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THE LOWER BACK COMPLEX

Lumbar Spine: it is made of 5 large vertebrae with an intervertebral disc in between. The lower part sits on the sacrum which is part of the pelvis and the upper part links to the thoracic spine. Even though we divide the spine in regions that have specific characteristics, the spine is one continuous element with each region influencing the area above and below. The lumbar spine is well designed to perform motions like flexion, extension and side bending.

Core Muscles: it consists of a series of muscles surrounding the lumbar spine and spine in general.

If we compare your core to a cylinder, the front and sides of it are made by the abdominal muscles. We have several layers of them and each layer has a different function in regards to creating stability.

The backside of the cylinder is made of the erector spinae and the multifidus. The multifidus sits deepest and closest to the spine. It is a major stabilitizer. The erector spinae run from the sacrum to the base of the skull. Together they will resist flexion or bending. We also have the quadratus lumborum linking the lower rib, vertebrae and pelvis. This muscle is also important in resisting sidebending.

Finally the top of the cylinder is made of the diaphragm which we use to breathe but also to create stability. The bottom is made of the pelvic floor and also helps create stability.

Hips: our hips are the joints that connect the lower extremities to the pelvis and the pelvis acts as a base for the spine just like a triangle. We need enough hip mobility and stability to maintain that base stable and avoid compensation in the lumbar spine. Just like a house needs a sturdy foundation, so does our spine to be healthy.

The hips can move in all 3 planes of motions and as result have lots of muscles surrounding them to ensure stability and power development.

Thoracic Spine: it sits directly on top of the lumbar spine and runs to the base of the neck. It is made of 12 vertebrae and each one of those vertebrae attaches to the corresponding rib on either side. Its main functions are to give an anchor in the back for the ribcage and thus is important for breathing and it is built to rotate during movements.

Hip Extension: that is the ability to bring your back while maintaining a neutral spine. We do not have much but it is very important for bipedal use. It is generated by the gluteus maximus and tends to be restricted by your hip flexors (iliopsoas and rectus femoris).

Cycling as a sport almost never requires full hip extension. It can lead to shortening of the hip flexors which prevent us from achieving full hip extension. As a result, we begin to rely on lumbar extension to stand upright or walk. This is how cycling may lead to pain/discomfort in daily life and yet no pain while riding.

Hip Flexion: it is the ability to bring your thigh toward your chest. It is important to have enough especially in dissociation, that is raising one thigh up while the other stays down. When we lack this motion in cycling, we usually compensate by flexing and rotating our lumbar spine more which we know is a risk factor for low back pain.

Thoracic Rotation: it is the ability of each vertebrae to rotate on top of one another to produce a rotation movement such as looking behind you. In contrast to the lumbar spine, which is well suited for flexion, extension, and side bending, the thoracic spine is more suited for rotation. If not enough rotation is available in the thoracic spine, we will often compensate by trying to rotate in the lumbar spine. Over time this can lead to pain and discomfort.

Hip Rotation: it is the ability to rotate your hip inward or outward. While we do not use or need much hip rotation in cycling as both our feet tend to be attached or at least staying put on pedals, we do need a certain amount to carry out daily activities and perform a bunch of performance enhancing exercises such as squatting, lunging, etc. Since cycling does not challenge hip rotation much, it may lead to reduced hip rotation which we often compensate for by trying to rotate the lumbar spine. Since it is not designed to do so, it may lead to pain or discomfort in the low back.

Loss of Hip Extension

As mentioned prior in this presentation, cycling does not make use of full hip extension. When cycling is our primary sport and we do not do anything to counteract all the hours spent in the saddle, we can easily lose some of that hip extension. We may not notice it while on the bike but it will affect us off the bike especially when standing, walking, running. In those activities, we require full hip extension and when we lack it, we will usually use some low back extension in order to perform them. It can lead to low back irritation and pain.

The tissues often responsible for limitations are going to be your hip flexors such as your iliopsoas, rectus femoris and even your tensor fascia lata (TFL). In more severe cases, the joint itself can become stiff.

Loss of Hip Rotation

Just like hip extension, we do not use or need much hip rotation in cycling as both our feet tend to be attached or at least staying put on pedals. However, we do need a certain amount to carry out daily activities and perform a bunch of performance enhancing exercises such as squatting and lunging or any activities requiring a certain amount of hip rotation.  Since cycling does not challenge hip rotation much, it may lead to reduced hip rotation which we often compensate for by trying to rotate the lumbar spine. Since it is not designed to do so, it may lead to pain or discomfort in the low back.

C-shaped Spine Adaptation

Cycling usually involves long periods of time in spinal flexion, that is being over with our spine in a C-shaped position. Over time this may lead to a relaxation of the muscles and spine into this position to such an extent that it may become difficult to get out of it. If you have ever spent several hours cycling without much interruption and then found it difficult and even painful to stand up straight when first getting off your bike, this is exactly what we are talking about. 

A spine that does not move well into extension is a spine that will not remain healthy. When considering the thoracic spine, if you cannot get much extension, you automatically cannot rotate well so when performing activities requiring that motion such as twisting, we will try to make up for that lack of motion in the lumbar spine which is not well adapted to rotation. 

Now imagine if your hips also lack rotation. Potentially this can become a dire situation for the lumbar spine.

In this section, we will use movement assessments to help you better understand your movement capabilities. These tests will give you into your mobility and core stability - two primary factors in assessing your overall lower back health.

Equipment needed: Partner, floor space, phone with inclinometer app, chair or box

In this section, we’ll review exercises that will help you improve your overall movement and maintain the health of your lower back.

Equipment needed: Foam Roller, Floor Space, Chair, Superband for mobilization exercises