Cycling and Neck and Back Pain
Back pain is one of the most common causes for discontinuing exercise as well as one of the most common causes for time off work. Back pain doesn’t just affect the unfit, it can affect everyone and that includes cyclists.
A study in the USA in 2010 looked at both amateur and professional cyclists and found that up to 60% suffer from back pain and this can be pain from the base of the skull and headaches to pain at the base of the spine and even into the groin, and into the leg in the form of sciatica.
At our Islington clinic our chiropractor, osteopath or physiotherapist will do everything possible to make a diagnosis and we can’t fix your problem without a diagnosis!
What do we do to assess the spine?
1. Palpation of the spine to assess for inflammation and tenderness as well as feeling how the spine is functioning
2. Neurological evaluation assessing muscle strength, sensation testing and reflexes.
3. X-ray studies.
4. CT scans for cyclists that get pain on hyperextension of the spine.
5. MRI for cyclists that get pain on flexion or with any neurological signs or symptoms such as tingling, numbness, burning pain down limbs, or muscle weakness or when a disc herniation is suspected.
Common causes of neck and back pain in cyclists:
1. Trochanteric bursitis can occur due to the repetitive peddling action.
2. Degenerative changes to the hip joint.
3. Iliopsoas tightness on the down stroke of peddling.
4. Trigger points in the neck muscles in a response to repetitive looking over shoulder.
5. Trigger points in the neck due to hyperextension of the neck and in a response to degenerative changes to the facet joints and disc degeneration.
Common diagnosis of neck and low back pain in cyclists:
1. Trochanteric bursitis due to repetitive peddling motion.
2. Degenerative change to the hip
3. Tightening to Iliopsoas resulting in a ‘snapping’ feeling on the down stroke of peddling.
4. Trigger point pain in low back and neck.
5. Facet joint pain in cervical spine due to repetitive hyperextension of the neck.
6. Decreased posterior intervertebral disc height due to repetitive hyperextension and associated nerve root irritation.
Assessment of low back pain:
Core stability should be assessed; to power the bike requires the low back to be stabilized by core muscles. It is desirable to have as much energy as possible transferred to the legs and to do this you want to prevent rotation of the spine.
If the lumbar spine rotates on every down stroke of the legs during peddling over time it will lead to degeneration to the lumbar spine.
Cycling and Neck and Low Back Pain Part 3 will look at the assessment of core stability and how to improve core stability through specific exercises.