HAPPY MEMORIAL DAY!

As we enter the kick off to the summer this weekend, we may be doing some extra-curricular activities that may impinge upon our running bodies. For example, while pulling out the barbecue the other day, I felt slight twinge in my lower back, and just like that I strained a lower back muscle and have been sidelined from running.

Searching the internet, I found a study published in Medicine & Science in Sports & Exercise where researchers compare three different exercise protocols for runners suffering from chronic lower back pain. 

The researchers studied 84 recreational runners. They’d all had back pain for at least three months, and ran two to five times per week.

They were assigned to one of three eight-week exercise programs which included:

1. Lower limb exercises: Leg presses, single-leg squats, and wall sits.
2. Lumbar extensor exercises: Focused on the back muscles that allow you to arch the lower spine, and included exercises like back extensions and “bird dogs.”
3. Lumbar stabilization exercises: Focused on the core muscles that support the lower spine and keep it stable, with single-leg balance exercises, sitting on balance balls, and theraband resistance exercises.

The theory that the researchers wanted to understand is if leg exercises might be a better than the  typical back exercises that are usually prescribed. They did an earlier study suggesting that runners with chronic lower back pain have weaker-than-normal quads, which could lead to worse shock absorption during running and more stress on the lower back. So the question is, can strengthening  weak leg muscles fix things?

The results weren’t complete, but overall the leg exercises performed well. After six months, all three groups had improved their pain scores by a similar margin of about 3 points (from just over 3 to just above 0) on a 10-point scale. On a 10-point functional scale of “self-rated running capability,” the leg exercise group came out significantly ahead, improving by about 3.8 points (from just over 6 to just under 10) after six months, compared to 3 or less for the other two groups.

The leg exercises produced a greater improvement in quadriceps strength—which, the researchers suggest, enabled their legs to provide better shock absorption during running, and is why they reported greater improvements in the self-reported functional scale.

More surprisingly, there was little or no difference among groups in measures of back strength, either for extensors or stabilizers. So doing a series of leg-strengthening exercises appeared to tax the back muscles just as effectively as back-specific exercises, while the converse wasn’t true.

What can we say from this? Well, the good news is that after six months, everyone was pretty much back to normal (near 0 on pain and 10 on running function). The bad news is that there was no control group, so we don’t really know if the same results would have happened with no intervention at all.

As for the differences among the three groups, they’re also subtle at best. Still, in a situation where no one really knows the “right” answer—the causes and treatments for lower back pain remain vague and poorly defined—the findings from this study may influence how I think about my lower back pain. It can't really hurt if we know leg exercises help strengthen the legs and the back.

In the meantime, take it easy this weekend and be mindful of your back when you perform different activities.