Neck and Back Pain in Cycling
Neck and back pain are very common in cycling. Many riders experience occasional or recurrent neck and back pain related to their riding.
will tend to pull the pelvis forward, while tight hamstrings predispose to backward pelvic tilt. Also, the strength of the abdominal muscles is critical to maintaining stable pelvic positioning. Pushing large gears, or extended hill climbing may fatigue the gluteus and the hamstrings, causing the pelvis to tilt backwards, aggravating the back musculature and causing pain. Core muscle group strengthening and lower extremity stretching will help with proper pelvic positioning and should lead to pedaling efficiency.
Frequent changes of riding position can help with back pain. Moving hand position from the drops to the brake hoods to the top of the handlebars allows for changes in posture, reducing strain on the back. When climbing or pushing a big gear, moving slightly back on the saddle will decrease strain on back. Back pain while sprinting can be helped by moving slightly forward on the saddle.
Riders whose neck or back pain is refractory to the above techniques should decrease their weekly mileage by 10% until the back pain disappears. During this period of mileage reduction, they should also avoid climbing and sprinting, and use a high cadence, low resistance spinning technique. Ice and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, may be used to provide pain relief. NSAIDs should be taken with food, and if the pain is not resolving within 1 week, medical evaluation is recommended. Medical management may include continuation of NSAIDs, trigger point injections, and possible a referral for physical therapy to improve core strength and flexibility.
In summary, although neck and back problems are very common, they can usually be managed by a combination of bicycle adjustment, technique change, and minor medical treatment.
Chad Asplund, MD
Dr. Asplund is a family physician and avid competitive cyclist who treats sports related injuries in the Washington, DC area. Send your cycling injury and health-related questions to info AT roadcycling.com. Dr. Asplund will answer selected questions in future articles.