Low Back Pain Whilst Cycling?

Get sorted and take part in National Cycling Week this week!

Cycling is growing in popularity across the country and London is no exception. With improvements to the cycle superhighways and Boris Bikes available all over the city, it’s never been easier to get about by bike.  Cycling is an excellent form of exercise but it is not free from injuries. Back pain is a common complaint in cyclists, especially those new to the sport or those undertaking longer distances. To avoid being one of the many cyclists with back pain, consider these three points:

A close up of a set of handlebars showing the stem.

The stem, attaching the handlebars to the main frame can be altered for length and angle.

Cycling position – the sustained, flexed forward position during cycling can often be the culprit here and , especially if you are new to cycling, it may be worth avoiding a very flexed, aggressive cycling position (often adopted by professional cyclists to optimise aerodynamics) by ensuring that the handlebars are not too low. Small adjustments such as changing the stem height and length or rotation angle of the bars can help to adjust these aspects. It is always worth seeking advice of the best way to do this from a professional and taking pictures before and after to make sure the changes are suitable.





A person on a bike which is too big for her, potentially causing low back pain

The cyclist here is shown over reaching on a bike frame which is too large for her, causing her to lock out the elbows.

Handlebar reach – reaching too far forwards or having the handlebars too close can be another cause of back pain in cyclists. Test your reach by leaning the bike against a wall or ask a friend to hold the bike steady for you. Adopt your cycling position with your hands on the bars, or on the drops if you are using a road bike, then try to maintain this position of the trunk while you take your hands away. If you cannot maintain the position or feel strain in the back, it may be an indicator that the reach is too far for you. Again, stem length can be adjusted to shorten the reach or your saddle can be moved forwards or back, but it is worth consulting a professional to fit and adjust this for optimal positioning.




Fatigue – cycling can be very tiring and maintaining the flexed trunk position requires good trunk stability, adequate hip mobility and muscular strength and endurance. If you are adding in a cycling commute or starting to cycle as a hobby, start slowly by only commuting a few times a week or cycling only one way to work. At weekends, keep the bike rides shorter in distance and ensure you have plenty of breaks to allow you to get off the bike and move from the flexed over position. As your endurance and strength improve, you’ll be able to slowly increase the distance you cycle.

The research into cycling and low back pain remains quite sparse with most of the studies being of a poor quality. As with many sports, there is no single answer for everyone and it is vital to ensure the adjustments made are correct for you. Here at Central Health Physiotherapy, we offer 60 minute bicycle fitting sessions with our experienced clinicians at out St John’s Wood and Chancery Lane clinics. These provide a personalised bike fit for your body specific to your bike. For further information or to contact the clinics click here.

For more information about tips on general cycling fitness, see our cycling blog, or read all about the importance of seat height here.



Visentini, P., 2017. A systematic review of parameters related to cycling overuse injuries or pain. Journal of Science and Medicine in Sport, 20, pp.e69-e70.

Streisfeld, G.M., Bartoszek, C., Creran, E., Inge, B., McShane, M.D. and Johnston, T., 2017. Relationship between body positioning, muscle activity, and spinal kinematics in cyclists with and without low back pain: a systematic review. Sports health, 9(1), pp.75-79.

Marsden, M., 2010. Lower back pain in cyclists: a review of epidemiology, pathomechanics and risk factors: review article. International SportMed Journal, 11(1), pp.216-225.


Posted in Cycling, Back, Injury Prevention and tagged , , .

Jenny Sharpe

Jenny Sharpe is a musculoskeletal physiotherapist with Central Health Physiotherapy, specialising in MSK conditions (spinal and peripheral), sports injury and post operative management and rehabilitation. She has also been the physiotherapist for several national sports teams.

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