Tips for Running with Back Pain

Unless you are a heel strike runner, back injuries remain very rare in forefoot running because chronic overloading via shock is significantly reduced. But if you got a back injury from a non-running related activity, you can still maintain your regular running volume (within reason, however), but there are things to keep in mind when running with back pain.

Running With Back Pain

Tips for Running with Back Pain

When you have back pain, you may automatically modify your forefoot running biomechanics in ways that may exacerbate the injury and potentially cause more injuries to other areas of the body (Hanlon and Anderson, 2006; Murray et al., 1984). We know from past studies that people with back pain walk with an altered gait to compensate for the pain. For example, low back pain sufferers tend to walk slower with a more extended, locked knee-joint. But, these studies did not attempt to figure out how back pain affects running gait.

A study by Muller et al. 2015 found that runners with lower back pain had different knee and trunk kinematics as compared with healthy runners. The study found that runners with lower back pain had less pelvis and trunk rotation as compared with healthy runners. Restricting pelvic and trunk rotation, as the runners with lower back pain, may be less resistant to mechanical forces as compared with healthy runners who let their trunk and pelvis rotate.  The study also found that runners with lower back pain landed with a more extended knee as compared with healthy runners. Landing with an extended knee induces more shock on the body –there is a strong relation between an extended knee at touchdown during running and poor shock absorption of the lower leg.

So, if you are really wanting to run with an injured back, I would say go for it, but you need to be more strategic with how you run by NOT running with a guarded-gait and to make sure you land with a flexed, bent knee. To avoid further injury, allow your trunk and pelvis to rotate as naturally as possible because it is a natural strategy to defend against impact. Where you get into trouble is when you start running with a compensatory gait in attempt to reduce pain.

Another popular, yet effective way to help with your back pain is through the process of earthing via walking and running barefoot because doing so activates a plethora of nerves in the body’s joints which may save you from making biomechanical errors, such as landing with high knee extension.

  • The most important factor about practicing barefoot running is that nerve connections between the feet, ankles, knees, hips and back are amplified, giving you a more pronounced awareness of your interaction with the ground. It will also automatically give you more knee flexion which reduces pressure on the knee-joint.

So, I would first up your barefoot running and walking activity, just so you can improve the sensory receptive field in your feet, which will stimulate the motor areas in the brain that will fix biomechanical flaws related to running in cushioned running shoes, therefore taking more stress away from the back.

More From Run Forefoot:

Comparing Heel Strike vs Forefoot Strike Running

Barefoot-Feeling Forefoot Running Shoes

Where is Your Forefoot?

Best Barefoot Running Resources


Hanlon, M., Anderson, R., 2006. Prediction methods to account for the effect of gait speed on lower limb angular kinematics. Gait Posture 24 (3), 280–287.

Muller et al. Low back pain affects trunk as well as lower limb movements during walking and running. J Biomech, 2015;48, 1009-1014.

Murray, M.P., Mollinger, L.A., Gardner, G.M., Sepic, S.B., 1984. Kinematic and EMG patterns during slow, free, and fast walking. J. Orthop. Res. 2 (3), 272–280.

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!