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Dr. Lee Brotherston

Biking a pain in the back?


Part 1 in a multi-part series on cycling and staying healthy.

If you’re like me, you may think the bicycle is one of the most simple, and beautiful of all humanities’ inventions. Sometimes though, our love of cycling leads to pain and discomfort. Non-traumatic injuries (those not sustained in a crash) make up the bulk of injuries experienced by cyclists – particularly recreational cyclists, as we don’t have the luxury of a full complement of bike fitters and coaches at our disposal. These types of injuries result from poor technique, insufficient training, inappropriate equipment, overuse, or more likely, some combination of the above.

Unlike walking, which we evolved to do over millennia, the bicycle is a comparatively modern invention, and our bodies sometimes clash with the novel and unforgiving design of the bicycle. There are two ways we can address pain on the bike, and they must be considered in conjunction with one another, not independently. The first way is to train our bodies to deal with the stress of cycling. The second way, which we’ll discuss in an upcoming post, is proper bike fit.

The most common areas for non-traumatic injuries acquired from cycling are the knees, neck, low back, hands, gluteal region, and perineum. All of these areas deserve their own blog post, but today we will discuss the low back, and how we can help stop low back pain from ruining your ride.In order to talk about low back pain as a result of biking, we need to discuss core endurance. Many people talk about a strong core being an important protective mechanism against low back pain. However, what they should say is that appropriate core endurance is a protective mechanism against low back pain. Outright core strength may be an advantage in certain athletic situations, but core endurance is required to maintain ideal body position with movement, and in day-to-day life. Studies show that cyclists with low back pain had a loss of co-contraction of the small stabilizing muscles in the spine as the duration of their rides increased. Essentially, the small but important stabilizing muscles fatigued before the quadriceps, hamstrings, and calf musculature used for propulsion did. As the core fatigues, the spine is placed in a more flexed forward position – a position that increases stress on the spine and it’s pain-producing structures.

Thankfully, there are many safe exercises to increase core endurance. The ‘Big 3’, identified by back pain guru Dr. Stuart McGill, are a good place to start. These include the modified curl-up, the side bridge, and the bird dog.

Add these exercises to your routine for an increase in core endurance, and a decrease in your back pain. As with any exercise, proper technique is critical! For more information, and a personalized treatment program give us a call, or drop by the clinic.

Happy pedaling,

Dr. Lee Brotherston

Partner, Chiropractor

Oak Ridges Health Group

Uxbridge ON

 

References

Burnett, A., Cornelius, M., Dankaerts, W., & O’Sullivan, P. (2004). Spinal kinematics and trunk muscle activity in cyclists: a comparison between healthy controls and non-specific chronic low back pain subjects—a pilot investigation. Manual Therapy, 9(4), 211-219. http://dx.doi.org/10.1016/j.math.2004.06.002

Liebenson, C. Functional training handbook (1st ed.).

McGill, S. (2009). Ultimate back fitness and performance (1st ed.). Waterloo, Ont.: Backfitpro Inc.

Van Hoof, W., Volkaerts, K., O'Sullivan, K., Verschueren, S., & Dankaerts, W. (2012). Comparing lower lumbar kinematics in cyclists with low back pain (flexion pattern) versus asymptomatic controls – field study using a wireless posture monitoring system. Manual Therapy, 17(4), 312-317. http://dx.doi.org/10.1016/j.math.2012.02.012:

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