A weak core and overusing flip-flops: the perfect combination for lower back pain<\/h2>\n
The two main causes of lower back pain are:<\/p>\n
- \n
- A lack of core<\/a> strength<\/strong> (the body\u2019s centre of movement). The core is often defined as a \u201cmuscular corset\u201d that supports and stabilises the whole body. <\/li>\n
- Overusing summer flip-flops<\/strong>. Switching from closed shoes to the classic summer flip-flops. <\/li>\n<\/ul>\n
The spine\u2019s natural curves are designed to protect and cushion impact while walking and, above all, while running.<\/p>\n
That familiar \u201ckidney\u201d pain\u2014or lower back pain, as we physios call it\u2014is simply pain in the lower back<\/strong>. It affects the lumbar area between L1 and L5, but if the lack of strength and balance between the lumbar and abdominal muscles is severe, it can affect the sciatic nerve, causing sciatica that can disable the athlete very aggressively.<\/p>\n
It can get so bad, due to reduced mobility and pain, that the athlete can\u2019t normally do basic movements like getting out of bed, sitting down or standing up from a chair, or going to the bathroom as usual.<\/p>\n
Core balance to avoid vulnerabilities<\/h2>\n
Core balance is extremely important for the proper functioning of normal walking and running biomechanics. The balance between the transverse abdominis, diaphragm, pelvic floor and multifidus muscles must stabilise the load transmitted to the hip\u2014a joint that acts as a crossroads for 26 muscles that attach to it. <\/p>\n
![\"Core](\"https:\/\/42krunning.com\/wp-content\/uploads\/2023\/06\/jna6760-scaled.jpg\")
<\/a>Ultrarunner Iv\u00e1n Penalba receiving guidance from David Valenzuela.<\/figcaption><\/figure>\n The necessary balance in the core area is important to avoid vulnerability in the vertebrae. Keep in mind that the vertebrae bear body weight, with 70% supported by the anterior part and 30% by the facet joints (posterior part). If there isn\u2019t proper core balance, the intervertebral disc is left vulnerable, which can lead to the dreaded disc herniation that ends up closing the intervertebral foramen (the tunnel where the nerves pass), creating brutal sciatica that may sometimes require surgery. <\/p>\n
And why can overusing flip-flops increase the risk of lower back pain?<\/h3>\n
When you walk in flip-flops, body weight concentrates on the heels. This creates lumbar tension and reduces the natural cushioning of the lordosis (the normal lumbar spinal curve), leading to abnormal postural biomechanics patterns.<\/p>\n
![\"Flip-flops](\"https:\/\/42krunning.com\/wp-content\/uploads\/2023\/06\/vista-frontal-manos-sosteniendo-chanclas-scaled.jpg\")
<\/a>Overusing flip-flops can be harmful. Image: Freepik<\/figcaption><\/figure>\n This injury mechanism causes the athlete to adopt a flexed posture. Combined with the time they may spend sitting for work reasons, or leaning forward when running uphill terrain (especially for trail runners), it means the psoas (hip flexor muscle) creates tension that, together with core weakness, leads to the well-known runner\u2019s lower back pain.<\/p>\n
Tips to prevent dreaded lower back pain<\/h4>\n
Below are a series of tips to help prevent dreaded lower back pain.<\/p>\n
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- See a physiotherapist for a core assessment. Physiotherapy tests can show whether your gait pattern (anterior\/posterior posture) and core are strong and have good activation timing. (VALOBANDO app) <\/li>\n
- Specific protocols with core exercises to strengthen the abdominal-lumbar area if needed.<\/li>\n
- Improve the lumbar extension pattern.<\/li>\n
- Improve hip mobility.<\/li>\n
- Specific leg strength work.<\/li>\n
- Specific stretching of the muscles on the back of the leg.<\/li>\n
- Relax the psoas to avoid the flexor pattern.<\/li>\n
- Improve your breathing pattern, helping diaphragmatic and abdominal breathing to be correct and controllable.<\/li>\n<\/ol>\n
![\"Lower](\"https:\/\/42krunning.com\/wp-content\/uploads\/2023\/06\/jna6477-scaled.jpg\")
<\/a>Carmen P\u00e9rez, ultrarunner, doing core-strengthening exercises.<\/figcaption><\/figure>\n It\u2019s worth knowing that 85% of lower back pain cases are acute and that, according to studies, almost 90% of the world\u2019s population will experience lower back pain at some point in their lives.<\/p>\n
Most lower back pain is due to muscular causes, but what if there\u2019s nerve involvement? The first thing to do is see a doctor for a nuclear magnetic resonance (MRI<\/a>) to determine whether there\u2019s a disc herniation and, most importantly, whether the intervertebral foramen where the nerves pass is being closed off. <\/p>\n
Once you know whether the injury requires surgery or not, the steps to follow would be:<\/p>\n
- Overusing summer flip-flops<\/strong>. Switching from closed shoes to the classic summer flip-flops. <\/li>\n<\/ul>\n