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Questions and Answers
Q: I'm over 50 with a bad back and
my doctor says to give up running altogether. One
of the key things that help keep me motivated in maintaining
fitness is anticipation of summer and completing two
or three short-distance triathlons which include a
5k run. I use an elliptical trainer throughout the
year but am concerned that I can't use that exclusively
to train and will eventually have to do some sort
of training runs in preparation. I wonder if a couple
of 30 minute slow jogs a couple of weeks before the
event or maybe just one long on a week would get me
ready and minimize further injury. Any suggestions
about how to minimize exacerbating back problems and
still complete the run?
I will answer your question in general terms as I
do not know your medical history, have not examined
you and do not have information regarding any diagnostic
studies that were done. Given that preface, here are
a few comments that may be beneficial to someone that
has a back problem that enjoys running as a part of
their fitness routine.
1. Find an experienced physical therapist in private
practice that specializes in back injury rehabilitation,
especially in the athletically active individual.
Back rehabilitation should include appropriate exercises
(flexibility, strength, and endurance), body mechanics
training and nutritional information including weight
loss to an ideal body weight (IBW).
2. Use only quality shoes that are extra-cushioned
for training.
3. Train only on flat surfaces without side slope.
4. Use a treadmill for the majority of training. Treadmills
have a great degree of "give" than most
surfaces (i.e. road, dirt tracks, etc.). Landice and
Cybex make excellent treadmills. Be prepared to pay
about $2,000, but the treadmill with be worth the
investment. The concept of specificity of exercises
is important. In short, specificity of exercise means
training by a method that is similar to the event
that you will be completing in. The treadmill would
meet that criterion.
5. Cross training may also be beneficial. Training
runs on flat surfaces with highly cushioned shoes
or better yet, on the treadmill 3 days per week alternating
with the elliptical trainer or other exercises the
other other days is suggested.
6. Finally, as one gets older, the lack of flexibility
and back mobility seem to be the primary culprits
that lead to a significant amount of back pain and
thus functional limitation. Therefore, flexibility
training (with special focus on hamstrings, quadriceps,
heed cords, etc.) as prescribed by an experienced
physical therapist specializing in back injuries should
be most helpful when done pre and post-exercise/training.
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