Knowledge Base

Training with back pain: is it possible?

Almost every athlete is familiar with back pain. But how do you deal with it? Take a break from training or maybe not?

back painAutor: Cornelia Caviglia, physiotherapist MSc and sports physiotherapist ESP, Medbase Zürich Löwenstrasse, and quality manager at the Medbase Group.


Common source of back pain: weakness in back and core muscles

Given a choice, the back would choose variation and movement. In normal everyday life, however, many people sit and move almost nothing. This can result in tension. Light exercise in everyday life and exercise can help against this – insofar as the pain allows it. This is because movement that is as habitual as possible helps to relieve tension. Physical activity can also actively counteract stress, which in many cases is partly responsible for back pain. For triathletes who spend a lot of time on the bike, however, sitting on the bike for a long time is often the cause of the pain, or the back and core muscles are too weak.

Continue training or take a break?

Intuitively, many people take a rest period when they suffer from back pain. They fear it will get worse. But for sustained recovery, it’s important to keep moving. This is because back pain causes the muscles to tighten, which in turn causes the pain to increase. To break this vicious cycle, exercise helps. For triathletes it is also important to continue their basic endurance training. In general, it is recommended to replace the sport that causes pain with another sport for the duration of the pain. So if running hurts, it is better to take a break from running and schedule an additional cycling or swimming session.

Running training with back pain?

It may be advisable not to train too intensely and for too long for the duration of the back pain. This is because when running, the body has to cushion several times the body weight with each step. Therefore, a soft running surface is highly recommended. If the running training is causing the pain, it is worth taking a closer look at the movement patterns, or the running technique. Is the strength really coming from the hip extensor or from the calf muscles? Specific exercises such as stretch running or targeted strengthening of the trunk muscles can prevent the pain and increase the efficiency of the sport.

Bike training with back pain ?

Yes, if the pain allows it. Cycling can even be beneficial for back pain. In order for the training on the bike to be back-friendly and pleasant, the bike must be set up correctly. The frame must fit the body size so that triathletes do not have to bend too far forward, which causes tension in the lumbar region. The choice of saddle and the saddle angle are also crucial: Ideally, the hips and buttocks should not slide back and forth when pedaling. In addition, the saddle should not be too high, so that you don’t have to twist and stretch out your legs with every turn of the pedals. For most people, a horizontal saddle position is suitable, but in some cases it helps to change the angle of the saddle tip if you have back pain. Handlebar height must also allow for a comfortable, upright posture with elbows slightly bent. Triathletes with back pain should also train on flat stretches or stand uphill. At the same time, the deep muscles of the back should be stabilized and strengthened with specific exercises.

If the pain is too severe for bicycle training, training on a bicycle ergometer is a good option because it allows you to sit upright.

Swimming training with back pain ?

Swimming is ideal, but here too it is important to keep an eye on the training intensity and technique and to consult a doctor if the pain worsens under stress.

What if the pain increases during exercise?

If the back pain increases during exercise or does not improve after two weeks, you should discuss the problem with a doctor. It could also be an injury or a structural problem.

What else can help with back pain?

Painkillers can be supportive, but non-drug treatment is the main focus. For example, heat pads, a warm bath, massage, light exercise or relaxation exercises can provide relief. Manual therapy, physical therapy or acupuncture are also helpful.


The best prevention is to have a well-trained body, especially strong back and core muscles. It is also helpful to add variety to your workouts.

Who is Medbase?
Medbase is the largest multidisciplinary sports medicine network in Switzerland and offers specialized sports medicine services for athletes, clubs and sports associations of all activity levels in the areas of sports medicine, sports physiotherapy, performance diagnostics and training advice.