Lower Back Pain in Cyclists: Part 1

This is part one of a two-part blog outlining the need to know information about low back pain in cyclists. In part one we will be discussing why it happens, and the risk factors surrounding it.

We will also delve into ways to modify the extrinsic factors to maximise effort while minimising pain, as well as finally talking about the most important modifications you can do to your bicycle to in relation to the prevention and management of low back pain.

Lower back pain in cyclists: Why do we have it and how can we manage it?

Lower back pain is a common condition in the population, affecting from 5-20% of the population at any one time. For cyclists, that percentage is even higher. Studies have shown that between 30-50% of recreational cyclists, and 50-70% of elite cyclists have experienced low back pain, to varying degrees, associated with the sport at some time in their life.

Mechanisms

But why does this happen? There are multiple and varied theories surrounding this question, but what most of these theories have in common is the agreement that the majority of low back pain can be explained by the prolonged and flexed (forward bend) position of the lower lumbar spine during cycling. This prolonged flexion produces a repetitive increase in tensile strain on some structures, while producing increased compressive forces on other structures of the lumbar spine.

Risk factors

The risk factors for lower back pain in cycling contain a few extrinsic factors and many intrinsic factors. Below is a table laying out the most common risk factors for low back pain in a cyclist.

Prevention and management

The best way of preventing/managing lower back pain in response to cycling is by reducing the risk factors.

Extrinsic factors:

• Modification of distances with a slow and controlled progression is the best approach.

• Also, watch for the terrain. If you are used to riding on all flat surfaces, it may increase your risk of injury if you were to suddenly do hill riding. Again, progress slowly and let your body adjust to the increased load placed through it.

• Use higher gears when indicated. Find a cadence that works for you and work the gears to stay around that cadence if possible.

Intrinsic factors:

• Cyclist/bicycle fit

Perhaps the most important factor, with the most evidence surrounding it, involved in the prevention and management of low back pain in cyclists. The two sub-factors of cyclist/bicycle fit most correlated to low back pain are saddle angle and reach distance.

• Saddle angle

By changing the angle of the saddle it is possible to change the tilt of your pelvis. Tilting the saddle of your cycle downward by up to 15 degrees will cause your pelvis to be tilted forward. This, in turn decreases the flexion (bend) at the lower lumbar spine and takes some of the load off. 

• Reach distance

A reach distance that is too short will cause the pelvis to tilt backward as the spine curves to fit. This will put you in a flexed position and increase the chance of back pain. It is thought that a longer reach distance is better, but each individual will need to be fitted for their bicycle.

While there are many things to consider when cycling, correct posture is one of the most important. It is important that you have your bicycle set up for ideal positioning and posture with minimum effort on your part. Save the energy for the ride!

If you are experiencing lower back issues when cycling, or if you have any further questions, come on down to Absolute Health & Performance, 199 William St, Melbourne CBD or call us on 1300 19 19 62.

Written by Physiotherapist Kristin Cameron | Absolute Health & Performance- Physiotherapy Services Melbourne CBD.