Are Runners Doomed to Have Back Pain?

I've heard running wrecks your lower back? Is that true? – Margie Semilof, Boston, Mass.

The truth is, more than 80 percent of Americans have experienced pain in the last five vertebrae of their spine at some time or another. Running is known for being a notorious back killer, especially for those who are just starting out or those who frequently pound the pavement. Fortunately, for the most part, this is a completely avoidable situation.

Runners are magnets for backaches for three main reasons: Poor running form, overall poor posture, and weak muscles (usually the core muscles of the abdominals and lower back). Though I will treat them as three separate problems, as you will see, they are all related.

Running is something we are all able to do naturally, but hang out by a track or a running path sometime and you'll see an amazing amount of terrible technique. From splayed knees to curved spines to rounded shoulders, some of the form is so bad it actually looks painful. If you think of your bones as links in a chain (the ankle bone's connected to the knee bone, the knee bone's connected to the thigh bone and so on) it's not such a leap to understand why even a mistake as low down on the chain as rolling the foot excessively inward (known as pronation) or as high up on the chain as hunching your shoulders can lead to a pain in the spine.
To perfect running form, I usually recommend people spend 15-20 minutes each week doing nothing but focusing on form. Go through a head-to-toe mental checklist, taking a moment to pause and really think about things like how each part of the body is placed, whether your muscles are tight or relaxed, and how everything feels. This is where a treadmill can come in handy, especially if you can find one situated near a mirror so you can continually peek at yourself while in motion. I also recommend practicing this checklist on uphills and downhills – if you're tired or inexperienced at running slopes, your technique can get left by the side of the road.

Once you shower, toss your clothes in the laundry basket and change into street shoes, do you go about the rest of your day hunched over like a gerbil eating a carrot? This is a fairly common mistake all people make, not just runners. But if you run regularly and you sit at a desk for much of the day and you work at a computer, you are practically doomed to fighting posture problems. And it's a vicious cycle: If your posture is generally bad, it will get even worse when you run, which will make it worse in general.

You can counteract some of the pain by making sure your desk is set up correctly and taking frequent breaks where you physically get up from your desk, move around and stretch to balance out all of that forward rounding. I recommend incorporating yoga or Pilates into your workout routine -- these disciplines do a wonderful job stretching, pulling and lengthening everything back to where they belong.

However, a note of caution: As great as yoga and Pilates are, many of their positions call for you to lie on your stomach and lift your chest, legs, or some combination of the two, off the floor. While the purpose of these moves is to strengthen your back and stretch out your abs, they're often the straw that breaks the proverbial camel's back. Pushing past the point of natural flexibility can lead to strains and pulls. Always move into a back arch carefully and never force yourself past your natural arch. If you're a serious runner, you might want to consider yoga for runners.

A regular yoga or Pilates routine can also help rebalance the strength and flexibility of all of your muscles, especially those core muscles. If you can find two 10-minute pockets to do some weight training, it will help build that deep-down strength that supports the middle of your body and helps prevent back pain. If you're especially prone to lower back attacks, avoid overhead pressing movements and anything that involves a lot of quick, sudden twists. Most lower back injuries can be prevented during pressing exercises by lightening the load and tightening your abdominals to create additional stability and support for your lower back.

Last week I gave you the three great core exercises to try. At the very least do those if your back bothers you after a run. And remember: any exercise you do wrong – be it running, Pilates or weight training -- can contribute to your back woes instead of solving them, so practicing good form no matter what you do is essential.

Oh, before I sign off, a few more things that may help: Lighter runners have an easier time carrying the load so shedding any excess weight will be easier on your back. Make sure you wear a good bra so excess bounce isn't contributing to fatigue and wear shoes that suit your running style and preference.

Any other advice out there for Margie-the-runner and her quirky lower back? Either post it here or tweet me Lizzyfit@twitter.