If you want to solve a problem, you have to go to the source. The only problem: Pinpointing the source of your back pain can be somewhat tricky. The discomfort can stem from your running, but also activities beyond your workouts, like lifting something that’s too heavy or sleeping on a brand new mattress.

To help find the common causes of back pain in runners, though, researchers of a study published in Pain Research and Management surveyed 800 marathon runners to better understand how they experience lower back pain and identify potential risk factors. Of the marathoners who reported pain, risk factors included an insufficient warm-up, fatigue, poor running posture, and even the environmental temperature.

While these may cause you to experience aches in your back, we asked a physiotherpist and sports physician for other surprising and common causes of back pain — plus what you can do to avoid all of these risk factors for discomfort.

1. You’re Not Strength Training
A weak core — or any weakness along your kinetic chain, including in the muscles around your feet, ankles, knees, or hips — can affect your body’s ability to absorb the impact of running.

“If a runner’s body isn’t absorbing shock well or efficiently, there will be excess impact forces that are transmitted through the legs and up into the spine or lower back, which can cause low back pain or discomfort,” Daniel Giordano, physiotherapist and co-founder of Bespoke Treatments, tells Runner’s World.

This is why it’s so important to strength train at least twice a week, so you can build stronger running muscles for the road. For runners with a weak core or hips, practicing planks and lunges can help stabilise these muscles, says Giordano. Other moves to target typically weak areas of runners include single-leg calf raises for stronger ankles, lateral banded walks for knee strength, and glute bridges for stronger hips.

The best way to zero in on weaknesses and compensations is to visit a professional, like a physiotherapist, biokineticist or sport physician, who can use technology like a 3D gait analysis to assess your running form and measure your ability to absorb shock, and motion analysis to measure your joint range of motion.

2. You Don’t Warm-up
You need to warm-up before every workout to properly prepare your muscles for what’s to come, especially if you spend a lot of time sitting throughout the day.

“If you’re sitting all day, your hips are probably going to be tight,” says Giordano. “Then, if you’re not warming up after sitting and just going straight into a run, you’re not going to be ready to run.” Essentially, your body won’t be able to get through ideal gait mechanics without overcompensating.

For example, “tight hips can limit your range of motion and force other parts of your body, such as your back, to compensate for the restricted movement, which can also result in pain and discomfort,” he explains.

To fix this, Giordano suggests doing a dynamic warm-up, which requires actively stretching your hips, glutes, hamstrings, quads, calves, and rotating your spine to ensure your muscles are ready to go at run time. To target these areas and activate these muscle groups, try body-weight squats, mini-band lunges, pogo jumps, and standing spinal rotations. Also, jog in place or walk for a few minutes before you start picking up the pace, he adds.

3. You’re Wearing the Wrong Shoes
Finding the right pair of running shoes will help improve shock absorption, which can decrease back pain.

When determining which shoes to choose, it’s all about your running gait, Professor Aaron Mares, associate professor at the University of Pittsburgh Medical Center and associate medical director for the Pittsburgh Marathon tells Runner’s World. You may need more or less cushion depending on your biomechanics.

More specifically, your level of pronation — the inward movement of your foot as it rolls optimally to distribute the force impact as you run — will contribute to the kind of running shoe you need, says Mares.

A running gait analysis can also help identify the shoe that’s best for you. For example, if the analysis determines you overpronate, you might want to consider insoles or a stability shoe.

Also, look for a lightweight shoe with cushion, as this can not only help you avoid pain but also keep you from slowing down, says Giordano. Heading to your local running store to test shoes before you buy them is always a smart move.

4. You Increase Your Mileage Too Quickly
“If you’re increasing your volume or your intensity too fast, and your body’s not equipped to handle it, that will lead to excessive force on your lower back,” says Giordano.

That’s why it’s important for you to slowly increase your training volume by 10 to 15%  each week, so your body can build strength and endurance, he explains. This means if your longest run is five kilometres but your goal is to run 10 kilometres, you’d increase your longest run by about 0.5 kilometres each week until you reach your goal.

Also, you may want to consider where you’re running, especially if you frequently run on concrete or up hills, as this can also contribute to your pain. “If you’re running on a really hard surface, you’re going to put a lot more impact force up through your kinetic chain versus if you run on soft dirt, fine gravel, or a trail,” says Mares.

A change of scenery can offer a simple fix — head out to the trails or softer paths like grass — but you also might want to consider dialling back your frequency or intensity. Cross-training with cycling or swimming, especially if running somewhere else isn’t an option, is also a smart option for sidestepping aches when your back asks for it, Mares adds.

5. You're Not Recovering Properly
“If you’re not sleeping well and not recovering, your body’s never healing. You're constantly in a state of stress, and probably should take more days off,” says Giordano.

Your body needs complete rest days mixed into your schedule so it can properly heal before your next workout. Adequate rest days will prevent you from overtraining, therefore helping you decrease your chances for muscle issues, like back pain, that can stem from an overuse injury.

Ideally, you want to have one full rest day a week, and get at least seven to nine hours of sleep each night.

6. You’re Not Drinking Enough Water
Believe it or not, inadequate hydration levels can also contribute to the risk of back pain. “If you’re not well hydrated, your muscles can become tight and it can lead to strains or sprains, including those in your lower back,” says Giordano.

To avoid this, aim for the Institute of Medicine’s recommendation of men taking in at least 3.7 litres and women 2.7 litres, per day, from fluids and water-containing foods.

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