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6 Ways to Prevent Back Pain

Rally UHC cyclists share their tips

By Molly Hurford | June 20, 2019 | Rally Health

Imagine hunching over a set of handlebars for six hours, climbing thousands of feet up some of the steepest mountains in Europe. You’re staying tucked to be as aerodynamic as possible, squeezing your muscles until they’re burning to hold your position. No wonder back pain is a huge problem for cyclists, just as it is for average Americans. Whether it’s the result of an injury or sitting at a desk all day, more than 20 percent of American adults experience lower back pain, according to a 2016 CDC report. Eighty percent, the NIH says, will have it at some point in their lives.

Almost all of Rally UHC Cycling’s pro racers deal with back pain at some point each season, and have developed ways to avoid or treat it without skipping a day of training or racing. Rather than waiting until back pain strikes, these athletes say that taking a defensive approach is best — by incorporating strength training into their weekly routines, stretching throughout the day, and being proactive when they start to feel a twinge. We asked our cycling pros and a few experts for their best advice for preventing and controlling back pain.

Train your core

Every Rally UHC Cycling racer keeps core work in his or her training regimen throughout the year to stay strong on the bike. “You need that core strength to avoid back pain,” says team doctor Kelby Bethards, MD. It’s not just cyclists who are at risk, either.  A small study published in the Journal of Biomechanics last year concluded that runners with weak deep core muscles may also be at higher risk of experiencing low back pain.

The core isn’t made up of just your abs; it comprises muscles throughout your torso, or “trunk,” including your back, so exercises that activate stomach muscles alone aren’t enough to strengthen you all-around. When your core isn’t strong, your posture can suffer. Poor posture can lead to back pain. “Your core is the foundation of so many athletic endeavors: If you don’t work on your core, you risk injuries,” Bethards  says.

Every racer on the team has a core routine they practice three to four times per week outside of competition. Longtime Rally UHC racer Ryan Anderson’s routine focuses on a combination of bodyweight exercises like planks and side planks, though he’ll add in new exercises like clamshells to change things up when the routine feels stale. “I like bodyweight exercises that I can do on the road in a hotel,” he says. His mixes up his sets and reps, but always spends at least 10 minutes three times each week doing those key core exercises.

Stretch (carefully!)

Stretching can keep muscles limber, strong, and healthy. Forgoing it can limit your range of motion and put you at risk for injury. Stuart McGill, professor emeritus of spine biomechanics at the University of Waterloo, Canada, is one of the world’s foremost experts on exercise and the spine. He recommends a gentle cat-camel move (or cat-cow pose, as it’s known in yoga) to loosen up the spine before a workout. To do it, get on the floor on hands and knees, and slowly draw the belly in, rounding the spine. Reverse the movement, arching but not overextending the back. Repeat the sequence five to eight times.

Practicing yoga may also help alleviate back discomfort. A 2011 study of 320 people with chronic low back pain published in the Annals of Internal Medicine found that yoga was “similarly effective” to physical therapy against participants’ pain. Rally UHC cyclist Sara Bergen loves incorporating yoga into her daily routine during training season. “One side of my back is always bothering me from an old injury,” she says, “so I need to incorporate a lot of stretching into my day.” Bergen is on the road most of the year, which makes it hard to find a studio where she can practice. That’s why she’s a fan of online videos. In the off-season, she’ll practice with full classes three to four times per week.

Massage it out

Research is mixed as to whether massage is an effective therapy for lower back pain. In 2017, the American College of Physicians issued new guidelines for noninvasive treatment of acute or subacute low back pain, concluding that massage can be recommended to patients as an alternative to medication. For athletes, massage may offer other unique benefits. Some studies suggest that massage can prevent delayed-onset muscle soreness (DOMS), reduce perceived fatigue, and promote recovery after exercise.

Registered masseuse and former racer Myriam Desrosiers is Rally UHC Cycling’s team soigneur, the person on a cycling squad charged with keeping athletes happy and healthy during intense training camps and stage races. Whether she’s recommending stretches or actually massaging the riders post-training, she’s an invaluable part of the team. “Massage is a great tool to release muscle tension,” says Desrosiers.  “In my massage practice, I see good results when we address muscle imbalances and tightness.”

Can’t make it to a massage therapist on a regular basis? Cyclist and former runner Krista Doebel-Hickok uses TriggerPoint balls—similar to lacrosse balls but slightly softer and with more grip. She’ll lie on the floor, on her back, with a TriggerPoint ball positioned under a tight muscle, and roll into it until it releases. “I focus on rolling my back and glutes, and it feels amazing,” she says.  

Her teammates Murphy and Bergen prefer foam rollers, which studies suggest may also reduce DOMS. Murphy uses the roller on his back by positioning it horizontally across the center, in line with his heart. Then he lets his muscles relax into it and slowly rolls back and forth 10 times, for around five minutes.  

If you’re a cyclist, get a proper bike fit 

If you’re a regular cyclist who copes with back pain more often than not, your bike may need some adjustments. “Having a professional bike fit done helps to ensure that one has the proper bike size, that the saddle is at the right height and right position and same for the handlebars,” says Desrosiers, who’s suffered back pain herself because of an improper bike fit in the past. “Having a poor fit will cause stress on the body.”

A local bike shop should be able to help you get a basic fit. If you ride a lot, consider enlisting a professional bike fitter to assess everything from your saddle width to handlebar height to ensure a more comfortable ride.

Switch things up

When Anderson’s back starts to bother him during training, he knows it’s time to do something different. “I swap my road bike for a gravel bike or mountain bike and hit the trails when I need a break,” he says, adding that switching from a road bike to a mountain version taps different muscles when you ride.

Bethards notes that the major mistake athletes make when dealing with an overuse injury is “taking on too much, too fast when coming back.” If your back has been bothering you on the bike, rather than racing to get back onto that same bike, try some cross-training instead. Cross-training can prevent overuse injuries and give worn-out joints and muscles a break. “If you take a few extra days to come back, you’re less likely to end up with a more serious overuse injury that will result in even more time off the bike,” Bethards says.

Changing up your workouts is a great idea no matter what your fitness preferences are. Runners can benefit from sneaking in miles on the bike, swimmers can benefit from hiking, and CrossFit athletes can see benefits from the occasional yoga class. Sticking to one specific workout over and over again can lead to a sore set of muscles, with other muscles being under-utilized, so make sure you’re adding variety to your workouts—you might even find a new sport you enjoy even more.

Remember: If your back pain is severe or doesn’t improve after three days, you should call your health care provider. And always seek medical attention if you have back pain following an injury. Better safe than sorry.

Molly Hurford
Rally Health