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Cycling Low Back Pain

Low back pain is the most common overuse complaint amongst cyclists. Cycling requires a sustained and very flexed posture of the spine, which has long been associated with low back pain in other endeavours (eg office ergonomics and lifting injuries). There are many theories as to the cause of back pain in cyclists. Some relate to the rider and their training and other relate to their bike fit:

  • Increasing training load too quickly
  • Unbalanced disc strain due to compressive forces being higher at the front of the intervertebral discs
  • Tissue ischaemia (reduced blood flow) due to the spine being immobile while riding
  • Muscle fatigue from the spinal muscles working for long periods of time without rest
  • Muscle inhibition reflex where the back muscles turn off and provide ineffective support to the spinal column when the spine is extremely flexed
  • Some authors believe the opposite is true, that the spinal muscles go into spasm and are overly contracted, causing pain
  • Poor core strength and stability resulting in ineffective spinal control
  • Poor saddle height setting resulting in increased side to side rocking
  • Upward saddle tilt causing cyclists to flex the spine further to avoid groin discomfort

With so many different potential contributing factors, a full assessment is really the best way to work out the cause of low back pain and the best intervention. However, some simple measures that are often successful in the short term include:

  • Changing the saddle position
  • Reducing training load
  • Spending more time riding out of the saddle to reduce spinal flexion
  • Changing position regularly while riding (alternating between hands in the drops, on the bar tops and holding the hoods)

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