Strength Training for Chronic Low Back Pain: Is It Better Than Core Exercises Alone?

Running is one of the easiest and healthiest forms of exercise. Whether you're training for your first 5K or your tenth marathon, running improves cardiovascular health, strengthens bones, and boosts mental health. Unfortunately, it also comes with a downside. Research shows that 25-30% of all running-related injuries occur at the knee , making it the most commonly injured joint in runners. The good news? Many of these injuries are preventable.  What Causes Running Knee Injuries? A recent systematic review analyzed 20 different studies involving endurance runners to identify what consistently increases the risk of knee injuries. Instead of finding one single cause, researchers discovered that knee pain usually develops from multiple factors working together. The three biggest risk factors were: Previous knee or running injury Training too much or progressing too quickly Biomechanical factors (how your body moves while running) The Biggest Predictor: Previous Injury One of the strongest findings from the review was that runners who had been injured before were much more likely to get injured again. Why? After an injury, many runners return to training before they've fully recovered. Even if the pain is gone, there may still be: Muscle weakness Poor balance Reduced flexibility Changes in running mechanics Decreased shock absorption Without addressing these issues, the body often compensates, increasing stress on other joints and tissues. More Miles Isn't Always Better Many runners believe that more training automatically leads to better performance. Not necessarily. The review found that rapid increases in weekly mileage, longer training hours, and higher overall training loads consistently increased the risk of knee injuries. Your body needs time to adapt. When muscles, tendons, and joints don't have enough recovery time, repetitive stress begins to build faster than your body can repair it. This is when overuse injuries begin to develop. Running Form Matters Researchers also found that movement patterns can influence injury risk. Some runners demonstrated: Increased pelvic tilt Poor hip control Excessive trunk lean Abnormal knee loading Reduced shock absorption These movement patterns may place additional stress on structures around the knee, especially during longer runs. It's important to remember that there is no single "perfect" running form. Instead, the goal is to identify movement patterns that may be contributing to your specific pain. Common Running Knee Injuries The review highlighted three conditions that occur most often. Patellofemoral Pain Syndrome (Runner's Knee) Often felt around or behind the kneecap. Pain usually worsens with: Running hills Stairs Squatting Sitting for long periods Contributors include poor hip strength, altered mechanics, and training errors. Iliotibial Band Syndrome (IT Band Syndrome) Pain develops on the outside of the knee. This condition is commonly associated with: Increased training volume Hip and pelvic control deficits Running biomechanics Previous injury history Patellar Tendinopathy (Jumper's Knee) Pain occurs just below the kneecap where the patellar tendon attaches. Risk increases with: High training volume Tight hamstrings Previous knee injury Poor load management How Occupational Therapy Can Help At Thrive Sports & Spine, occupational therapy focuses on helping runners return to the activities they love. Treatment may include: Strengthening weak hips and legs Improving flexibility and mobility Addressing balance and stability deficits Correcting movement patterns during functional activities Building a gradual return-to-running program Reducing pain while improving performance Rather than simply treating symptoms, we work to identify why the injury developed in the first place. Chiropractic Care Can Improve Movement Restricted joints can alter the way forces travel through the body while running. Our chiropractors evaluate spinal, pelvic, and lower-extremity mobility to help restore efficient movement and reduce unnecessary stress on the knees. Acupuncture Can Help Manage Pain For runners dealing with persistent soreness or overuse injuries, acupuncture may help: Reduce pain Decrease muscle tension Promote relaxation Support recovery between training sessions Prevention Is Better Than Recovery The biggest lesson from this review is that most running injuries don't happen because of one bad run. Instead, they develop gradually through a combination of previous injury, excessive training, and movement patterns over time. If you're preparing for a race—or simply enjoy running for fitness—taking the time to improve strength, mobility, and recovery can help keep you healthy for miles to come. Ready to Keep Running Pain-Free? Whether you're training for your next marathon or just getting started, our multidisciplinary team can help you move better, recover faster, and reduce your risk of injury. From gait assessments and strength training to manual therapy and personalized rehabilitation, we'll build a plan that keeps you doing what you love. Reference Senthil, K., Whitaker, S., Goodloe, J., et al. (2026). Common Risk Factors for Knee Injuries in Runners: A Systematic Review. Orthopaedic Journal of Sports Medicine.

Many people think chronic low back pain is simply caused by sore muscles or a "bad back." However, new research suggests that long-lasting back pain affects much more than the spine. It can change how your body processes pain, reduce your physical fitness, and even impact your mental well-being. What Did the Study Find? Researchers compared adults with chronic low back pain to healthy individuals to better understand how pain affects the body. They discovered that people with chronic low back pain had: Higher levels of anxiety and depression More pain catastrophizing (expecting the worst from pain) Greater signs of pain sensitivity, also known as central sensitization Reduced walking endurance during a 6-minute walking test The researchers also found that pain sensitivity and psychological stress explained about 60% of the differences in walking ability , showing that chronic pain affects much more than just the muscles and joints. Your Nervous System Can Become More Sensitive When pain lasts for months, your nervous system can become overly sensitive. This process, called central sensitization , means your brain and spinal cord begin to amplify pain signals. As a result: Normal movements may feel painful. Minor aches can feel much worse than expected. Pain may continue even after tissues have healed. This helps explain why many people continue experiencing back pain even when imaging shows only mild changes. Chronic Pain Can Affect Your Fitness The study found that individuals with chronic low back pain walked significantly shorter distances than healthy adults. This often happens because people begin avoiding movement due to fear of pain. Unfortunately, less movement can lead to: Muscle weakness Reduced endurance Poor conditioning Increased stiffness Greater disability over time The good news is that safely increasing movement can help reverse this cycle. Your Mind and Body Work Together One of the biggest findings from this research is that psychological health and physical health are closely connected. People experiencing more: Anxiety Depression Fear of movement Pain catastrophizing also tended to have poorer walking performance and greater pain sensitivity. This does not mean the pain is "all in your head." Instead, it shows that chronic pain is influenced by both the body and the nervous system. Treating only one piece of the puzzle often isn't enough. How Our Team Can Help At Thrive Sports & Spine, we use a team-based approach to address the many factors contributing to chronic low back pain. Occupational Therapy (OT) Our occupational therapists help patients: Restore strength and endurance Improve movement patterns and body mechanics Increase walking tolerance Reduce fear of movement through graded exercise Return to work, hobbies, exercise, and everyday activities safely Chiropractic Care Our chiropractors help improve: Joint mobility Spinal mechanics Overall movement efficiency This can decrease stiffness and improve how the body moves throughout the day. Acupuncture Acupuncture may help: Reduce pain Calm an overactive nervous system Improve relaxation Support the body's natural healing process Medical Providers Our medical team can: Evaluate persistent pain Rule out underlying medical conditions Coordinate medications or additional treatments when appropriate Ensure you're receiving the right care at the right time The Best Results Come From Treating the Whole Person This study reinforces an important message: Successful treatment of chronic low back pain goes beyond treating the spine alone. By improving: Strength Endurance Movement quality Pain sensitivity Confidence with activity patients can often move with less pain and enjoy a higher quality of life. Don't Let Chronic Back Pain Control Your Life If you've been living with back pain for months—or even years—you don't have to simply "learn to live with it." Our multidisciplinary team works together to identify the factors contributing to your pain and create a personalized treatment plan that helps you: Move better Feel stronger Reduce pain Improve confidence Get back to doing the activities you enjoy Every journey starts with a comprehensive evaluation and a plan tailored specifically to your goals. Study Link https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-026-08634-8  Reference Yeung, M. J. L. C., Fok, F. H. Y., Kwan, J. W. L., Lui, C. W. S., & Tsang, S. M. H. (2026). Profile and association between pain sensitivity and physical fitness in individuals with chronic low back pain. BMC Musculoskeletal Disorders, 27, 586.

As we get older, aches and pains often become part of everyday life. Back pain, neck pain, arthritis, and joint stiffness can make it harder to stay active and enjoy the things you love. Many older adults are interested in chiropractic care but wonder if it is safe for their age. A new systematic review published in Chiropractic & Manual Therapies helps answer that important question.

Heel pain can make even simple activities like walking the dog, exercising, or standing through a work shift uncomfortable. One of the most common causes of heel pain is plantar fasciitis, a condition involving irritation of the thick band of connective tissue that supports the arch of your foot. While many people improve with stretching, supportive footwear, and activity modification, others continue to experience pain for months despite trying multiple treatments. A recent study published in the Journal of Clinical Medicine examined how radial extracorporeal shockwave therapy (ESWT) affects patients with chronic plantar fasciitis that had not responded to conservative care.

Low back pain affects people of all ages and activity levels. Whether you enjoy working out, playing sports, gardening, or simply want to keep up with your family, back pain can make everyday activities more difficult. A recent study published in the Journal of Back and Musculoskeletal Rehabilitation found that a structured whole-body strength training program significantly improved pain, strength, and function in people with chronic low back pain. The findings support an approach that combines proper movement with progressive strengthening to help people recover and stay active.

Positive Outcomes of spinal decompression for low back pain

A 2025 systematic review of 36 randomized controlled trials (~2000 patients) found PRP significantly reduced pain scores compared to controls at...

If you’ve ever felt pain on the inside of your elbow when gripping, lifting, or swinging a golf club — you might be dealing with medial epicondylitis, also known as golfer’s elbow.

When people think about preventing falls, they usually focus on balance.