Long Term Back Pain

Hi all,

There are a lot of posts on here about back pain and I don’t mean to add to the noise, but I haven’t seen anything that fits my situation precisely. For the last few years I’ve had a consistent problem with low back pain, dead center, right at the bottom of the lumbar, just above the sacrum. It’s bad enough that I usually back way off on the intensity, and sometimes end up walking up steep singletrack climbs.
It almost never bothers me on the road bike, even on higher intensity, 3+ hour rides. It almost always shows up on mtb rides, usually after only 30-40 minutes or so. And it occasionally bothers me on gravel/cyclocross rides. Because of this, I think it has something to do with the jackhammer effect of singletrack (my mtn bike is a hardtail). Also, a couple years back I spent five days riding in Fruita on a rented full-suspension bike and my back was great. But I should say that steep, sustained, dirt climbs also seem to contribute to the pain (might be a gearing issue since I’m forced into a much lower cadence than I’d like, <75rpm).
So it seems the best solution would be to just go full-suspension but it’s not financially in the cards for the near future.
As the back pain got worse over the last couple years I’ve added various things to combat it, which have all helped, but nothing has completely solved the problem. I see a sports massage therapist once a month and she spends a lot of time on all of my hip attachments and muscles (on the theory that my glutes, hams, etc are too tight for my low back muscles and so pull my hips into a nasty configuration). I stretch after every ride, again paying attention to hip attachments and mobility. I stretch and use a foam roller after strength work (1-2 times per week). I’ve also been doing martial arts for 15+ years, which I would think might help balance out the one-dimensional nature of cycling movements.

Any and all suggestions welcome. The back pain effectively limits my mtb rides to an hour or less, which is super frustrating. Please help!

Dude have you gone to an actual doctor? You could have a serious malfunction.
As a practitioner of back pain management, I can say there’s only so much you can accomplish when confronted with a mechanical issue in your spine.

Not an expert here but have experienced something similar, a few suggestions to try:

  1. Strengthen the crap out of that area. Look up Foundation Training, I’ve tried a bunch of stuff and this had the most immediate effect https://www.youtube.com/watch?v=vOgxWp0WyiI . Also try this, it is surprisingly hard to do but doing this consistently at least once a day over time it made a huge difference in my spinal cord flexibility and core strength. https://www.youtube.com/watch?v=GfBbiiFMVnc

  2. Ride out of the saddle more. This both relieves the hits on the back and strengthens the core

  3. Stand up whenever there’s a chance you’re going to take a good hit, even just transferring more weight into the legs or barely hovering over the seat momentarily when you’re rolling over some rough stuff makes a big difference

I think what’s going on at least with me is I have some prior injuries that I didn’t really pay attention to (compromised disc) and it simply needs to be protected. Having very good bone alignment and muscle tone around the area helps a ton to protect the back. So my solution is to make sure my mobility is top notch, my core strength is all that, and my posture is great. For example I don’t have a chair at work at all, 100% standing desk on a Whirly Board.

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I have this too. I get it when hammering on the CX bike, also get it on the 120/115 MTB after about 90-minutes. I’ve been stretching and when it feels better I’ll try some gym work, hopefully it will get better next season.

No doctor yet, but that might be the next step. Since the issue is mainly on the mtn bike and pretty much every other physical activity I do is fine I was hoping to, you know, skate on. But that could be foolish.

Great, thanks for the videos! They look helpful, I’m going to start them today. And the out-of-the-saddle advice is good too – I’ve noticed that the more of it I do the less irritated the back gets.

I thought of a few other things… You have a dropper seat post? Even standing up I think some hits aren’t avoidable without slowing down a lot (and in some steep sections not at all) without it. Tire pressure and size. On a hardtail, a bigger rear tire at lower pressure does help soften the hits. If you’re not good at a pump track, spend some time there – sometimes it is more efficient to stand up and pump a section vs. sitting and pedaling.

Do you sit a lot for your job or commuting? Do you do any core/strength work?

I solved all of my back and neck issues when I discovered the concept of muscle imbalance. 10 minutes a day of strength and stretching has kept me pain free for a few years now and that is with 6-13 hours a week on the bike all year.

Lower crossed syndrome is the basic imbalance for the back. Look for other videos/web sites as to which exercises to do. A really good sports medicine doc would know about this stuff. Regular docs will just go straight to muscle relaxants and pain killers or PT. It’s even hit or miss with PTs on whether they know this stuff.

This imbalance can be exacerbated by cycling because we end up with over developed quads. Hitting the posterior chain with weights can also help.

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Yep the lower back overall problems are often linked to systemic postural issues like super short hip flexors (that basically yank on the lower spine from the inside). Couch stretches (brutal, look it up) help for such things. It isn’t really that difficult to grasp the body mechanics on how the whole posterior chain is linked together, it’s a pretty simple mechanical system that will do just about anything to keep its functionality short term, with sometimes very poor long term outcomes.

Kelly Starrett’s Supple Leopard book is the best resource on this subject I know of, but you can piece it together from youtube videos and such.

I have a herniated disc in my lower back. Sneezing used to cause it to seize up and I’d be stiff for a week. I started rock climbing again (5 years ago) and it really really helped. That said, a consistent core workout is the one thing that I recommend.
I’d try a simple 5 minute core workout every day or couple days. Lots of them on YouTube. Worked wonders for me. Sneeze with ease.

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Over the last 4 years I’ve had constant discomfort and sometimes hard pains not only in lower back but in general in all my spine upto the neck. About 2 months ago I’ve started doing coach Chad core strength exercises and after those I streach my back using in some exercises a foam roller. I’ve noticed some big improvements. My back is not hammering me all day long anymore. Only some ocasional smal disconfort due to posture while working at my office desk.
This improvement may also be related to the changes I’ve made in my nutrition over the last semester of 2019. Going almost exclusively on a vegan diet that clames to decrease tissue and nerves inflammation when compared to eating a lot of meat and other animal proteins has I did before.

I don’t know exactly which change has contributed the most but I’ll keep on betting on this two fields nutrition and exercises.

Hope your problem can be solved either way without needing a cirurgicall intervention. Both my orthopedic doctor and my osteopathic doctor haven’t been able so far of solving my problem.

No dropper, but I do stick with some larger tires (29x4), more as an attempt to make up for my lack of skill descending. But they the low back for sure, a friend of mine talked me into some 29x2.2s for an XC race and I had a bad time.
Pump track’s a good idea. I moved to a new town last summer that has a skills course and I’m amazed at the difference some work there can make. Finally starting to learn how ride my mountain bike for real.

Have you tried a chiropractor? They have helped me.

I do sit a lot for work (I try to take frequent breaks to walk around but who knows how consistent that actually is), and I also do a fair amount of core work (weights and martial arts stuff). But given the stories from everyone here I’m starting to think I don’t do enough to strengthen the low back and posterior chain (because I basically do nothing for it except stretch).
I like the Starrett’s podcast a lot, I’m ordering his book today.

I’ve had low back pain on the bike for years and basic core work and stretching helped some. But i’m just getting to the end of a pretty intense 12 week weight lifting program and my back has never felt better. I was doing mostly lower body stuff (squats, leg press etc) plus the Foundation routine mentioned above and a ton of core work. I feel more comfortable on the bike than I have in years.

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Do you use a camelback on your mtb?

We do short videos on various topics related to pain. Your question inspired this one:

I have the same problem, but more advanced. I’ve been fighting with it on and off for 20 years. About 5 years ago I asked a sports medicine doctor about it and, rather than suggest any plan of action, he just ordered an x-ray. That’s something the paramedical practitioners don’t usually start with, but real doctors are keen on.

Turned out to be degenerative disc disease at L4/L5. That’s where it started, and it’s a pretty common problem in western populations that tend to overweight and sit a lot all day. After not really doing much about it for 17 years, it’s now facet joint syndrome. None of this is directly treatable; the tissues are gone and they don’t re-generate. So get an x-ray ASAP and someone who really knows what to look for when evaluating it. Get the images on media if you can; I did and it was very useful.

To ameliorate the problem, since it can’t be fixed, I almost always ride full suspension. A hard whack on my CX bike during training took me out for three weeks last year, so a hardtail is pretty much out. Techniques from Kelly Starrett’s “Supple Leopard” are the most helpful thing I’ve come across. The muscles back there will involuntarily contract to guard any spinal injury site, and they benefit from regular smash and floss maintenance.

That and regular core strength work (TVA, hip flexors, glutes) should keep me racing into my fifties at least.

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I use a camelbak on about one in five-ish rides. Since I’m usually only riding for about an hour, I can get away with bottles on the bike. Longer rides definitely have a camelbak, but they’re pretty rare.

I’ve had back surgery twice now and wrote the following up for someone who was asking about training after sciatica.
While it doesn’t sound like you have it, it’s a worthwhile read:

The biggest thing is 1) making sure you have the right fit, and 2) working mobility
They go hand in hand, and as mobility increases you should have your fit reassessed. Even since I wrote the original post i’ve been able to change some things due to increased mobility and better muscle activation.

Back pain is rarely due to the back itself. If your back is actually messed up you’re likely going to have leg issues (ie sciatica). Back pain is generally the result of muscle activation issues which causes some to tire before others and then all of that pulling into the muscles in your back which then fatigue and give you the “sore back” feeling. So when @TLRozzle was saying that they get pain hammering on CX bike I am very sure that’s muscle activation (likely glutes) not happening properly. Glutes tire, they in turn then start pulling on lower back muscles to pick up the slack…bam sore back. CX can do this because big power and slower cadence combined really can tire out your glutes quick if fit is not accurate.

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