By Mathew Bennett
Do you suffer from pain or discomfort for many days post-riding unlike others in your cycling group?
Does nagging pain interfere each time with the pleasure you’d otherwise derive from cycling?
Is injury acquired from cycling stopping you from ‘being out on the road’, benefitting from what you enjoy most?
Keep your own wheels turning by maintaining frame of body, bike & mind.
Enjoyed by many people of different ages and fitness levels as social activity and exercise, cycling is an excellent, invigorating way to improve fitness and relieve stress. Being a non-impact activity unlike running, and offering encouragement and social interaction from group riding, it provides many advantages to those participating in large cycling clubs and smaller social groups.
Frustratingly, despite the benefits derived, many injures can be acquired, interfering with participation in an activity which many people enjoy. This is unfair when willingness to get out on your saddle, elevate your heart rate, complemented by a change of sight and scenery is prohibited by something otherwise resolvable using the right exercise-therapy approach.
On average, a road cyclist pedals over 5000 times in one hour, with many rides lasting between 2-3 hours (Abt 2007). With the repetitive, rotational movements involved and the increased time spent ‘in the saddle,’ excessive stress and adverse physical load will accumulate and be placed upon the cyclist’s muscles and joints, regardless of their level of fitness, willingness and persistence to ride. This can lead to injury, prevent participation and deriving of the pleasure and physical benefit from what they enjoy most.
A vast percentage of road cyclists (recreational and competitive) suffer from over-use injuries acquired through riding, the most common being lower back, knee pain and neck pain. Up to 60% of cyclists suffer from ‘non-specific lower back pain’. (NSLBP). In Lehman’s Terms, this refers to back pain felt, despite there being no detectable nor explanatory reason for the cause of the pain and suffering felt within this area. Coincidentally though, respected researchers (Burnett et al. 2004) established that cyclists with NSLBP all possessed an increased bending-twisting posture and strain upon their backs, initiated and exacerbated by cycling. This probably sounds familiar, experienced by some of you reading this.
The posture adopted by a road cyclist whilst riding has been described as ‘anti-natural’ due to the ‘flexed, rounded back’ position adopted whilst leaning forwards towards the handlebar (Muyor et al. 2011). This is worsened when cyclists opt to lower the handlebars further than others. The lower spine (lumbar) is naturally intended to be a concave shape, essential for correct movement, balance and alignment when standing still, walking and running. The upper spine (thoracic) is designed to be partially rounded/convex. Despite being encouraged by therapists to maintain natural alignment and correct spinal curvature during riding, many cyclists, particularly professionals and triathletes, by choice adopt an exaggerated, rounded convex curve of the upper and lower spine. This drastic alteration results in lower back pain felt due to increased pressure and strain upon the delicate spinal discs and ligaments located between the spinal bones which are otherwise intended to absorb impact and ensure correct alignment and functioning of the spine. Prolonged exposure to this position whilst cycling and subsequent postural change during daily activity greatly increases the risk of extreme, debilitating and inhibiting injuries to the lower back such as spinal disc inflammation (herniation) and splitting or dislodging of the discs (slipped discs).
The aforementioned upper spine and its convex, rounded curvature (kyphosis) is more pronounced, apparent visually and felt by cyclists physically whilst standing and lying down (Muyor et al. 2011). The effects can last for many hours and days after getting off the bike, exacerbated in the body of those who spend many hours professionally or recreationally in front of a computer or tv. This postural position will ultimately lead to adverse changes in the structure and composition of the spine, as well as the surrounding muscles designed to stabilise and align the spine, having a negative, chain reaction effect higher up and lower down in the body.
The endless hours of riding and increased rounding of the shoulders adopted on the bike requires an increased lifting of the head to maintain vision on the road ahead. Combined with the post riding postural changes and activity off the bike, tension, tightness, pain and movement restriction will inevitably occur in and around the neck and shoulders. This too will lead to adverse postural and structural alterations higher up in the neck (cervical spine) to which the upper back (thoracic spine) connects and effects, worsened by use of phones and tablets, looking downwards for prolonged periods while using them.
This also prompts tightening in muscles around the chest region, greatly involved in expanding the lungs as to allow deep breathing, essential for fitness as to counter steep hill climbs! Restriction in breathing and lung capacity will occur, having a detrimental, inhibiting effect upon the performance and capability of the rider.
Scientific evidence (O’ Sullivan et al. 2006) has established that important structural muscles, essential for correct alignment and functioning in the back and stomach become increasingly weaker when subjected to the ‘slumped’ position typically adopted by road cyclists. This, together with the resulting round-shouldered ‘kyphotic’ posture acquired from cycling and/or desk work can ultimately lead to faulty, compensatory movements in the spine, exacerbated by increased stress upon the spine, significantly contributing to lower back pain (Streisfield et al. 2017)
Research by Abt (et al 2007) has proved that core, muscular inactivity around the stomach, exacerbated by muscle fatigue in this area increases the risk of injury to the knee joints whilst cycling. This is due to the change in the pedalling mechanics of the body and increased stress placed upon them.
The abdominal and spinal ‘core muscles’ serve not only the purpose of maintaining correct posture whilst riding, but during static and dynamic normal daily physical activity too. They also provide the essential foundation for the rider’s legs to pedal from while cycling. If these muscles lack adequate strength for cycling or become tired during the ride, the pedal motion is greatly affected, creating and placing greater stress and load upon the muscles, bones, ligaments and tendons in the lower body. Evidence (Bailey et. al 2017) has established that cyclists with recurring knee pain displayed a very apparent ‘knock-kneed’ leg misalignment (valgus deformity – see diagram) while pedalling on their bike compared to those cyclists experiencing no knee discomfort. As a result, this causes the knee to be positioned much closer to the centre of the bike, rather than in correct alignment with the ankle and hip during each rotating, pedalling motion. If pedalling on average 5000 times as aforementioned, this will place short and long-term stress upon these joints, inevitably leading to injury and inability to ride, doing what many enjoy most recreationally as a means of relieving the stress accrued from the working week.
The knock-kneed position is symptomatic of a weakness or tiring of the ‘gluteus medius’ hip muscles, essential for correct lower body alignment and functioning during normal daily activity and exercise such as walking, lunging and running; applicable particularly to those cyclists who are also triathletes and/or runners. This change in alignment and functioning places increased, excessive stress upon the ligaments, muscles and cartilage within the knee causing wear and tear, pain, degeneration and injury, affecting the hip and ankle too.
To counter and otherwise prevent this recurring; selective, intervention training targeting the strength and control of structurally important spinal muscles resulted in significant reduction in pain whilst cycling (Van Hoof et al. 2011) Consequently, training of specific abdominal and spinal muscles to help maintain correct posture and control body movements on and off the bike will help to decrease pain and discomfort. Pain further decreases with greater joint mobility and muscle length surrounding the hips (Van Hoof et al 2011). This is achievable with selective sports massage techniques such as trigger point therapy to complement static stretching.
Our aim at Bodyrefine certainly isn’t to deter you from cycling. After all, it’s an excellent form of exercise, offering many physical, mental and social benefits, for which your efforts should be commended. On the contrary, our intention is to help educate you, condition your body, ensure correct physical functioning and alignment, prevent pain and injury otherwise felt in your body, ultimately ensuring you can enjoy your rides and derive the many benefits from them, be they recreational or competitive.
All Bodyrefine, injury treatment, rehabilitation, sports massage and strength training-flexibility programmes are preceded with a comprehensive, systematic assessment of the entire body to establish the root cause of your pain, discomfort and/or injury. Rather than just symptomatically treating in isolation the parts of the body which are experiencing pain, we adopt a holistic approach to our work; identifying and addressing all of the causative issues which are ultimately leading to pain. This helps prevents pain and injury occurring/recurring rather than providing a temporary benefit offered by other types of therapy.
Our approach addresses and helps prevent the adverse postural effects and pain which cycling prompts. Other exercise methods used by some in the industry, particularly core and postural strengthening, though with good intention, can actually exacerbate this. We don’t employ a ‘one size fits all’ approach when prescribing exercise as peoples’ posture can vary considerably, as can their strength and capability. What may benefit and be capable of by one person can otherwise hinder and injure another performing the same exercises and stretches.