Q & A Back Pain

I am getting back pain when cycling, what is causing this, and can I do anything to improve it?

Lower back pain can have a number of causes. In cyclists it is usually a combination of factors, including:

Top tube of frame / stem / reach on handlebars too long (common with ladies riding gents bikes, as the proportion of torso and arm length compared to leg length in women is different to that in men. For equivalent height, women's legs are typically longer.)

Tendency to try and "push" too high a gear, rather than spin a lower one.
Having the saddle sloping forward, rather than flat: ladies and for some bizarre reason Triathletes tend to do this. It puts strain on the whole back, but the lower back and upper arms particularly. In the case of female riders, it is usually done to relieve pressure on the crotch. The Terry saddle should help solve this problem, but do check your saddle height too: If your saddle is sloped down by the nose to relieve pressure, your saddle height may be set too high.
Lack of flexibility in the calves / hamstrings / gluteals and piriformis muscle groups. There are some good stretches for these that will help no end. Problems tend to come from here because if the muscles of the buttock and back of the leg are not flexible enough, the only flexibility in the whole back comes from the sacral and lumber vertebrae. These are being pulled apart, and the muscles that support them are fighting to keep them together: the end result is a deep, persistent ache that usually appears after about an hour on the bike, and disappears about ten minutes or so after you get off.
Cold back - Again, ladies tend to suffer because in general, the bust gets in the way of wearing bib shorts or tights, and for reasons known only to the manufacturers, many "Ladies Cut" shorts have a low back, and many "Ladies Cut" jerseys are too short at the back: The end result is that the lower back gets chilled, and eventually starts to ache - lack of flexibility again.
One leg of dissimilar length to, or one leg stronger than, the other. No, I'm not accusing anyone of being an understudy for Quasimodo, but many people have legs that have either grown to different lengths (me amongst them), or they have broken a leg and they have healed that way. This means that the back is twisted on the bike, and again, the lower back suffers the brunt of it.

There are still more problems that can cause chronic or acute back pain, but the above covers most of the common ones. So - solutions:

It is well worth being measured on a "Bio Racer" or similar system. The results give a reasonable, though not absolutely "Gospel", indication of saddle height, top tube length, stem length, reach required in the handlebars, positioning "fore and aft" of the saddle, and of crank length. Unless the client is a very odd shape indeed, it is usually possible to adapt an "off the peg" frame to the rider by careful selection of bars, stem, saddle, seat-posts and cranks. Before you sell your bike and change your riding position though, make sure that you record your existing position. The reason for this is that if you change suddenly to a riding position different to that to which your body has become accustomed, you may find yourself in greater discomfort than when you started!
Use toe clips or a clipless system to attach your feet to the pedals, and concentrate on a fast, smooth pedalling motion. Most riders pedal at about 70-80 RPM. It is far more efficient to pedal at 90-100RPM, and places far less strain on all of the muscle and connective tissue systems concerned. It is far more efficient for both hill climbing and acceleration. It also has considerable benefits as far as Cardiovascular fitness is concerned, and is highly beneficial in improving the return supply of blood from the lower limbs, so is wisely adopted by those who by genetics or medical practice are made susceptible to circulatory difficulties.
Check that your saddle is parallel to the floor. If it slopes down, raise the nose, and check your saddle height. A rule of thumb to set saddle height for a rider using a rigid "Racing" type shoe is to stand straight with your back against the wall, feet about 12" apart. Get a partner to slide a thick book up into your crotch, with the spine against your body, and the edge of the book against the wall, so that the spine of the book is at 90 degrees to the wall. When the pressure on your crotch is roughly that of sitting in the saddle, step carefully away from the wall, without moving the book. Measure from floor to the spine of the book, divide this by 100 and multiply by 109. (Don't ask me why this works - it just does!) This will be the distance from the flat of your lower pedal, to the lowest part of the top of your saddle, when your cranks are in line with the seat tube. (i.e. almost vertical). Remember to alter your saddle height, whether it is up or down by no more than 2mm per 100 miles ridden - it may take some time to achieve the correct height if your saddle is currently at the wrong height, but it will prevent further damage or injury. When I was a lad (dim mists of time, etc..), at National Youth Week, Norman Sheil, who was then National Junior Coach, measured all of our saddle heights. Out of 20-odd riders, he found only three at the "right" height - and we all thought we knew what we were doing! As a quick check on saddle height, when you are pedalling, your hips should not "rock" from side to side - they will if your saddle is too high, and to a lesser extent, if it is too low.
OK, flexibility. This is going to be fun without pictures! The general rules of stretching first - all movements are slow and gentle. Don't "bounce" to increase the stretch - you won't, and you may damage connective tissues or muscle. Stretching should be done after a (very) light warm up so that all the tissues are supple - maybe ten minutes or so on the bike. Stretching, when you are doing it, is mildly uncomfortable - but it shouldn't be excruciating! Relax and breath out as you increase the stretch, but don't hold your breath. Tension in one part of the body transfers to other parts of the body in unexpected ways. To stretch the calves, simply bend from the waist, with your knees locked straight, to touch the floor with your hands. If you need to increase the stretch, try crossing your legs so that your feet lay next to each other, and the back of one knee is against the front of the other. This is an OK stretch for the rest of the muscles under discussion, too, but needs augmenting. Average for females is being able to touch the floor. Good is palms on the floor, excellent is head against the knees! (Men seem generally less supple. Again, I don't know why, it is just my observation). The augmenting stretches are first, the hurdle position, and second the piriformis stretch. The hurdle is to sit with one leg stretched out in front of you, back of knee against the floor, foot relaxed. The other leg can be bent so that the sole of the foot lays down the inside thigh of the right leg, with the outside of the knee joint close to, or on the floor, or it can be simply flexed out to the side - whichever you find more comfortable. Breath out, and slide your fingertips down the outstretched leg, trying to reach as far down your leg with your nose as you can. Don't just try and touch your head or face to the knee, as this curves the back - hence, "follow your nose" to keep the back straight. As with the standing stretch, hold the stretch at its max for five seconds or so, and gradually release. Repeat several times for each leg. The last stretch is not going to be easy to describe, but here goes: lay on your back, knees bent and slightly apart. Take one lag, bend it and cross over the other, so that the ankle bone of the crossing leg is resting just above the knee of the leg that you haven't moved. Place a hand behind the thigh of the leg that you haven't moved, and pull it gently towards you, lifting the foot off the floor. This will push the ankle of the crossing leg towards you - elegance was not considered when devising this stretch, believe me! Place your free hand gently against the knee of the crossing leg, and prevent it from coming towards you, so maximising the stretch that you will feel deep in the buttocks. Repeat having held for five beats, then change legs. Do the routine a few times. I would recommend doing the stretches in this order, too. Especially in the case of the last one - DON'T force it - you are opening the hip joint, and twisting the knee joint - it's absolutely safe, so long as you have no discomfort in either of these areas, but if you have any doubt, stop, and get a physio to work with you on this one.
Cold back - try to find a bib tight/short that you can wear, and ditto, check the length of the back of garments - crop tops are my pet hate in this area. Why do so many clothing manufacturers make them for on-the-bike use? Leg lengths - difficult to self diagnose, but any good sports physio or masseur can help. You need to have a good massage and/or stretch prior to being checked over, because tight connective tissue can skew the results. If there are differences of more than 5mm or so, you may have a small, but not insurmountable problem. Remedies are usually orthotic insoles in shoes, a small build up under the shoe-plate if you are using them on the bike, and a regular stretching regime to minimise any muscular problems that might be exacerbating the problem. The build-ups or orthotics, by the way, are scarcely noticeable, usually less than half the leg length difference, but they make a tremendous difference. I speak from experience!