Trail Running and Lower Back Pain: How to Run Without Back Issues

Trail running is far more than just running on paths. It’s movement in nature — freedom, silence, and discovering new terrain. But if your lower back starts to sting, ache, or tighten during or after a run, your body is telling you something isn’t working as it should. Lower back pain is not uncommon among trail runners. On the contrary — because of the technical terrain, it’s one of the most frequent issues leading to reduced performance, interrupted training, and, above all, missing out on trail adventures.

In this article, you’ll learn why back pain occurs in runners, which forces act on the body, why running alone isn’t enough, and what role proper strength training plays.

Why Does Lower Back Pain Occur?

Every step in mountain running is a unique biomechanical challenge. Uneven ground, long descents, and demanding climbs create loads that runners often don’t feel — until pain appears. The spine is exposed to compressive forces that can exceed three times your body weight. At the same time, shear and rotational forces pass through the vertebrae and joints. If the trunk and pelvic muscles don’t handle these forces properly, the load shifts to the joints and intervertebral discs.

Runners with back pain often show characteristic movement patterns — increased trunk rotation, reduced activation of core stabilizers, and greater vertical oscillation (Vincent, 2024). The body compensates with alternative movement strategies that can cause micro-injuries over time. Ascents and descents on trail courses directly influence running biomechanics. Downhill running loads the lower back very differently than flat terrain, especially when fatigue sets in or the terrain is technically demanding (Thuany, 2025).

The Role of Muscles in Protecting the Spine

You often hear that mountain runners “have strong legs.” But stability isn’t just about legs — it’s about coordinated action of multiple muscle groups.

Quadriceps are crucial for deceleration on descents and force production on climbs. Just before the foot strikes the ground, the hamstrings begin to brake knee extension, preparing the leg for contact — essentially acting as a brake to prevent uncontrolled swinging. This phase is demanding and commonly linked to higher injury risk.

The glutes, especially the gluteus medius and maximus, stabilize the pelvis and prevent it from dropping to one side — something that directly affects the lumbar spine. Calf muscles and foot muscles absorb impact forces during ground contact; if they don’t function well, the forces travel upward, often reaching the lower back.

The core is the control center — a system of muscles that stabilize the spine and enable efficient force transfer. Without a strong, functional core, all other muscles perform significantly less efficiently.

Why Strength Training Isn’t Optional — It’s Essential

Running alone doesn’t develop all the abilities required for stable, efficient mountain running. Strength training is key for injury prevention, movement control, and long-term health. Quality training includes activation of deep core stabilizers, strengthening of the glutes, quadriceps, and hamstrings, as well as exercises for rotational control and balance. This type of training does not replace running — it supports it and protects the body from chronic issues like sciatica and herniated discs. Runners who regularly incorporate strength training report fewer back problems and have better body awareness (Vogt, 2019).

Interestingly, using trekking poles can already reduce vertical forces during ascents, which has been proven to unload the spine (Lazzer, 2025). This highlights how important it is to optimize movement strategies.

A Real Example: Helena’s Marathon!

Helena struggled with pain caused by piriformis syndrome — pain that affected everyday movement and, above all, made running impossible. With physiotherapy and targeted training at KinVital, she gradually eliminated the problem. Today, she runs pain-free — and with the help of KinVital experts, she successfully completed a marathon. The combination of individualized programming, targeted strength training, and professional guidance allowed her to return to running even stronger than before.

How Does KinVital Approach This?

At KinVital, runners are treated holistically. They begin with a video running analysis to examine body alignment, core function, hip mechanics, and foot behavior. Typical patterns in runners with back pain include trunk rotation, pelvic drop, inactive glutes, excessive lumbar lordosis, and uneven stride length.

Based on the analysis, they create a program that includes strength and stability exercises, learning proper movement technique, and manual therapy when needed. Within a few weeks, most runners report improvement, greater stability, and a better running experience — without lower back pain.

Who Is the KinVital Team?

KinVital is a team of physiotherapists and kinesiologists who have helped more than 5,000 people. They believe every runner is unique — and the approach should be too. Their goal is to help you return to movement without pain and enjoy running again.

If you’re dealing with lower back issues, you can sign up for an initial assessment.

Sources

Vincent, H. K. et al. (2024). Gait signatures of endurance runners with low back pain. Gait & Posture, 113, 184–190.

Thuany, M. et al. (2025). Change in elevation predicts 100 km ultramarathon performance. Scientific Reports, 15(1), 25176.

Lazzer, S. et al. (2025). The impact of pole use on vertical cost of transport and foot force during uphill treadmill walking. European Journal of Applied Physiology.

Vogt, L. et al. (2019). Why Are You Running and Does It Hurt? Pain, Motivations and Beliefs about Injury Prevention among Runners. International Journal of Environmental Research and Public Health, 16(19).