Have you ever wondered how Forrest Gump managed to run 25,000 kilometers without ever suffering from back pain? Well, it’s very simple. He did it gradually, and accustomed his body to running.
Rob Pope wanted to find out for sure and reproduced dear Mr. Gump’s crazy journey.
Let’s put ourselves in the context of a common situation. You are running gradually and everything is going well. Except that, all of a sudden, while trying to tie your shoes one morning, without warning, you throw your back out and suddenly have to change your half-marathon plans!
Did you know that four out of five adults will experience back pain? That means pain in the back area at least once in their lifetime? (reference on back pain)
We will first briefly explain the different types of back pain and what they have in common.
Then, we’ll explain the seven steps you need to know if you want to get back to running with a smile on your face:
- Find your baseline
- Walk frequently
- Gradually increase the volume of your walks
- Do lower limb and core strengthening exercises
- Increase your speed
- Do split running programs
- Have fun!
But before we get into the nitty-gritty, let’s review a few things to better understand back pain.
The stages of back pain
The stages of back pain Whether you’ve had a lumbar sprain, disc disorder, low back pain, or just plain old spinal pain, these ailments have a few things in common.
Although we sometimes use different terms, it is estimated that 85 to 90% of back problemsare non-specific, meaning that there is no structure we can easily blame for the cause of the pain. This is also true for imaging, as there is not always a strong correlation with how the pain presents.
The acute phase causes an important inflammation sequence, which often results in severe pain. You are probably also very limited in your movements and activities.
You sleep very poorly and it quickly becomes a vicious circle. Perhaps you are also worried or stressed about the situation?
The experience is usually unpleasant. You may have heard a lot of conflicting advice, so you are not sure what you should or should not do.
Although the pain can feel very alarming, back pain is rarely a cause for concern. In fact, less than 1% of back pain cases involve serious pathologies such as cancer or fractures.
Pain serves as a protective mechanism, a bit like orange cones used to warn you of upcoming roadwork. The level of pain also does not correlate directly with the severity of the injury. This means that more pain does not necessarily mean more damaged structures.
Once this acute inflammatory phase is over, can you safely go back to your activities, such as running?
Some people think it’s best to rest, but is that really the best option to optimize your recovery?
Can you prevent back pain?
Let’s take a look at the next step before you get back to sports.
How to treat back pain before going back to running
You can take a few days off and use the strategies that help you best manage your pain to get through the initial inflammatory phase.
Change positions more often if sitting is a problem.
When suffering from pain, you can use distraction strategies to move your focus away from the pain. Doing breathing and relaxation exercises can help calm your nervous system.
In the following days, a more active approach is often appropriate. We strongly recommend that you resume your daily activities and try to stay active after a lower back injury. This will help you in your recovery process.
Complete rest for several weeks is not the answer!
Here are some examples of exercises you can do if you feel relief.
Preventing lower back pain may not be the right way to put it. Rather, we should talk about reducing the risk of recurrence. Most back pain episodes will last a few weeks, but it is not unusual for it to take up to 3 months.
This healing process may be marked by short episodes of pain, as recovery is not always linear, and this is not alarming.
Now that you have overcome the acute phase, you can finally return to your favourite sport: running.
Here is the advice we give to all our patients who want to start running again. It applies even if you still have some back pain.
But do not forget to listen to your body and respect your limits!
1 - Find your walking baseline (starting line/level)
You live with your pain on a daily basis, so you know better than anyone how much activity you can do within your personal pain tolerance without it becoming too irritating.
Tolerable means that you can have a little pain, but it doesn’t become too annoying. Non-irritable means that your pain does not flare up significantly within 24 hours of doing the activity; in other words, that you return to your normal pain level quickly.
If 15 minutes of walking is tolerable and does not irritate you, then that is YOUR baseline!
2 - Walk frequently
Grab your running shoes and, while respecting your baseline, go for a regular walk! Your goal is to go often, almost daily, while respecting your symptoms.
3 - Gradually increase the volume of your walks
Increase your walking intervals by a few minutes. Gradually build up to your usual running time or distance.
The key is to go gradually, adding a few minutes at a time.
4 - Do lower limb and core strengthening exercises
Whether it’s for lower back pain or to stay in shape for running, exercise is always a good idea! Here are some strengthening options that you can do every day as long as you feel well.
This is an example. You can adjust it to suit your fitness level.
5 - Increase your speed
If you are feeling comfortable, you can go for the walk-run intervals directly and move on to step 6.
Otherwise you can do some walking sessions at a slightly faster speed as a first step.
6 - Do split running programs
A split running program, like the one from the runner’s clinic, is a good way to get back into running with walking intervals. You are still aiming for a good pace to gradually get your body used to small doses of running.
Example: Start with 5 min of walking followed by intervals of 1 min of walking and 1 min of running repeated 3 times. Then, add one more interval each time you go out! So: 3x 1:1, 4x 1:1, 5x 1:1, etc.
7 - Have fun!
Of course the important thing is to do an activity that you enjoy while respecting your personal limits. Go at your own pace and have fun!
Always keep in mind that our advice is general and cannot replace a consultation with a health professional like our physiotherapists.
If you don’t have any strategies to help you reduce your pain, do not hesitate to contact us.
Please note that if you have had a significant trauma or a neurological loss of function, you should start with a medical consultation.
We recommend that you seek emergency medical attention ifyour back pain is associated with loss of urinary or bowel function with a loss of sensation in the perianal or genital area.
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Ariane graduated from McGill University in physiotherapy in 2009. She works with people with orthopedic injuries and in vestibular rehabilitation.
She has worked with different clients, including athletes like runners, and non-athletes. She has also worked with professional dancers and is a yoga teacher.
Besides running after her daughter, she loves nature, working out, yoga and a good dose of laughter.
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