By Bruce Hendler and Ron Fritzke, D.C.
Few issues are as universal to the cyclist as that of lower back pain and soreness. It seems that most riders, especially as they get older and more experienced, are gifted with this common problem. While it’s easy to say “I’ve got low back pain,” identifying the exact source and fixing it can be much more difficult and frustrating.
In reality, with most types of pain, “the exact source of the problem” is usually too simplistic to be of any help as you begin the process of identification. Your spine and pelvis are part of the neuromusculoskeletal system, and as the name implies, there is an important interaction between the neurology, muscles, and joints. In short, the statements “I think I’ve got a pinched nerve”, “I pulled a muscle in my back” or “my back is out of place” paint an incomplete picture.
As the transition period (off season) of the cycling year fast approaches, this time of year offers an opportunity to identify why lower back pain and soreness happens with cyclists. The goal would be to prevent it from happening next season.
So What IS The Problem?
As cyclists, we’ve constrained ourselves to movement patterns dictated by this machine called the bicycle. Road biking demands that we subject our lower back to a prolonged flexed posture (i.e. bent with a closed hip angle.) This is hard on the joints and muscles and over prolonged time does not make them very happy. In fact, they usually revolt!
We already spend far too much time in this flexed position. Most of our lifestyles dictate that we sit for long periods of time throughout the day (at a desk) resulting in short, contracted hip flexors. We even spend time curled up when we sleep, further shortening the psoas, iliacus, rectus femoris, and sartorius muscles.
Several other muscles comprise the hip flexor group, but if you start appreciating just how complex the entire low back and hip region is, you’ll be on your way toward helping and preventing many low back injuries common to cyclists.
There are actually very few activities of daily living that stretch out the hip flexors.
The extreme flexed position that we subject ourselves to when cycling forces our hip flexors to perform somewhere between “short and shorter.” In short (pardon the pun), “short and shorter” muscles are prone to fatigue and spasm.
You may have noticed the problem of short hip flexors when you’re doing prolonged hill climbing. In order to get some relief, you stand for a short while and force your hips forward, attempting to stand up straight on the bike while moving. You’re experiencing the benefit of stretching out this muscle group during the ride.
It’s even more beneficial to take care of them OFF the bike with a consistent hip flexor stretching routine and deep tissue massage. What’s good for the pros is good for the amateurs. And as we mentioned before, the off-season, with less riding, offers a great opportunity to do this.
No discussion of low back pain would be complete without emphasizing the necessity of increasing core strength. Without the foundational stability from a strong core, prolonged flexion and extension of the legs is limited. In short, you need a strong core to keep pedaling when the going gets tough.
But it’s Not Just the Muscles…
The sacro-iliac joints are also often overlooked in a discussion of low back pain. Because of the complex nature of the muscles affecting these joints, including most of the hip flexors, sacro-iliac pain can be a common source of a cyclist’s low back pain.
The sacroiliac joint is the junction of the sacrum (lowest part of the spine) and the ileum (pelvis.) Until about 1930, it was thought that there was no movement in the sacroiliac joints, but we now know that there is a limited degree of normal movement.
Any cyclist who’s experienced sacroiliac pain also knows that when this joint gets stuck (fixation), severe pain is close behind. Chiropractic manipulation of restricted sacro-iliac joints offers a great deal of relief in most cases. But we’re getting ahead of ourselves. Our objective is to give you some things to do before your sacroiliac complex goes into painful spasm.
Don’t Forget the Obscure Stretches
We’ve already alluded to the benefits of alternating sitting with standing in order to lengthen the hip flexors. Continuous stretching out this muscle group at home is invaluable to riding comfort. And this goes for both younger and masters-level athletes. For younger riders, although you won’t see the differences as much now, establishing these habits will be vital for a longer and less painful cycling career. Take it from us older guys!
Most discussions of cycling stretches include the hamstrings, quadriceps, and calves. Some discussions will cover stretching the hip flexors, the IT bands, and perhaps some general low back stretches. These are all important. But often neglected is a critical group of muscles directly affecting the sacroiliac joints and lower lumbar spine.
Because of limitations of space, a detailed demonstration of each stretch isn’t possible in this article. We’ll trust that your Google-sleuthing skills will lead you to effective stretches for each of these. There are many excellent stretching sites within reach of a simple search engine query. There are also many books on the subject. Two of our favorites are The Anatomy of Stretching, by Brad Walker and Stretching, by Bob Anderson.
Here are three overlooked muscle groups that should be emphasized in addition to those mentioned above:
• The psoas muscle is critical to hip flexion and, because cyclists are bent at the waist, this muscle has to do its work while in a “shortened” position. Because the psoas muscle begins along the lumbar spine and crosses the sacro-iliac joint on its way to the femur (long bone in the thigh), it can directly contribute to many forms of low back pain. Do everything you can to keep it long and loose.
• The gluteus muscles are a complex composed of the maximus, medius, and minimus muscles. Chronic tightness of this group can lead to painful trigger points along the backside of the top of the pelvic bone (iliac crest). Effective massage therapists are well aware of the location of these trigger points. When they find them, you’ll be overly aware of them, too!
• The piriformis muscle begins along the side of the sacrum and crosses the sacro-iliac joint to the femur. Any muscle that crosses a joint will directly effect that joint and this little muscle as it relates to the sacro-iliac joint is no exception. Additionally, 15% of the population (cyclists included) has their very large sciatic nerve running through this muscle instead of under it, making them more susceptible to sciatic nerve impingement when this muscle is too tight.
Injuries affecting cyclists are often dictated to us by the nature of the machine we’ve attached ourselves to. Repetitive, short range, very controlled movements is a recipe for a host of overuse injuries and general soreness.
Subjecting ourselves to the confines of the bike necessitates preventative measures such as stretching some obscure muscle groups in addition to the common stretches already being done.
Outside help in the form of muscle work and joint mobilization can help tremendously. Think of it as you would your dental care. While your efforts at home are essential, professional help offers something you can’t accomplish on your own.
The neuromusculoskeletal system works holistically, with each component– nerves, muscles, and joints– affecting the other. A multi-disciplined approach is often the most helpful.
Optimally, a good understanding of potential injuries and the relatively simple ways to avoid them will prompt us to act preventively.
Ride safe, ride strong.
Bruce and Ron
Bruce Hendler created AthletiCamps to provide cycling specific coaching and training to athletes and cyclists of all levels. Find out more at www.athleticamps.com and check out the AthletiCamps Blog.
Ron Fritzke, D.C. has maintained a private practice in Mount Shasta for
22 years and currently serves as the chiropractor on the College of the
Siskiyous sports medicine team. A former 2:17 marathoner, he
currently races bikes and manages a site dedicated to helping cyclists choose the right equipment. Visit him at www.cycling-review.com.