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Study uncovers potential key to preventing back pain in runners

A new study from The Ohio State University Wexner Medical Center examines what may cause chronic back pain in runners and the exercises to help prevent it.

The study, published in the Journal of Biomechanics, suggests that runners with weak deep core muscles are at higher risk of developing low back pain. And, unfortunately, most people’s deep core muscles aren’t nearly as strong as they should be.

To examine the role of the superficial and deep core muscles, researchers used motion detection technology and force-measuring floor plates to estimate muscle movements during activity. 

“We measured the dimensions of runners’ bodies and how they moved to create a computer model that’s specific to that person. That allows us to examine how every bone moves and how much pressure is put on each joint,” said Ajit Chaudhari, associate professor of biomedical engineering and physical therapy at Wexner Medical Center, who led the study. “We can then use that simulation to virtually ‘turn off’ certain muscles and observe how the rest of the body compensates.”

What they found is that weak deep core muscles force more superficial muscles like the abs to work harder and reach fatigue faster. When those superficial muscles are doing the work the deep core should be doing, there are often painful consequences.

“When your deep core is weak, your body is able to compensate in a way that allows you to essentially run the same way,” Chaudhari said. “But that increases the load on your spine in a way that may lead to low back pain.”

Experts say it’s common for even well-conditioned athletes to neglect their deep core, and there is a lot of misinformation online and in fitness magazines about core strength. Traditional ab exercises with a large range of motion, such as sit-ups or back extensions, will not give you the strong core needed to be a better runner. 

Instead, Chaudhari says exercises such as planks that focus on stabilizing the core, especially on unstable surfaces, are what’s really going to make you a better runner.

“Working on a six-pack and trying to become a better runner is definitely not the same thing. If you look at great runners, they don’t typically have a six-pack but their muscles are very fit,” Chaudhari said. “Static exercises that force you to fire your core and hold your body in place are what’s really going to make you a better runner.”

Engineering medical innovations

Engineers have a lot of unique insight to offer when it comes to working on innovative medical research, Chaudhari says.

“There’s so much engineers learn about how to solve problems, how to break down larger problems, how to understand needs so that you can then try to find solutions,” he said. “That way of thinking is definitely not typical for people of other backgrounds who might be trying to do things in the biomedical space.”

Alumna Margaret Raabe, who earned a PHD in biomedical engineering from Ohio State in 2017, was instrumental in conducting the study as part of her studies. She developed the full-body lumbar spine computer model that Chaudhari says is the foundation of the entire project.

Using open source software and some existing models, she created the first OpenSim full-body model that includes the major muscle groups of the lower extremities in addition to the eight major muscle groups of the lumbar spine.

Now Raabe is applying the skills she learned at Ohio State in her role as a research engineer for Globus Medical, a medical device company.

“Globus Medical primarily produces spine-related implants, so my specific research at Ohio State prepared me immensely for my role at this company,” Raabe said. “I am applying my knowledge of trunk and spine anatomy and biomechanics to various industry research projects in our biomechanics lab at Globus that aim to gain knowledge that will lead to innovative solutions to clinical problems and advances in spinal-related implants.”

Moving forward

In the future, Chaudhari and his team hope to study the results of using deep-core focused physical therapy intervention on real patients to see if it reduces the incidents of low back pain or helps people with low back pain.

“We’d love to be able to try to prevent some of that low back pain in the first place,” he said.

This research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health

Updated March 20, 2018

by Alexis ShawWexner Medical Center Public Affairs and Media Relations and Candi Clevenger, College of Engineering Communications