Bicycle Back Pain

Continued...

Your chiropractor, sports medicine physician, and physical therapists have ruled out disc and vertebral problems, and you have done all the necessary stretching and strengthening exercises for the back. Cortisone injections should only be considered if you have a diagnosis and know what it is you are trying to treat.

I think your problem results from an incorrect fit and riding form on the bicycle. You say you built the bike from scratch starting with the frame. The most difficult part of finding a correctly fitting bicycle for a woman starts with the frame, particularly with the proper top-tube length. According to Casey Patterson, the 1987 Race Across America winner, the longer the top-tube length, the more likely you are to develop back pain. And most bike frames were designed with the larger bodies of men in mind.

Adjusting the stem length can compensate for this to some degree, but not entirely. Flattening your back out over the top tube like "all the pros suggest" is recommended to decrease the amount of wind resistance you encounter. However, it actually increases stress on the back.

To reduce strain on the lower back, Casey recommends shortening the top tube, raising the height of the handlebars, and lowering the seat height. She also says that even minor misalignments can cause back pain when they are exacerbated by long bicycle rides. Make sure your seat is correctly lined up and pedal heights are set right. Take your bike to a good bicycle shop and have it "tabled" to make sure the frame is correctly aligned.

You may have started with a frame that is too large for you and you may need to replace the bicycle with one that fits correctly. Another option is to try riding a mountain bike, where you're not stretched out so much.

Assuming this is the problem, even after you get a correctly fitting bicycle the pain may not disappear immediately. Several weeks of alternative exercise, such as swimming or jogging, may allow the nerve and muscle to be less likely to spasm when you resume cycling.

Keep doing your stretches and abdominal strengthening exercises. They are important to maintaining a healthy back, and may be the reason you are pain-free except when cycling. Abdominal strengthening can reduce the load on the back by 60 to 80 percent.

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About the authors: Carol L. Otis, M.D., is Chief Medical Advisor to the Sanex WTA and a UCLA student health physician. Roger Goldingay is a former professional soccer player. They are married and the co-authors of The Athletic Woman's Survival Guide.

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