3 Ways to Combat Low Back Pain in Runners

By Ryan Domeyer PT, DPT, CMPT for Athletico Physical Therapy

For runners, the compressive load during foot strike is between 2.7-5.7x body weight,low back pain in runners which can contribute to back pain. That said, there is no consensus on whether running is a risk factor for developing low back pain, with some research  suggesting a weak association of low back pain with elite competitive runners. However, since there is a high prevalence of low back pain in daily activities, it is not uncommon for runners to experience pain in the lumbar spine (lower back) during training. Here are three ways to help combat low back pain in runners.

1. Neutral Spine Position

The spine has three natural curves that allow the body to stay erect and absorb force during locomotion. While running, it is common to see an excessive arch or a rounded lower back. Both of these compensations can lead to increased stress on spinal tissues and possible pain. Prior to running, runners can use a mirror to determine if their low back is too arched, too flat or in a neutral position. Runners can also request an appointment at Athletico for a video gait analysis. At the end of the analysis, the patient will receive individualized comments and images of their running gait, along with tips, exercises and critiques to help maximize running performance.

2. Improve Core Strength

One way the spine is protected is by having large muscles groups to help maintain the neutral spine position. The “core” muscles include the abdominal muscles as well as the back and leg muscles. For more information about the core, read Athletico’s “What is the Core of My Body?

Although the traditional exercise for improving core strength is sit ups, there are other alternatives that improve strength without stressing the spine. Planks and supermans, for example, are both good exercise options because they help to improve strength while maintaining the neutral spine when performed correctly.

3. Improve Hip Strength

The gluteal muscles are the largest muscles in the body and are commonly underutilized due to the high prevalence of sitting during daily activities. The gluteal muscles work to propel the body forward and also protect the low back from stress. When the gluteal muscles are weak, more stress can be forced on the low back, which can potentially lead to pain. The easiest way to improve strength of the gluteal muscles is with bodyweight exercises like bridges, planks, side planks, bird dogs and hip abduction raises.

Taking the Next Step

If you are a runner that is experiencing back pain, consider taking the next step by scheduling a comprehensive examination with a physical therapist. Doing so will give you specific direction to help you run without back pain

Schedule a Complimentary Injury Screen

Should 15,000 Steps a Day Be Our New Exercise Target?

Taking 10,000 steps per day is often suggested as a desirable exercise goal for people who wish to improve their health. But a new study of postal workers in Scotland suggests that that number could be too conservative and that, to best protect our hearts, many of us might want to start moving quite a bit more.

It has been almost 70 years since the publication of the London Transit Workers Study, a famous work in which researchers tracked the heart health of London bus drivers and conductors. They found that the conductors, who walked up and down bus aisles throughout the workday, were substantially less likely to develop or die from heart disease than the drivers, who sat almost constantly while at work.

This study was one of the first to persuasively show that being physically active could lower someone’s risk for heart disease, while being sedentary had the opposite effect.

Since then, countless large-scale studies have substantiated that finding, and at this point, there is little doubt that moving or not moving during the day will affect the health of your heart.

But precisely how much exercise might be needed in order to avoid heart disease has remained very much in question. The threshold of 10,000 daily steps, incorporated as a goal into many activity monitors today, has not been scientifically validated as a way to lessen disease risk.

So for the new study, which was published this month in The International Journal of Obesity, researchers at the University of Warwick in England and other institutions decided to refer back to but also advance and expand upon the results of that foundational Transit Workers Study by examining another group of employees whose workdays involve mostly walking or sitting. They turned to postal workers in Glasgow, Scotland.

The Glaswegian mail carriers generally cover their routes on foot, not by driving, and spend many hours each day walking, the scientists knew. But the mail service’s office workers, like office workers almost everywhere, remain seated at their desks during the bulk of the workday.

This sharp contrast between the extent to which the workers move or sit during the day could provide new insights into the links between activity and health, the scientists felt.

They began by recruiting 111 of the postal-service workers, both men and women, and most between the ages of 40 and 60. None had a personal history of heart disease, although some had close relatives with the condition.

The researchers measured volunteers’ body mass indexes, waist sizes, blood sugar levels and cholesterol profiles, each of which, if above normal, increases the chances of cardiac disease.

Then they had each volunteer wear a sophisticated activity tracker for a week, while at work and at home and during the weekend.

Afterward, the researchers determined how many waking hours each day the volunteers had spent seated or on foot. They also calculated how many steps each person had taken each day.

The variations turned out to be considerable. Some of the office workers sat for more than 15 hours each day between work and home, while most of the mail carriers barely sat at all during working hours.

These differences were echoed in the volunteers’ risk factors for heart disease, the researchers found. Those workers who sat for most of each day tended to have much larger waistlines, higher B.M.I.’s and worse blood sugar control and cholesterol profiles than those who frequently stood and moved, even after scientists controlled for age, family history, late-night shift work (which is known to affect heart health) and other factors.

The risks were magnified at the extremes. For every hour beyond five that workers sat each day, the researchers found, they added about two-tenths of a percentage point to their likelihood of developing heart disease, based on their cumulative risk factors.

Meanwhile, almost any amount of standing and walking reduced a worker’s chances of having a large waistline and other risk factors for heart disease.

But the greatest benefits came from the most exaggerated amounts of activity. Those mail carriers who walked for more than three hours a day, covering at least 15,000 steps, which is about seven miles, generally had normal body mass indexes, waistlines and metabolic profiles. Together, these factors meant that they had, effectively, no heightened risk for cardiac disease.

Of course, this study provides a single, limited snapshot of people’s health and lives. The researchers did not follow their volunteers for decades to see who actually developed heart disease. This kind of study also cannot prove that walking or sitting caused the differences in people’s risks factors for heart disease, only that there were associations between activity and risks.

But the findings do imply that there are good reasons to get up from our desk chairs and move, even more than many of us may already be trying to do, said Dr. William Tigbe, a physician and public health researcher at the University of Warwick who led the study.

“It takes effort,” he said, but we can accumulate 15,000 steps a day by walking briskly for two hours at about a four-mile-per-hour pace, he said.

“This can be done in bits,” he adds, perhaps with a 30-minute walk before work, another at lunch, and multiple 10-minute bouts throughout the day.

“Our metabolism is not well-suited to sitting down all the time,” he concluded.


Breaking the Two-Hour Marathon Barrier

Dennis Kimetto about to set a new world record at the Berlin Marathon on Sept. 28, 2014. 

Lowering the men’s marathon world record to below two hours could be easier than some experts have predicted, according to a timely new study of how to run fast. Of almost equal interest, the rest of us could use a few simple tweaks to improve our own, admittedly more pedestrian race times.

The current world record for the 26.2-mile distance, set by Dennis Kimetto of Kenya in 2014, is 2 hours, 2 minutes and 57 seconds. To shave close to three minutes from that time and drop below two hours, the study finds, may require only a few simple adjustments to elite runners’ racing strategies and equipment.

Several programs, some funded by running shoe companies, are working with small groups of world-class male runners in an attempt to shatter the two-hour barrier.

To date, much of the effort in these programs has focused on improving runners’ strength and endurance through longer or more strenuous training. But some scientists have begun to ask whether it might be worthwhile to focus more intently on other aspects of running and, in particular, economy.

In simple terms, running speed depends on both a runner’s aerobic capacity and his or her running economy, also known as efficiency. If one athlete is more efficient than another, his body can use less energy to go at the same pace as the other runner and he should be able to run longer or harder.

For the new study, which was published recently in Sports Medicine, researchers from the University of Colorado in Boulder and the University of Houston decided to calculate the time savings that might be achieved by a series of surprisingly simple changes to how racers run and whether they would be sufficient, by themselves, to get top marathoner runners below two hours.

They began by considering the environment, which can have an outsize effect on running speed. Headwinds and hills reduce efficiency. So one quick way to improve efficiency and speed, they write, is to run downhill. The current world record was set in the Berlin Marathon, which is mostly flat or downhill.

International sports regulations specify that, for world-record consideration, a course cannot drop more than about 140 feet from beginning to end. But a marathon course with precisely that much altitude loss would allow an elite runner to be about 1 percent more efficient and faster, the researchers calculate.

Reducing wind resistance would provide an even greater boost, they next determined. Specifically, if every racer in a small, lead group ran for about three minutes at the head of a line of other runners and then dropped to the back of that group, as bike racers do in a pace line, the runners would all be faster than if they ran side by side. Each racer would use more energy than normal while at the head of the line, since he would be blocking the wind for the others, but would conserve a great deal of energy when tucked in behind the other runners, producing a significant net improvement in efficiency, the researchers calculate.

Finally, they found that by changing shoes, marathoners could very easily increase their speed. Shoes are costly, in terms of efficiency. It takes energy to swing legs, and the energy demands are amplified if weight is on the foot. In past studies, the Colorado researchers had found that adding 100 grams (about 3.5 ounces) to the weight of a shoe reduces a runner’s efficiency by about 1 percent. Lighter shoes make more efficient runners. When Mr. Kimetto set the current world record, he wore shoes that weigh about 244 grams each, the researchers write. Had his shoes been 100 grams lighter, he might have run the same course a minute faster, they conclude.

Interestingly, running barefoot is not necessarily better for efficiency than lightweight shoes, the researchers point out, since a barefoot runner’s foot and leg muscles work harder to offset the absence of cushioning that otherwise comes from shoes. (Nike has reportedly engineered a specialized running shoe as part of its effort to break the two-hour marathon barrier, but the shoes are controversial because they may provide too much of a competitive advantage and not yet available for purchase.)

Taken together, these strategies could potentially improve a world-class racer’s efficiency by almost 3 percent in a given marathon, the researchers calculate, which should reduce their finishing times by nearly four minutes and easily drop the world record below two hours.

Given this data, “I think we will see a sub-two-hour marathon a lot sooner than many people think,” says Rodger Kram, a professor of biomechanics at the University of Colorado, Boulder, who conducted the study with Wouter Hoogkamer, a postdoctoral researcher at the same school, and Christopher Arellano, a professor at the University of Houston.

In the meantime, Dr. Kram says, these strategies might also substantially improve efficiency and race times for the rest of us.

Look for a marathon that advertises itself as having a downhill course, he says. Running the California International Marathon in Sacramento, for instance, which drops about 340 feet from start to finish, could allow an otherwise four-hour marathon runner to shave about 2.5 minutes from his or her finishing time, compared to running a completely flat course, Dr. Hoogkamer estimates.

Similarly, convincing a few fellow runners to join you in a pace line during the marathon might shave nearly four minutes from your time if you would normally finish in four hours, Dr. Hoogkamer says.

Finally, lighter shoes could lower your time by another minute or so, although it’s wise to break in any new shoes well in advance of race day to avoid blisters or other problems.


One Run May Add 7 Hours to Your Life, Study Says

Getting fit for Summer

Running is a simple and efficient way to exercise: all you need is a pair of shoes. It’s been shown to lower a person’s risk for heart disease and cancer, possibly by regulating weight and blood pressure. Now a recent study, published in the journal Progress in Cardiovascular Disease last month, reports that people who run tend to live about three years longer than those who don’t.

The researchers, who have studied the benefits of running in the past, decided to look at available research and investigate whether other forms of exercise like walking and biking provide the same benefits, or if runners have a special advantage.

The study’s authors found that while other types of exercise like walking and cycling were linked to a longer lifespan, it wasn’t to the same degree as running. The researchers calculated that a one-hour run may translate to an additional seven hours added to a person’s life. The benefits capped out at about three years, and the researchers found that the improvements in life expectancy leveled out at about four hours of running per week. More running wasn’t found to be significantly worse for a person, but the researchers say there are no further apparent longevity benefits.

However, the researchers only found an associational relationship between running and longevity. Their data showed that people who run tend to live longer lives, but not that running specifically increases a person’s lifespan. Runners tend to have other healthy lifestyle behaviors like maintaining a healthy weight, not smoking and only drinking low-to-moderate amounts of alcohol, the authors note. Still, the findings suggest running is an especially effective form of exercise.

The study also found that runners who also do other types of physical activity have the same lower risk of early death, though combining running with other exercise is “the best choice,” the researchers write. (Federal guidelines recommend both aerobic exercise, like running, and strength training for optimal health.) They also acknowledge that it’s not yet clear how much running is safe, or if a person can run too much.

“Running may have the most public health benefits, but is not the best exercise for everyone since orthopedic or other medical conditions can restrict its use by many individuals,” the authors concluded.

By Alexandra Sifferlin for Time Health