How to Help Cyclists Reduce Low Back Pain

When the cyclists you coach come to you with complaints about aches and pains, it’s a safe bet that “My lower back hurts” is something you hear a lot. Perhaps it’s hardly surprising, given how many miles they spend hunched over the handlebars. But while back pain is common, it isn’t inevitable. In this article, we’ll explore how to help your coaching group reduce the risk of back pain and what to do if they get a flare-up. 

Prevent Pain: Creating a Solid Hinge

All too often, the response to lower back pain is a reactive one. In other words, your athletes will wait until they feel a twinge before they do anything about it or push through until the issue exacerbates itself and they’re forced to consult you or a PT for help. To truly tame back pain, your clients would be better off becoming proactive and trying to get ahead of the issue before it becomes a chronic problem. 

This begins with their positioning on their bike. What do they look like when they start a training ride? And how does this change as tiredness starts to set in? As General George S. Patton once quipped, “Fatigue makes cowards of us all.” It also makes your cyclists more likely to slump into poor, unsustainable positions that will cause or contribute to back pain. If you can’t watch your athletes in person because they live far away or COVID protocols prohibit it, then ask them to have somebody video them at the beginning of a ride and partway through it so you can assess their positioning and suggest cues and corrections. 

It will be easier for your clients to get into and maintain a functional hinge position on their bikes if they can also feel the pattern in the gym. When strength training, a lot of athletes like to jump right into heavy deadlifts, but first, it’s important that they can demonstrate an understanding of the exercise with lesser intensity. Here’s a reasonable progression that you can monitor. If someone starts struggling at one point in the process, then regress them back to the previous step until they’ve gotten it down. It’s worth investing ample time here as if they’re unable to hinge well on a stable, closed chain environment, it’s unlikely they’ll be able to do it while atop a thin, tippy platform (i.e., their bike) while moving at speed. Here are a few exercises worth testing out:

1) Waiter bow 

2) TRX Suspension Trainer hinge

3) Kettlebell deadlift

4) Kettlebell Romanian deadlift (RDL)

5) Two-hand kettlebell swing

Treating Lower Back Pain Without Surgery or Painkillers

The tips and techniques above are intended to get ahead of lower back pain. But even if your athletes are strong, have advanced movement fluency and display good form on their bikes, they might still struggle with the peskiest of ailments from time to time. In which case, they need some tools that don’t involve popping painkillers or getting surgery. 

This is where mobility work comes into play. One of the challenges with the lower back is that there are so many tissues tugging on it from different directions. If a cyclist’s middle or upper back is tight, this can send excess stiffness downward. Or should the powerful muscles of the hamstrings and glutes get glued down, they’ll send tightness up the posterior chain. The front of the body can also exert undue influence on the lower back. If abs and obliques get matted down, this can contribute to lower back pain as can hip flexors and quads made tight by mile after mile on the road or trail. 

Here are a few exercises to pass on to your athletes that tackle each of those trouble spots:

Lower Back Smash

The Quadratus Lumborum or QL isn’t one muscle but actually two, both of which run like thick cables on either side of your spine from the base of the rib cage to the top and back of the pelvis. Cycling, running, and jumping can all irritate the QL. Here’s a couple of exercises to calm it back down again. 

1. Lie on your back in front of a couch.
2. Put your heels up on the couch with your knees bent.
3. Place a double lacrosse ball or MWOD Mush Gemini (smaller size) either side of your spine, just above the back of your pelvis.
4. Slowly sink your left hip toward the ground, come back to the middle, and then sink the right hip toward the floor.
5. Repeat 10 to 20 times, and then move the tool up your lower back a little further.
6. Keep going until you’re just below the back of your rib cage.
7. If having your feet up on the couch seems to be aggravating your lower back, you can perform the same exercise with your knees bent and feet on the ground.

Hamstring Tack and Floss

1. Sit on a plyo box, bench, or chair.
2. Place a lacrosse ball between your hamstrings and the seat.
3. Starting just above the back of the knee, roll the ball slowly back and forth across your hamstrings, staying in one place if it’s particularly painful.
4. Move the ball up your hamstring and repeat, until you get to where the back of your upper leg meets your butt.
5. Repeat on the other leg

Pigeon Pose + Glute Smash 

Sometimes it’s useful to combine a static or banded mobilization with one that involves soft tissue manipulation. In this case, performing the yoga pigeon pose first can prime your glutes for smashing afterward.

Pigeon Pose

1. Sit on the floor or on a yoga mat with one leg out in front of you and the other behind
2. Keeping the outside of your front leg in contact with the ground or mat, bend your knee to 90 degrees.
3. Fold forward at the hips until you feel a slight stretch in your glutes.
4. Pause for 10 to 15 seconds, relax, and repeat four or five times

• Try leaning forward toward your midline and out to the side as well as just hinging forward. This will help you hunt down and alleviate excess tension. 
• After two or three minutes, switch sides

Glute Smash

1. Sit on the floor or a yoga mat.
2. place the lacrosse ball under one buttock.
3. Slowly roll back and forth across it.
4. To increase the stimulus, you can cross the inactive leg over the top of the active one.
5. Want to target where the top of your glutes meet your lower back? Next, place the ball in this area after lying down flat on your back. Then proceed to roll back and forth. 
6. Switch sides.

Abdominal Rollout

It might seem counterintuitive, but the release catch for a sore lower back is often either the iliacus or psoas, both of which attach on the front. Excess ab tension can also tug on your lower back. So rolling out this area can feed slack into your lower back. 

1. Lie on your front on the floor or a yoga mat.
2. Place a softball-size ball like the MobilityWod Mush Ball between your abs and the ground or mat.
3. Slowly roll back and forth across the ball. If this is too painful at first, try taking big nasal breaths or just sinking down into the ball. 
4. Start at the top of your “six pack” and work downward steadily.
5. To get to the iliacus and psoas insertions, proceed with caution just inside the front of your hip bones. Can’t seem to get deep enough on the sore spot? Then try the Hip Hook from Aletha.  

Quad Roll + Couch Stretch

Here’s another handy combo of exercises that can relieve tension in your quads and hip flexors that might be adding stiffness to your lower back:

Quad Roll

1. Lie face down on a yoga mat or rug.
2. Place a roller or ball between one quad and the mat or rug.
3. Starting just above the knee, slowly roll back and forth across the roller or ball. Most people roll up and down a muscle but going across it can be more effective in removing adhesions. 
4. Steadily move the roller or ball further up your quad, stopping before you get to the bottom of your pelvis.
5. Switch sides.

Couch Stretch

1. Kneel in front of a wall or the side of your couch.
2. Place the front of one shin up against the flat surface, while stepping the other foot out in front of you (the finish position should look like a lunge but with the rear leg elevated).
3. Push the back hip down toward the floor until you feel a stretch in your hip flexor. Use your abs and glutes to stabilize the position, hold for 10 to 20 seconds, relax, and repeat. 
4. If you have the range of motion, try getting your torso all the way upright and repeating the motion to target the top of your hip flexors.
5. Spend three or four minutes couch stretching one side, then switch to the other