According to physical therapist, Chandler R. Taylor, low back pain is the second most common complaint among bicyclists (Pruitt, 2006). The aerodynamic posture of a bicyclist in spinal flexion can increase the pressure on vertebral discs and increase the risk of low back pain (Mellion, 1994). There are numerous genetic and environmental factors, which can create low back pain. There are numerous medical treatments for low back pain. For the purpose of this article, Chance will discuss bike fit and exercise for low back pain prevention.
I recommend all bicyclists who train greater than 1-2 hours a week consider having a professional bike fit. Each individual has differences in flexibility, leg length asymmetry, trunk length, and arm length. The appropriate fit for one bicyclist may be completely wrong for another.
There are numerous variables that can create low back pain while bicycling, including: leg length discrepancy, excessive flexion or extension of the spine due to inappropriate handlebar reach, pelvic rocking side to side due to poor seat height, excessive pelvic tilt due to inappropriate saddle height, and progression of mileage too quickly in the presence of core weakness (Pruitt, 2006) (Mellion, 1994).
A leg length discrepancy occurs when one leg is longer than the other. Mild leg length discrepancies are considered normal and typically are not a source of pain. Significant leg length discrepancies can create pain and are typically addressed by adding a shim to the cleat of one shoe (Pruitt, 2006) (Mellion, 1994).
Finding the perfect fore-alt position of the spine while cycling will improve comfort and reduce the risk of back pain. If the rider’s reach is too long, lumbar lordosis is exaggerated, and pressure on the facet joints will be increased. If the rider’s reach is too short, the spine will be more flexed, and pressure on the anterior components of the lumbar disc will be increased (Mellion, 1994). Adjusting the bicycle stem and handlebar height will lengthen or shorten a rider’s reach to comfort. Mellion suggests starting the season with a more upright posture and gradually move lower as your body adapts and core strength improves (Mellion, 1994).
Pelvic rocking side to side occurs when a rider’s seat is too high and the rider’s pelvis moves laterally during the pedal down stroke (Mellion, 1994). Adjusting the seat to a lower position will quickly resolve this deviation.
Inappropriate saddle height can also lead to low back pain due to its effect on pelvic tilt. A saddle height which is too high can create a lower knee ankle at the bottom of the pedal stroke and lead to excessive posterior pelvic tilt in someone with poor hamstring flexibility. The pelvis rotates backwards to accommodate tight hamstrings, which increases stress on the lower spine. Adjusting seat height to allow between 25-40 degrees of knee extension at the bottom of the pedal stroke and working on hamstring flexibility will improve the position of the pelvis. The appropriate knee angle is dependent upon the individual’s flexibility and optimal power production (Burt, 2014).
Progressing mileage too quickly is a common error among bicyclists that can lead to back pain and increase the risk of overuse injuries. Progression of mileage should be no more than a 10 percent increase per week. Mellion suggests that most authorities recommend starting the season with spinning at high cadence and low resistance (Mellion, 1994).
Now that we have addressed bike fit, I would like to discuss the importance of flexibility and daily exercise to prevent low back pain with bicycling.
Maintaining full range of motion in the spine is essential to injury prevention and bicycling efficiency. Lumbar discs are avascular and spinal movement is required for nutrients to enter and metabolic waste to exit (Mellion, 1994). If stiffness or loss of motion is present in one spinal segment, additional stress is placed on the spinal segments above and below that segment which can further lead to injury.
Flexibility exercises can be performed daily to improve spinal range of motion and decrease risk of injury. I recommend the yoga cobra stretch, double knee to chest stretch, and lying spinal rotation stretch to improve spinal flexibility and comfort while on the bike. Perform these stretches daily for optimal results. These stretches are recommended to improve mobility in individuals who are not currently having pain. If you are experiencing pain, consult your health care provider. Please email me at firstname.lastname@example.org for any questions or comments.
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1. Mellion, M. B., & Burke. E. R. (1994). Clinics in sports medicine: Bicycling
injuries. Philadelphia, PA: W.B Saunders Company.
2. Pruitt, A. L., & Matheny, F. (2006). Andy Pruitt’s complete medical
guide for cyclists. Boulder, CO: VeloPress.
3. Burt, P. (2014). Bike fit. London: Bloomsbury Publishing Plc.