One of our readers, Nick, wrote me that he had had slowly increasing lower back pain despite exercising regularly. He ran, he stretched, he did abdominal exercises. Nick's doctor told Nick to give up running and take up low impact activity. Giving up running made Nick miserable but he did it. The pain came and went, but overall did not change. One day during a walk, his pain had spread into the back of his hip and was unendurable. He didn't feel able to make it back home, and wound up in the emergency room.
His x-rays were inconclusive and he was sent home with anti-inflammatory medicines, instructions to stretch his hamstrings, and rest or try other non-impact activity. This is a common story that readers mail me. It is unfortunate because:
- The real cause of the pain was missed.
- You do not need to give up running.
- This kind of back pain is not inflammatory so does not benefit by anti-inflammatory medicine, which often causes its own problems.
- Hamstring and other stretches commonly prescribed, more often contribute than help lower back pain, see Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch.
- Forward bending abdominal exercises are a large and misunderstood contributor to back pain - see Good Life Works Better Than Bad Ab Exercise.
- Impact is not the problem. With a little common sense you can see if you clomp instead of walking or running lightly. Use leg muscles to step lightly instead of bashing down with no control. You should be able to run and jump with little impact. Many people walk with higher impact than a good runner lands during running. Future posts will cover this.
Most important was the missed cause - lower back pain during and following running, walking, lifting, and other upright activity is usually from allowing the lower spine to over arch. This hyperlordosis is not caused by an anatomic problem "condition." It is a bad posture, which is easily correctable. Hyperlordosis is one of the most commonly missed causes of lower back pain.
Left drawing shows neutral spine. Right drawing shows one kind of hyperlordosis.
In the left neutral spine figure, the hip is level and horizontal from front (ASIS) to back (PSIS). The hip is also vertical from the top of the leg (greater trochanter) to the center crest of the hip. The right drawing shows allowing the front of the hip (pelvis) to tilt forward, which increases the lower spine angle. A small inward curve in the lower back is necessary for disc health and shock absorption. A high angle is as painful as any other pinching and pressuring of an area.
This is what I had Nick do. You can try it too.
Check yourself these two ways to see if you stand in hyperlordosis:
- Stand up and look sideways in a mirror. Your belt should be level-green line in left neutral drawing. The side seam in dress or trousers should be vertical from leg to waist - black arrow in left drawing, not tilted forward at the hip
- Back up slowly and gently into a wall. If your backside touches first, it may be an indicator that you lean forward at the hip. If your upper back touches first it is usually a good indicator that you lean the upper body backward, which increases a second kind of hyperlordosis. See Neutral Spine or Not? for more.
Here is how to reduce an overly large arch:
- Stand with your back against a wall, with heels, hips, upper back and back of your head touching.
- Put your hands on your hips, thumbs facing the back.
- Roll your hip under so that your thumbs come downward in back.
- Feel the large space between lower back and the wall become a smaller space.
- Keep your heels, hips, upper back and the back of your head touching the wall and stand tall and straight. Lower back pain that is caused by hyperlordosis should ease right away.
- Keep the good new neutral spine when you walkaway from the wall, and all the time.
Two more good techniques are on
- Innovation in Abdominal Muscles
- and Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine.
More posts on understanding and recognizing hyperlordosis:
- What is Neutral Spine and Why Does Sticking Out In Back Harm?
- Fixing the Commonest Source of Mystery Lower Back Pain
- More step-by-step instructions and photos in the Ab Revolution manual.
Check back often. I am working on the next part of this post: Another Common Cause of Back Pain With Running.
Nick was quickly able to return to running by stopping hyperlordosis. So was Ted - Back Pain From Running. Recognize hyperlordosis. It will save office visits, even emergency room visits, tests, time, money, stress, and worry. Reduce hyperlordosis to neutral spine with a simple repositioning technique to stop and prevent much pain.