4 Part series on low back pain

Part 1 – Society’s pain in the back



Back pain has become a real pain in the back to society. Up to eighty per cent of Australians will experience back pain at some point in their lives and 10% will experience significant disability as a result. Back pain disrupts individuals’ quality of life and accounts for an enormous cost to the community. It is costing Australia billions each year in health care and time taken from work due to back pain.

The National Health Priority Areas (NHPAs) are diseases and conditions that the Australian government have chosen for focused attention because they contribute significantly to the burden of illness and injury in the Australian community. The 9 NHPA’s are:

  • Cancer
  • Cardiovascular health
  • Injury prevention and control
  • Mental Health
  • Diabetes Mellitus
  • Asthma
  • Obesity
  • Dementia
  • Arthritis and musculoskeletal conditions.

Back pain is the most common condition in the bracket of “Arthritis and musculoskeletal conditions” as a NHPA. Interestingly, a staggering 14% of Australians (3.0 million) are affected by back problems, followed by 8% with osteoarthritis (1.8 million), 3% with osteoporosis (728,000) and 2% with rheumatoid arthritis (445,000) according to 2011-12 self-reported estimates. To read more visit http://www.aihw.gov.au/national-health-priority-areas/.

Back pain is a big issue and we need to do more about it.

Watch this space for the following blogs to this series:

  • Part 2 – where does the pain come from?
  • Part 3 – Causes and Symptoms
  • Part 4 – Treatment.

The core essence of running

There would be far less runners’ injuries if runners had a stronger core. Does this mean you need to jump on a Pilates Reformer, use the TRX or do 100 crunches per day? No!

The reason the core has become so weak is because our lives are very sedentary. Sitting for 60 hours per week at the desk and then trying to run for half an hour isn’t exactly going to balance things up.


Running with a weak core, exposes you to poor running postures and hence injuries. See the examples below:

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 Picture A                                         Picture B

The runner in Picture A has a poor running technique due to areas of weakness. As he is not strong in the right places, particularly the core, he drops his hip and pelvis out to the side, which makes his knee drop in towards the midline and he lands heavily on his foot. This will expose him to lower back, hip, knee or ankle injuries while running.

The runner in Picture B, the one and only Usain Bolt, has the most superior ability to activate his deep core while running which gives him the ultimate stability and alignment that makes him the world’s fastest runner. Check out the position of his spine in the picture above.


Common core exercises that won’t improve your running posture:

1. The Pilates reformer

During WW1, Joseph Pilates helped wounded soldiers lying in their hospital beds who were looking very weak. So, he rigged springs to hospital beds, so they could exercise against resistance to improve their strength. This was how the reformer was invented. It is fantastic for rehabilitation. However, it is not functional enough for runners. Instead, runners need to train their inner core in running based positions.

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Above: Pictures of Joseph Pilates on the reformer. Notice the resemblance the reformer has to the hospital bed.


2. Crunches

How about crunches then? Being able to do 100 crunches doesn’t mean you have a strong core that will improve your running technique. It just means you have a six pack.


Where does that leave you then?

The layers of your trunk muscles are like an onion. There are deeper layers and there are outer layers. Each layer has a different function.

The outer layers:

  • Are what people commonly exercise when they do sit ups and weights at the gym.
  • Are fast twitch fibers which means they will switch on and off to give you power.

The inner layers:

  • Are what runners commonly don’t exercise
  • Are slow twitch fibers which means they should be switched on all day to hold you up.
  • Are the muscles that give you a strong inner framework. They are stability muscles that give you good alignment and posture.

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Picture far left: Your core muscles are like the layers of an onion, with outer layers and inner layers.

Picture second from left: Rectus Abdominis – the 6 pack muscle that sits in the outer core.

Picture second from right: Transverse Abdominis – the inner core muscle that gives you the stability and alignment you need to activate to improve your running.

Picture far right: A corset resembles where the inner core muscle runs. The inner core literally sucks your gut content in  and stabilises your spine, like a corset.


The benefits of having a strong inner core are that you will have a much more stable framework to move from. And this is how injuries will be prevented.

To activate the inner core, think of a low deep triangle that runs from hip to hip and down to your pubic bone. Try to shorten the triangle by 1cm. As you do, keep your outer core muscles relaxed. Get this checked with an expert Sports Physio!


 The big secret to improve your running posture

Once you know how to activate your inner core, maintaining its strength is best done in running based positions. If you want to learn a language it’s best to go to that country to immerse yourself in it. That’s functional. If you want to learn how to switch your deep core muscles on while you are running, then do so in running based positions. That is functional. That is the key.

Squats are one of the most functional exercises a runner needs to get right with the utmost control of the spine. You don’t even need to use much weight. If your spine is in good alignment then you are more than likely activating the deep core muscles that give you your stability. Keep your spine in neutral alignment as you squat, and make sure you don’t over extend or over flex the spine. (Best to get your technique checked with a Sports Physio).


The Core 101 wrap up

It’s not about doing loads of ab crunches or spending years on a reformer. To be a strong runner, strengthen up in running based positions! Get yourself to a Physiotonic class today to learn from the experts.