While training for the Broad Street Run — or anything else — it is important to take care of your back.  The pounding that each step can cause, especially while running on pavement, can lead to low-back pain in about 15 percent of runners.

I learned this painfully several years ago after running a half-marathon with my daughter in Florida.  The run was a great father-daughter memory, but on the flight home to Philadelphia, while reaching up to put my carry-on bag in the luggage bin, I felt something snap in my back.

It was February, and my plans to run Broad Street that May were canceled.  The pain did not get better, and after several months of discomfort (and walking slightly tilted to the left), I saw an orthopedist.  He ordered an MRI, and told me that I had a ruptured disc.  His advice was that it would get better with time, that I should not run anymore, ever, and it would be wise to find another way to exercise that would cause less pounding. He suggested swimming; I told him that I hate to swim.

Like so many folks who have experienced continued back pain, I was faced with the choice of surgery, an epidural injection, or physical therapy.

He recommended physical therapy, and this led me to begin a daily exercise routine involving stretches with a big emphasis on building up my core muscles.  The first few months of therapy were painful, but slow and steady progress motivated me to continue the routine that the therapist taught me, long after I stopped going to therapy.

So, when the health editor of the Inquirer and Philly.com sent me an interesting article published in a journal that, as a cardiologist, I usually do not read — the Journal of Biomechanics — I was interested.  The deep core muscles, called the quadratus lumborum, psoas major, external oblique, and the deep fascicles erector spinae, attach directly to the lumbar vertebrae, and function primarily to stabilize the lumbar spine.  This small study found that these deep muscles, when weakened, led to worsening lower-back pain.  Improving the strength of these deep core muscles, by doing exercises such as front and side planks, may lead to less discomfort, and reduce or prevent a runner's risk of developing low back pain.

Doing all this core work can pay off.  It took quite a while before running became an option for me again.  I used a recumbent bike, and then an elliptical trainer.  But, as runners know, there is nothing better than a good run, and last year, I ran Broad Street for the first time in three years.  I did it again with my daughter; we both had an easy, pain-free run, and finished together.  Ironically, standing next to my daughter and me in the huge crowd, just as we were getting ready to run, stood my orthopedist.  He was running the race, too, and was kind enough not to comment on the fact that running was not good for my back.  I hope to run my 10th Broad Street this May, and perhaps see him at the starting line again.

Here are a few of the things that I would recommend if you are running Broad Street and are concerned about your back:

  1. Stretch every day, even if you are not running.
  2. Begin core exercises, doing side and front planks.
  3. Think about getting a 65 cm yoga ball, as doing back stretches with your feet on the ball, and other yoga poses, can further help your core.
  4. If you have back discomfort, see a physical therapist. You might not need ongoing treatment, but you can learn the right core exercises for your back.
  5. Try not to run on pavement or concrete. These dense surfaces cause more pounding when compared to running on a softer trail or good treadmill.

David Becker, M.D., is a runner, frequent Inquirer contributor, and a board-certified cardiologist with Chestnut Hill Temple Cardiology in Flourtown, Pa. He has been in practice for 25 years.