Lower back pain

markhewitt1978

I've never entirely been a stranger from back pain when cycling, but only mild and infrequent. e.g. If I've changed to a lower position it was normal to have some twinges for the first ride but be ok after that.

The present problems go back to last summer. I was having problems with my knees after long rides really hurting, so I went and had a bike fit, apart from a few minor adjustments the main thing was my saddle was way too high - by 23mm - so he adjusted that to the correct height, which felt very strange indeed, but I stuck with it.

However over the next few weeks, my knee pain had gone but had been replaced by pain in my lower back - not intense just enough for it to be quite distracting. Mostly on longer rides or related to the amount of effort I'm putting in. The worst was on a local sportive where I was putting in quite a bit of effort but after 20 miles had to stop as the pain was getting too much.

Since then I've raised the saddle back up a little, which has helped but not solved the issue. I've done the usual things of fitting a shorter stem to bring the bars closer, rotating the bars up, and I've got shorter cranks.

But the problems remain. It seems to be related to effort more than time, e.g. I did a steady flat 100km and had no issues at all, but I did a slightly more hilly 100km and I started having issues. This week I've been out a couple of times at lunchtimes - just 40 minutes per ride but putting in a lot of effort which is still hurting now

- If it matters I ride a Scott CR1 road bike. 52cm, 165mm cranks, 75mm stem. Myself I've just turned 37 years old and I'm 5'6".

djfleming22

Whats the measurements from the top of the hood to the tip of the saddle and from the middle of the stem to the tip of the saddle ... in my bike fit i went with a 54 frame and a 90mm stem ..i am not saying we are both the same because everyone is different but you sound very cramped up

markhewitt1978

The figure the bike fitter gave me after the fit for the reach was 470mm from the middle of the bars (the steam seam) to the nose of the saddle.

When I first got my bike it had a 90mm stem and I have trouble reaching it, so I then went with 80mm and now 75mm.

It's part of the reason I'm a little confused as to which way to go as most solutions for back pain are just don't lean over quite as much so bring the bars closer, higher up etc.

chrisw12

As I asked in the last back pain thread (I think) how often are you on your bike, can you be more specific than 'a couple of times'?

I'm just curious by the way, every time these threads come up, people quite rightly go into great detail about bike fit but never mention frequency of rides. For me when i rode weekend only, I'd get back pain, now I try to ride every day and get no pain on shorter rides.

Now that being said, I did a 4 hour ride last Sunday on tt bike pushing big gears, big effort and low low cadence (it's a bad habit I have) and I had back pain.

So for me it seems. back pain is a 'fitness issue'

markhewitt1978

chrisw12 wrote:

As I asked in the last back pain thread (I think) how often are you on your bike, can you be more specific than 'a couple of times'?

It's mostly been once a week on a Sunday morning. During the summer months I can put in a weekday ride. Although just this week I've started bringing my bike to work to do a 10 mile loop at lunchtime which after doing that twice on Tuesday and Wednesday am still sitting here with back pain on Thursday morning.

I'm just curious by the way, every time these threads come up, people quite rightly go into great detail about bike fit but never mention frequency of rides. For me when i rode weekend only, I'd get back pain, now I try to ride every day and get no pain on shorter rides.

Now that being said, I did a 4 hour ride last Sunday on tt bike pushing big gears, big effort and low low cadence (it's a bad habit I have) and I had back pain.

So for me it seems. back pain is a 'fitness issue'

Interesting point, it's definitely related to effort rather than duration. e.g. I can potter around turning small gears not going to fast and it not be a big issue. Or like the sportive I was doing it started twinging because I'd been putting in a lot of effort - frustrating because my legs and everything else feel good.

DKay

Do you stretch regularly? Tight hamstrings, glutes and hip flexors can often be the cause of lower back problems. Especially with cycling.

markhewitt1978

DKay wrote:

Do you stretch regularly? Tight hamstrings, glutes and hip flexors can often be the cause of lower back problems. Especially with cycling.

No. I've been looking at the youtube videos etc but there's a bewildering array of stretches.

DKay

markhewitt1978 wrote:

DKay wrote:

Do you stretch regularly? Tight hamstrings, glutes and hip flexors can often be the cause of lower back problems. Especially with cycling.

No. I've been looking at the youtube videos etc but there's a bewildering array of stretches.

Doesn't really matter which ones you do, as long as you're stretching the relevent muscles. Just do them right.

Mad_Malx

I never felt the need for stretches, but with advancing years I am becoming more convinced.
Also, Tom Danielson's 'Core Advantage' gets a lot of recommendations. There is a chunk viewable as a preview, and quite a few of the exercises shown on Youtube. I've been doing a few regularly and they help me.

markhewitt1978

I might add that I wonder about getting more upright to help my back or if that's making it worse?

One thing is that my wife has got an exercise bike, which has about as upright a position and it's possible to get, and yet I've had some of the worst back pain by using that!

jimwalsh

a large scale meta analysis of stretching, strengthening and balance work saw little or no benefit for stretching in lower back pain. strength exercises are much more beneficial.

ai_1

DKay wrote:

Do you stretch regularly? Tight hamstrings, glutes and hip flexors can often be the cause of lower back problems. Especially with cycling.

Reading your description this was the first thing to occur to me too. I used to have a little back pain when cycling and it was only bad when I was putting in a hard effort like sustained climbing or a TT effort. This was when I started riding and I thought I just didn't have good back flexibility. However when I started stretching my hamstrings the pain pretty much vanished. Tight hamstrings transfer the stress from your legs to your lower back. If your core strength isn't great then this stress can cause too much strain on your back causing pain. At least that's my, non-expert analysis. No guarantee this is your problem too but it's worth investigating. I didn't find it too hard reducing hamstring tightness enough to get rid of the pain just by doing some stretching a couple of times a day for a few weeks. Core exercises on the other hand I am terrible at. They're particularly unsatisfying so I never manage to keep at it over a sustained period. The best solution if this is your problem is to do both. Hamstring stretches alone MIGHT be enough to get rid of the pain but might not address the underlying problem, core strength.

jimwalsh wrote:

a large scale meta analysis of stretching, strengthening and balance work saw little or no benefit for stretching in lower back pain. strength exercises are much more beneficial.

I would say it's a little silly to make it an either/or. The core muscles are used to maintain posture. Tight muscles can harm posture. Flexibility removes the source of many potential posture problems, and core strength provides protection should these or other factors cause a threat.
If you're only doing one, core is probably best. While stretching is the easier fix for isolated issues. But both together are the ideal.

markhewitt1978

Some of the exercises eg on GCN appear doable so I'll give it a try. Most seem to involve bending backwards basically!

In terms of bike fit again. Is it possible for lower back pain to be caused by the bars being too close or your not stretched out enough? As all the advice is always shorter stem higher bars and apart from that being bad for aero the bars already feel a bit close.

Edit: this article does suggest too short a stem can be an issue http://www.bikeradar.com/gear/article/h ... ain-22868/

chrisw12

Just in case Bahzob questions my palmares, I've had 10 years at this including a 240 mile bahzob matching 12hr twice so I'll share my experiences with back pain. I ride in a reasonably extreme aero tt position 99% of the time and have always been overweight(for a cyclist) and very inflexible. I was once described as a journeyman timetrialist, by someone I respected, which I interpreted as 'you're censored , but hard working'

1) Ibuprofen solves most problems upto about 5 hours, then you're treading a line...
2) I don't get how static stretching solves a dynamic problem like lower back pain.
3) The more I ride and the harder I ride the less chance I get of back pain.
4) Bike position is critical in that 1cm extra reach causes problems where as 1cm extra drop causes no problems up until an extreme point is reached.
5) I had a bad bout of sciatica last year. I couldn't walk, sitting was painful but I managed a century in the aero position as this was the best relief I could get. This perhaps wrongly gives me the idea that position is bit of a red herring, a good position on the bike can be quite comfortable.
6) To be investigated, I have a nasty, lazy, low cadence habit, I stick both levers in the ego gear position and just ride. On future long hard rides I'm going to force myself to be less lazy with the right hand and see if this solves the back pain at 3hr problem.


and all this should contain a 'FOR ME'

jimwalsh

I dont want to get into an argument about the relative evidence for stretching vs strengthening.

however these exercises are really all you need.

https://www.youtube.com/watch?v=AmgQ_cjAPU4

I use variations on these with most of my pateints.

chrisw12

jimwalsh wrote:

I dont want to get into an argument about the relative evidence for stretching vs strengthening.

yeah me neither, that's why I cautiously typed what I did, but do you really think it's as easy as a few stretches?

frisbee

It'll probably get a load of people foaming at the mouth but I've always found doing some free weight sessions has sorted my occasional back pain.

kajjal

It really depends what causes your back pain and where it is. If it is an on going medical condition you should get it investigated to understand what the cause is and how to relieve it.

Also give the person that did the fit a call and explain what has happened to see what they advise. Unfortunately you have made some adjustments since which is a shame or they could have advised directly from their bike fit. Having the saddle too high will cause all kinds of issues compared to it being slightly low. At least your knees are better now !

ai_1

chrisw12 wrote:

...2) I don't get how static stretching solves a dynamic problem like lower back pain....

You've written this like there's some obvious error here. I don't understand what point you're trying to make. Can you explain? You're using the same body whether you're moving or not. Why would flexibility or strength improvements made statically not help on the bike? Incidentally, your upper body is in fact very static on the bike so even if static didn't help dynamic for some reason (which I contest) then does that only apply to the legs?

markhewitt1978

It's certainly gotten worse recently as just after the bike fit it was bad during the ride but thereafter no problems, whereas now it still hurts 2 days after my ride .

The only thing I can really do is stop cycling for a week or so and see if it clears up. Then if I go for another ride and it starts up again I know it's that.

ai_1

markhewitt1978 wrote:

It's certainly gotten worse recently as just after the bike fit it was bad during the ride but thereafter no problems, whereas now it still hurts 2 days after my ride .

The only thing I can really do is stop cycling for a week or so and see if it clears up. Then if I go for another ride and it starts up again I know it's that.

I would definitely go to a physio. Even if it clears up and comes back when you ride again it will not tell you whether there's something wrong with your bike or something wrong with you which your bike is aggravating.

jimwalsh

chrisw12 wrote:

jimwalsh wrote:

I dont want to get into an argument about the relative evidence for stretching vs strengthening.

yeah me neither, that's why I cautiously typed what I did, but do you really think it's as easy as a few stretches?

the majority of backpain can be resolved through exercises like the ones posted above (which are strength exercises rather than stretches).

however there are occasional pathological states that need greater intervention and management so it is worth finding a good physio osteopath etc who can advice if things are not resolving.

back pain is a black box, it is poorly understood and for the most part badly managed by the majority of practitioners.

for the most part self management with strength work is the ideal solution.

surfgod

Increasing my q-factor (speedplay zero with longer spindles) and changing to a wider specialized romin saddle helped alleviate a lot of lower back pain I used to suffer from while cycling. When you think most cycling gear is designed for rail thin racing cyclists, and it's only quite recently those of us who are broader across the beams are being catered for..

ncr

jimwalsh wrote:

chrisw12 wrote:

jimwalsh wrote:

I dont want to get into an argument about the relative evidence for stretching vs strengthening.

yeah me neither, that's why I cautiously typed what I did, but do you really think it's as easy as a few stretches?

the majority of backpain can be resolved through exercises like the ones posted above (which are strength exercises rather than stretches).

however there are occasional pathological states that need greater intervention and management so it is worth finding a good physio osteopath etc who can advice if things are not resolving.

back pain is a black box, it is poorly understood and for the most part badly managed by the majority of practitioners.

for the most part self management with strength work is the ideal solution.

Why is strength work required ?

diy

I'd suggest you do a combo of stretching and core/body weight exercises. You should do a 5 minute cool down stretch after every ride, irrelevant of any pain, simply to correct the impact of cycling which will otherwise leave you with tight/short muscles as they recover. That 5 minute one is going to focus on the muscles you worked. In addition you should do a 15-20 minute body stretch ideally twice a week to work the rest of you. There are lots of core strength exercises you can do also, but I'd start with stretches.

post cycle stretch 3-5 min: (apologies for the sound quality - I have squeaky floor boards)
https://www.youtube.com/watch?v=QgEbH31FbWs

twice a week stretch
https://www.youtube.com/watch?v=WElIDKxmyQo

ai_1

ncr wrote:

jimwalsh wrote:

chrisw12 wrote:

jimwalsh wrote:

I dont want to get into an argument about the relative evidence for stretching vs strengthening.

yeah me neither, that's why I cautiously typed what I did, but do you really think it's as easy as a few stretches?

the majority of backpain can be resolved through exercises like the ones posted above (which are strength exercises rather than stretches).

however there are occasional pathological states that need greater intervention and management so it is worth finding a good physio osteopath etc who can advice if things are not resolving.

back pain is a black box, it is poorly understood and for the most part badly managed by the majority of practitioners.

for the most part self management with strength work is the ideal solution.

Why is strength work required ?

Because core strength is what maintains your posture and is seriously compromised for most of us due to our mostly sedentary lifestyles. Cycling does almost nothing to help build any core strength but can sometimes cause problems that this strength is needed to combat.

ncr

Ai_1 wrote:

Because core strength is what maintains your posture and is seriously compromised for most of us due to our mostly sedentary lifestyles. Cycling does almost nothing to help build any core strength but can sometimes cause problems that this strength is needed to combat.

A lower back is only as strong as its weakest link. I have always found simple core exercises (the plank etc.) to be sufficient for keeping it in good condition. Believe it or not the root cause of chronic (on the bike only) lower back pain is natural pedalling, because with maximum force applied vertically downward, the lower back is put under continuous stress. The solution can be found in this man's technique in which max force is applied equally in both a forward (over TDC) and downward direction, transferring all this stress to the powerful hips.
https://www.youtube.com/watch?v=7hh2DcgpnkU

ai_1

ncr wrote:

Ai_1 wrote:

Because core strength is what maintains your posture and is seriously compromised for most of us due to our mostly sedentary lifestyles. Cycling does almost nothing to help build any core strength but can sometimes cause problems that this strength is needed to combat.

A lower back is only as strong as its weakest link. I have always found simple core exercises (the plank etc.) to be sufficient for keeping it in good condition....

I don't disagree. This may be enough.

diy

Taking this beyond cycling for a moment.. I have mixed opinions about back specific exercises designed to strengthen your back muscles. I have no doubt that a strong set of back muscles take pressure off and reduce the skeletal issues, but I tend to find they bring as many injuries and problems mainly due to difficulty in doing an exercise with the proper technique. For example dead lift, rows, shrugs, clean and jerk etc are all quite technique dependent. Doing it wrong will almost instantly causes a problem. Bodyweight or low weight based workouts built in to exercises which push range, while less focused, will IMO give you better results for sports like cycling.

markhewitt1978

I've tried quite a few of the exercises on youtube - particularly those on GCN, hard to tell but it feels like it's making it worse

ai_1

diy wrote:

Taking this beyond cycling for a moment.. I have mixed opinions about back specific exercises designed to strengthen your back muscles. I have no doubt that a strong set of back muscles take pressure off and reduce the skeletal issues, but I tend to find they bring as many injuries and problems mainly due to difficulty in doing an exercise with the proper technique. For example dead lift, rows, shrugs, clean and jerk etc are all quite technique dependent. Doing it wrong will almost instantly causes a problem. Bodyweight or low weight based workouts built in to exercises which push range, while less focused, will IMO give you better results for sports like cycling.

Weights based exercises aren't necessary for core strengthening. Some pilates type stuff, planks etc is fine. No equipment needed. Although a carpet, gym or yoga mat does make it more comfortable.