Objective: Negative beliefs towards running may impact participation. This study explored differences in beliefs towards running in adults with and without chronic low back pain.
Methods: This mixed methods cross-sectional study compared adults with chronic low back pain (n=39) to pain-free adults with a history of chronic low back pain (n=28) and a low back pain naive control (n=71). Quantitative outcomes were activity specific beliefs, pain intensity, disability, and habitual physical activity. Qualitative analysis examined free-text responses regarding activity specific beliefs.
Results: Participants were primarily male (62%) and had a mean (SD) age of 50 (9) years. The chronic low back pain group reported running was less safe than low back pain naive controls (mean difference [95% CI]: -0.32 [-0.61, -0.03] points, P=0.028). There were no other significant between-group differences. Among participants with chronic low back pain who reported a variation of running as unsafe (n=27), 93% limited how much running they did because of this belief. Reflexive thematic analysis identified three themes: (a) running is unsafe due to the impact it imparts on the spine, (b) running is natural and has many health benefits, and (c) numerous factors determine the safety of running.
Conclusion: Individuals with chronic low back pain hold more negative beliefs towards running compared to individuals with no history of low back pain. These negative beliefs limited participation in running despite evidence that running is likely safe for this cohort. Targeting negative beliefs towards running may facilitate greater uptake of running and guideline-based physical activity.