Massage therapists are not doctors. We do not diagnose illnesses, diseases or any other medical conditions nor do we prescribe medications or any form of treatment(s). Information contained in this article is for reference only and is intended for the average person, therefore, it is not overly technical in nature. It is based on my training in massage/muscle therapy and experience with clients in my practice. Being active myself, I have had personal experience with many of the injuries I describe here. Please consult your healthcare practitioner for a proper diagnosis and your treatment options. In health, -Norm
At any given time, the US government reports that lower back pain is classified as one of the top two or three medical complaints in the country. The biggest contributors are sports & work related injuries from improper lifting, slips & falls, poor posture and more. For the average runner, low back pain seems to be more of constant nagging pain as opposed to a debilitating injury. The kind of discomfort that takes the joy out of your daily run and makes it a chore; you cut back on mileage, speed and start to wonder what's wrong.
Anatomically, the focal point of the low back is the sacrum; the base of the spinal column where your hips meet your spine and buttocks. This area is also known as the sacro-illiac (or, S-I) joint. This is a major functional point, many muscles attach in this area. From this central location your body;
- Bends forward at the waist.
- Bends backward at the waist.
- Bends side-to-side (leaning).
- Rotates about the hips (turning to look over your shoulder).
- Raises the hips (side-to-side) during movement as in walking or running.
To accomplish all of these tasks requires dozens of muscles, all of which tie into the lower back. If you look at a body from the rear view, picture an 'X' covering the entire back down to the knees, the center of the 'X' should be at the sacrum. All it takes is for one muscle to be too strong, have a length differential with an opposing muscle, or to become strained or injured and the 'X' is now pulled out of whack - the center, the sacrum, is where many of the injuries will show-up in the form of pain and discomfort as the muscles struggle to pull the sacrum out of position. For this reason, if you visit my office for lower back pain don't be surprised when I treat more than just the specific spot that hurts.
Potential Physiological Causes of Lower Back Pain:
- Ruptured or herniated disk. This is a serious problem and should be handled by a physician.
- Muscle imbalances in strength and length.
- Lack of flexibility.
- Weak abdominal muscles.
- Leg length differences.
- Over-weight.
Contributing Factors From Running:
- Excessive stooping or hunched-over during run (this puts more muscle strain in the buttocks/glutes and along the crest of the hip).
- Gait problems; rotational or stride length differences from leg to leg.
- Foot problems
- 'Stiff' upper body movement during run.
Treatment Protocol:
This injury should be checked by your physician to rule out disk or spinal problems. Serious, long-term complications are very real if vertebral problems are left untreated.
- Rest & ice for the first 2-3 days, then;
- Easy movement & stretching. Try not to tax the area or fix it in one day. The book 'Stretching' by Bob Anderson is a very good guide.
- Consult the appropriate healthcare professional to troubleshoot problem.
- Massage or other bodywork to ease discomfort & promote healing.
- Self massage such as lying on a tennis ball or rolled-up sock can help relieve trigger points in the area.
- Other care givers that may be able to help:
Physical therapist or personal trainer to teach weight conditioning and strengthening program.
Acupuncture may be helpful in managing the pain if it is severe.
A chiropractor will be helpful if the cause is centered around a spinal alignment problem. Be sure disk problems are ruled-out prior to receiving a chiropractic adjustment.
A podiatrist if the problem seems to stem from your feet.
Neurologist or orthopedic surgeon if more serious conditions are found to be the cause.
Long-term Outlook:
It seems people with back problems, particularly as we age, have it to a varying degree for life. A modification of activities and a consistant health maintenance routine are essential to managing the discomfort and allowing you to pursue the activities you enjoy. Left unchecked or only partially treated will guarantee recurring problems.
Norm St.Onge, a massage & muscle therapist, is MA & NH licensed and internationally certified . He is the owner of ProTouch; Professional Massage & Muscle Therapy in Townsend, MA. and is a member of the American Massage Therapy Association, Associated Bodywork & Massage Professionals organization, and the Nashoba Valley Chamber of Commerce.
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