Cycling Pains - Back and Neck

Lower back pain is another common complaint on the bike. In a positional sense, the most frequent cause is too much seat setback or incorrect seat height. Having your bars too far away and having to “reach” forwards beyond your capabilities to stabilise the resulting position can create this issue as well. Another more complex and difficult to pick issue is poor on-bike stability which can have a multitude of causes – not all of them positional.

Here you can see a gentleman who is young, fit and strong with no obvious signs of instability off the bike, but who functions as you can see here. This is an extreme example of poor on-seat stability but is by no means the worst we’ve ever seen. It is easy to see how this fellow developed his back pain on the bike! Some good core strengthening work off the bike will usually moderate this “rock and roll” style over time, leading to happier backs and knees on the bike.

Unilateral lower back pain, structural injury aside, is usually caused by excessive dropping and rotating of one of your hips. Most commonly the right side hip will drop excessively and roll forwards during the downstroke, this can create right sided lumbar pain from excessive lateral flexion or, in some, left sided lower lumbar pain due to the repeated compressive forces acting on the left side. The same can be said about a left hip drop creating conversely orientated pains.

Neck pain is more simple and is usually caused by a lack of necessary functional extension in the neck whilst in the cycling position. We can alter the circumstances around which we develop neck pain by either increasing the capability of our necks to extend easily (which requires a lot of off-bike flexibility work) or by altering the position such that your neck and shoulders are sitting in a more natural, unloaded position. Thankfully, most neck pains are muscular in origin and there is often no damage associated with them, just muscular discomfort.

Shortening up the reach to your bars via a shorter stem, or lifting the stem further up the steering tube is the most common improvement we will make to lessen this problem. Bearing too much weight via your upper body and arms can cause neck and upper back pain as well, rather than forcing the neck into end of range extension. Correcting your seat setback and reach to the bars is important not only to unload the upper body musculature from a pain perspective, but by disengaging these muscles you will free up bloodflow and oxygen delivery to be pushed towards the more important areas – your legs.