It is sooo annoying when an injury that is totally unrelated to running, prevents you from hitting the road. In this article I explain what 4 steps you should take to safely return to running when you have back pain.
I've also discussed this in more detail in this video:
Step 1: Understand the cause
This is really key to getting your recovery on track. If you can understand why you have your back pain and what structures are involved, then you know what exercises you should be doing as well as roughly how long your recovery period will take.
You don’t need any scans for this. A skilled physiotherapist will be able to assess you and provide you with a diagnosis and treatment plan.
Step 2: Treatment = Mobility + Strength + Moving
There are plenty of different structures (muscles, ligaments, joints, discs, nerves) that you can injure in your back as well as different types of injuries (overuse, acute strains, compression etc.) that the same structure can sustain. And all of these will require a slightly different mix of mobility and strength exercises as well as just general movement. I explain this in a bit more detail in the video but if I had to summarise these:
Mobility: Some back injuries do really well with strong stretches and movements into full range while others (like acute strains or disc injuries) only want very gentle range of motion movements that are initially kept in the pain free ranges.
Strength exercises: Most back injuries can benefit from strength training as it helps to improve the circulation and the stronger your muscles, the better they can support your spine. However, these have to be set at the correct level for your injury and not cause any pain during or after you’ve done them. There’s an endless list of exercises that you can do, so just because one set hasn’t worked for you does not mean that you can’t strength train – you just have to find the ones that are right for your back.
Moving: Probably the best thing that you can do for a back that is sore, is to move. For someone with an acutely painful back, this may mean a short walk. but for others this may mean a long walk, swimming or cycling. Any activity that can increase the blood flow in that area and get the joints moving will help as long as you can do it with only mild discomfort.
Step 3: Time
The body takes time to heal because it has to produce new healthy cells to replace the damaged ones. Changes in flexibility and strength also takes several weeks. As a rough guide you can expect the following healing times:
A mild sprain – 4 to 6 weeks
A more significant sprain – 8 week or several months
A mild disc injury – 8 to 12 weeks
A more severe disc injury – This can vary a lot but anything from 6 months to 2 years to get back to full function.
An injury affecting one of your nerves in your leg – this can vary a lot depending on the type of injury but can take anything from 3 months to 2 years.
Important: The level of pain you have is NOT an indication of the severity of your injury. I often find that severe pain can actually settle down to very mild levels once a person start doing the right things. I can usually predict much more effectively how long an injury will take to recover by observing how a person's pain changes within the first 2 weeks of following my treatment advice.
Step 4: Walk/Run programme
This is a very important step. By following a walk/run programme, it allows your back to slowly get used to the impact forces from running. It also allows you to really focus on your form during the short run intervals. I discuss this in more detail in the video above.
Because the first sessions are usually also quite short, if your back does decide to flare up it is usually only a mild discomfort that settles quickly. Whereas if you go for a long continuous run, it can often cause a quite intense flare-up that may take several days to settle down.
Let me know if you have any questions. Need more help with your injury? You’re welcome to consult me or one of my colleagues online via video call for an assessment of your injury and a tailored treatment plan.
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