How to Avoid Back Pain During Training

How to Avoid Back Pain During Training

By Kathleen Leninger, PT, DPT

There is nothing worse than waking up on Monday morning to go to work but not being able to sit or stand because your back is so painful from your long run.  When marathon training, you are expecting pain in your legs, feet or knees but back pain is always surprising.  

A recent study looked at the risk factors of low back pain in runners training for marathons and half marathons.  The study found that the presence of low back pain in runners was not associated with their occupation or running pace.  The questionnaire that was given to 800 runners found the following were risk factors for low back pain: 1 – insufficient warm-ups, 2 – fatigue, 3 – poor running gait posture and 4 – uncomfortable environmental temperature.  Let’s go through some easy fixes! 

  1. Insufficient Warm-Ups.  We never have enough time to do “all of the things” but prioritize doing something.  Pick the most important warm-ups that address your nagging areas and also target the most areas.  You can do hip bridges or leg swings when eating breakfast.  You can do walking lunges to get out the door.  The other things you can do is add in dynamic stretches and warm ups at red lights in the first few miles. 
  2. Fatigue.  When your mileage is at its highest for the year, you BETTER be sure your hours of sleep are also at their highest.  It is okay to say “no” to dinners, events and other plans so you can prioritize your sleep.
  3. Poor Running Gait Posture.  It is important to have a few phrases to help you maintain good posture (“Pelvis forward”, “run tall”, “shoulders back”, “push the ground away”).  When running your longer runs, make sure you are saying these phrases out loud every few miles. Practicing them when you are fresh and when you are tired helps to make permanent postural changes.
  4. Uncomfortable environmental temperature.  Planning out your week around the weather is so important.  Make sure you are starting your run early enough or wait until it cools down at the end of the day.  The hotter it gets, the harder it is to maintain good posture. 

Back pain doesn’t have to be a part of your training!  Core stabilization, good recovery and postural awareness are all things we can work on together, just ask your therapist! 

Wu B.,  Incidence and risk factors of low back pain in marathon runners.  Pain Research and Management 2021, 2021.  

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