Low Back Pain and Cycling

Cycling is regarded as a highly enjoyable and effective form of exercise. However, there is some confusion about how posture while riding can affect the lower back and whether cycling is helpful for recovery from lower back pain.

Bicyclists ride with either a round-back, flat-back, or curved-in back, which is based on the degree of pelvic rotation and spinal flexion. It appears that the choice of posture when riding a bike is primarily related to seat height, seat angle or tilt, and handlebar type. Some handlebars offer multiple options as to where you can place your hands, such as on the grips (most upright), on the bar closer to the stem (middle position), or on the drops—the lowest option offered on the curl under/racing type of handlebars.

One might think that flat-back posture would be best for the lower back, simply because it avoids the two extremes. However, this position is associated with increased wind resistance and will likely be avoided by more serious cyclists who are looking to ride as efficiently as possible. One pilot study looked at the lumbar spine angle of young adult recreational cyclists as they utilized all three postures in ten-minute intervals with different bike configurations and found that the “curve-in back” position caused by gripping the drops resulted in the greatest increase in spinal flexion over time. For individuals with a low back condition, this increased spinal flexion could result in increased pain and related symptoms over time.

Another study looked at how a bike is fit, the position of the cyclist, and the perception of comfort, fatigue, and pain. Here, twenty cyclists rode in three of nine potential positions for 45 minutes at 50% of their peak aerobic power output. The three positions were defined by two parameters: knee flexion angle (20°, 30°, 40°) and trunk flexion angle (35°, 45°, 55°), in a random order. The results showed that having the trunk upright (not bent forward) and the seat height adjusted so the knee flexion angle was 30° was the most comfortable position for participants. Additionally, the researchers found that tilting the seat forward lessened low back pain in those with the condition.

As part of the recovery process for low back pain, doctors of chiropractic often encourage patients to exercise. Because of it’s low-impact nature, as well as being highly enjoyable, cycling is a great option. However, it’s important to make sure your bike it fitted so that you can comfortably ride with good posture and as to not exacerbate your condition.

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