Claire, our resident Personal Trainer, Sports Massage Therapist, Sports Nutritionist, and also recently qualified Strength and Conditioning Specialist, has written a series of blog posts on common cycling injuries. In the previous article, she was discussing shoulder and neck pain, this time she is going to concentrate on another niggle that is often associated with cycling, which is lower back pain. So, over to Claire…
“Similarly, to neck and shoulder pain, lower back pain can very quickly arise from an inappropriate bike set-up, in general, but especially if the lower back pain is recurring and/or causes referred pain or sensation down the leg, it is worth getting any spinal issues checked out early by an osteopath or physiotherapist (ideally, pick one who is familiar with your sport); some imbalances are easily identified and corrected early and may require manual therapy, but can be a lot harder to tackle once left to settle.
Spending time with your lower back stretched out, even in an aero position, is not inherently harmful. However, prolonged time in the saddle will tighten your hip flexors, at the front of your hips. If these don’t get stretched and lengthened out, they are prone to staying short and tight (especially as so many of us spend so much time sitting). That results in a tipping forwards of the pelvis, making it harder for the gluteal muscles (the buttock muscles) to do their work to stabilise posture, which will tighten the lower back as it picks up the slack.
My go-to hip flexor stretch is a low lunge but keeping the knees strictly at 90-degree angles. Stay tall in the waist, keep the hips facing forward, and push the shin of the back leg into the ground continuously. If that’s not enough to feel a stretch in the front of the hip or thigh, you can tilt the bottom of the hips forward by squeezing the buttock of the back leg. Reach the arm up on the same side as the back leg, to feel an extra bit of lengthening in the waist and hip.
As when dealing with shoulder and neck pain, you’ll want to start strengthening to areas that will counteract the shortening of the hip flexors at the front of the hips. In this case, it means strengthening your gluteus maximus (the biggest, fleshy muscle of the buttocks) as a priority; hip bridges or weighted hip thrusts, where you lie with knees bent on the floor or with your shoulders on a bench or Swiss ball, respectively, and push through your feet whilst squeezing your glutes to raise the hips up. If your hip flexors are tight, you might also feel this as an opening in the front of your hips! Be careful to keep your feet, shins, and thighs parallel to each other as you perform these.
Any other “compound” (i.e. works multiple muscles) lower body exercises, such as squats or lunges, will also work the glutes, provided they are performed with proper form; weight through the heels, core engaged, and make a deliberate and conscious effort to use your buttocks!
3. Develop awareness
Most of us have no idea what our hips are doing at any given point in time; do you sit with your tailbone tucked under at your desk? Do you hitch your hip to one side when standing around? Do you jut your pelvis forwards and dumb your weight into the small of your back when standing?
These are all very common postures, which may go some way to explaining why non-specific lower back pain is so widespread.
Try lying down on your back, with your knees bent and feet flat on the floor, and curl your hips like you’re tucking the tailbone between your legs – notice how that feels – now reverse it so you arch your lower back – and notice how that feels. Try the same thing standing – start with big movements, and gradually make them smaller and smaller until you find a spot in the middle that feels comfortable. Work to find that “sweet spot” in whatever position or exercise you’re in; you’ll soon get there instinctively. Notice how your lower abdomen has to switch on gently, without bracing, and how there is no pinching in the lower back. When you stand tall, you should feel like your tailbone is pointing down between your heels, and slightly behind you.
And yes, you can do this even in the saddle! Naturally, your hip flexors will be shortened and your lower back may be a little more stretched out, but see if you can create more length in the front of the hips and untuck the tailbone a little. The good news is, the whole spine works together, so doing this work for your lower back should also improve your posture in the upper back!