How to Prevent Lower Back Pain When Running

Is your lower back sore during or after running? If you heel strike when you run this may be your problem, but luckily, forefoot running may help significantly un-stress the lower back to the point where it may bring full resolve to your running-related lower back pain.

How Heel Strike Running Causes Lower Back Pain
Heel strike running may cause lower back pain over forefoot running because more impact is more highly dispersed up the lower back.

There are 2 ways heel strike running may cause lower back pain: over-striding and knee-joint stiffness, both result in poor impact absorption and increases transient vibrations on the lower back.

Over-Striding

Over-striding (shown below) means the knee-joint is extended when the foot strikes the ground [1], and tends to be more easily engaged when landing heel-first when running. This is because to land heel-first while running, the leg tends to over-reach in front of the body, causing the knee to completely unbend (knee extension). Landing this way creates a longer distance separation between initial foot strike position and the upper body (which is also the centre of mass). The problem with this landing configuration is the body comes to a crashing halt for a longer period of time than if the foot landed closer to the upper body, like it does in a forefoot strike landing.

Heel Strike Running May Cause Lower Back Pain

Furthermore, landing with the foot too far in front of the hips (over-striding) alters the position of the lower back and contributes to excessive anterior pelvic tilt, which is a major risk factor for lumbar lordosis [2,3].

Knee Joint Stiffness

Knee-joint stiffness at touchdown is another problem more common in heel strike running than in forefoot running. As stated above, the knee is usually extended at heel strike which means the knee-joint is less flexed and compliant, making it less able to attenuate shock [4]. This loss of impact absorption amplifies impact to the lower back.

How Heel Strike Running May Cause Lower Back Pain
The farther back you land on your heel when running, the more the knee-joint tends to extend (unbend). The more the knee unbends at landing when running, the more it becomes stiff and locked out. An extended knee at touchdown restricts the knee-joint’s range of motion, resulting in poor compliance [4]. This makes the knee less able to attenuate shock and may cause more impact to ripple up the leg, through the back.

Why Forefoot Running May Stop Your Lower Back Pain

A growing body of evidence shows that foot strike pattern when running directly influences knee-joint and leg swing mechanics whereby landing forefoot-first when running has been shown to be a significant contributor in reducing knee extensibility and the overstride angle. This can permit net impact to occur at lower intensities which can be less distressing on the back.

Forefoot running engages these positive changes in mechanics because the action of landing forefoot-first when running naturally causes the knee-joint to slightly flex (bend) which actively encourages the foot to land closer to the center mass, shown below:

Forefoot Running May Prevent Lower Back Pain
There seems to be less forward reach of the leg when you land with a forefoot strike. This also prevents over-striding because the knee-joint tends to bend more at touchdown, resulting in under-hip-foot-placement [5,6]. This is important because it shortens the distance between initial foot strike position and the centre of mass. As a result, the body spends less time braking into the leg and weaker all-around impact forces are produced. A bent knee at landing when running also results in a more compliant knee-joint which improves shock attenuation [7]. This is how forefoot running may do a better job at shielding the lower back from impact vs heel strike running.
The final piece of good news is since the over-stride angle is naturally reduced in forefoot running via increased knee flexion at landing, this may keep the position of the pelvis in a safer range, helping reduce stress on the lower back.

Evidence like this is just more confirmation that forefoot running is an exceptionally effective way to limit the impact forces most commonly linked to heel strike running  which are also most commonly linked to lower back pain.

If you enjoy my blog on forefoot running, you’ll love my Run Forefoot YouTube channel here!

More to Explore at Run Forefoot:

Forefoot Running Shoes

Chronic Exertional Compartment Syndrome

Metatarsal Stress Fractures

Barefoot Running

Why Heel Striking is Bad for You

Preventing Runners Knee


References:

[1]. Altman AR, Davis IS (2012) Barefoot running: biomechanics and implications for running injuries. Curr Sports Med Rep 11:244 – 50. doi:

[2]. Delgadoet al.(2013). Effects of Foot Strike on Low Back Posture, Shock Attenuation, and Comfort in Running. Med Sci Sports Exerc, 490-96.

[3]. Schache, AG., Blanch, P., Rath, D., Wrigley, T and Bennell K. (2002). Three-dimensional angular kinematics of the lumbar spine and pelvis during running.Hum Mov Sci,21:273–93.

[4]. Nicola, TL and Jewison, DJ. (2012). The anatomy and biomechanics of running. Clin Sports Med, 31(2):187–201.

[5]. Franz, JR., Paylo, KW., Dicharry, J., Riley, PO and Kerrigan, DC. (2009). Changes in the coordination of hip and pelvis kinematics with mode of locomotion. Gait Posture, 29:494–8.

[6]. Kerdok, AE., Biewener, AA., McMahon, TA., Weyand, PG and Herr, HM. (2002). Energetics and mechanics of human running on surfaces of different stiffnesses. J Appl Physiol, 92:469–78.

[7]. Hamill J.,  Moses M and Saey J. Lower extremity joint stiffness in runners. Res Sports Med, 2009;17(4):260-73.

Bretta Riches

"I believe the forefoot strike is the engine of endurance running..."

BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.
Bretta Riches

P.S. Don't forget to check out the Run Forefoot Facebook Page, it's a terrific place to ask questions about forefoot running, barefoot running and injury. I'm always happy to help!