Conquer the London Marathon without Suffering from Back Pain

  • Leading Back Specialist provides advice to help people cross the London Marathon finish line pain-free
  • For many, back pain won’t appear until a day or two post-race
  • Complementary online masterclass’ for those in need of back rehabilitation


As the London Marathon (21 April) draws near, participants are gearing up for the big day. However, excitement for the event is often tinged with apprehension about the aches and strains, particularly back pain, that can accompany a 26.2-mile run across the city.


Leading UK osteopath, Mr Michael Fatica, assures runners that back pain doesn’t have to be an inevitable part of the marathon experience. With just five simple steps, both novice and seasoned runners alike can prevent back pain from hindering their race and potentially causing long-term issues.


Mr Fatica, from the Back in Shape Program, is keen to highlight the strain long-distance running can put on the back. This includes fluid loss between the spine’s intervertebral discs, which can cause temporary height loss in runners. However, fluid levels typically revert 24 hours post-race. Additionally, significant compression and rotational forces are exerted on the lower lumbar discs.


He explains: “Running essentially involves many thousands of smaller impacts through the lower back, which accumulate over time. It’s often the constant landing and impact that overwhelms the discs and can lead to back pain, particularly in the closing miles of the race when the steps, and their associated impacts, tend to get heavier.


“While most muscles in the body heal very well and bounce back quickly, as a result of a great blood supply and daily movement, the spinal discs do not share this same ability to heal. It is crucial, therefore, to ensure the right steps are taken to help reduce the likelihood and severity of back pain developing in the immediate days and weeks post-race.”


Mr Fatica recommends the following steps, for the days/weeks leading up to and following the event, to help prevent marathon-related back pain:


  1. Decompress the spinal discs. The key to alleviating lower back pain lies in decompressing the spinal discs, especially the L4, L5 and L5, S1 discs – the last two discs in your lower spine. The Towel Stretch and the Bed Decompression are two stretches that can directly relieve pressure on these discs (pls see below). The former involves lying over a rolled towel positioned under your lower back to support the spine’s natural curvature, thus relieving pressure on the discs. The latter involves lying on a bed with your head off the edge, using your arms to press against the side of the bed to create a gentle decompression effect. Repeat these gentle stretches a couple of times a day, starting on the evening post-race, for periods of 3 to 5 minutes at a time.
  2. Enhance circulation with hot and cold therapy. Managing inflammation and promoting recovery in the lower back can benefit significantly from contrast therapy, which alternates between hot and cold treatments, such as an ice pack and a hot water bottle. This method helps reduce inflammation that accumulates from the strain of running a marathon and enhances the recovery process by improving blood flow to the affected area. Start post-race, and continue daily into the following week, use each for periods of 3 to 5 minutes, 2 x in a row. Repeat this a couple of times per day spread evenly.
  3. Self-massage to reduce muscle stiffness. Post-marathon, it’s common to experience stiffness in the muscles of the legs, which can impact the lower back. Massage guns can effectively alleviate this stiffness without the risk of over-stressing tendons, which is a possibility with traditional stretching. These devices aid in muscle recovery by improving blood circulation and reducing stiffness, thus indirectly benefiting the lower back. Use every evening in the week post-race for about 10 to 15 minutes at a time.
  4. Maintain activity and mobility. Even if you don’t feel like it, it’s crucial to stay active after the marathon to aid recovery. Participate in gentle activities, such as walking and swimming, in the days immediately afterwards. This can significantly help muscles from ‘seizing up’ and promote overall bodily function. Hydration also plays a crucial role in this process, as it helps to flush out toxins and waste products from the muscles.
  5. Combine strategies for maximum benefit. Incorporating all of the above into a comprehensive two-week, daily, post-marathon recovery plan can significantly help reduce the risk of lower back pain and help facilitate a quicker return to normal activities. Not only will this support the lower back’s immediate recovery, but it will also help prepare the body, and spine, for future physical challenges.


Despite the potential back issues caused by running, Mr Fatica remains a staunch advocate of its benefits. He adds, “Running is not just about physical fitness; it’s also about mental well-being. The sense of achievement when you cross the finish line, especially in a prestigious event like the London Marathon, is unparalleled. So, don’t let back pain hold you back. With the right preparation and care, you can conquer the marathon and enjoy the journey.”


For those who find themselves struggling post-marathon, or whose lower back injury has prevented participation this time round, Michael offers a dedicated, complementary online workshop ‘fixing back pain masterclass’, to help those in need of back rehabilitation.


For more general information about the Back in Shape program, please visit

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