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HEALTH AND FITNESS: ASK THE COACH
Katharine McCoy
August 11, 2009
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Doesn't everybody wish that they had access to a personal coach for their questions about training and fitness? Road Bike Action recently caught up with Johnathan Edwards M.D. Dr. Edwards is a practicing sports doctor and anesthesiologist in Las Vegas, Nevada. He has been a sports doctor for American cyclists as well as in Europe. He is a USA Cycling certified level 3 coach, has worked with athletes during the Paris Dakar rally. As a former professional motocross racer and current Cat 2 road racer, he understands the health and training needs of cyclists of all levels.
I am 25 years old and often get lower back pain while cycling. What can I do?
This is a common problem in cycling that is seldom discussed. There are many causes of back pain in young cyclists. To answer the question, lower back pain in a young cyclist without any other problems or history of back pain is often due to mechanical factors (versus intrinsic problems inside your body). The most common is bike fit, then bike fit and then bike fit. In my experience, many cyclists are riding bikes that are too big for them and many cyclists lack proper flexibility and/or their core strength is lacking. Take the time and have your bike fitted to your body. Also back pain can arise from anatomical causes like leg length discrepancy or misalignment of your spine.
So much of what cyclists do is hunching forward, working on computers, riding bicycles, eating at dinner tables all contribute to bad spinal health. Poor spinal health is common in young cyclists and often due to bad posture (on and off the bike) and injury. If you favor one side of your body or the other due to injury or poor posture, your back eventually takes the strain. An imbalance in the spine will cause overuse of the lower back. Lack of flexibility such as excessive hamstring tightness also contributes to lower back pain. Leg length discrepancies (LLD) are common and consider that the average person has a LLD of 3 – 6-millimeters. Generally, most authorities on bike fit will correct a LLD greater than 6-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.
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 in 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.
A fresh 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 a 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
The information provided in the ASK THE COACH column does not constitute formal medical advice. The information provided on this public web site is provided solely for general interest of the visitors to the site. Information in this column does not constitute medical advice nor establish a doctor-patient relationship with Dr. Johnathan Edwards. Readers of this column should not act upon any information contained in the web site without first seeking medical advice from their personal physician.
If you have your own question about health or training that you would like to ask a coach please send them to fitness@roadbikeaction.com
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