one foot? Hold on while you try this so you don't fall down please.
Does your back often feel stiff and on the edge of getting injured, especially, but not exclusively when running?
Do you have a pain that refers to your buttocks, but does not travel below your knee?
If you answered yes to any of these questions you might be dealing with low back pain that can be improved with targeted manual therapy, strength training and mobility exercises. Click here to request a completely free consultation with a physical therapist. We can quickly figure out what’s causing your pain and limiting your mileage without it costing you a dime.
Running should be the time that you can focus on you. You need to be able to enjoy it without pain.