Health: Protect your back

If you don't look after your back, your cycling days are numbered

Cycling might give you the cardiovascular system of someone 10 years younger, but if you want to carry on riding injury-free into your dotage, you need to look after your back.

According to a recent study in the International Journal of Sports Medicine, if your back’s trouble-free you’re in a clear minority. California State University researchers questioned 518 recreational cyclists and found a staggering 85 percent of them harboured at least one recurrent injury.

Clocking an average of 75 miles a week, 79.1 percent reported neck or back problems, almost twice those hobbling with knee issues (41.7 percent), while 36.1 percent harboured groin and buttocks strains, and 31.1 percent wrist and hand pain. Perhaps the most worrying finding was that just 36 per cent sought any professional help to ease the pain.

“Most cyclists think you can just jump on a bike and go, when that’s far from the case,” explains Dr Michael Lanning, a Harley Street chiropractor who specialises in cycling-related joint and spine injuries. The back, he says, or more properly the abdomen, is by far the weakest link for the majority of riders.

“Cyclists have huge leg muscles but don’t have the torso strength to support and resist the tremendous forces which the legs can generate,” he explains. If the torso is weak, he says, that force doesn’t go into the pedals but is dissipated in flexing of the abdomen. “Look at tired riders – every stroke generates an ‘S’ curve in the back, causing fatigue and muscle spasm.”

No rider will ever develop a sufficiently strong torso through riding alone, says Dr Lanning. “Riding with undeveloped abs is something like riding a bike with a cracked frame – all the energy gets dissipated in flexion, and doesn’t get you down the road.” Unless that road happens to lead to A&E…

Here then, is how to prevent that happening – or, if you’re already suffering a niggle or two, how to get back on your bike and stay problem-free through every season.

Neck and upper back pain

Neck and upper back pain is most often caused and exacerbated by riding position and technique, explains elite cycling trainer Andy Wadsworth.

Riding in drop handlebars for long periods will not only increase the load on the arm and shoulders, it will also hyperextend the neck.

“Prolonged hyperextension leads to ‘trigger points’, small rubbery knots that form in muscle and adjacent fascia muscle sheaths, which send pain signals to the brain and contribute to a pain-spasm-pain cycle,” says Wadsworth. 

If the virtual top tube length (top tube plus stem length) is too long for the rider, or if aero bars are used, hyperextension is a near certainty, he says. “It’s especially common in the early season when riders are increasing both their mileage and the time they spend in the saddle.”

To avoid early season overuse injuries, says Wadsworth, you should initially ride at high cadence and low resistance, and only increase training mileage by 10 percent a week, gradually building to goal mileage.

If you suffer from neck pain you should also inspect the setup and fit of your bicycle. You might find you have to raise the handlebars, change to bars with a shallower drop or reduce the virtual top tube length by using a stem with a shorter extension.

“Moving the saddle forward should also reduce virtual top tube length, but be careful as a poor saddle position can lead to knee issues which are just as hard to sort when they set in,” Wadsworth cautions.

Changes to riding technique can also help. Riding with unlocked elbows and regularly changing your hand position from the drops to the hoods can spread the load on key muscles.

Lower back pain

With your lower back, the problem is most likely linked to your pelvic position, a weak core and crash damage. “I see so many riders who spend hours and hundreds of pounds sorting out their bikes after a crash, but don’t think twice about their bodies,” says Joy Potts, an osteopath specialising in sports injuries.

“Without you realising, it can cause the pelvis to become twisted and make your legs different lengths; issues which create muscle imbalances and put huge pressure on your lumbar spine as you twist your abdomen for power. Always, always get a professional once-over after any crash. Leave it too late and it can result in months of pain.”

As with neck pain, focus on your bike setup. “If your saddle’s too high, you’ll rock side to side causing the muscles between your pelvis and lower back to spasm,” she says. “Put your heel on the pedal at the six o’clock position and sit on the saddle – your leg should be almost straight and you shouldn’t have to rock your hips to reach down.”

Pelvic position is paramount, she says. “Tight quads will tilt the pelvis forward, while tight hamstrings will tilt it back; in both cases, your lower back will over-arch and start to take the strain when it should be your much bigger muscles in the core.”

Pushing bigger gears or overdoing your hill sets can overly fatigue the glutes and hamstrings, again leading to pain. “The key message is you need to strengthen your core away from the bike before your back takes the strain, and focus on stretching to maintain pelvic position even when you’re dog-tired," says Potts.

And the one muscle cyclists ignore at their peril? The gluteus medius. On the outside of the buttocks, it’s a muscle we never use when we walk, but when cycling the demand on it increases by a factor of eight.

“It literally holds your pelvis in place so you get an efficient transfer of power in the lumbar region,” says Paul Massey, physio with the British Olympic Association. “Three sets of 10 side leg raises twice a week is sufficient to build and maintain strength here as well as in your transverse abdominals [a major muscle of the functional core].”

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Workouts

“You need to incorporate core stability, flexibility and conditioning drills into your training to make your time in the saddle more comfortable, less likely to develop muscle imbalances, and improve performance and speed,” says Paula Coates, author of Exercise Yourself to Health: Back Pain. “Mix and match the following exercises and stretches in a simple 20-minute workout twice a week and in just a month you will see noticeable improvements.”

Walking lunges

Targets: Quads, core and hip flexors

3 x 15-20 reps

1 Step forward into a lunge position, bending the front knee and ankle to 90 degrees which will help you keep your knee behind your toes. Keep your weight on your back leg and clench your buttocks.

2 Dig your front heel into the floor and step the other leg forward into the lunge position. Keep your steps wider than your pelvis as this will increase your base of support and stability.

The cat stretch

Targets: Spine and core

Unlimited – repeat little and often

1 Kneel on all fours with your knees a hip distance apart and your hands a shoulder width apart. This can also be done sitting on your bike.

2 Imagining your pelvis is a bucket filled with water, tilt your pelvis forwards and backwards for one to two minutes as if you were tipping water out of the front and back of the bucket.

The Bug

Targets: Core

3 x 10 breaths

1 Lie on your back with your arms reaching up towards the ceiling and your hips and knees bent to 90 degrees. If this feels too difficult, you can support your legs on a gym ball or on the arm of your sofa.

2 Making sure your spine is flattened gently against the floor and your pelvic floor is lifted, hold this position as you gently breathe in and out. Repeat three times for 10 breaths, resting between each set.

> You should feel this in the tummy not the back; if you have back pain, wait until you’re stronger or reduce the time you hold the position.

Variation 1: Arm floats: As you breathe out, slowly raise your left arm over your head, then breathe in and return your arm to the start position. Repeat with your right arm and alternate each arm for 30 seconds, increasing to one minute as you become stronger.

Variation 2: Leg floats: As you breathe out, slowly lower your left foot towards the floor, but only as far as you can while keeping a neutral spine. Breathe in and return the hip to the start position. Repeat with your right foot. Alternate legs for 30 seconds, increasing to one minute as you become stronger.

Crucifix stretch

Targets: Lumbar spine and hips, buttocks, back muscles and hamstrings

2 x 10-15 reps

1 Lie on your back with your arms stretched out at right angles to your sides and both your legs straight, as if you’re on a crucifix. Keep your arms in contact with the floor at all times.

2 Lift your right leg 2in off the floor and swing your leg over and across your left leg so the toes on your right foot are sliding towards your left hand. Only swing your leg as far as you can comfortably.

3 Return your right leg to the starting position and repeat with the left leg. Do two sets of 10–15 repetitions.

> If your flexibility is poor or you’ve had a flare up of low back pain, bend your knees, keeping your feet on the floor, and roll your knees from side to side.

Dynamic hamstring stretches

Targets: Hamstrings, piriformis, tensor fasciae latae and calf

10-20 reps in each position after every ride

1 Standing with your feet together, take three small steps (heel to toe) so you stop with one foot in front of the other.

2 Lean forward and slide your hands down your leg to your ankle. The forward movement should come from your lower back and your hips.

3 Take three more small steps so your opposite foot is in front, and again reach your hands down to your ankle. Repeat 10-20 times.

4 The next stretch starts in the same way – take three small steps but turn the toes of your front foot out with the outer side of your heel level with the big toe on the back foot. Repeat 10-20 times.

5 The final stretch starts in the same way with three small steps, but this time turn the front foot in, keeping the inside of your heel level with the big toe on the back foot.

Thoracic extension stretch

Targets: Spine and chest

Daily 15-20 minutes

1 Use an exercise ball, or roll up a small bath towel so it has a diameter of 10-15cm and secure with rubber bands.

2 Lie on the ball or, if using a towel, a bed with the towel lengthways down your spine, from the base of your neck to the middle of your back.

3 Raise your arms to either side of your head and let them hang or rest on the bed. If this is too much of a stretch, support or rest your arms on pillows to reduce the pull across your chest.

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