Low Back Pain with Cycling



Anatomy 101
Low back pain often occurs while cycling.  In fact, over 50% of cyclists experience low back pain at some point while riding.  There are many factors that may contribute to low back discomfort.   We will focus on muscular causes, specifically tightness or weakness of muscles that attach to the pelvis.  

The spine is a column composed of 24 vertebrae (7 cervical/neck, 12 thoracic, 5 lumbar/low back, sacrum and coccyx/tailbone).  Think of the vertebrae as a tower of blocks needing a strong base of support, which is the pelvis. Stability of the pelvis is an important task (look what happened to the Tower of Pisa), and we are equipped with 45 muscles attaching to the pelvis to do the job.  If the base is stable, the spine has a better chance of maintaining proper posture (like the Eiffel Tower). For the cyclist, the primary muscle culprits for dysfunction are the hip flexors, extensors and piriformis.  

Often, cyclists have tightness or shortening of the hip flexor muscles.  Unlike running, cycling demands little hip extension, so the hip flexor muscles are really eager to shorten as they spend so much time in a flexed posture.  The major contributors to hip flexion are the psoas, iliacus, (as they come together, referred to as iliopsoas) and rectus femoris (the only one of the four quadriceps muscles to cross the knee and the hip).   Tightness or weakness of the hip extensors (hamstrings and gluteals) and piriformis can also play a role in low back pain.  

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Common Causes of Low Back Pain

The first thing to assess is your bike is set up or fit.  It is necessary to ensure correct riding position to lessen the forces through your low back.  Starting with the cleat, a good fit can help control aberrant motions that rock the pelvis (remember, we need a stable foundation).  Working up the chain, your pelvis should be maintaining optimal contact with the seat, which requires correct seat height and fore/aft position, which also impacts how your upper extremity contacts the bike.  This is extremely important to maximize efficiency and your comfort on the bike.  In addition, and perhaps most importantly, the type of saddle can have a profound effect on your pelvis position and mobility.  The saddle supports the pelvis.  Back to the former analogy of the Eiffel Tower and Tower of Pisa, pelvic stability is the foundation for the spine.  The right saddle is imperative.

If your bike is set up correctly and you are still suffering from back pain, a musculoskeletal evaluation is recommended.  In general, as the larger muscles fatigue, such as your hamstrings, quads, and calf muscles, the movement pattern of your pelvis on the saddle changes, which directly affects lumbar posture and therefore the loading and forces that affect the low back.    While biking doesn’t specifically strengthen the core muscles, core strength is imperative in warding off back pain and preventing this excess motion.  Often, as cyclists fatigue, they increase lumbar flexion or forward bending in the lower spine (losing the natural curve in the lumbar spine), which decreases the activity of the deep back stabilizers, facilitating even more unwanted movement and back pain.  

The inefficiency of movement while pedaling can also be due to asymmetry in the pelvis or inefficient movement of the lower extremities.  Poor muscle flexibility, muscle strength imbalance, joint restrictions or poor motor control of the hip musculature, pelvis, and lumbar stabilizers are often contributors.  A thorough assessment can determine specifics for you and a physical therapist can guide you in appropriate and specific treatment and exercises.

Quick Suggestions To Keep You Rolling

  1. Open up through your hips before and after biking with a simple forward lunge stretch and overhead reach.
  2. Stretch your lower extremity muscles after biking – include: quads, hamstrings, gluts, piriformis, and calf muscles.
  3. Stretch your low back: up dog/down dog and knee to chest stretches are GREAT!
  4. Work on your posture: a better head, neck and upper back posture will also take stress off the low back.
  5. Do CORE strengthening.

Professional Help. Fit Your Body.  Fit Your Bike. Fit Both.

  1. Consult a physical therapist to –
  • Assess your posture and symmetry
  • Measure your strength and flexibility
  • Identify other biomechanical challenges that need to be addressed in bike fit
  • Make recommendations based on your specific needs
  1. Make sure your bike is properly fit –
  • Optimize cleat position
  • Millimeters matter in seat position, both
  • Check upper extremity positioning on handlebars
  • Find the RIGHT saddle.  There is no substitute for trying them out
  • Realize that bike fit may require more than moving existing components- you might need to invest in a different saddle, stem, bar width, crank arm length, etc.  
  1. If you want to fit the bike and fit the body all in one visit, please call Cronometro at 608.243.7760.

Have fun out there!  Contact us at Cronometro and Crono PT to keep you rolling pain free.

Fit the Body. Fit the Bike.  Fit Both.

PT appointments can be made online at www.cronometro.com or email to schedule:

Heather      Heather.CronoPT@gmail.com

Stacey      Stacey.CronoPT@gmail.com