Seeking help with low back pain in cyclocross

Chris Ramsey

2018-10-22

Hi Erik. Sorry to hear this, but rest assured you are not alone in this, particularly in the cyclocross world. Speaking as a PT who personally deals with athletes of all abilities (currently seeing weekend warriors and Olympic gold medalists alike), there can be many causes of pain in the low back. Certainly bike position could be one of them. Technique could be another (gearing selection, gear-shift timing, preferred cadence, etc). I echo Mark's comment below that a PT knowledgeable about bike position is important. For the sake of exploring other potential sources, though, let's presume that your bike position is correct and your technique is adequate (I say adequate because course conditions will sometimes dictate those choices).

Core strength does, indeed play a significant role in low back pain (LBP), and given that your back issues sound activity specific, are a likely culprit. Beyond that, though, is a need to understand the inter-relation of strength, power, endurance, and control. In my experience, people often focus on the first parameter, presuming the rest of them are simply synonyms for "strength". Strength (how much weight you can move) is important, but in cyclocross power (how fast you can move weight) and endurance (how long you can keep moving that weight) are of huge importance and often under-developed because people typically think that more time on the bike should trump time in the weight room.

But in my opinion, that last parameter, control, forms the most important pillar in good movement. Having great strength but poor control yields inefficient movement. I can't drink my coffee, despite being strong enough to lift the cup to my face if I keep missing my mouth, nor does the person with the strongest arms in the world make for the best typist (to use two common examples I use to help people understand control).

When it comes to cyclocross, you need tremendous power, and you need it out of every corner. You can compensate for inefficient patterns for a while, but inefficiency fatigues tremendously faster than efficiency, and so your ability to compensate ultimately breaks down early in the race, and then your ability to generate *any* power declines.

Finding a PT or a strength and conditioning expert who can assess you, and find the right starting point to develop your weaknesses while continuing to allow you to use your strengths will ultimately result in your best bet to a faster, painfree (well, at least low back pain-free) racing.

My $0.02

-chris ramsey, PT, DPT, OCS
www.portlandpace.com


Leibowitz, Flora Lynn

2018-10-19

I have got very good results in the same pain from two things:
First, a PT who worked on my glute medius and minimus on the side that hurt. It hasn't bothered me in some years. The other thing that helped was having an off season training plan that focused on all over body conditioning and not just quads or some specific thing. I got a trainer to put the program together, which is a bit of a luxury (or a bit of luck, since my trainers are OSU grad students in the kinesiology program who do internships at our campus rec center). However your fitness club may have plans that discount bundles of appointments.
________________________________________
From: OBRA [obra-bounces@list.obra.org] on behalf of Norrene Godfrey via OBRA [obra@list.obra.org]
Sent: Friday, October 19, 2018 9:13 AM
To: obra@bushtit.obra.org
Subject: [OBRA Chat] Seeking help with low back pain in cyclocross

Hi Erik,

I have (had) all the same pain symptoms as you; when I really need to go hard, my right lower back would send shooting pain through my body and would get more and more intense the longer I stayed in maximum power output.

I lived with the pain for the last 6 years and finally retired from racing this year BUT I found things that have been working for my back and while I have not gotten on my bike to go hard, yet, I can get out of bed or off the couch without hurting.

My back problem stemmed from a crash some 12-13 years ago where I landed hard on my right hip, but didn't get it checked out, because, well, you know, cyclist are tough, so slowly things started to tweet out of alignment. My first advice to you is check your alignment, make sure something isn't out of wack, slow speed crashes do more damage than you think. I've been through a lot of physical therapy, but my chiropractor has been the best help, he checks the alignment and helps me address all the little core muscles that need to function correctly to help deliver power to the big cycling muscles. I also have custom insole, as one leg is 3mm longer than the other, but pilates has been the best thing for me, outside of getting a proper bike fit.

For me, pilates has been a game changer, it focuses on all the little core muscles that whole the big muscles together, lower abdominal, oblique abdominal, gluteus minimus, gluteus medius, spine stretching and chest expansion to get out of the hunched over position.

If you decide to try this, please take a few classes with a certified instructor, so they can show you proper techniques, and they will be able to pin-point the key weak areas and you can build those areas up, so you can get back into tiptop cross performance.

Good luck Erik, back pain SUCKs, but fix it now, even if that means forgoing a season, your body and family will love you, when your out there killing it at age 90!

Cheers
Norrene

John Wilger
October 19, 2018 at 8:22 AM
I'm no medical professional or athletic trainer, so someone with more
experience there can feel free to tell me I'm full of it, but here's my
*own* experience with this. Obviously no two people are the same, so what
works for one person may not work for the next even if we have similar
symptoms. In my case (and keeping in mind this is only my second season
racing cyclocross), while the core exercises, stretching, and foam rolling
helped, they weren't quite sufficient; I thought I was just going to have
to deal with it forever. Pretty much identical sounding symptoms�I'd be
fine at the start, but then my lower back (my erector spinae in particular,
it seemed) would start to feel so sore and crampy that every pedal stroke
hurt and my power just dropped to the floor.

This season I started hitting the weight room, mostly starting to prep for
road/crit racing next year, since cyclocross is more my off-season,
fun-biking jam. While core strength is certainly part of what I work on,
the thing that I've added is good old-fashioned squats (and similar) with
both free weights and the leg press and hack squat machines. And just this
last week I had my first cross race where I had *no* lower back pain at
all. My *guess* (again, someone with actual training in this stuff would
know better) is that the free weight squats have made the biggest
difference, since they are going to not only strengthen but also teach you
main movers and your core stability muscles to work together in order to
lay down power in a motion very similar to pedaling.

On Fri, Oct 19, 2018 at 2:08 AM Erik Hammerquist via OBRA <
obra@list.obra.org> wrote:

> Wondering if anyone has any secrets that I haven't already done or thought
> of to cure or at least manage lower back pain. Here's my symptoms: tight
> dull pain in low back (feels muscular) after about lap 2, loss of power and
> snap with the pain, almost never have pain off the bike. Here's what I've
> tried/am currently doing to fix it with little success: core stability work
> (could probably be stronger still), stretching with emphasis on posterior
> chain, numerous bike fits, custom insoles, and played around with crank
> length. I have the same pain occasionally on the road, but its manageable
> and usually doesnt hurt my power.
> Thanks!
> _______________________________________________
> OBRA mailing list
> obra@list.obra.org
> http://list.obra.org/mailman/listinfo/obra
> Unsubscribe: obra-unsubscribe@list.obra.org
>

--
John Wilger | +1 (971) 678-0999 | http://johnwilger.com

Erik Hammerquist
October 18, 2018 at 6:47 PM
Wondering if anyone has any secrets that I haven't already done or thought of to cure or at least manage lower back pain. Here's my symptoms: tight dull pain in low back (feels muscular) after about lap 2, loss of power and snap with the pain, almost never have pain off the bike. Here's what I've tried/am currently doing to fix it with little success: core stability work (could probably be stronger still), stretching with emphasis on posterior chain, numerous bike fits, custom insoles, and played around with crank length. I have the same pain occasionally on the road, but its manageable and usually doesnt hurt my power.
Thanks!

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Norrene Godfrey

2018-10-19

Hi Erik,

I have (had) all the same pain symptoms as you; when I really need to go hard, my right lower back would send shooting pain through my body and would get more and more intense the longer I stayed in maximum power output.

I lived with the pain for the last 6 years and finally retired from racing this year BUT I found things that have been working for my back and while I have not gotten on my bike to go hard, yet, I can get out of bed or off the couch without hurting.

My back problem stemmed from a crash some 12-13 years ago where I landed hard on my right hip, but didn't get it checked out, because, well, you know, cyclist are tough, so slowly things started to tweet out of alignment. My first advice to you is check your alignment, make sure something isn't out of wack, slow speed crashes do more damage than you think. I've been through a lot of physical therapy, but my chiropractor has been the best help, he checks the alignment and helps me address all the little core muscles that need to function correctly to help deliver power to the big cycling muscles. I also have custom insole, as one leg is 3mm longer than the other, but pilates has been the best thing for me, outside of getting a proper bike fit.

For me, pilates has been a game changer, it focuses on all the little core muscles that whole the big muscles together, lower abdominal, oblique abdominal, gluteus minimus, gluteus medius, spine stretching and chest expansion to get out of the hunched over position.

If you decide to try this, please take a few classes with a certified instructor, so they can show you proper techniques, and they will be able to pin-point the key weak areas and you can build those areas up, so you can get back into tiptop cross performance.

Good luck Erik, back pain SUCKs, but fix it now, even if that means forgoing a season, your body and family will love you, when your out there killing it at age 90!

Cheers
Norrene

John Wilger
October 19, 2018 at 8:22 AM
I'm no medical professional or athletic trainer, so someone with more

experience there can feel free to tell me I'm full of it, but here's my

*own* experience with this. Obviously no two people are the same, so what
works for one person may not work for the next even if we have similar

symptoms. In my case (and keeping in mind this is only my second season

racing cyclocross), while the core exercises, stretching, and foam rolling
helped, they weren't quite sufficient; I thought I was just going to have
to deal with it forever. Pretty much identical sounding symptoms���I'd be
fine at the start, but then my lower back (my erector spinae in particular,
it seemed) would start to feel so sore and crampy that every pedal stroke
hurt and my power just dropped to the floor.

This season I started hitting the weight room, mostly starting to prep for
road/crit racing next year, since cyclocross is more my off-season,
fun-biking jam. While core strength is certainly part of what I work on,
the thing that I've added is good old-fashioned squats (and similar) with
both free weights and the leg press and hack squat machines. And just this
last week I had my first cross race where I had *no* lower back pain at

all. My *guess* (again, someone with actual training in this stuff would
know better) is that the free weight squats have made the biggest
difference, since they are going to not only strengthen but also teach you
main movers and your core stability muscles to work together in order to
lay down power in a motion very similar to pedaling.

On Fri, Oct 19, 2018 at 2:08 AM Erik Hammerquist via OBRA <
obra@list.obra.org> wrote:

> Wondering if anyone has any secrets that I haven't already done or thought
> of to cure or at least manage lower back pain. Here's my symptoms: tight
> dull pain in low back (feels muscular) after about lap 2, loss of power and
> snap with the pain, almost never have pain off the bike. Here's what I've
> tried/am currently doing to fix it with little success: core stability work
> (could probably be stronger still), stretching with emphasis on posterior
> chain, numerous bike fits, custom insoles, and played around with crank
> length. I have the same pain occasionally on the road, but its manageable
> and usually doesnt hurt my power.
> Thanks!
> _______________________________________________
> OBRA mailing list
> obra@list.obra.org
> http://list.obra.org/mailman/listinfo/obra
> Unsubscribe: obra-unsubscribe@list.obra.org
>

--
John Wilger | +1 (971) 678-0999 | http://johnwilger.com

Erik Hammerquist
October 18, 2018 at 6:47 PM
Wondering if anyone has any secrets that I haven't already done or thought of to cure or at least manage lower back pain. Here's my symptoms: tight dull pain in low back (feels muscular) after about lap 2, loss of power and snap with the pain, almost never have pain off the bike. Here's what I've tried/am currently doing to fix it with little success: core stability work (could probably be stronger still), stretching with emphasis on posterior chain, numerous bike fits, custom insoles, and played around with crank length. I have the same pain occasionally on the road, but its manageable and usually doesnt hurt my power.
Thanks!


Mark Hand

2018-10-19

I highly recommend seeing a physical therapist who is also a bike fitter. We see issues with riders in their backs, knees, hands/wrists, etc, who after being looked at by a professional physical therapist and then fitted properly for their specific bike have very quick relief to their pain issues. Beyond the fitting, the physical therapist will work with you to strengthen the areas of your body and provide you exercises and routine to make the body changes more lasting. We recommend PDX Bodyworks Physical Therapy (https://pdxbodyworkspt.com/). They are located on NE Broadway, near Lloyd Center.


John Wilger

2018-10-19

I'm no medical professional or athletic trainer, so someone with more
experience there can feel free to tell me I'm full of it, but here's my
*own* experience with this. Obviously no two people are the same, so what
works for one person may not work for the next even if we have similar
symptoms. In my case (and keeping in mind this is only my second season
racing cyclocross), while the core exercises, stretching, and foam rolling
helped, they weren't quite sufficient; I thought I was just going to have
to deal with it forever. Pretty much identical sounding symptoms—I'd be
fine at the start, but then my lower back (my erector spinae in particular,
it seemed) would start to feel so sore and crampy that every pedal stroke
hurt and my power just dropped to the floor.

This season I started hitting the weight room, mostly starting to prep for
road/crit racing next year, since cyclocross is more my off-season,
fun-biking jam. While core strength is certainly part of what I work on,
the thing that I've added is good old-fashioned squats (and similar) with
both free weights and the leg press and hack squat machines. And just this
last week I had my first cross race where I had *no* lower back pain at
all. My *guess* (again, someone with actual training in this stuff would
know better) is that the free weight squats have made the biggest
difference, since they are going to not only strengthen but also teach you
main movers and your core stability muscles to work together in order to
lay down power in a motion very similar to pedaling.

On Fri, Oct 19, 2018 at 2:08 AM Erik Hammerquist via OBRA <
obra@list.obra.org> wrote:

> Wondering if anyone has any secrets that I haven't already done or thought
> of to cure or at least manage lower back pain. Here's my symptoms: tight
> dull pain in low back (feels muscular) after about lap 2, loss of power and
> snap with the pain, almost never have pain off the bike. Here's what I've
> tried/am currently doing to fix it with little success: core stability work
> (could probably be stronger still), stretching with emphasis on posterior
> chain, numerous bike fits, custom insoles, and played around with crank
> length. I have the same pain occasionally on the road, but its manageable
> and usually doesnt hurt my power.
> Thanks!
> _______________________________________________
> OBRA mailing list
> obra@list.obra.org
> http://list.obra.org/mailman/listinfo/obra
> Unsubscribe: obra-unsubscribe@list.obra.org
>

--
John Wilger | +1 (971) 678-0999 | http://johnwilger.com


Erik Hammerquist

2018-10-19

Wondering if anyone has any secrets that I haven't already done or thought of to cure or at least manage lower back pain. Here's my symptoms: tight dull pain in low back (feels muscular) after about lap 2, loss of power and snap with the pain, almost never have pain off the bike. Here's what I've tried/am currently doing to fix it with little success: core stability work (could probably be stronger still), stretching with emphasis on posterior chain, numerous bike fits, custom insoles, and played around with crank length. I have the same pain occasionally on the road, but its manageable and usually doesnt hurt my power.
Thanks!