How to Train for a Race or Triathlon with Back Pain

Find out how to avoid pain and even when to call it quits when you’re training for a race or triathlon.

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When training for any event that involves running, biking, or swimming, it’s only natural that sometimes, it can take a toll on the body. Pulled hamstrings, twisted ankles, and sore heels can be par for the course, but what if your race or triathlon training is causing or worsening back pain? Since the back muscles are connected to so many other muscles in the body, any little movement after a tough training session can be excruciating.

People training for triathlon race without back painRaces and triathlons can be hard on your back, so train smart with these tips.

Back in 1986, researchers studied Ironman triathletes who had recently completed the competition in Hawaii. They found that 91% of the athletes had suffered at least one soft-tissue injury during training, with 72% of those athletes reporting low back pain or sciatica. Other athletes, when they complete less-strenuous training, still have been known to experience back pain. For instance, one 2020 study in BMC Musculoskeletal Disorders found that 14% of recreational half-marathon runners had low-back pain within the previous year.

If your back is hurting, and that race or triathlon is right on the horizon, how do you address your back pain before it gets worse? Or when is it time to throw in the towel? Suzanne M. Manzi, MD, owner of Performance Pain & Sports Medicine with offices in Houston, TX and New Jersey, is here to share her words of wisdom on this subject. (Dr. Manzi is also the daughter of an Ironman triathlete.)

Why Race Training Is Hard on the Back

When it comes to any high-impact activities, all that repetitive motion and pounding may challenge the joints and spine, according to Dr. Manzi. And bad form only aggravates the problem.

“Stress of repetitive motion, especially in the setting of poor form, can lead to breakdown of the joints and spine,” Dr. Manzi says.

If your muscles are weak, something that might be true if you’re new to intense training, this can also attribute to back pain and injury.

“Stabilizer muscles are sometimes neglected, but these muscles are important for supporting the vital structures in the midline, the spine, and joints,” Dr. Manzi notes. “Ensuring a strong base, glutes, back muscles, and core to stabilize the spine and joints for the wear and tear from a repetitive motion sport like triathlon, is vital.”

Training Mistakes

Even the most seasoned athletes have been known to make mistakes during their training. And these mistakes can lead to backaches.

Dr. Manzi says that the biggest mistake she sees people make during triathlon training is that they only train by swimming, biking, and running.

“Of course, sport-specific preparation for a triathlon is important,” she says, “however, lifting, core strengthening, and flexibility are usually neglected.” In other words? You probably haven’t been hitting the weight room enough during your training.  

Rest is also a vital part of an intense training program that often gets overlooked, Dr. Manzi says, which can lead to overuse injuries. Also, nutrition and calories are important.

“When people skimp on feeding their body, they can suffer from injury and ailment, which in turn can lead to pain,” Dr. Manzi explains.

How to Avoid Back Pain When Training

You might be wondering how you might sidestep back pain altogether during your training. Dr. Manzi shares her top six tips.

Get Some Shuteye

As with any healthy lifestyle, sleep is a non-negotiable, and it may become even more important during your training program. Dr. Manzi says that sleep is imperative for “successful training” and “making gains,” since it allows muscles to recover adequately before training again. Sleep can also be beneficial for the mental aspects of a race or triathlon, since any competition is very mentally challenging, “and psychology is key to performance,” as Dr. Manzi says.

Work on Flexibility

Dr. Manzi stresses that muscles need to stay flexible to preserve muscle function and recovery ability.

She says, “After exercising including running, biking, swimming, as well as all of the supplemental training that is needed, stretching and working on flexibility is key to feeling good and performing better. Stretching should be done after an activity when the muscles are warm, and the muscle fibers can be elongated and stretched out for adequate recovery.”

Eat Right

“We are what we eat,” Dr. Manzi says. “We put high-performance gas in our high-performance cars. We need to do the same with our bodies to support the excess calorie deficits that come along with long haul training and races.”

Get Stronger

Dr. Manzi says that a solid foundation is key in any training because our muscles power our skeletons to move.

“We need to support our bones with the strength of our muscles. Our muscles are our own bracing system, and specific back exercises that target the multifidus muscles—the body's internal back brace—must be nurtured to prevent spinal injury.” That means including back-strengthening exercises in your training regimen, such as:


  • Cat-cow stretches
  • Glute bridges
  • Bird dogs
  • Superman extensions
  • Planks

Include Rest Days

You may notice in your training plan that rest days have been built in—don’t train on those days. Pushing through won’t make you stronger or better. But skipping rest days can lead to injury, including spinal injuries.

“After multiple days of training, a day of rest is always important,” Dr. Manzi says. “Not just sleeping all day, but active recovery days are always good. Moving and stretching, foam rolling, massage, and other types of body rejuvenation could do the body and mind good, allowing for adequate recovery and further training.”

Improve Form

Have you ever seen a hunched-over runner, or one with too short a stride, and think, “They’re going to be hurting later”? Good form really can make the difference between an injury-free athlete and an injured athlete.

“Form follows function,” Dr. Manzi says. “Before starting, it may be helpful to have your gait, swim stroke, and bike technique evaluated by professionals to ensure that proper form is being used during the long training hours.”

And again, this is where the importance of those rest days comes in.

Dr. Manzi says, “Fatigue can also lead to poor form, putting excess stresses on the joints and the spine, which can lead to injury.”

Listen to Your Body

You may have heard the phrase, “Train through the pain.” This is the opposite of what you should be doing when training for any competition, and it’s something that can greatly exacerbate a spinal injury.

Dr. Manzi says that you should always pay attention to pain that doesn’t go away after exercise or warming up, pain that limits function, and pain that interferes with activities of daily living. These are all conditions that should be checked by a doctor.

When to Call It Quits

You’ve been training hard. You’ve looked forward to this competition for months. Maybe you’ve even bought plane tickets. Needless to say, it can be disappointing to throw in the towel, but sometimes, it’s necessary for your back, and your overall health.

“It’s important to stop if the body signals one to stop,” Dr. Manzi emphasizes. “This is why we feel pain. It’s our internal mechanism that tells us something is wrong. We don't drive our car around on a flat tire, right?”

When it comes to your back, Dr. Manzi says that it’s crucial to pay attention to continuous pain, pain that isn’t just in the back but radiates down the legs, and pain that leads to weakness, tingling, or numbness. These symptoms should be immediately evaluated by an expert, who may say that it’s wise to end your training.

“Listen to your body,” Dr. Manzi says. “It can be hard to stop after months of training for a race, but you only get one body. Take care of it, nurture it, and listen to it if it is injured.”

Updated on: 08/23/21
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