Can you exercise without your back hurting? The older I get, the more I wonder about this! Many people, whether they are elite athletes, or just fitness freaks, complain that one of the worst aspects of exercising is back pain.

There are specific sports in which this is more common than others, such as running, but it is probably something everyone has experienced from time to time.

What causes back pain?

The first thing to think about is whether it actually is your exercise which is causing your back pain. You may find that you have low-grade back pain quite frequently, which you actually notice more after exercising.

Are you sitting at a desk all day? Then check your posture, particularly if you are using a computer. I found that the simple measure of raising my computer screen to eye-level has cured months of back pain.

What sort of mattress do you use? Is it soft, making you roll towards the middle of the bed all night? If so, that will definitely cause back pain, and you should replace it with a firm mattress.

In particular sports, the cause of back pain is usually either incorrect technique, or weak back muscles or a combination of both.

How to prevent back pain

There are five basic steps for preventing back problems:

• Educate yourself about your particular sport or type of exercise, and how you should train to get the most out of it.
• Look after your posture, since your back muscles should be properly aligned in order to prevent stress affecting the back.
• Build strength in other parts of your body, so that your muscles are sharing any stress, and not simply transferring it all to your back muscles.
• Make sure that you are building flexibility in your joints and muscles.
• Build up your back muscles, which will result in less back pain, and less severe injuries.

Warming up and stretching

The key to preventing any injury is attention to warming up and stretching. These are not the same thing.

Warming up literally means raising your body temperature by performing light activity. So start a run with a light jog, and a cycle by spinning on a light gear on the flat.

Once you are warm, then stretch. If you run or cycle, you probably concentrate only on stretching your calves, quadriceps and hamstrings. I know that I do! But if you want to protect your back, you must stretch the muscles in your shoulders, arms and back as well. This is particularly important for cyclists, who use all these muscles when hill-climbing.

Strength training

When you exercise, if the muscles you use in your particular sport are not in shape, then some strain is going to be passed on to your back. When you work out a strength-training regime, you must make sure that you are concentrating on those muscles which you use in your sport, as well as strengthening your back. The combination of the two will protect your back.

I favour weight training, at a gym, where you can ask either a personal trainer, or one of the attendants for advice on which machines to use for particular muscle groups.

In general, you should aim to exercise all muscle groups regularly, whatever your particular sport. All-round body strength will definitely protect your back.

Interestingly, people who are not active at all develop wasting of the muscles of their backs, which I'm sure will contribute greatly to back pain.

Back pain in runners

This is such a common problem that it warrants a specific note. In his book 'The Lore of Running', Tim Noakes classifies runners with back pain into two groups. He says that there are those in whom pain results from degeneration of the discs between the vertebrae, and those in whom pain comes from other tissues, such as the ligaments, muscles, and small joints of the back.

Those with degenerative disease of the back will need to modify their training, in consultation with a qualified sports doctor or physiotherapist. The second group will benefit from appropriate lower back stretching and strengthening exercises.

The bottom line

If you have symptoms of back pain which include tingling down one leg, increasing weakness of one leg, or extremely severe pain which has not settled after a night's rest, then you need to see your doctor before you continue with any training programme.

But, in most cases, activity the best cure for aches and pains, and lower back pain, in most cases, is no exception. If your back is sore after you exercise, analyse what you are doing, find the cause, and modify it. Don't stop exercising. That will only make the problem worse in the long run as you lose fitness and strength, and lack of fitness is strongly associated with an increased incidence of lower back pain.