There are many reasons a runner may develop lower back pain, and some of those reasons may have nothing to do with sport. Spending too much of your week sitting, or repetitive activity involving the lower back may of course contribute, however it may well be your running posture that’s tipping things over the edge.
One such mechanism may be running with excessive lumbar extension and a forward tilting pelvis. Think the amazing Michael Johnson who was dominating the 200m and 400m in the mid-late 1990’s (see pic below). Whilst this running posture obviously worked for Michael – and his body tolerated it, generally this type of over-extended lower back and forward pelvic tilting running posture can contribute to overload of tissues in the lower back, SI Joints, and/or upper hamstrings.
Image: Michael Johnson in full flight
It’s important to state that there is no such thing as perfect posture, or perfect running posture, however during this propulsion phase (pushback) of running it is normal for some forward tilt of the pelvis and some extension of the lumbar spine to allow for optimal leg extension. Australian middle-distance runner Lissy Duncan demonstrates a “more-ideal” running position in the image below.
Image: Lissy Duncan
Test: Where do you generate your extension?
A great test you can do at home to get an indication of whether you may be using too much lower back extension and forward pelvic tilt is the bridge test.
Lying on your back with your knees bent and your feet on a step or chair (60cm is ideal), push your hips towards the ceiling. Be aware of where and what you use to produce this extension as well the posture and movement of your lower back and pelvis. If your lower back arches and you feel the muscles of your lower back excessively working, chances are you are over extending through this region when you run.
Image: Bridge Test Start Position
Image: Bridge Test Finish Position
If you feel or notice your body adopting an extended-forward tilt position either with the bridge test or whilst you’re running, there’s two things to do.
Firstly, be conscious of, and work gradually on changing your position both whilst running and also with exercise. Think of this as the motor skill component.
Secondly, strengthen the muscles that are often weak(er) in runners that can contribute to the lower back and pelvis falling into this posture – the abdominals and hamstrings.
Your hamstrings and abdominals can never be too strong, so here’s 5 exercises that will help you maintain a strong, stable and efficient running posture.
Exercise 1: Nordic Hamstring Curls
Image: Nordic Hamstring Curl Start Position
Image: Nordic Hamstring Curl Finish Position
Begin with your shoulder, hips and knees in a straight line. As you slowly lean forward you will feel your hamstrings activate and your pelvis wanting to tilt forward and your lower back extend. Focus on using your hamstrings to prevent your pelvis from tilting forward and use them to control the loading in your lower back.
Exercise 2: Jack Knifes
Image: Jack Knife Start Position
Image: Jack Knife Finish Position
The focus should be on engaging your abdominals to prevent and resist excessive lumbar extension (don't let your back sag toward the ground) especially whilst returning to the start position (straightening your legs).
Exercise 3: Abdominal Roll Out
Image: Roll Out Start Position
Image: Roll Out Finish Position (go further if you can control it!)
Begin in kneeling position. Roll outwards using your shoulders and lowering your hips towards the ground. Ensure your shoulders, hips and knees stay in a straight line. As you move the wheel away from your body you will feel your back starting to arch. Use your abdominals to control this extension. Go out only as far as your abdominals can control loading through your lower back. Pull back to the start position.
Exercise 4: Leg Lowers
Image: Leg Lower Start Position
Image: Leg Lower Finish Position (go to horizontal if you can control it!)
Begin with your legs at the top position (hip 900, legs towards the ceiling) and lower back relaxed against the floor. Slowly lower your legs towards the floor until you feel your pelvis tilting forward and your back lifting off the floor. Focus on using your lower abdominals to resist and control this. Return to the start.
Ensure you do not lower your legs so far down that you have excessive movement in your lower back. This can be a major reason why this exercise may give you lower back pain.
Exercise 5: Swiss Ball Push Backs
Image: Push Back Start Position
Image: Push Back Finish Position
Start in a press-up position with your feet on the Swiss ball. If this is too hard – place your shins on the ball to make it easier. Keep your shoulders, hips and ankles all in alignment. Push back off both your shoulders, extending your arms and pushing the ball backwards. The spine will want to sag into extension, ensure your abdominals are active to prevent this (resisting extension). Pull yourself back to the start position using your shoulders keeping your shoulders, hips and ankles all in alignment at all times.
There can be other reasons for an anterior pelvic tilt and extended lumbar spine, so I always recommend getting a qualified health professional to assist with your conditioning and any injury management.
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