It has been interesting to discover the most common aches and pains of various athletes. Hockey players always have hip problems. Crosffitters usually have shoulder and upper back pain. The most frequent complaint I receive from cyclists is low back pain.

More specifically, the pain usually comes from the quadratus lumborum (QL) which is a deep core muscle that connects the twelfth rib to the lumbar vertebrae and the top of the hip bone. It is so deep in fact that it really quite difficult to reach on your own; it is underneath several muscles that are too thick to get through. This is why rubbing your low back never seems to provide much relief. The primary functions of the QL are to side bend your body, hike one hip or the other, or extend or arch the back when both work together.

Understanding the anatomy of this muscle makes it much easier to understand why it hurts for many cyclists and then gives us clues as to how prevent that pain in the future.

When your back is neutral, the QL is in a neutral position as well, but when you are flexed and hunched over like you are when you ride, the QL is constantly stretched. There is nothing inherently wrong with stretching, but constant stretching for hours on end multiple times per week can lead to pain over time.

As a general rule, muscles are at their strongest in their neutral position. Too long is relatively weak and so is too short. This becomes important when we look at the hip hiking function of the QL. As I already mentioned, the QL is constantly stretched while riding, but if it is required to contract from this position to adjust the hips, it is subjected to tremendous amounts of strain. If in addition to adjusting the hips, your body starts oscillating side to side, you are just adding to the demands of a muscle that is in a very weak position and has been there for a long time.

In my opinion, those are the primary causes of low back pain in cyclists. A constantly lengthened QL from being on the bike for hours and then requiring demands on the muscle in that lengthened position.

So how do we fix it? There isn’t much to do about the poor posture as that is necessary for the cycling sport. I would advise frequent breaks to extend the back and allow the muscle to be in a more neutral position for a period. On slow easy rides, you might spend more time upright with an arched back to put it in in a more neutral position as well.

The biggest relief will likely come from working on the hips though. If your hips are working properly, it is unlikely that the QL will be called on to hike the hip during each pedal stroke. Removing this contraction demand from the stretched muscle should do wonders for preventing the low back pain. There are several ways to get this done. My favorite is sitting on the softball or lacrosse ball. Get either one and put it under one cheek and start rolling around. Play with different leg positions  on the side being worked. Try it with it crossed on the non-working leg, straight out, bent under the non-working leg and any other variation you can think of. If you find spots that hurt, you are probably in a good spot. Work on both hips every day if you suffer from regular low back pain. This will improve hip mobility and function and reduce the demands on the QL.

Reducing the lateral motion of the body while riding requires more focus during riding, but is important to relieving the strain on the QL as well. Focus on a still upper body as often as possible. This will improve performance as well as relieving the back pain because it is more efficient as well.

In my experience the best way to avoid low back pain in cyclists is to keep the QL in a neutral position as often as possible, improve hip function through self massage, and improve upper body efficiency while riding. These three things should make a huge difference in your comfort during your rides and when you get off the bike.

If these things still don’t provide relief, it is probably time to see a massage therapist. The QL is very difficult to reach on your own, but a massage therapist has ways of accessing and treating it. They can also do wonders for opening the hips and improving function there.