40 | Cycling World
Healthy Cycling
Preventing Back Injury
Written by Denise Kesson – BackCare Trustee,
The Charity for Back and Neck Pain
O
ver recent years, there has been significant
growth in cycling as a hobby and sport.
Inevitably, this has resulted in increased
injuries, including back and neck pain issues.
BackCare, the national charity for supporting people
in managing and avoiding back and neck pain, is keen
to raise awareness of the many factors that contribute
to the frequency and severity of cyclists’ injuries as
it has been estimated that between - percent
of cyclists will get back pain when carrying out the
activity. Many of these injuries can be prevented with
careful management, which can contribute to ensuring
that cyclists have an enjoyable and healthy experience
whether or not they are taking the sport up on a
competitive basis or as a leisure activity.
Back pain from cycling can be caused by a number of
issues such as a poor riding position; the wrong size or
type of bike; wrongly positioned handle bars or saddle;
weak muscles; prolonged cycling; or riding rough terrain.
The simplest of things can have a large impact on
performance levels and avoiding in uries. The factors
that contribute to both in ury and the effects of over-
training can be body type or size, the use of inappropriate
equipment or a combination of both. Within the cycling
population, big sprinters experience very different
complaints compared with small hill climbers purely due
to their body type, hereditary conditions and the type of
discipline-specific training they undertake. On the other
hand, poor equipment choice will have an impact on
back or neck pain. For example, we commonly see very
small female cyclists using frame sizes designed for much
larger people, with some extremely detrimental results
not only regarding injury level, but also on performance.
There are a number of simple measures that can be
taken to avoid injuries from cycling through education
and in respect of the more complex and long-standing
issues, interventions from professional experts, such
as physiotherapists, osteopaths and chiropractors are
desirable.
edalling technique can be a significant factor in the
development of the most common cycling in uries. The
motion of the pedal stroke needs to look and sound
smooth and continuous. When the cyclist tries to create
an up-stroke this can become in urious. The use of cleats
on the pedals will aid proprioception, stopping the foot
falling off the pedal. The up-stroke phase of pedalling
will bring the psoas and hamstring muscles into play,
while in a less-than-optimal length-tension ratio, creating
the effect of destabilising the pelvis, reducing the rider s
ability to efficiently produce power.
On Bike Posture’, showing the need for the cyclist to disassociate
their hips to generate leg power.
While cycling, a sustained, exed posture
can lead to mechanical low back pain.
Many cyclists are prone to this as the
position places pressure on the front of
the spinal discs and keeps posterior sacral
ligaments in a lengthened position. It has
been shown that adjusting the inclination
of the seat as an anterior tilt of between 10 and 15
degrees reduces low back pain in cyclists. Changes to
the set up of bikes, along with advice from professional
practitioners to identify early signs of low back pain,
can help manage this condition. The adoption of pre-
habilitation and post-habilitation plans developed by
your physiotherapist, osteopath or chiropractor can
be effective in preventing mechanical low back pain
becoming an acute or chronic issue. Furthermore,
practitioners can advise on how to develop a pedal stroke
that is more gluteal dominant during the drive phase,
which leads to better performance and injury prevention
than the more common ‘hamstring drag’ pedal stroke.
A number of cyclists tend to develop pain on the outside
aspect of their knee around the knee cap and over the
oint line. This is caused by a friction effect of the iliotibial
band (a strong connective tissue) rubbing the bursal
structures small uid-filled sacs that sit between the
iliotibial band and the bone. The pain is the result of the
knee being at the wrong angle. The knee needs to be
positioned with no less t