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Lower Back Pain From Running: Full Guide

Humans are born to run. Our bodies are mechanically designed to run and run well - but that doesn't make us impervious to aches and pains. The lower back is a complex system, but here I will isolate where you need to focus for resolving lower back pain from running specifically.

This guide covers the two things to consider when rehabbing lower back pain from running - 1) muscle tension/spasms (majority of cases), and 2) spinal/vertebral issues (minority of cases). Save and bookmark this, and make sure to thoroughly read Case 1 for the best chance of understanding and fixing this problem.

Lower Back Pain After Running

 

Is Running Bad For The Lower Back?

No. I believe our muscles and joints were meant to move. I also know that movement naturally lubricates our muscles, spine, and joints and keeps our muscles fresh, pliable, and functioning properly.

As for running - the above two sentences apply completely. Running is a natural, mechanically beautiful movement when done correctly, and it not only doesn't cause problems inherently but it also can correct others (imbalances, weaknesses, etc.).

Lower Back Pain When Running Stride

Natural Running Stride - A Capability Most Adults Lose

Beyond the muscles, joints, and mechanics, running is great for the heart, brain, lungs, and entire body. It increases blood flow and even has positive mental and emotional effects. And above all, humans have been running forever and we were born to run.

Don't let a little lower back pain hold you back. This guide is here to get you back on the road.

 

How To Fix Lower Back Pain When Running:

This post breaks lower back pain from running down into 2 cases - 1) Muscle tension & release, and 2) structural damage. Case 1 is much more common, thorough, and actionable, while case 2 requires some professional opinion.

 

Case 1: Muscle Lower Back Pain From Running

This may be new or old news to you - but to understand why your lower back hurts when running we need a quick muscle anatomy lesson to uncover where the pain is coming from. I'll make this concise I promise.

Muscle Tension -> Lower Back Pain

Running is stressful on the body. Not in a negative way, but it requires a lot of muscles to engage and work hard.

Muscles can develop tension when they are pushed beyond their limits, used without a proper warmup, and/or not given enough love and attention in recovery. Running is no exception - this goes for any physical activity.

Once muscle tension is present it can create imbalances, tug on joints, and cause pain: In this case, what underlying muscle tension manifests in the body is lower back pain when running.

Muscles That Develop Tension When Running

"Muscles develop tension" is quite broad and unhelpful, so here we will isolate the exact muscles that get tight and cause lower back pain from running specifically.

These muscles are listed in order of most to least significant for lower back pain after running. Take note of the trigger point pain pattern chart and descriptions to determine which muscles need the most attention - but do yourself a favor and give muscles 1-3 an inspection.

Muscle 1: Gluteus Medius

Also occasionally grouped in with Gluteus Minimus, Gluteus Medius is arguably the most active and most important muscle in the body during running. Without Gluteus Medius, you would not be able to stand on one leg - much less run.

Gluteus Medius - Lower Back Pain Running

Gluteus Medius Muscle

Gluteus Medius sits in the under buttock in the pocket of the hip, and it works hard when pushing off on one leg (during the hip extension portion of running). In addition, Gluteus Medius functions in hip abduction (swinging the leg to the side) which includes staying upright while standing on one leg.

Gluteus Medius Pain Pattern

Gluteus Medius Pain Pattern [1]

The pain pattern for Gluteus Medius is underappreciated and often neglected - but as you can see it is a gnarly source of lower back pain when tight. This tension is extremely common in runners due to the stress and work that running places of Gluteus Medius.

Deep tissue massage to Gluteus Medius alone has the potential to overcome lower back pain from running. Scroll down to "The Fix Step 1: Deep Tissue Massage" to see how this is done.

Muscle 2: Quadratus Lumborum (QL)

Quadratus Lumborum (QL muscle) is a deep lower back muscle that is required to work during nearly every physical activity. QL works hard to stabilize the spine while lifting, standing, running, or doing anything on the feet.

QL Muscle - Lower Back Pain Running

Quadratus Lumborum (QL) Muscle

The main role of the QL during running is to stabilize the pelvis and lower back - without the QL muscle, your lumbar spine would be as flimsy as a flower on a stem [2].

QL Pain Pattern

QL Muscle Pain Pattern [1]

The QL muscle pain referral pattern is slightly lower than the muscle itself. That being said, if your lower back pain extends beyond running and feels achy and constant 24/7 - the QL muscle should be a primary suspect for contributing to pain.

Much of your QL lower back pain relief will come from massage and strengthening. A tight QL is also a weak QL, so incorporating QL exercises like side planks along with the massage techniques below can fast-track recovery and bulletproof the lower back when running.

Muscle 3: Tensor Fasciae Latae (TFL)

The TFL isn't exactly a lower back pain muscle - but it does cause a ton of hip pain when running. If you feel your whole lower back/hips/glutes are locked up, this muscle is one to inspect because of its crucial role in running (see quotes at the bottom for reference).

TFL Muscle - Lower Back Pain Running

TFL Muscle

The TFL muscle connects from the top of the hip to the knee, and it can cause pain all along that connection. The TFL muscle also contains the IT Band. If you have heard of IT Band syndrome, runner's knee, or a similar synonym - the TFL muscle is the actual source.

TFL Muscle Pain Pattern

TFL Pain Pattern [1]

Most of the TFL pain relief benefits will come from massage alone. Make sure to massage the bulb part of the TFL muscle itself, not the IT Band.

TFL - Lower Back Pain Running

Muscle 4/5: Psoas & Iliacus

These muscles don't actually cause lower back pain when running, this is just a litmus test. If you hear advice on releasing either of these muscles to assist with lower back pain from running specifically - you are sadly misled.

Psoas Muscle - Lower Back Pain Running

Psoas Muscle

Psoas and Iliacus cause a ton of lower back pain in sedentary folks from sitting, and some will throw these out as a blanket fix for all cases of lower back pain. The problem is - running is actually phenomenal for these muscles.

Running naturally lubricates, unsticks, and mobilizes Psoas and Iliacus as the human body was intended. The running stride is mechanically beautiful at opening these muscles up and they are the least of your concerns as a runner.

 

Releasing The Muscles That Develop Tension When Running

Fixing the muscle tension causing your lower back pain from running is simple in concept. First, we massage the key muscles above. Next, we stretch. Lastly, we strengthen so the pain is less likely to return.

The Fix Step 1: Deep Tissue Massage

Running builds great strength, endurance, blood flow, and functionality in the body, but it tends to build tight, tense muscles as well. The goal here is to physically massage and iron out any trigger points, knots, or rigid muscle tissue that currently holds constant tension in the body.

The muscles to massage: Gluteus Medius, QL, TFL

QL Claw

The best tool for Gluteus Medius, QL, and TFL massage is the QL Claw. You can also visit a professional physical or massage therapist, but QL Claw is the next best thing and you can use it right at home.

Gluteus Medius Massage Release:

Gluteus Medius Release - Lower Back Pain Running

Gluteus Medius Setup - Lower Back Pain Running

Glute Medius Massage - Lower Back Pain Running

Gluteus Medius Release Tutorial

QL Massage Release:

QL Placement - Lower Back Pain Running

QL Laying - Lower Back Pain Running

QL Massage - Lower Back Pain Running

QL Release Tutorial

TFL Massage Release:

TFL Release - Lower Back Pain Running

QL Claw

Whichever massage method you choose - try to accumulate 5-10 minutes of massage on each muscle for 2-3 days. This is a lot of volume, but that is what it takes to resolve potentially years of tension buildup contributing to lower back pain from running.

The Fix Step 2: Stretch

Stretching increases the length of muscles, reducing their tension and pull on joints. It is important to do this after step 1 because a rigid, trigger-point-ridden muscle often will not stretch.

The muscles to stretch: Gluteus Medius, TFL

Work up to 2 minutes stretching each muscle per day. There are several tutorials online for stretching each of the two, but the pigeon stretch and couch stretch are great for Gluteus Medius and TFL respectively. (We also have a lower back flexibility program, but these two stretches should be plenty).

Gluteus Medius/Minimus Stretch

The Fix Step 3: Strengthen

Strengthening is important because it increases your body's work capacity, and your ability to run without pain for longer. Strengthening also reduces the risk of tension and pain from coming back (lower back pain should be mostly gone by step 2).

The muscles to strengthen: Gluteus Medius, QL

Strength training is a lifelong journey, and "use it or lose it" is real. As long as you want to run without lower back pain, I would train the Gluteus Medius and QL for at least 2-3 sets 1-2 times per week.

Two easy exercises you can do for this are the Fire Hydrant and Side plank for the Gluteus Medius and QL respectively. (See optional lower back strengthening program as well)

QL Strengthening Exercises

 

Case 2: Structural Lower Back Pain From Running

This is more of an edge case than scenario 1 above, but it is worth mentioning. The only real way to know if you have structural vertebral damage in the lower back is via an MRI and consult with a doctor.

That being said, structural spinal damage is incredibly rare from running alone. Vertebral damage that causes lower back pain when running likely also causes pain 24/7 and can be traced to a single or few high-impact events (i.e. car crash, lifting a super heavy object, a sharp tweak in your back while playing a sport, etc.).

Consult a doctor or professional for more on this, it is a little outside of my wheelhouse and expertise. Even if you suspect structural damage to be causing lower back pain when running, I always recommend trying step 1 - massage with QL Claw above because it is low cost, non-invasive, non-permanent, and can potentially fix the problem altogether.

 

Born To Run - Why You Can Run With Lower Back Pain

I believe the human body was designed with the capability to run. The more I learn about muscle anatomy and biomechanics, the more I appreciate running as a natural and mechanically beautiful movement.

I also believe that running is good for the lower back. I may be in the minority in this belief, but lower back pain actually be corrected and worked out from running because of the positive effects of increased blood flow, unsticking of muscles, and lubrication of muscles and joints.

There is no other movement that lubricates the muscles and joints, activates crucial muscles, builds strength and endurance, and increases blood flow quite like running.

 

Lower Back Pain After Running Does Not Go Away

If lower back pain when running persists, it is always best to consult a professional. Speak openly about what you have tried and your response to the massage, stretching, and strengthening techniques above.

One thing a professional can also do is make sure you are rehabbing correctly. It is one thing to know which muscles are tight and what the problem is, but it is another thing entirely to effectively execute massage, stretching, and strengthening to its optimal level.

 

Lower Back Pain Running: Sources & Quotes

Gluteus Medius chapter [2]

  • "Other potential causes of overload in these muscles are weight lifting, running, falls, aerobic exercise, sitting on a wallet in your back pocket, and habitual weight bearing on one side of the body, such as carrying a child always on the same hip. Standing or sitting still for long periods of time makes the gluteus medius vulnerable by encouraging stiffness"

Gluteus Minimus chapter [2]

  • "Falls, sports activities, prolonged sitting, prolonged standing, and running or walking too much are examples of things that can foster trigger points in gluteus minimus muscles. Suddenly overcontracting the muscle, a fall that causes trauma to the soft tissue, chronic overload from being overweight or carrying heavy objects, and injections can all cause trigger points in this muscle"

TFL chapter [2]

  • "The tensor fasciae latae muscles help stabilize both the pelvis and knees during walking and running. In runners and other athletes, the tensor fasciae latae muscles are usually very highly developed. Sit-ups also require the action of these muscles."
  • "Tensor fasciae latae muscles are stressed even more by walking or running on uneven ground."

Gluteus Maximus chapter [1]

  • "Teng et al¬†found that runners with weak hip extensors utilized a more erect posture during running, resulting in increased demand on their quadriceps muscles to attenuate ground reaction forces, leading to overuse running injuries of the knee" (p. 1286)
    • Translation: Weak glutes cause you to run more upright, placing more pressure on the quads and knees.

Gluteus Medius chapter [1]

  • "Effective hip abduction training is essential for athletes because researchers have found that weak hip abductors play a role in anterior knee pain and are correlated to a higher incidence of anterior cruciate ligament ruptures.¬†Lower activity of the gluteus medius muscle has been also found in patients after diagnosis of patellofemoral pain¬†or after

    reconstruction of the anterior cruciate ligament. Additionally, this reduced activity in the gluteus medius muscle is higher in runners with rear foot strike and patellofemoral pain syndrome, which suggests that the entire lower extremity should be evaluated. Nevertheless, others have observed that higher gluteus medius muscle activity during running is a risk factor for hamstring injury in football players. Therefore, proper evaluation and treatment of the gluteus medius muscle is essential for athletes as part of a comprehensive lower extremity plan of care."

    • Translation: Weak hip abductors (Gluteus Medius & Minimus) correlate to increased knee pain and ACL injuries. Low Gluteus Medius activity is associated with rear-foot striking and more knee pain. Hyperactive Gluteus Medius muscles may be correlated to hamstring injuries as well.

TFL chapter [1]

  • "Long-distance runners may report functional limitation because of increased pain in the thigh area from the increased load placed on the tensor fasciae latae muscle during running."
    • Translation: TFL can be strained, cause pain, and limit performance from running a lot.
  • "Poor conditioning and inadequate warm-up stretching exercises can lead to injuries that activate or perpetuate TrPs in runners. Weakness or inhibition from TrPs in the gluteus medius and gluteus minimus muscles may also cause overload to the tensor fasciae latae muscle because of its synergistic role in stabilizing the pelvis in the frontal plane. Allison et al¬†found in individuals with gluteal tendinopathy that the tensor fasciae latae muscle was activated quicker when compared with controls in the early mid-stance phase of gait to assist the gluteal muscles in lateral hip stability."

    • Translation: Running without a warmup can increase the chance of injury and tension/trigger points in the TFL. Weak Gluteus Medius/Minimus muscles force the TFL to work harder and take more load.
  • "It is also important¬†for a runner to avoid shoes that are excessively worn and to avoid running on surfaces that¬†slope from side to side. Runners with tensor fasciae latae TrPs may benefit from running on¬†a level track, running on one side of the road in one direction and on the same side of the¬†road for the return trip, or running only on the crown of a traffic-free road."

    • Translation:¬†Running on slanting or uneven surfaces is harder on the TFL than running on a flat track.

 

Thank you for reading about lower back pain when running! Share or send this to a friend who suffers from lower back pain from running to help this solution reach more people. Read next:

 

QL Claw

Piriformis Syndrome Exercises

Hip Pain After Running

 
 
 

Sources:

[1] Donnelly, Joseph M. Travell, Simons & Simons Myofascial Pain and Dysfunction: the Trigger Point Manual. 3rd ed., Wolters Kluwer Health, 2019.

[2] Davies, Clair, and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 3rd ed., New Harbinger Publications, Inc., 2013.

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