How to Avoid Lower Back Pain While Cycling

Lack of flexibility, such as excessive hamstring tightness, also contributes to lower back pain. Leg length discrepancies (LLD) are common, with the average person having an LLD of three to six millimeters. Generally, most authorities on bike fit will correct an LLD greater than six millimeters. If this is a problem for you, then go to a reputable source who has experience with LLD, because it is easy to over-correct and cause a knee pain that will take you out for months.

Is Your Riding Style Causing You Pain?

Finally, riding style can cause lower back pain. Lower back pain may arise in cyclists that push big gears, especially while climbing. The angle of your back in relation to the bike can increase or decrease the strain on your back.

Consider this analogy: If you lift a 25-pound object with your back flexed towards 90 degrees (as in the TT position), it would take 140 lbs of force; however if your back is only flexed 45 degrees (about halfway), the force decreases to 120 lbs. Consider alternating climbing positions by standing up and changing the angle of your back, especially during long rides or climbs.
Core strength is very important to avoid lower back pain. Any back rehabilitation program includes some type of exercise directed at improving core strength. Core strength is not just your abdominal and back muscles that you can touch or see; it is rather a collection of hundreds of muscles both big and small that collectively work together to give you core stability. Consider going to a gym where they focus on core strength such as Pilates or some types of yoga.

An example of back pain in a young rider that I treated was during the 2009 Four Days of Dunkirk race in France. Clement L'Hotellerie (2008 polka dot jersey winner Paris-Nice) came to the medical car complaining of wrist pain. He fell a week earlier and had very bad wrist tendonitis.

During the last stage of the tour (where there was a lot of climbing), he was unable to ride or climb standing up and was forced to ride with one hand. Courageously, he actually made it through most of the race, but what eventually forced him to retire was his lower back pain (that he did not have at the start of the race).
The key words are bike fit, core muscle stability and riding style—all of these likely contribute to back pain. Fixing these problems, however,  is another discussion.

Good Luck, Dr. Edwards

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