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Mountain Bikers: Protect Your Back!

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A study published in the International Journal of Sports Medicine found that 85 percent of 518 recreational cyclists reported one or more overuse injury. One of the most common sites of pain reported was the back (30.3%). Matthew T. Boes, MD, discusses the cause of back pain and how it is treated. The orhopaedic surgeon and sports medicine specialist at Raleigh Orthopaedic Clinic and team physician at North Carolina State University also advises who cyclists should see to treat pain and how it can be prevented in the following interview.  

About.com: What are some reasons cyclists may feel back pain when riding?
Dr. Boes: Mountain bikers are particularly susceptible to back pain due to prolonged positions that are required during rides. An aggravated and hunched position of the spine can promote spasm and irritation along the paraspinal muscles that control position and posture of the spine. During longer rides, the paraspinal muscles can become fatigued and deconditioned which can lead to pain and muscle spasm. The pain that is felt is usually not due to specific injury, so riders should not be overly concerned that pain is due to an underlying structural problem in the spine. As stated above, most pain is due to muscle fatigue and can be combated by an regular and focused stretching and exercise routine that can help strengthen muscles that are at risk.

About.com: If a cyclist experiences back pain, what is the first thing he/she should do?
Dr. Boes: When a cyclist experiences back pain, the first thing to consider is whether or not their symptoms are due to pain alone, or whether it involves radiating pain down to each or one of the legs. Achy pain in the low back is most likely due to muscle fatigue as described above, but pain radiating to one or both legs or any problems with numbness or weakness in the legs may be due to compression of the nerve roots in the lower spine that innervate the legs. Fortunately, nerve root compression is relatively rare in an active population such as regular mountain bikers, but if present, treatment should be rendered by a qualified spine specialist to rule out the chance of nerve root compression.

About.com: How is back pain treated?
Dr. Boes: Most back pain is initially treated with rest, avoidance of aggravating activities, and physical therapy exercises to help alleviate any muscle spasm and irritation.  Anti-inflammatory medication such as naproxen or ibubroen are often helpful if taken continuously for 7-10 days,  Icing after exercise and heat applied before exercise may also be helpful. Masssage therapy with attention to alleviating deep muscle spasm is very helpful in most back pain cases.

About.com: Who should a cyclist see to treat the pain? Why?
Dr. Boes: The majority of low back pain cases in cyclists can be treated by primary doctors, physical therapists, chiropractors or massage therapists. Again the goal is to alleviate muscle spasm that is usually at the root of most of the pain. The exception is the patient with sudden pain, numbness or tingling, weakness in the leg muscles or problems with bladder or bowel function - these patients are best treated by a qualified spine specialist - usually an orthopeadic spine doctor or neurosurgeon.

About.com: How can back pain be prevented?
Dr. Boes: The key to preventing back pain is to maintain a strong core and back as well as abdominal muscles. Most recreational athletes make the mistake that by assuming they are active in certain areas that they are maintaining good back and spine precautions. A certified personal trainer can be instrumental in instructing on a sound core and low back program that can be done at home and can prevent much low back discomfort that can occur in an active, athletic population. Take the time to utilize these exercises and incorporate them into your long-term training program and they can provide huge dividends in preventing injury and discomfort.

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