Two weeks until the Marathon

‘I’ve got 8 days until the London Marathon and have terrible lower back pain - I don’t think I will be able to compete, can you help?’

My patient had a long history of lower back pain and had come to me 8 days before the London Marathon with a flare up of back and hip pain after a massage, he was doubtful he would make the start line. When back pain like this has been around for years and keeps returning under load, it's rarely about a single injury. It can be about the position the spine is being asked to work from.

A lifetime of back pain, 8 days to fix it

He'd carried lower back pain for years, the kind that had become background noise rather than a single event he could point to. He'd spent most of his working life at a desk and by the time he came to see me his body had adapted.

The driver of his spinal problem was the position he held his pelvis in. He sat, stood and walked with his pelvis tucked under him.  The position of his pelvis was pulling his lower back into bend during sitting, standing and walking.  This was changing the way the lumbar spine was able to absorb normal force and had resulted in bone thinning or osteopenia at 2 levels in his lumbar vertebrae.  The joints themselves weren't damaged, but being held in that position hour after hour was exactly why they kept getting sore. This problem had not been spotted before.

A plan built around the real cause

With 8 days to work with, we focused first on correcting his posture to take the joints out of that constant stressful bend, we used taping to help with this and support his spinal muscles.  We integrated the new posture into his strength programme so that his back muscles were were more efficient at supporting his spine and maintaining the correct posture helping it sustain race conditions as well as low load activities like sitting and walking.

It took four sessions to get there.

How did he do?

He completed the London Marathon comfortably and was elated by his success. What mattered more than finishing the marathon successfully was that he left understanding his own spinal bio-mechanics well enough to apply the postural correction to any movement, not just running.