The Sled Push for Runners With Lower Back Pain

You're listening to the Restoring Human Movement podcast, where movement experts discuss the latest evidence-based practices to help you and your clients move with mastery. Hey everyone, it's your co-host, Sebastian, with the Restoring Human Movement podcast. Thanks for joining the Movement Movement. I am covering lower back pain with distance runners today, and one of the best exercises that I saw someone do at the gym this morning for lower back pain, if you're trying to keep your body loaded and moving and challenged while you're recovering from the back issue. Now, if you've been dealing with back pain for a long time, you know just as well as I do that it's a vicious cycle.

Sometimes you get back pain and you try to be active to keep your body physically able as it repairs itself, but you notice that as you go for a run, it hurts more. Or you've been told that I should do these exercises at the gym, or my physical therapist said I should do these exercises, and you do them in order to get your hips stronger or legs stronger or core more stable, and you feel worse after. So, how do you do this? How do you keep your body conditioned, keep load onto your legs and tendons of your legs, and also decrease back pain? Well, that is kind of the artistry with it, but I think what it comes down to, at least in theoretical conversation, is that exercise selection actually matters.

So, there's certain exercises that you'll fare better with just because we know where the loads are going. For example, if you had lower back pain associated to running, but you did a calf raise, you'd probably be okay because the load's into the calf. But if you did a back squat, a barbell back squat, a lot more loads in the back, so it makes more sense. So, a sled push is one that is so overlooked. It's so useful, though. There's very low load into the lower back, especially as compared to a back squat. A deadlift is actually lower load in the low back than a deadlift is. So, a back squat is the highest, at least with a barbell.

But the benefits of the sled is core strengthening. It helps improve posture as well, especially for running. It's a low impact exercise as well, and it helps keep, I don't want to say it already, but it enhances hip and leg strength. So, the way mine is set up here is that there's about 30, 40 yards at the gym of turf. The turf has three tires of different sizes, and they have a sleeve on it, so they're a little bit more slippery than just a tire tire. And they have a sled, which you can put plates on. And so, the way I use the devices is if I don't have access to the sled sled, then I will choose a tire.

There's tires of different sizes, again, so I can push them at different speeds. I'll talk about reps and sets a little bit later, but generally speaking, I'm not super specific. And that's just because I'm not training for anything in particular. I'm just trying to keep myself challenged. But if I do go for a strength set, I will end up doing strength reps and sets. I won't do it with high volume. And so, it's when I start getting into the sled sled is when I start doing more of that approach. So, the things that you'll benefit from, though, is the core support. People with lower back pain, especially runners, suffer from something what we call extension intolerant lower back pain.

Extension intolerant lower back pain, you can learn more about in the free webinar that we have for this podcast in the description. We also cover flexion intolerant back pain and sciatica as well. But just so you guys get a basic idea, extension intolerant lower back pain is pain with more lumbar extension. So, lumbar extension is generally coupled with anterior tilt or hip extension. So, if you are running, then your hip extends. When the hip extends, the anterior tilt happens automatically. When that happens, the lumbar spine extends. Now, if we had to combine, say, 100 degrees of extension movement and only, say, 15 degrees came from the hip, but you could get maybe 17, the extra degrees come from other areas above or below.

So, that's how the body incorporates the other joints with this coupled movement. And so, a lot of people who have extension intolerant lower back pain, they end up have limitations of either the thoracic spine or into the hip. But the point is, more load goes into the lumbar spine in extension. So, one way to combat this is to put your hands on an object and force it down. A plank is a good example of this. A push-up is a good example. Like, your core works during these exercises. Any pushing exercise, your core has to work. So, when that happens, it stiffens your core. So, if it's stiffer, when you're pushing the tire or the sled, you'll get more leg drive and less low back extension.

This is one reason when I have runners get back into running, sometimes I ask them to actually go push a sled or to run up a hill. It requires more leg drive when you have more, or sorry, it requires more arm drive. When you have more arm drive, there's more core stiffness. When there's more core stiffness, there's less low back extension, there's less provocation, and there's more drive into the leg, which is what we want overall. So, if you've been dealing with lower back pain, it may be a really easy entry point because we don't want you to go into that vicious cycle of having a reoccurrence of lower back pain just because you're trying to rehab your back.

Also, something that it does is it improves posture. Posture in running is important. I have been very clear over the years with what I like on this podcast. I like baseball. And if I didn't mention already, I've done half marathons. I've done 70.3 Ironmans. I've done century rides. I don't really like endurance stuff. I don't. I don't enjoy it. It doesn't mean I won't help you guys do it. Like, there's nothing wrong with us having different passions. I prefer baseball. I love doing it. I've been doing it since I was 10. And so, that's what I like to do. But what I noticed then, and maybe this is myself trying to validate that I shouldn't be doing endurance because everybody, I feel like the notion is that, especially in the endurance world, like people say, oh, well, you did a half?

Once you do a full max, it's like longer is better, right? It's just different. But I think one of the hardest races that I ever did was a 5K because I wanted to throw up, right? And the half marathon wasn't, I don't want to say it wasn't hard. It was just different hard, right? So, I'm trying to convince myself that I shouldn't be doing it. And I look around the people on the beach path here in Huntington Beach, and I see that people, especially when they're trudging along the beach path, a lot of times their mid-back is super flexed forward. Like, their upper back is super flexed forward. And it almost looks like their head or their nose is leading their running.

In this case, what is occurring is they're having a posture breakdown, okay? Some people have stiffness in the mid-back. Yeah, we can debate that on another day, and maybe that's just how they are. Or maybe what they've done chronically over the years has done this to them. Maybe it's sitting. Who knows? But what we know from people with lower back pain is that the spine has yin and yang. It has ebbs and weaves. They're called lordosis, kyphosis, or curves, right? And so if one curve is dominant, the other one will zag in the other direction, which is, in this case, if it rounds more in the upper back, it'll zag or go the other direction or extension in the lower back.

So we're really not putting ourselves up for success if we have excessive curve in a different part of the back. So one thing we can do, at least early on, before any physical changes happen, like degeneration in the spine or scoliosis and stuff like that, is that we can try to build a strong postural system. And so that's going to be strengthening some of the backside muscles, but also the front side. And pushing the sled helps out a ton with this. You can't push a sled by having a rounded upper back. Like you have to kind of elongate to push the sled. And so what we know with people with lower back pain as well is that they have, especially chronic lower back pain people, is they have a buildup of fatty infiltrate, or fat replaces their muscles of their multifidus muscles.

And so how hard would it be to keep good posture if your muscles were replaced with fat? So to arrest that process, and by the way, I don't know if you can actually stop it. Sorry, I don't know if you can actually reverse it. But to arrest that process, you should condition the muscles. Pushing the sled does that for you. So that is a very simple way to help condition posture muscles. Third thing is you have low impact exercise. And so if you have problems with the impact of running, this is lower. It still mimics running. There's still leg turnover. There's still core endurance. There's still postural muscles going on, and you still get strength in the hips and legs.

So it's very low impact to do, and especially lower impact on the spine, especially when compared to back squatting. The last thing I will cover is hip endurance and leg strength. Let's just, how you push the sled or however it is is going to dictate which one is more biased. If your knees are closer to the ground, you'll be a little bit more quad-y, which is fine. If your legs are up a little bit or your hips are up a little bit, it's going to be a little bit more hippy. That's fine too. But we know from a lot of the research over the years that lower back pain tends to turn off the glutes. It also makes people distrusting of working their legs and strengthening their legs.

It also convinces people that doing something hard or heavy sometimes is dangerous, and those aren't necessarily the case. So if we can be creative about working around any of our fears and also making sure it doesn't hurt when you're doing it, those are good things to do. And pushing the sled is a very simple way of keeping the load away from the lower back while we're getting the legs and hips a little bit more active. Even the calves and feet will benefit from this. We actually use a sled push or a toe cocked back type of training system when we're dealing with people with knee and plantar fasciitis.

Now, if you guys are looking for help, reach out to us. We have that free webinar about lower back pain in the description. But also, too, we offer consultations and we have telehealth sessions. We're licensed in different states, and we would love to help you get back into running.