Lower Back Pain Prevention and Management for Increased Performance

By Teige West

Lower back pain is a common complaint of most athletes, often hindering training and competition performance. The lower back is a complicated part of the body, with many small muscles, spinal and pelvic nerve endings and other tissues; all of these bodily components serve as a bridge between the legs and the upper body, and as a hurdler, you know that success in your sport depends on the interplay between your arms, core and legs as you move. And that interplay can often lead to a sore lower back.

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In this article you will find information on how you can prevent soreness, manage pain when it occurs, and increase your training effectiveness.

The vast majority of back pain the athletes is soreness from training and competition, but it is important to know the difference between normal discomfort and an injury because the treatments for these two possibilities are very different. Generally, an injury occurs suddenly. You’re running, lifting or moving across a hurdle and you experience an immediate, acute pain that can indicate a muscle tear, a sprain, a broken bone or some other abrupt injury to the body. If this happens, stop training and tell your coach or trainer. It’s best not to push through it or you risk worsening your injury. Injuries are usually treated with rest, ice and sometimes pain medications to control inflammation. While injuries almost always occur with a sudden pain, muscle soreness is almost always gradual, but can still be very painful. You may have heard of Delayed Onset Muscle Soreness, a condition where you train and several hours to a day later your muscles are especially tender. The soreness tends to peak about 24- 48 hours after onset. DOMS is an intense form of muscle pain. You may not experience this. Your muscles may be fatigued and a bit achy. Either way, your soreness is a symptom of your muscles being used; when you train, you create tiny muscle tears which your body repairs into larger, stronger muscles.

Stretching both before and especially after training and competition is the best way to minimize pain. Lower back pain can come from stress on the lower back, but it can also be caused by tight leg muscles, particularly the hamstrings. The hamstrings are such an integral part of hurdling—they are used in sprinting and clearing the hurdles, so your performance depends on their strength and flexibility. Below are several stretches that target both the hamstrings and the lower back muscles. These are gentle stretches; it’s best to do them after training. Do your normal cool-down stretch routine, adding these toward the end. On your rest days, take a walk outside before doing these stretches to maintain flexibility and keep blood circulating into your muscles.

Stretches:

The following stretches are gentle, but effective; do these after your normal cool-down, post-training stretching. You can also do these before bed or on rest days to stay flexible.

1. Knee to Chest Stretch

Lay down on your back with your legs out straight. Bring your right knee up towards your chest as far as you comfortably can. Hold 20- 30 seconds. Bring leg back down and repeat with the other side.

2. Hamstring stretch

Lay down on your back with your legs extended. Bend your right knee and bring is to your chest, then extend your leg up into the air as far as you comfortably can. Hold 20- 30 seconds. Repeat with the left leg.

3. Crossed Leg Knee to Chest Stretch

Lay down on your back with your legs extended. Place your right ankle on your left knee. Gently bring your left knee towards your chest until you achieve a comfortable stretch. Hold 20- 30 seconds. Repeat with the other leg.

4. Back twist

Lay down on your back with your leg extended and your arms stretched out, perpendicular to your body. Bend your right knee and move it across your left leg. Turn your head so that you are looking across your right shoulder. You should feel a slight twist in the lower back. Hold 20 seconds. Repeat on with the left leg.

5. Child’s pose

This is a simple movement that is good for a final stretch. On a mat, sit on your knees with your legs together. Bring your arms over your head and lean down so that your hips are over your feet. The more flexible you are, the deeper you can make this stretch, so start gently.

Even the most disciplined athlete will stretch, hydrate, eat well—do everything “right”—and still have soreness as your muscles build, especially when you are increasing strength or speed, or when you are in competition season. Unfortunately, muscle pain isn’t a high priority for medical research, so there is a lot of conflicting advice over the best methods to manage pain. I had a trainer tell me to use a foam roller, only to later read an article that foam rolling has no scientific credibility; the day after that I saw a top university basketball player using a foam roller before his game. What do you do with so much conflicting advice? The best suggestion is this: try these different methods and see what works for you.

Heat and movement seem to have the most scientific and anecdotal recommendations. Again, muscle soreness comes from the small tears that need to be repaired. Your body sends blood, nutrients and cells to mend the muscle tears, and heat helps speed up the process. There are two ways to heat your muscles: a hot bath/hot tub and a heating pad. The hot bath is ideal because you are immersed in water that raises the temperature of the entire body, going deep into the muscle tissue. Make sure the water is comfortably warm/hot, and keep your bathroom cooler to avoid overheating which can cause fatigue. Make sure to drink water before or after your bath. If you are not able to take a bath, try to take a warm shower after you train. You will still get some benefit from a shower. Another recommendation is a heating pad. This is concentrated heat on a specific muscle. While the heating pad will not penetrate as deep into the muscle as a bath, the focused heat will still provide relief. There are some experts who advise using ice, or rotating ice and heat. You should almost never ice your lower back. The cold isn’t beneficial unless you are trying to reduce the swelling of an injury. As for other muscles, if your trainer tells you to rotate, follow his/her directions, but general muscle soreness is best treated with heat.

The second best way to manage tenderness and fatigue is to keep moving. If you are in school or you work a desk job, most of your time is spent sitting. When you sit or recline, your muscles are shortened, and tight, short hamstrings or leg muscles will pull on your back muscles. If you are able, try to get up every 45- 60 minutes and move. Take a short walk, pace around your office. On rest days get outside and walk around the block a few times. If you can work some light stretching in after a walk, or later in your day, all the better. The movement will keep blood circulating into the muscles and will help you maintain flexibility. During the summer months (or if you have access to an indoor pool), swimming is a wonderful option. Swimming is low-impact, which is a good break for your joints, and it requires stretching and twisting through the water which promotes flexibility.

The foam roller was mentioned above as another option for pain management. The idea behind using a foam roller is to address muscle knots that many people get from training or even from stress. Again, there is controversy about these knots, called trigger points. Some researchers have said the idea of a trigger point is an unscientific wives’ tale; other experts have written books averring their existence. Nevertheless, after training, especially lifting, or even after a long school or work day, many people can massage their shoulders and find a particularly painful lump in the muscle. These are the supposed trigger points, and if you’ve experienced one of these, you know something is there causing pain. Two ways that may help address these sore points are foam rollers and a tennis ball. The purpose of the roller and ball is to concentrate your body weight onto the trigger point to provide relief and to relax the muscle to prevent further soreness. A word of caution: start slowly. The points may be intensely sore, and this method puts a lot of pressure onto that area. If the below instructions are too painful, modify your position so that less weight is on the point. There are three body parts that may contribute to lower back pain: the glutes, the hamstrings and the calves. To use the roller for your glutes, place the roller underneath the sore area, concentrating your weight on that trigger point. You may have to move around and adjust to find the exact spot. Bend the knee on the side you are rolling (so if it is your left glute, bend your left knee), placing your foot on the ground. Take the opposite foot and place it on the knee of your planted foot. Lean over so that your body is centered over the trigger point. If this is too much pressure, put both feet flat on the ground. You can also put both legs out straight instead of placing your feet on the floor in order to reach the sides of your hips. To roll your hamstrings, place the roller underneath the muscle, then stretch your legs out straight. You may need to lift your upper body off of the ground to move the roller and find the trigger point. If you continue rolling down your leg, you will be able to massage your calves with the roller. If the roller isn’t enough pressure, substitute a tennis ball for these exercises, but be advised, the tennis ball is very intense, so go slowly.

Some others tips:

1. Take an extra rest day. If you are sore and fatigued more than usual, take another day to do some light movement and stretching. This is especially important when you are increasing strength training in anticipation of an upcoming competition season. It is always better to rest than to risk injury.
2. Wear proper shoes. High-heels, tight shoes, and sandals can contribute to back pain when you aren’t training. Make sure your feet are supported and shoes fit properly.
3. Get your nightly Z’s. Remember to rest your body, especially in competition season. You can put pillows under your knees if you sleep on your back, or between your knees if you sleep on your side to support your spine.
4. Pain medications. These should be used sparingly as ibuprofen and acetaminophen both have unwanted side effects and are usually only used for injuries. If you find yourself needing these frequently, talk with your trainer or doctor. You may be overtraining, or there could be a specific cause of your pain rather than everyday-training soreness.

Lower back pain is common for athletes, but stretching, heat, movement and foam rolling should help you address your soreness. Remember to always talk to your coach or trainer about persistent issues with any kind of pain. These people know your training level, your schedule and your life and can help you prevent and manage pain so that you can continue increasing your performance level.

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