Due to the addition of bike lanes in the city of Buffalo and increased paths throughout the surrounding suburbs, cycling is an activity gaining greater traction in WNY. Riding a bike can be an easy mode of transportation with a host of benefits. As children, we couldn’t wait to jump on our bike and ride over to our friends place. It seems once we pass that drivers test, we toss the bike aside and forget biking is a very useful (and FUN) form of transportation. Biking can improve the environment, has less of a financial burden than a car, and is an excellent form of exercise!
A study of cyclists in the Netherlands, where riding is more globally accepted and apart of the culture, found that the average amount of time on a bicycle was 74 minutes per week for adults (1). This greater participation in cycling has drastically decreased the amount of health related deaths (6500 per year) and raised the nation’s overall life expectancy. Still not convinced? The economy benefited by 19 billion Euros due to reduced health care burden. The increased health benefits, more money in your pocket, and environmental benefits sound great, right? Here is where we bring on the bad news; with benefits also come potential risks.
Cycling, like many other forms or exercise, can lead to injury. Outside of traumatic injuries (wear a helmet!), cyclists can suffer from overuse injuries or muscular imbalances. The knee is responsible for 40-60% of overuse injuries in cyclists (2). The lumbar spine (low back) is another area of potential injury with prolonged bike riding. Long periods of time spent in a flexed (bent) position can place greater loads on the lumbar discs and overstretch the low back musculature (Figure 1). How can some cyclists put on hundreds of miles a week pain free while others succumb to injury?
The key to avoiding injury starts with proper fitting equipment. Variables to pay attention to are the seat height, seat position, as well as handlebar setting. As a general rule of thumb, the knee should be bent to 30 degrees when the pedal is in the lowest position (Figure 2). If your seat has fore and aft positions, it should be adjusted so the top of the shin and pedal are stacked in a line while the pedal is in the forward position (Figure 3). On road bikes, the seat height tends to be three to ten centimeters higher than the height of the handlebars (2). A lower handlebar position makes for a more aerodynamic and efficient rider. This handle bar drop can increase the amount of stress on the low back. A simple adjustment can be made by raising the handlebars if you aren’t trying to win any races. Formal fittings can be performed at most bicycle shops for optimal positioning.
Now that the equipment is all set, time to make sure the motor (YOU) are prepared to hit the roads. Muscular weakness or tightness in the hips, thighs, and core muscles can leave you reaching for the ice pack and ibuprofen. Research has found that cyclists with low back pain have a greater amount of lower lumbar rotation and flexion. When compared to the asymptomatic cyclists, injured riders also had decreased ability to contract the stabilizing muscles for the low back (3,4). Hypermobility coupled with weakness of the core muscles is a recipe for potential injury.
A solid stretching, strengthening, and stabilization program can help reduce the risk of sustaining a low back injury from cycling. Stay tuned for a follow-up article addressing possible muscle imbalances, core weakness, and mobility deficits that can impact your cycling. Until then, get out an enjoy the new bike paths!
1. Fishman E, Schepers P, Kamphuis CBM. Dutch Cycling: Quantifying the Health and Related Economic Benefits. Am J Public Health. 2015;105:13-15.
2. Wanich T, Hodgkins C, Columbier JA, Muraski E, Kennedy JG. Cycling Injuries of the Lower Extremity. J Am Acad Orthop Surg. 2007;15:748-756.
3. Burnett AF, Cornelius MW, Dankaerts W, O’Sullivan PB. Spinal Kinematics and Trunk Muscle Activity in Cyclists: A Comparison Between Healthy Controls and Non-Specific Chronic Low Back Pain Subjects-A Pilot Investigation. Man Ther. 2004;9:211-219.
4. Van Hoof W, Volkaerts K, O’Sullivan K, Verschueren S, Dankaerts W. Comparing Lower Lumbar Kinematics in Cyclists with Low Back Pain (Flexion Pattern) Versus Asymptomatic Controls-Field Study Using a Wireless Posture Monitoring System. Man Ther. 2012;17:312-317.