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1201 Views 2 Replies Latest reply: Sep 26, 2012 10:08 AM by JamesJohnsonLMT
WendyMiller1174 Rookie 1 posts since
Jan 23, 2012
Currently Being Moderated

Sep 22, 2012 1:29 PM

Sharp pain in low back. Marathon training. Help!

Hi. I'm a 30 y/o female in training for my fifth marathon, which is six weeks away. I have been running in the mid 70s for mileage with no problems at all.

 

Until two days ago. I was at work, and preparing to go out for my second easy run of the day. I decided to do some reverse lunges, which I commonly do in order to prevent runner's knee that I dealt with a long time ago. That is to say, my body is very accustomed to these lunges. On the third one, as I went down (normally--no twisting or anything), I got a sharp, knife-like pain in my left lower back. I tried to stretch it out, but couldn't. Then I realized I couldn't stand up straight and could hardly walk. I saw a chiro that afternoon, but am not much better.

 

What makes it worse:

leaning backward

walking

sitting upright for a long time

 

What makes it better:

leaning forward

lying completely flat (pretty much all I've been doing)

 

No burning at all, and it does not radiate down into my butt or legs. Everything I reads points to facet syndrome, but that tends to be chronic. This was definitely acute, and I had no warning. Obviously, i can't run until I can walk without pain. Going on day 3 of no running (and barely any walking) and obviously concerned about my race. Any experiences similar to this--what it might be and what helped? Thanks!!

  • Coach_Christine D Rookie 4 posts since
    Jan 21, 2008

    Oh now, I'm sorry this happened! I would recommend going to a doctor or physical therapist (ideally with running back ground) asap. It almost sounds like a pinched nerve or muscle. Maybe this can be fixed with ART (Active release therapy). Also, try to apply heat in that area. Good luck!!

  • JamesJohnsonLMT Legend 1,167 posts since
    Aug 23, 2009

    Sounds like a typical strain of one or more of your core muscles, probably Glute Medius or Minimus, maybe some QL (Quadtratus Lumborum), to be expected after the wear and tear of 70-mile weeks. This would be especially likely if you spend any time sitting, like most of us do.

     

    The QL produces knife-like pain and splinting in the lower back, and the upper Glutes stabilize the pelvis while walking, also producing lower back pain. You can't stand straight without their full support. Any of these muscles can act (or fail to act) in support or reaction to the other.

     

    I am not in favor of any exercises before warm-ups, even if the usual effect on a healthy frame is to "loosen up." It's different when you are suffering the insidious effects of high-mileage marathon training (read Galloway on that subject). Doesn't take much to force a semi-permanent spasm with a general splinting effect.

     

    I had the same problem the day before a 15k, could not stand up straight, felt the whole thing in my lower back, which then contorted into temporary scoliosis (check in a mirror). I blew 30 bucks on 15-20 minutes with a good sports massage therapist who knew what she was doing. She spent almost the whole time on my upper pelvis and edges of the sacrum. It hurt so much I cried. Somewhat numbed with less of a limp, I ran without any problems the next day, the pain banished to memory.

     

    A reverse lunge requires a breaking effect from your core along with stabilization of the relationship between your back and pelvis. These muscles are very important to that action, and probably don't like being awakened that way before a gentle warm-up. A good rule of thumb when you are performing proactive therapeutic exercises or stretches like these is to do your warm-up first, then the exercises, then the workout. Hell you're spending enough time running, this little bit of extra time won't matter much. You're just juggling the order of things a bit.

     

    If you haven't the time or money for a real professional, you can work out the bugs with a tennis ball between your butt and the wall, in an average case. Skilled fingers are a plus in extreme cases, but you do not want to underestimate what some targeted self-massage can do. With all the time you spend training, this needs to be added to your survival toolkit. Avoid sitting for prolonged periods of time, as it causes ischemic pressure on (and forced elongation of)  important muscles that need better circulation, more so during these latter phases of your training.

     

    Regarding differential diagnoses, particularly as I find them on-line, muscle (myofascial) pain is often missing from the priority list, probably because it is too little understood within the general medical community that comes up with these lists. In the real world that I inhabit, it needs to be at or near the top of the list, any time you have a sudden onset of crippling pain like this. Soft tissue such as muscles tends to complain long before the tougher tissues it moves, and often produces pain in areas where it is not caused, due to the way our brains interpret sensations coming from the area. Your case is not unusual. I wouldn't call it "normal," but neither is marathoning.

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