Running with Lower Back Pain and Herniated Disc
Importance of Running
For many active individuals, running is an important component of an active routine. Although running is not a high risk activity for herniating a spinal disc, avid athletes who participate in a number of sports may injure themselves during a different endeavor. That was the case for myself. I ran college cross country, and after injuring my back during a heavy lifting workout, I wasn’t quite sure what the best way to continue with my distance training was. Considering it sometimes hurt just to be upright, I wasn’t even sure if it was safe for me to run again at all. However, after a lot of research and some trial and error, I managed to not only return to my distance running training but also set a personal record the season after my lower back injury.
To begin with, I recommend you check out my article on what to do in the immediate aftermath of a lower back injury, whether it’s pain, strain or disc herniation. Surprisingly with lower back injuries, the mental aspect is often the most challenging for many people. At the very least, it can be a close second to the actual pain or other physical symptoms. For many active individuals, the thought of taking some time off can be extremely demoralizing. The athletic trainer at my college actually praised me for being willing to take some time off from running to deal with an unrelated injury. Many runners will ignore symptoms until they are unbearable, at which point the rehab will take far longer than if simply addressed earlier. That’s why one of the first things you should do when seeking to return to an activity such as running is to lay out a plan to return to that activity. Understand that most people who herniate a disc can and do return to running, assuming they’ve made that return through safe and sustainable efforts. Put together a timeline of small, sustainable activities you can pursue or habits you can create that lead up to your full return. And as always, consult a medical professional about your conditions, and run your workout plans by them before beginning a new regimen.
Easing back into it
Most people who herniate discs in their lower backs can plan to return to running about 4 weeks after the initial injury. In the immediate aftermath of such an injury, it’s best to take 2-4 days to rest and treat what will be the worst symptoms of the herniation. For myself, I was bedridden for nearly a day after both straining my back and getting a bulging disc. However, it’s important not to stay idle for too long. Once the worst of the pain has subsided, you can begin with core strengthening exercises and light and low impact aerobic activity. If you’re looking to return to running, walking is a great option. Walking and running both involve expansion and compression of the spine as the weight of your body comes to the ground, then rises back up as you push off with your foot. However, this motion is far more gentle in walking, and can actually be a good thing. This gentle expansion and contraction can increase blood flow to your spine and help with the healing process. Start with periodic short walks throughout the day, then two weeks later start progressing to longer and longer walks. Make sure to listen to your body and not overdo it, but there’s no reason that you couldn’t do 30-45 minute walks 3-5 times per week.
Increase your activity level
Assuming that you’ve kept up with your walking and core strengthening exercises, then you should be able to start running again around 4 weeks after your initial injury. However, you shouldn’t start back up at your previous mileage. Start with replacing one of your walking sessions with a short jog 5-10 minutes long. Stick to soft surfaces such as grass, as this will cushion the impact to your spine. Then, sleep on it. One of the best ways to find out what you’re body is up for is to perform a shortened version of that activity, then see how you feel the next day. If that short run felt good, get in another walking day, then replace your next walking day with a slightly longer run. Go for a length of time, rather than a set distance, then gradually increase that time. Over the course of 1-2 months, gradually replace your walking with running and establish a time or distance baseline.
Once you’ve determined what you can comfortably do in a week, increase that by not too much more than 10% week over week. Increasing your running by 10% a week can seem like far too little. However, it’s a good rule of thumb for staying healthy. The last thing you want to do is to overdo it, then have to start back from square one. Continue to do as much of your running as possible on soft surfaces. If you have to run on hard surfaces, get some good running shoes with built in cushioning. At this rate, you should be close to your original mileage between 6-8 months after your injury. Although this is a long time for some runners, it may actually have some advantages. One thing I noticed as I resumed running after getting a bulging disc was that I had far fewer peripheral injuries than before. I believe this was due to going back to basics, and rebuilding my running style from the ground up. With such low initial mileage, I paid far greater attention to my running form and habits, and managed to fix bad habits while picking up better ones. Also, doing more mileage on soft surfaces is great for your connective tissue. For a time, I actually went shoeless after discovering barefoot running. Even now, I use minimal footwear when running, which has greatly contributed to my running abilities. However, barefoot running could easily be the subject of an article all on it’s own (it’s already a book!)
