Back Pain – Cycling

Back pain – cycling. Research studies have shown that back pain in cycling is something that affects up to 70% of cyclists , together with neck pain. This is hardly surprising as cyclists regularly spend hours in the saddle. The cycling action involves the repetitive bending of alternating hips and knees, whilst maintaining a fixed back posture. Added stress on the back comes from vibrations from the ground which are transferred from the seat to the spine.

Neutral or near neutral position for your back on the bike is vital. Hinging forwards in the saddle from the hips rather than curling from the lower back. Studies show that cyclists who suffer from back pain tend to curl forwards more in their lower back.

Hamstrings and hip flexors need to be flexible in order to allow you to hold your spine in neutral. If they are tight your body will compensate by curling your back round.

Seat height is important. Too low and your low back will be forced to flex too much for you to pedal freely and too high will cause you to bend forwards through your back to reach the handlebars.

Neck pain is also very common in cyclists. The more you round your back, the greater the need to lift your neck upwards in order to look ahead. This compresses all the neck joints setting you up for pain and stiffness.

To prevent this you need to hold your spine straight and use your eyes to look ahead rather than always lifting your head. Every now and again, you should bring your head down to your chest whilst cycling in order to reverse the prolonged stiff posture of holding the neck in extension.

Back pain – cycling. In Summary

  • Maintain adequate spine flexibility especially in the thoracic area (between shoulder blades)
  • Develop good hamstring and hip flexor flexibility
  • Check saddle height (possible bike fit from local shop)

Learn to hold neutral spine while riding (see pic above)

Marathon Running

Marathon Running

For Marathon Running, stretching can be useful for two different reasons. First of all, you can use stretching to address specific muscle restrictions which are identified as being contributory to a specific injury. Tight or shortened muscles are commonly associated with overuse injuries. The shortening may be at the same site as the injury or in the muscles close by. Muscle tightness may be secondary to neural restriction, muscles imbalances or trigger points. This needs to be corrected first if stretching is to be effective.

For example, a runner who has weakness in the buttock muscles is likely to have particularly tight hamstrings, Any amount of hamstring stretches will not resolve the issue and gluteal (buttock) strengthening exercises will need to precede the stretching programme. Stretching needs to be done on a regular basis, as instructed by the sports therapist or physiotherapist.

Secondly, stretching is very important as part of an injury prevention programme. Running is a very repetitive, one dimensional activity. This means that the muscles and joints are only working in very small, specific ranges of motion. This means they are likely to become short and tight.

Marathon running – warm up

In general, it is suggested to do dynamic stretches at the beginning of a training session. This should follow a short warm up, which may be jogging. Dynamic exercises include running with high knees, kicking heels to bottom and stride lunges. They should all be comfortably performed. This is even more important before a speed or interval training session.

Marathon running – cool down

At the end of a training session, a cool down is very important and this should include stretching. Technique is key when it comes to stretching, and runners would be advised to seek advice on the best way of stretching all the key muscles groups.

Here are some stretches to help with injury prevention:

Keep your chest up as you maintain a curvature in your lower back as you lean forward.

Hold for 30 seconds.


Stand and hold onto a support. Keep your back flat and draw up your bent knee. Keep both thighs level to each other and feel the stretch in the front of your thigh. Make sure you do not allow your back to arch as this will reduce the stretch.

Hold for 30 seconds.

Calf (Straight leg):

Stand with your affected foot behind you and keep your heel on the floor as you lean forwards until you feel a stretch in your calf. Make sure both your feet are pointing forwards.

Hold for 30 seconds.

Calf (bent leg- soleus):

Bring the back foot in a bit and bend the knee until you feel a stretch lower down in the Achilles tendon. You can balance out your weight on both legs as you stretch.

Strength balance training

Strength balance training

“Physios can help prevent repeated falls in older people”

So says NICE, the National Institute for Health and Clinical Excellence in its new quality standard for falls in older people.

Strength balance training

Older people with a history of falls should be referred to experts, such as physiotherapists, who can provide them with strength and balance training.

Falls are the leading cause of injury-related death in people over 75 in the UK.

NICE says that falls are the leading cause of injury-related death in people over 75 in the UK, and cost the NHS an estimated £2.3 billion each year. As a result, the quality standard aims to help NHS staff prevent further injury in older patients who have already had a fall.

Physiotherapist Vicki Goodwin, research officer for the CSP professional network Agile, was part of the NICE quality standards advisory committee, which developed the standards.

Quality standards

The document sets out a series of standards to ensure that older falls patients receive a comprehensive assessment and support to prevent them falling again.

These include that:

NHS organisations with inpatient beds should ensure that all staff follow ‘post-fall’ protocols, which include checking older people who have fallen for fractures and spinal injuries before they are moved.

Older people who have fallen in the past should see an expert who can help them start exercises to build up their muscle strength and improve balance.

Older people who are treated in hospital for a fall should be offered a visit from a trained professional who can check their home for anything that puts them at risk of falling again.

Full report from the Chartered Society of Physiotherapy here…

Strength balance training

Physiotherapy helps restore movement and function when someone is affected by injury, illness or disability. It takes a holistic approach that involves the patient directly in their own care. Physiotherapists treat people of all ages, helping them manage pain and using a number of methods to aid recovery. Although they’re often thought of as just dealing with musculoskeletal problems, physiotherapists are trained healthcare professionals who work in many areas, and in particular strength balance training of the elderly.

Ski Stretching

Ski Exercises

For anyone planning to ski in this new year, here are some ski exercises that are recommended to give you the best control on the slopes.

1. Standing on a slant board your knees and hips need to be bent at a 45 degree angle. Try and stand for as long as possible until your quads (front of thighs) can no longer take it. Rest for a minute and then go again. Repeat once more. This will really help build some quad endurance that is essential for skiing.

2. Single leg supermans. Stand on one leg or on a wobble cushion and slowly hinge the hip whilst keeping the back straight. The body should end up being quite horizontal with the non-stance leg out straight in order to counter-balance the forward body lean. Aim for 3 sets of 10 reps on each side. This is a great balance exercise to develop single leg limb control, as well as working on hamstring and glute strength. This is very important for skiing.

3. Side Planks. Prop up on one elbow and keep feet together and hips off the floor. Hold for 20-30 seconds on each side and then repeat 3 times. This is great for trunk and core stability that will help stay strong on the ski’s.

The Optimal Sports Therapy Centre at Basingstoke, Hampshire, offers a wide range of treatment and correction aimed to speed up recovery, restore function and help you return to your normal daily activities at work, leisure or sport. Preventing injury and optimising performance is beneficial to everyone whether on the sports field, at work or at home. Through a comprehensive assessment of posture, muscle imbalance, biomechanics and flexibility, any imbalances will be identified.

A programme addressing these inefficiencies will allow you to continue your sport or activities with a decreased risk of injury while enhancing your performance.