With marathon training in full swing and with many people embarking on their longer weekend runs, runs upwards of 15 to 20 miles plus, it is so very important to maintain your health at this stage of training. With this phase of training it is the experience of some marathoners that nagging low back pain becomes a problem and may derail ones training in this critical window of preparation.
Predictably, early on in training , we see injuries develop in the feet and knees. As miles and overall duration of runs increase we begin to see a progression of injuries up the kinematic chain to the hips and lower back.
Today we are going to highlight an area that tends to be overlooked as we train. This area is the lower back, specifically, the influence of the hip flexors muscle group on the spine and the influence of the erector spinous group in low back injury. Sometimes neglected in our training routines, it is important to stretch and maintain flexibility in each of these areas. This is important because with our longer distance runs we tend to go into a more flexed posture as we run pushing through the longer distances and longer duration runs. In preparation for the great challenge of 26.2 miles, proper running form and running mechanics often suffer and break down. When this occurs, strength deficits in the proximal hips/core are exposed. We tend to shorten our stride and produce less hip extension which shortens our stride and potentially leads toward the development of the shortened hip flexor muscle group. Maintaining a strong core and balanced hip strength is important, but it is equally important to be stretching the hip flexors and maintaining healthy lower back flexibility by stretching both areas before and after runs. Below are two stretches you can do to maintain a healthy lower back as you progress through your marathon training programs.
Extension Stretch for Lower Back:
Hip Flexor Stretch in Kneeling Position:
After any type of physical activity especially after long training runs, it is very important to maintain good postural awareness. This is important because the soft tissue structures around the spine are “warmed up” and more prone to injury upon sitting in a slumped posture. A good practice to get into upon completion of a long run is when sitting down; utilize a towel roll behind you lower back. To do this make sure you sit with your backside to the very back support of the chair. Then place the rolled up towel just above your backside, which will help support and maintain the natural lumbar spine curve or lordosis and therefore make you less prone to placing increased stressors through the soft tissue structures of the low back.
As you progress through your training make note of these simple yet effective stretching practices to maintain a healthy back so that you can have a healthy and positive marathon experience. I wish one in all success as your race approaches.
Doug Hoogendyk, PT, DPT, Cert. MDT, CSCS
University of Southern California Orthopedic Resident.
About The Author:
Dr. Doug Hoogendyk, PT, DPT, Cert. MDT, CSCS is a physical therapist at Paulseth & Associates Physical Therapy, a longtime sponsor of the L.A. Leggers. Doug is an avid runner and triathlete and has successfully competed 5 marathons. Dr. Hoogendyk is currently training to compete in the Ironman Triathlon World Championship in Kona Hawaii.
NOTE: Let it be noted that the author of this article acknowledges that there are many other potential causes of low back discomfort and injury in the lumbar spine but these potential pathologies are beyond the scope of this article.