Hypomobile lumbar spine: The stiff back.  As we age, we naturally lose mobility in all of our joints.  The mechanics of running just seems to make this worse if we do not actively address it. 

History: Insidious onset (just gradually over time).  You are usually more sore as you wake up, and get better as the day progresses.  You cannot point to one specific spot, just the whole back.  You may have one or more spots with a lot of pain if those are too flexible those spots take all of the motion.  This can be caused by tight joints or tight muscles or both.

Self-Exam:  Here are some things you can look for in yourself. 

1)      Stand in front of a mirror.  You LOOK perfectly normal.  (and we won’t tell anybody otherwise.)

2)      You try to touch your toes.  You try, but you don’t get close.

3)      When you do calisthenics like Camp Gladiator, you do not turn as far as the rest of the class.

4)      You may have difficulty turning in your chair or looking over your shoulder when you drive.

Treatment:

1)      Manage the pain:

a.      NSAIDS will help. 

b.      Kinesiology taping with a light tension can relief some of the muscle soreness.  LIN

c.       Ice or heat can relieve your pain.

                                                              i.      Ice right after you get done running

                                                            ii.      Heat on non-running days

d.      Continue your normal running routine.

2)      Restore full motion:

a.      Tight back joints and tight back muscles are both part of the same problem.

                                                              i.      It is important to add short stretching sessions to your day.

1.      Sequential short-term stretches will address these muscles.  VID

2.      Core stretches with the Sequential Short-term stretches while sitting VID

3.      Closed chain trunk stretching

b.      Most stiff people are just born that way.  They picked the wrong parents.  You will need to keep up your stretching the rest of your life.

c.       Stretching does not have to be part of your warm-up or cool-down.  But it HAS to be part of your training program. LIN

3)      Begin non-weightbearing exercises to restore strength.

a.      It is surprising to me how often we see patients with very tight muscles also have very weak muscles.

b.      Exercises to strengthen your core.

                                                              i.      You probably know the drill.  Here are some videos to remind you.  VID

                                                            ii.      Crunches, plank, side-plank, super persons (Politically correct), the selection is endless.

c.       As you keep up with your core exercises, it is important to keep up your stretches to maintain your flexibility

d.      There is a misconception that muscular people have less flexibility.  This is absolutely wrong.  Strength and flexibility are not contradictory goals.

4)      Begin weightbearing exercises with emphasis on control versus strength and power.

a.      Apply the kinesiology tape to your back before you start your weight-bearing exercises.

b.      There are a lot of whole body exercises you can include which will get the core along with the rest of your body.

c.       Wall-slides, sit-to-stand, static lunges, lateral step-ups, etc.  LIN

5)      Correct running mechanics.

a.      Gradually return to your previous running.  Start on relatively flat ground or even on a treadmill.  The best part of returning to running with a treadmill is that you can actually hear your footsteps.  Also, a lot of treadmills are in front of a mirror so you can see your hands move and your feet move.  If your arms or legs swing weird, you may want to have a physical therapist complete an evaluation before you return to full running.  Listen and ‘feel’ how you run.  Is one leg hitting the ground harder than the other?  Does one arm swing differently than the other?  Until you can run without pain and with fairly symmetrical running mechanics, you are still at risk of reproducing your old injury or creating a whole new injury to another part of your body.

b.      As soon as you can run without pain and without a limp you can return to your normal running routine.

6)      Return to running speedwork and hills.  After you have been able to run on flat ground for a week with your with your normal training and have not had any pain, you can begin to add speed and hill training to your program.

7)      My favorite step, get back to full running!  Have fun.  Eventually you will bust something else and be back to the website to fix that. 

8)      If you follow the steps on the website for 2-6 weeks (depending on how badly you hurt yourself the first time and on how long you tried to ‘run through the pain’) and your problem does not resolve, then call our clinic for an appointment and we can do something Dr. Google cannot do.  We can complete a hands-on evaluation, in-person evaluation to determine the cause of your pain.