Health: Protect yourself from back pain

By Physiotherapist Tim Pigott, Triathlon Plus | Monday, August 24, 2009 3.00pm

The back is one of the most commonly injured body parts among cyclists, and one of the most common reasons for missed training and competition time. If you have suffered from lower back pain there are several sources you can look at.

Leg length

Check your leg length: if you have different leg lengths (either because of actual differences in the bone length, or because of severe pronation of the foot or a rotated pelvis) this will result in a sheering force as the shorter leg ‘pulls’ the hip down on that side at the bottom of the pedal stroke. Get someone to watch you from behind and check that your hips stay level, with no rocking motion as you pedal.

Stem length

Check your bike fit: usually the fault is that the stem is too short, which then forces you into a hunched-over position. This causes the ligaments and muscles to be overstretched around the back of the spine, and could even lead to a disc bulge pressing on the nerves. If the pain is in the upper back or around the neck and shoulders, it is likely the stem is too long, and putting you in an overstretched position. The other thing to check about the stem is its height – if it’s too low, you’ll stress the lower back.

Seat angle

A study looking at how the seat angle affected the angle of the lower back found an increased bend in the lower back increased the risk of back pain. By simply adjusting the seat angle to put the back back in a neutral angle, 70 percent of the cyclists were relieved of their back pain. So check your seat angle – as a rule of thumb the saddle should be level with the ground. If you have it angled either up or down, it usually shows there’s a problem with your overall bike fit. If in doubt, get a professional bike fit from a qualified coach or your local bike shop.

Vary your position

When out on the bike, practise good riding habits. Change your position regularly and stand up out of the saddle every few minutes to relieve the pressure on your back, even if the terrain doesn’t encourage it. On long climbs, switch between the front, middle and back of the saddle to vary the forces going through the lower spine.

Core stability

Athletes have been inundated with advice on core stability training. However, there remains confusion as to what actually IS the core, and how to specifically train these muscles. Usually people assume the core is made up of the abdominals and lower back muscles (rectus abdominus, internal and external obliques, and the transverse abdominus). However, when looking at core training and movement patterns, it appears the core is not simply these three muscles. For the lower back, pelvis and hip region there are 29 different muscles, each providing stability to the core.

The lower back pain or discomfort which cyclists suffer from can be because of the vast number of muscles in this region, and which may have been overlooked in any core program. If too much emphasis is placed on certain areas such as the abdominals (six-pack) then muscle imbalances can develop, leading to pain and injury. It’s therefore necessary to emphasise the importance of a comprehensive core development program to cover the whole lumbar, pelvic and hip region.

Initially you need to practise static postures to learn the correct positions and ‘neutral alignments’ – the position where your muscles are not put under strain. Make sure you see a coach, personal trainer or physio, or attend a pilates class, to learn these. Once you’ve got to grips with this, make the exercises more functional with dynamic movement patterns. When biking, keep the upper body as still as possible, reducing wind resistance and increasing the work the legs do.

Treatment

If you do get back pain, the most important message is that it is generally not due to any serious disease or injury, and it will usually improve within a few days. Use something to control the pain such as painkillers (see your pharmacist or doctor), ice in the first 48 hours or heat if more preferable, and gentle massage can also ease any muscle spasm. Obviously, reduce extreme activity so you don’t aggravate your back, but keep active or your back will stiffen up.

Check your posture, particularly if you spend a lot of time sitting down at a desk or driving, and ask your employer for a work place assessment. If your symptoms do not improve within a week or so, then see your doctor and get a referral to a physio for a detailed assessment to identify the exact cause of your pain (it could be a slipped disc, facet joint syndrome, sacroiliac joint dysfunction or sciatica, spondylosis) and to receive any necessary treatment.

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