Low back pain is not often thought of as running related injury. Running related back pain ranges from mild stiffness and soreness after a run to acute pain which makes even simple activities of daily living unbearable. Understanding how your low back functions during running is an important first step in the treatment and prevention of low back pain. The lumbar spine is comprised of 5 vertebrae and their associated joints. The facet (or zygapophyseal) joints are lateral to the vertebral body and allow us to side bend and rotate while preventing excessive motion. The lumbar vertebrae are beefy compared to the more mobile and smaller thoracic and cervical vertebrae.

Because humans are the only true bipedal (walk, run on two legs) mammals, a complex system of asymmetrical joint motion allows us to move on two legs over ground. An equally important muscular network allows us to stabilize our joints while providing the power to cause movement. Our center of gravity is located in the area at the base of our spine and pelvis. Although our center of gravity shifts slightly depending on the terrain we are running up or down, intrinsic (provided by our own muscular, ligaments, and joints) stability in our center of gravity is necessary for pain-free running. Therefore, it makes sense that low back pain associated with running may be caused by deficient or ineffective stabilization in the area of our center of gravity.

Counter rotation in key body areas allows for efficient, balanced running. Without counter rotation, running on level ground would feel like walking on a fixed piece of 2-inch webbing holding a 50 lb. box in your hands! The low back functions in close harmony with our pelvis during running. There is a reason why our right arm swings forward as our left leg strides forward. There is a reason why our right pelvis rotates backward during push-off as our left pelvis rotates forward during the swing phase of the running cycle. Counter rotation, therefore, provides stability and movement through an orchestrated firing of both postural and movement muscles throughout our core area (low back, hips, abdominals). *see figure below*

If the low back and pelvis are stiff and lack the movement necessary for counter rotation during running, then low back compression is increased and pain results. Stiffness in the low back will result in excessive motion elsewhere. For example if my low back muscle and/or joints are tight and stiff, I may compensate with excessive arm swing or increased torsion through my hips, knees, ankles, or feet. Listen to what your low back is telling you. Work on not only core strength, but spine and pelvic mobility exercises as well. If you have low back pain, see a physical therapist who understands running-related counter rotation and spinal mobilization to provide you with helpful, efficient solutions to allow you to run pain-free.

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Run far and run healthy!

John Fiore, PT