Back Pain – Is It About the Bike?

By Lee Shuemake

We have all had those long or tough days on the bike when our body is telling us it would rather be sitting on the couch watching cycling videos. I’m not talking about the normal pain in the legs, or the burning lungs. I’m referring to the pain in your lower back or that pinching feeling in your neck with that oh-so-pleasurable pain running down the inside of your scapula (also known as your shoulder blade). Maybe you’re even getting that most enjoyable loss of feeling in your hands to go along with it.

This isn’t necessarily another “bike fit” article, though hopefully at this point you have realized just how important a good fitting bike is. I’m going to take it one step further and look at another major cause of discomfort on your bike, your spine.

I’ve treated a lot of patients in my 11+ years as a licensed Doctor of Chiropractic in California. Statistics show that roughly 60% of those with low back pain have a structurally short leg. This means that either the upper bone or lower bone in one leg is actually shorter than the other. Obviously this would be a problem on the bike and is something that needs to be dealt with. It’s fairly easy for the trained eye to spot the cyclist with a significantly shorter leg. They are the one that is falling off one side of their seat to finish their down stroke. A small discrepancy is more difficult to spot however.

Depending on how much of a leg length discrepancy there is, it must be handled in different ways. Some minor discrepancies can be corrected with some simple shims and this is typically enough for most cyclists. For those few that are unlucky enough to have a more substantial leg length difference, the problem must be addressed by altering the pedal/crank/chain rings, and there are individuals who specialize in this process. In some cases the leg length difference can be caused by a misalignment of the pelvis and lumbar spine, but it takes someone with proper training and experience to recognize the difference.

No matter how hard we try to get the perfect bike fit, if your spine is in bad condition there may be no way to compensate for it. Compensating for spine problems by bike fit adjustment is not the answer long term either, as it will only help the problem short term and lead to more problems down the road. You could raise your handle bars up to give you a more upright riding position and probably decrease some of the pain in your neck and shoulder, but the real problem is more than likely a compression of the nerves exiting your spine being exacerbated by your positioning on the bike. If your body is forced to compensate for a short leg, think about how that may be affecting your cycling muscles on one side of your body compared to the other? We hear a lot of talk about using both legs equally and having a smooth spin, but how difficult would that be with such an imbalance? Of course, the unequal leg length doesn’t change once we step off the bike and as far as your health is concerned can be more or a problem in your every day life than it is on the bike.

Our bodies need to be functioning at 100% to be competitive in the sport of cycling and similar endurance sports. Many top athletes understand this. Lance Armstrong and the US Postal team along with many other teams had a full time chiropractor at the Tour and many other races to help keep their bodies going. If our body is forced to compensate for spinal/structural issues it will only make it more difficult to achieve our goals. Absence of pain does not mean that you don’t have a leg length discrepancy or other issue. For athletes putting in serious time on the bike, getting checked should be a routine part of preparation for competition. It is important to deal with these issues not only to achieve your maximum potential on the bike, but to live a long and healthy life off the bike as well.

So, where to go next? If you have back pain or regularly ride over 15 hours per week, I recommend getting your spine checked by a chiropractor. A well qualified chiropractor can spot a problem quickly and recommend any follow up treatment that may be needed. Once any spinal problems have been corrected a good bike fit will be easier to achieve.