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A common cause of low back pain with running is weakness of the core muscles. If your core is weak, as your foot strikes the ground the lower back may over-extend, overloading the facet joints of the lower back. A classic sign of core weakness is back pain aggravated when running downhill but relieved when running up uphill.
To test your core strength you can perform the side plank test: Set up in a side plank position – on your side with your spine straight, supported by your bottom elbow and both feet. Hold this position for as long as you can with good alignment. Make a note of the hold time before repeating on the opposite side. If you are unable to hold this position for 60 seconds on both sides, or there is a 5% or greater difference between sides, this is an indicator of core weakness or imbalance.
However, not all back pain with running is due to core weakness. If you pass the side bridge test but still suffer pain with running there is likely another culprit which you should have investigated. If you failed the side bridge test, take a look at the side bridge exercise progression below:
Side bridge progression for back pain with running :
The side bridge position can also be used as an exercise and is a great way to train the core as it works many key spinal stabilising muscles but with relatively low load on the spine making it extremely safe.
1) Side Bridge from knees
- Start the exercise lying on one side on your knees, feet and forearms, with your hips and knees slightly bent
- Your feet, hips and shoulders should all be in one line.
- Lift your lower hip up slightly and pull your lower shoulder down away from your ear so that your spine begins to straighten—this is the ready position
- Move into the plank position by raising your hips up and forward.
- Hold the position for 2 breaths before relaxing back into the ready position.
- Try and breathe into your stomach and the sides of your lower ribs rather than into your shoulders.
- You should feel the muscles on the bottom side of the trunk of the trunk working hard.
- Repeat up to 6 repetitions both sides
2) Full side bridge
Set up in a full side bridge (as per the test position). Start by performing 3-6 sets of 10 second holds. Slowly increase the length of the hold until you can perform holds of 1 minute. Goal is 3 sets of 1 minute on both sides.
3) Side bridge with leg lift
You can increase the intensity of the side bridge further by lifting your top leg. This will also increase the challenge on the stabilisers of the hips which work together with your core to support your back when running.
*Images reproduced from Liebenson. C., Journal of Bodywork and Movement Therapies
This post was written by Steffen Toates. Steffen is a chiropractor at Dynamic Health Chiropractic in Jersey, Channel Islands. For more information about Steffen click here.