| Summary: | The aim of this study was to determine the prevalence of lower back pain (LBP) in the running population and any initiating or aggravating factors. The aetiology of low back pain in runners was also investigated. A random sample population of 225 roadrunners were interviewed following the completion of six local road races. A further subgroup (n = 52) (LBP group as well as control group) of these runners was evaluated to determine if there were any biomechanical; muscle strength, flexibility and stability measures; as well as any training protocols which were more commonly associated in those runners who complained of LBP. Questionnaires were completed by 225 runners and a detailed clinical evaluation was performed to identify the incidence and aetiology of running-related lower back pain. Attention was focussed on the lumbar-pelvic muscles in terms of their flexibility, strength and coordinating ability as well as static biomechanical measures of the lower limb. LBP in runners was found to be common with an injury risk of 1.42 injuries per 1000 running hours. This running-related LBP seldom forced the athlete to stop running yet did affect running performance. It was associated with any increase in the running load. Hip flexor inflexibility on the left (p = 0.07); short hip adductor muscle length (p = 0.055), hamstring inflexibility (p = 0.09) and iliotibial band inflexibility (p = 0.036) on the right were found to be more common in the LBP group. The abdominal muscles were weaker in the LBP group when assessed in the trunk curl-up test (p = 0.0085) and the stabilising ability (p = 0.032) for this group was judged to be poor. Biomechanically, only a marginal difference was found between those with and without LBP (p = 0.077) with regard to the hindfoot and forefoot postures which were valgus and varus respectively for the lower back pain group. Lumbar intervertebral joints were mostly hypomobile (p = 0.004) in the LBP group. Adherence to a poor training regime (excessive running distances and frequencies) was associated with the LBP group. Attention to correct training patterns and adequate muscle control (strength, coordination and flexibility) is suggested to protect from this running-related LBP. Further research into a comparison of rehabilitation protocols is required to validate these findings.
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