If you think you have developed RLBS, it’s useful to ask yourself some questions:
1. Have I been travelling recently, sleeping in unfamiliar and not necessarily the best type of beds? Often sleeping in unfamiliar beds can prime us to be susceptible to lower back pain due to the strain that it can put on the tissues of the lower back. This is especially so for runners, who really need good support of our backs as we recover from our training sessions overnight (another good reason not to go and visit the in-laws at christmas!).
2. Have I sharply increased the intensity, length or duration of my running, or am I around six weeks into my first marathon schedule? The most common time for people to feel RLBS is about six weeks into training when we are starting to pump up the volume of runs. Every run will create a little irritation in all joints, which the body then heals and is stronger for it. But an increase in training that you are not used to (and possibly too quickly) can result in your body simply not having the time to heal the irritation before the next time you run. If this happens a few times you will inevitably start to hurt.
3. Are my running shoes giving enough support or cushioning to my foot (are they right for me?) or indeed are they worn out? This I mention regardless of the type of running injury, as it is so very important to get the right shoe, and to replace shoes BEFORE they wear out. The cushioning of good new running shoes helps reduce the shock of foot impact reaching the lower back. Of course, its even better to ensure you include grass or other softer surfaces in your training runs, rather than always pounding the tarmac.
Related: The best running shoes 2018
4. Have I been attending to my core strength? The muscles around the trunk provide a secure belt or corset that increases the stability of the lower back under the stress of running, and reduces vulnerability in the spine. The exercises that develop core strength can easily be learned from Pilates classes or videos, Yoga classes or videos, personal training sessions or just doing good old reliable planks (front and side ones please!).
5. Have i had in the last year or so an injury to my feet, knees, or hips that could have a knock on effect on my lower back? The leg bone’s connected to the thigh bone, which is connected to the lower back…….. in which case a prompt visit to a specialist running osteopath or physio can help to reduce or eliminate the adverse effects of these injuries.
6. Have i been running a lot of hills? A lot of people can develop stress in their lower back from being unaware of keeping their core strong as they run downhill. Holding your stomach in as you go down steep hills can take a lot of pressure off your lower back.
7. Could I be running asymmetrically due to some of my muscles being tighter on one side? Everyone’s muscles are tighter on one side compared with the other. So why is it that when we stretch, we spend the same amount of time stretching for example both calf muscles? Surely that just perpetuates the difference in flexibility that is already there? And surely that means that we would run asymmetrically, creating potential for all manner of running injuries? Balance and symmetry is so important to healthy and pain free running, so when you stretch I would recommend doing the following. Let’s take the calves as an example. Test which calf feels tighter by simply testing a stretch on each side. Identify the tighter muscle. Stretch the tighter side for 50% longer than the more flexible side. Do this protocol for every muscle that you stretch on a regular basis.
8. Have I seen a health professional? It is vital that you see a specialist running osteopath or physio. They will check your muscular balance, your spinal joint alignment, your pelvic alignment, and the bio-mechanical efficiency of your hips, knees, ankles and feet. The forces of your feet pounding the pavement are transferred quickly to the knees, hips and ultimately the lower back, which is often the last port of call. If there is any small imbalance or restriction of movement in your lower back, the forces being transferred up to the lower back will be distributed unevenly, resulting in strain and pain. Well worth the 50 odd quid of an appointment, I would say!