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Cycling and your aching back

Bryn Mawr Rehab Hospital October 2, 2019 Orthopaedics and Fitness

It seemed like a simple question. Does cycling increase or reduce low back pain? The physical therapist answered, “Yes.”

Lauren Feinberg, PT, DPT, Cert MDT, provides outpatient physical therapy at Bryn Mawr Rehab, part of Main Line Health. She explains how cycling can both contribute to back pain and provide an effective form of rehabilitation for people with back or neck pain.

Bike riding form and other causes of pain

Cycling is a low impact activity that promotes cardiovascular fitness while increasing muscle strength and flexibility. Despite the repetitive motion it demands, it is surprisingly easy on knees and other joints. When cycling results in pain, most often low back strain is the chief complaint and can be caused by several factors.

Good cycling posture is important for reducing strain and goes hand-in-hand with being properly fit to your bike. Choosing the correct bicycle size is only step one. While there are countless articles online about correct cycling form and proper bike posture, you can’t beat the hands-on guidance a good bicycle shop can offer. From handlebar position to saddle height and angle, the right adjustments can make a big difference and help ensure good cycling form.

Another cause of low back pain is overexertion. A weekend warrior may feel great during a two-hour ride. The problem occurs when that person gets off the bike after being in a forward flexed position for an extended period.

“Anytime people are in sustained positions, they may feel comfortable while in that position, but feel pain or discomfort once they move. Our bodies are meant to move. At a minimum, I recommend people change positions every 30 minutes. If you are riding a bike, adjust cycling positions, take a water break or stand up every once in a while,” says Lauren.

Overuse of hamstring (rear thigh) and calf muscles can also lead a cyclist to shift position and put strain on the lower back. Movements that stretch and strengthen these muscles can be helpful, as are exercises to fortify the core. Don’t limit your focus on correct cycling posture; pay attention to your posture throughout the day. Are you sitting straight with shoulders back or slumping over a desk?

Biking as physical therapy

As a physical therapist, Lauren treats patients of all ages, including those with neck, back or shoulder pain. Many are deconditioned, having lost fitness or muscle tone due to pain or injury preventing them from exercising at a normal intensity or frequency.

“For patients with neck pain, an arm bike, or upper body ergometer (UBE) can help them regain endurance and strengthen the muscles that support their spine, including the head and neck,” says Lauren. “Whether a patient is recovering from neck or back pain, I encourage sustained activity that is gradual, gentle and aerobic.”

One of the benefits of cycling is that in addition to being low impact, it is both familiar and accessible to most people.

“Virtually every fitness center—whether it’s a senior center, local YMCA, or national chain—has bikes, including upright stationary bikes and recumbent models, which offer enhanced lumbar support. I find it a great way to reintroduce cardio for people who are deconditioned, and because most people rode bikes when they were younger, it’s an activity they associate with fond memories,” she adds.

Main Line Health serves patients at hospitals and health centers throughout the western suburbs of Philadelphia. To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (225.5654) or use our secure online appointment request form.