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Recreational Cyclists: The Relationship Between Low Back Pain and Training Characteristics

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Abstract

This study investigated the relationship between low back pain (LBP) and training characteristics in recreational cyclists. Purposive sampling was used to recruit sixty-six recreational cyclists from nine cycling clubs. Participants completed a survey reporting training characteristics and LBP behaviour during a usual week of cycling. This included percent of time spent cycling in three common riding positions, cycling terrain, average cycling pace, number of gears, days per week cycled and number of cycling events per year. Fifty percent reported LBP during or after cycling or smoking and LBP. Cyclists who reported LBP cycled significantly further in a usual week of cycling than cyclists who did not report LBP (p=0.022). An odds ratio indicated that people who cycle 160 km or more per week are 3.6 times as likely to experience LBP compared with people who cycle less than 160 km per week (OR=3.6, CI=1.29-10.15). Preference for riding with the hands on the brakes approached significance with respect to LBP reports (p=0.06). No other significant relationship between LBP and training characteristics was identified. In order to reduce the risk of LBP recreational cyclists who report LBP should consider decreasing cycling distance to less than 160 km per week.
Original Research
Recreational cyclists: The relationship between low back pain and
training characteristics
SAMANTHA J. SCHULTZ* and SUSAN J. GORDON‡
School of Public Health, Tropical Medicine and Rehabilitation Sciences, James
Cook University, Townsville, Australia. susan.gordon2@jcu.edu.au
*Denotes undergraduate student authorDenotes professional author
ABSTRACT
Int J Exerc Sci 3(3): 79-85, 2010. This study investigated the relationship between low back pain
(LBP) and training characteristics in recreational cyclists. Purposive sampling was used to recruit
sixty-six recreational cyclists from nine cycling clubs. Participants completed a survey reporting
training characteristics and LBP behaviour during a usual week of cycling. This included percent
of time spent cycling in three common riding positions, cycling terrain, average cycling pace,
number of gears, days per week cycled and number of cycling events per year. Fifty percent
reported LBP during or after cycling or smoking and LBP. Cyclists who reported LBP cycled
significantly further in a usual week of cycling than cyclists who did not report LBP (p=0.022). An
odds ratio indicated that people who cycle 160 km or more per week are 3.6 times as likely to
experience LBP compared with people who cycle less than 160 km per week (OR=3.6, CI=1.29-
10.15). Preference for riding with the hands on the brakes approached significance with respect to
LBP reports (P=0.06). No other significant relationship between LBP and training characteristics
was identified. In order to reduce the risk of LBP recreational cyclists who report LBP should
consider decreasing cycling distance to less than 160 km per week.
KEY WORDS: Bicycling; injury prevention; cycling; low back pain.
INTRODUCTION
In Australia, cycling has increased in
popularity with approximately one million
people cycling for recreation, to work or to
destinations in inner cities (1). Although
cycling is a low impact activity, low back
pain (LBP) has been reported by 2.7-50% of
recreational cyclists (3,14,17).
It has been suggested that an extremely low
handlebar position (10) or riding in the
drop position, with the hands positioned on
the lowest part of the handlebars (14)
contributes to LBP in cyclists. Hence
suggestions to prevent LBP have been
made regarding handlebar height (15)
however no published studies have
examined the relationship between
handlebar height, riding position and
lumbar spine posture with respect to LBP.
Research investigating lumbar posture and
LBP in cyclists has provided two scenarios
in relation to symptom production. Salai et
al. (14) investigated pelvic tilt in cyclists
and found an inclination towards
hyperextension at the lumbo-pelvic
junction in those who reported LBP.
Intervention (N=40) by inclining the saddle
anteriorly by 10-15°, for six months,
resulted in greater flexion of the lumbar
spine on the pelvis and eradicated LBP in
72% of participants and reduced the
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frequency of LBP in 20% of participants
(14). Burnett et al. (2) recruited 18 subjects
to participate in a pilot study examining
whether differences in spinal kinematics
exist in cyclists with and without chronic
LBP. Spinal kinematics was calculated
using an electromagnetic tracking system
and abdominal and back muscle activity
was recorded with electromyography.
Subjects were requested to ride in one of
two different riding positions; being on the
drops or on the aero bars (similar to the
brake position with arms stretched further
forward). The results of this study
identified a trend toward increased flexion
and axial rotation of the lower lumbar spine
with a loss of co-contraction of the
multifidus muscle in nine cyclists with non-
specific chronic LBP (2). Furthermore,
increased upper lumbar spine rotation and
flexion was reported to be associated with
no back pain (2). However, these findings
were not statistically significant, possibly
due to the various cycling positions and
small sample size.
Additionally, it is a belief in the cycling
community that intensity, frequency and
duration of training may influence the
prevalence of non-traumatic injuries in
cyclists including reports of LBP (4).
However, a search of the literature using a
systematic approach identified only three
papers investigating overuse injuries,
including LBP, and training characteristics
in recreational cyclists. Of these, two
studies reported low prevalence of LBP in
cyclists, 2.7% (17) and 16% (7), with no
conclusions available regarding training
characteristics and LBP. Wilber et al. (18)
investigated overuse injuries including LBP
and training characteristics in recreational
cyclists from northern and southern
California. They reported that male cyclists
who cycled 104.4 miles per week (168
kilometres (km)) were significantly more
likely to report LBP than cyclists who
cycled 77.1 miles (124 km) per week
(p<0.05) (10). In addition, cyclists who
reported less number of gears on the cycle
(13 gears compared to 15 gears; p<0.05)
were significantly more likely to report
LBP. However, no significant relationship
between diet, education, cycling equipment
and attire, and hazards encountered when
cycling and LBP was identified. Other
factors, which may contribute to LBP,
include age related degeneration of lumbar
joints and discs (5,12) and a history of
cigarette smoking (8).
In the last decade bike design has advanced
and cyclists have adopted more
aerodynamic riding positions. Further the
increase in popularity of recreational
cycling and no available information in the
Australian context warrants investigation
of training characteristics in relation to LBP
in recreational cyclists. The current study
modified the survey of Wilber et al. (18) to
specifically investigate the relationship
between LBP and training characteristics in
recreational cyclists.
METHODS
Participants
Ethics approval for this study was granted
by the Human Research Ethics Committee
of James Cook University, Townsville.
Cyclists aged 18 years and over belonging
to regional and metropolitan cycling clubs
in Queensland were recruited by invitation.
Survey
A survey was used to collect demographic
information. It included questions from the
survey of Wilber et al. (18) and other
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81
questions considered pertinent to the aims
of this study: 1) Individual and training
characteristics (smoking history, years
cycling, kilometres cycled per week, days
cycled per week, cycling pace and number
of cycling events per year), 2) Type of
handlebars on the bike, 3) Number of gears
on the bike, 4) History of traumatic injury
to the lumbar spine in the past two years, 5)
LBP during or after cycling within the past
three or the past six months, 6) Any
referred symptoms related to LBP the
cyclist had experienced in the past six
months, 7) An estimate of the percent of
time spent cycling in different riding
positions and 8) The type of cycling terrain.
The survey was piloted with a group of six
cyclists for clarity and appropriateness of
the questions before a final survey was
produced and employed in the study (13).
Procedures-Data collection
An information letter and online survey
were distributed to cycle club members via
the cycle club’s website and monthly on-
line newsletter. Reminder e-mails was sent
one month after the initial survey
distribution. Information sheets inviting
cyclists to participate in the study were also
distributed during cycling events.
Voluntary return of the completed survey
constituted participant consent. Participants
were instructed to complete the survey
questions individually. In many instances
the survey provided participants with a
number of possible responses and
participants were asked to choose the
response that best described their
circumstance. For example when asked to
report the terrain in which they mostly
cycled participants were asked to choose
between ‘mostly hilly’, ‘mostly flat’ and
‘flat with rolling hills’
Procedures-Data management
For the purpose of this study, a recreational
cyclist was defined as any individual who
cycled regularly (at least once a week) and
did not participate in more than 50
organised cycling events per year. Low
back pain was defined as one or more
episodes of pain or discomfort in the area of
the low back, experienced during or after
cycling within the last three to six months
(18). Survey questions 9, 14 and 15 (see
Appendix A) allowed confirmation of
recreational and LBP status according to
these definitions. Questions 13 and 16
allowed identification of those who had
sustained a traumatic injury in the previous
two years resulting in LBP and/or known
lumbar spine pathology.
Statistical Analysis
Statistical analysis was completed using
Statistical Package for the Social Sciences
(SPSS) Version 16.0 (16). As the numeric
variables were non-parametric, median
values and standard deviations have been
presented. Mann-Whitney or chi-square
tests were performed to determine
significant differences between the training
characteristics of cyclists with and without
LBP. The level of significance was set at
P<0.05.
When significant differences were
identified logistic regression was
performed to adjust for potentially
confounding variables. Odds ratios (OR)
and confidence intervals (CI) were
performed to provide meaningful
interpretation of significant findings. When
the lower 95% CI of the OR exceeded 1 the
odds were significantly elevated, whereas
when the upper CI of the OR was less than
1, the odds were significantly protective.
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RESULTS
A total of 70 cyclists responded to the
survey (response rate of 20%). Four cyclists
were ineligible and therefore were excluded
from the study due to experiencing LBP as
a result of a traumatic accident in the
previous two years. Of the remaining 66
cyclists, 49 were male and 17 female.
Twenty-three male and 10 female cyclists
(Total N = 33) reported LBP during or after
cycling (non-traumatic) within the last six
months. Twenty-six males and seven
females (total = 33) reported no low back
pain (NLBP) during or after cycling.
Participant ages ranged from 18-61 y.
Initial analysis revealed no significant
relationship between LBP and NLBP
groups for age (P=0.967) and gender
(P=0.574). Further, as smoking has been
reported to contribute to LBP (8), analysis
was undertaken comparing smoking
history and those with and without LBP. Of
those participants with LBP, one cyclist
smoked, five had ceased and 27 had never
smoked. Similarly, in those with NLBP, one
cyclist was a smoker, six had ceased and 26
had never smoked. A Chi-square test
determined that there was no statistically
significant difference between LBP and
NLBP groups with respect to smoking
history (P=1.00).
As no statistical difference was identified
between age, gender and smoking history
in relation to LBP, further analysis of this
data set did not require stratification for
these variables. Response to questions
regarding training characteristics and LBP
and NLBP groups are summarized in
Tables 1 and 2. A significant difference was
found between the LBP and NLBP groups
for km cycled per week and riding with the
hands on the brakes approached
significance (P=0.06; Table 1).
Significant differences were identified in
the median km cycled per week for
participants with NLBP (150 ± 35 km, inter-
quartile range (IQR) =235) and for
participants with LBP (250 ± 131 km,
IQR=228) (P=0.02). Representation of self-
reported km cycled per week in Figure 1
indicates a change in LBP reports once
cyclists complete more than 160 km per
week. An odds ratio indicated that people
who cycle 160 km or more per week are
significantly more likely to experience LBP
compared with people who cycle less than
160 km per week (OR=3.6, CI =1.3-10.2). No
significant differences were evident
between LBP and NLBP groups for cycling
experience, cycling frequency, number of
gears on the cycle and riding position. A
post –hoc power calculation based on an
effect size of 0.63 (calculated according to
the presence or not of LBP) indicated that
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with this sample size the study achieved
greater than 74% power (13).
DISCUSSION
Australian recreational cyclists who report
cycling 160 or more km per week are
significantly more likely to report LBP. This
concurs with the findings of Wilber et
al. (18) that American recreational cyclists
who cycled an average of 104.4 miles per
week (168 km) were significantly more
likely to report LBP.
It has been suggested that sustaining one
riding position over a long duration,
pushing hard with big gears on the bike for
prolonged periods and prolonged climbing
of hills, gluteal, hamstring and back muscle
fatigue contributes to LBP in cyclists (11).
However, this study did not find a
statistically significant difference between
the number of gears on the cycle, riding
terrain or riding position and LBP reports.
Females are reported to be at greater risk of
spinal injury than males due to anatomical
differences in trunk muscle size as well as a
combination of trunk coactivity patterns (9).
This study did not find any significant
difference in training characteristics
between genders with respect to LBP
reports. Degeneration of the lumbar spine
in people aged 40 y and over has been
reported (5) and may possibly contribute to
the cyclists LBP as opposed to their training
characteristics. However, this study did not
find any significant relationship between
age and LBP. Future studies with a larger
sample may identify significant findings
between age, gender and LBP and training
characteristics of recreational cyclists.
However there are a number of the
variables, which were not considered in this
study or the study by Wilber et al. (18)
which may be potential confounders to the
findings regarding mileage cycled and
should be included in future research.
These include intensity of training,
anthropometric variables especially with
respect to bike set-up and favoured cycling
position at onset of LBP, which would be
best, investigated using a prospective
design.
Professional cyclists vary their training
frequency and intensity when preparing for
events. However, there is no evidence to
suggest that during an increased training
phase cyclists alter the proportion of time
they spend in each riding position. The
recreational cyclist may also vary training
frequency and intensity. It is possible that
some participants in this survey may have
experienced LBP within the last three
months while undergoing an intense
training period or they may have been in a
light training phase when survey data was
collected. While no relationship was
identified between frequency of cycling and
LBP, the speed and gear setting may
contribute to LBP and hence future studies
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84
should consider these parameters related to
intensity of cycling as possible confounders.
Recreational cyclists with LBP reported
more time riding on the brake levers (50%)
than those with NLBP (36.7%). In
comparison to upright and drops cycling
positions, riding on the brake levers results
in a mid position of the lumbar spine. It has
previously been suggested that end range
lumbar positions are the cause of LBP in
cyclists (2, 14) hence cyclists with LBP may
report a preference for the mid-position
brake lever position to unload the lumbar
spine and reduce their LBP. This study did
not set out to account for changes in riding
position as a consequence of developing
LBP while cycling. It is therefore unclear
from the survey data which cycling
position may have been linked to the initial
onset of LBP.
Geographic location did not allow the
investigators to measure the height and
weight of all survey respondents and self-
reports may be unreliable. Collection of
anthropometric data would have provided
further detail regarding the general health
of the cyclist. It would also have allowed
derivation of an indicator of obesity, such
as body mass index, and consideration of
the relationship between obesity and LBP
(6) in recreational cyclists. Additionally,
clarification of riding position related to
LBP would identify if cyclists who reported
experiencing LBP during or after cycling
had altered their riding position to relieve
their LBP. This additional information
should be collected in future studies
regarding risk factors for LBP in
recreational cyclists. A prospective study
investigating the riding positions of people
who commence cycling and subsequently
develop LBP may provide more
information on the relationship between
training characteristics and LBP in
recreational cyclists.
In summary, this study identified a
significant difference between self-reported
km cycled per week and LBP in recreational
cyclists. Those cyclists who reported riding
an average of 160 km or more per week
were significantly more likely, in fact 3.6
times more likely to report LBP than those
who rode less km. Agreement between this
study and that of Wilber et al. (18) indicate
that 160 km per week is a critical value in
preventing LBP in recreational cyclists.
Future research regarding the relationship
between LBP and training characteristics in
recreational cyclists should include
information about bike set-up, the training
phase of the cyclist and the cyclists’
anthropometric measurements.
ACKNOWLEDGEMENTS
No external funding or research contract was
involved in this study. The project was funded by
the Discipline of Physiotherapy, James Cook
University, Australia.
REFERENCES
1. ABS: 2008 year book Australia: sports and
physical recreation (Internet). Australia:
Australian Bureau of Statistics; cited 2008 Jun 10.
Available from: http://www.abs.gov.au
/Ausstats/abs. 2008.
2. Burnett AF, Cornelius MW, Dankaerts W,
O’Sullivan PB. Spinal kinematics and trunk
muscle activity in cyclists: a comparison
between healthy controls and non-specific
chronic low back pain subjects a pilot
investigation. Man Ther 9(1): 211-219, 2004.
3. Dannenberg AL, Needle S, Mullady D, Kolodner
KB. Predictors of injury among 1638 riders in a
recreational long-distance bicycle tour: cycle
across Maryland. Am J Sports Med 24(6): 747-
753, 1996.
CYCLING: LOW BACK PAIN AND TRAINING
International Journal of Exercise Science http://www.intjexersci.com
85
4. Dettori NJ, Norvell DC. Non-traumatic bicycle
injuries: a review of the literature. Sports Med
36(1): 7-18, 2006.
5. Fujiwara A, Tamia K, Yamato M, An HS,
Yoshida H, Saotome K et al. The relationship
between facet joint osteoarthritis and disc
degeneration of the lumbar spine: an MRI study.
Euro Spine J 8(5): 396-401, 1999.
6. Kaila-Kangas L, Leino-Arjas P, Riihimaki H,
Luukkonen R, Kirjonen J. Smoking and
overweight as predictors of hospitalization for
back disorders. Spine 28(16): 1860-1868, 2003.
7. Kulund DN, Brubaker CE. Injuries in the bike
centennial tour. Phys Sports Med 6(6): 74-78,
1978.
8. Leboeuf-Yde C. Smoking and low back pain: a
systematic literature review of 41 journal articles
reporting on 47 epidemiologic studies. Spine
24(14): 1463-1470, 1999.
9. Marras WS, Davis KG, Jorgensen M. Spine
loading as a function of gender. Spine 27(2):
2514-2520, 2002.
10. Mellion MB. Common cycling injuries:
management and prevention. Sports Med 11(1):
52-70, 1991.
11. Mellion MB. Neck and back pain in bicycling.
Clin Sports Med 13(1): 137-164, 1994.
12. Paajanen H, Erkintalo M, Parkkola R, Salminen
J. Age-dependent correlation of low-back pain
and lumbar disc degeneration. Arch Orthop
Trauma Surg 116(1-2): 106-107, 1997.
13. Portney LG, Watkins MP. Foundations of
Clinical research Applications to Practice (3rd
Ed). Pearson Prentice Hall, New Jersey.
14. Salai M, Brosh T, Blankstein A, Oran A, Chechik
A. Effect of changing the saddle angle on the
incidence of low back pain in recreational
bicyclists. Br J Sports Med 33(6): 398-400, 1999.
15. Silberman MR, Webner D, Collina S, Shiple BJ.
Road bicycle fit. Clin J of Sport Med 15(4): 271-
276, 2005.
16. Statistical Package for the Social Sciences (SPSS).
SPSS for Windows Version 16.0. Chicago:SPSS
Inc., 2009.
17. Weiss BD. Nontraumatic injuries in amateur
long distance bicyclists. Am J Sports Med
13(3):187-192, 1985.
18. Wilber CA, Holland GJ, Madison RE, Loy SF. An
epidemiological analysis of overuse injuries
among recreational cyclists. Int J Sports Med
16(3): 201-206, 1995.
... [27][28][29][30] Other uretogenital or perineal symptoms were also investigated in four studies. [31][32][33][34] Eight studies investigated multiple symptom areas, 8,10,11,[35][36][37][38][39] while lumbar pain 40 and foot pain 41 were both represented by one study. The type of bikes used included road bikes (3 studies: 10,32,40), mixed cohorts (6 studies: 8,11,29,31,39,41), city commuters (1 study: 35), mountain bikes (2 studies: 36,38), and stationary bikes (2 studies: 33,37). ...
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... However, this study was based on data collected via self-reported questionnaires, and did not distinguish between cycling for transport, and recreational cycling. Conversely, it has been reported that in 2008-2009, 58% of professional cyclists interviewed had experienced low back pain in the previous 12 months (Clarsen et al., 2010), and recreational cyclists who ride more than 160 km per week are 3.6 times more likely to have back pain compared to those who ride less than 160 km per week (Schultz & Gordon, 2010). These studies demonstrate that while cycling can provide many health benefits, factors such as posture and WBV exposure may lead to an increased likelihood of back pain. ...
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Exposure to whole-body vibration (WBV) increases the risk of low back pain, spinal degeneration, and injury. Cycling can expose participants to WBV, but there are limited data available. This preliminary study quantified WBV in road cyclists in accordance with ISO 2631–1, and determined the efficacy of two seatposts designed to minimise vibration, compared to an aluminium alloy seatpost. Sensors were used to measure the root-mean-squared acceleration (arms), frequency-weighted arms based on an eight-hour reference period (A(8)), vibration dose value (VDV), and transmissibility. Exposures were also calculated using the root-sum-of-squares of the frequency-weighted arms in all three axes (A(8)rss and VDVrss). The mean±95% confidence interval A(8)rss and VDVrss across all tests was 0.58 ± 0.07 ms−2 and 37.19 ± 4.70 ms−1.75 respectively at the saddle, if and 0.49 ± 0.06 ms−2 and 24.31 ± 2.89 ms−1.75 respectively at the lumbar position. Occupational limits were exceeded with all seatposts, and there were no significant differences between them (p > 0.227). Road cycling results in substantial WBV, and there was no evidence that the seatposts designed to minimise vibrations successfully do so. Further research into the effect of cycling conditions and equipment on WBV would be valuable to both the research and cycling communities.
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Low back pain sering dikeluhkan oleh pengendara sepeda road bike. Road Bike digunakan untuk durasi yang ekstensif dan memiliki frame sepeda yang menuntut postur baik selama penggunaannya. Studi terkait posisi tubuh dengan kejadian low back pain pada pengendara road bike masih perlu dikembangkan sehingga tujuan studi ini untuk mengetahui gambaran posisi tubuh saat bersepeda menggunakan road bike dengan kejadian low back pain pada road biker di Jakarta. Studi yang dilakukan adalah studi deskriptif observasional dengan desain potong lintang. Jumlah responden studi sebanyak 250 pesepeda road bike yang berdomisili di Jakarta secara consecutive sampling. Pengumpulan data low back pain dari sampel dilakukan dengan menggunakan kuesioner Oswestry Disability Index. Dari analisis data kuesioner ODI didapatkan sebanyak 125 (50%) responden memiliki keluhan lower back pain pada tingkat nyeri yang berbeda-beda dengan faktor ketinggian stang yang lebih rendah dibanding saddle, ukuran sepeda yang tidak sesuai, fleksi yang berkepanjangan saat otot sudah mengalami overexertion, dan defisit daya tahan ekstensor punggung terbukti mempengaruhi peningkatan resiko low back pain.
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Low back pain is a leading problem in bike riders and is increasing day by day due to faulty posture during bike riding. Objective: To find out the prevalence of low back pain in occupational and non-occupational bike riders. Methods: This was a cross-sectional survey conducted on 200 bike riders who were professional as well as non-professional riders. Data were collected using Oswestry Questionnaire. Results: Results showed that 52.5% bike riders had low back pain, this was further divided on severity of pain, 32% have mild pain on the movement, 11% experienced moderate pain, 5% bike riders experienced fairly severe pain during movement, 3% of the bike riders have very severe pain at movement, where as 1% of the bike riders are those whose pain worst imaginable at the movement. Conclusions: This study sums up that prevalence of low back pain is higher among occupational and non-occupational bike riders who were exposed to bike riding five or more hours a day. This also had a high effect on their sitting, standing, managing self-care and traveling. This study concluded that more than 52.5% bike riders had low back pain.
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ARTICLE INFO ABSTRACT Low back pain is defined when the pain happens in the area just below the ribs to the hips in normal human being in the back. This condition that can be caused by many causes like muscle and ligament injury or overuse. Whereas, Functional status refers to the ability of an individual to perform activities of daily living without any difficulty. If the individual experiences any kind of discomfort while performing these activities, that could be the result of many conditions and low back pain is one of them. The aim of this study is to find the prevalence and severity of low back pain among the population of two wheeler riders and assess its association with functional status. A survey was done among 50 two wheeler riders in Delhi. The questionnaire used for this study to detect the presence of low back pain and factors affecting the functional status was ODI (Oswestry Disability Index) and FSQ (Functional Status Questionnaire). Data analysis was done on Microsoft excel to find the result. Out of 50 respondents, the study determined that about 72% of the subjects experience disability and the 28% have no disability under which 36% subjects presented with mild disability, 24% with moderate disability, 10% with severe disability and 2% with the ODI score 35-50 as completely disabled. The prevalence of low back pain was more in the age group of 20-30 years. The study determined medium prevalence of low back pain in two wheeler riders and large strength of association was found between low back pain and functional status.
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The back is subjected to a great deal of strain in many sports. Up to 20% of all sports injuries involve an injury to the lower back or neck. Repetitive or high impact loads (e.g., running, gymnastics, skiing) and weight loading (e.g., weightlifting) affect the lower back. Rotation of the torso (e.g., golf, tennis) causes damage to both, the lumbar and thoracic spine. The cervical spine is most commonly injured in contact sports (e.g., boxing, football). One of the factors that increases the odds of injuries in athletes is excessive and rapid increases in training loads. In spite of currently emerging evidence on this issue, little is known about the balance between physiological loading on the spine and athletic performance, versus overloading and back pain and/or injury in athletes. This scoping review aims (i) to map the literature that addresses the association between the training load and the occurrence of back pain and/or injury, especially between the Acute:Chronic Workload Ratio (ACWR) and back problems in athletes of individual and team sports, and (ii) to identify gaps in existing literature and propose future research on this topic. A literature search of six electronic databases (i.e., MEDLINE, PubMed, Web of Science, SCOPUS, SportDiscus, and CINAHL) was conducted. A total of 48 research articles met the inclusion criteria. Findings identified that fatigue of the trunk muscles induced by excessive loading of the spine is one of the sources of back problems in athletes. In particular, high training volume and repetitive motions are responsible for the high prevalence rates. The most influential are biomechanical and physiological variations underlying the spine, though stress-related psychological factors should also be considered. However, limited evidence exists on the relationship between the ACWR and back pain or non-contact back injuries in athletes from individual and team sports. This may be due to insufficiently specified the acute and chronic time window that varies according to sport-specific schedule of competition and training. More research is therefore warranted to elucidate whether ACWR, among other factors, is able to identify workloads that could increase the risk of back problems in athletes.
Article
Background Sports is often considered to be a possible trigger for spinal complaints, particularly by those who practice little sport themselves. Objective Review and presentation of literature results on sport as a triggering factor for complaints and diseases of the spine. Materials and methods A search was performed for articles dealing with different sports and their load on the spine, and complaints possibly resulting from overuse and overloading, such as low back pain. The results are presented in terms of the different sports and in terms of spinal injuries/diseases. Results Articles dealing with beach volleyball, cycling, tennis, golf, skiing, climbing, and weightlifting could be found from German-speaking regions. Especially among elite athletes, a high prevalence of spinal diseases, e.g. disc degeneration and spondylolysis, is presented. No significant correlation between imaging abnormalities and the complaints experienced by the athletes could be found. Conclusions In general, sports activity can induce degeneration and structural abnormalities in the spine in relation to duration, intensity and type of sports. But a low amount of physical activity may also provide complaints in the spine.
Article
The increasing participation in the athletic forms of bicycling warrants expanded physician attention to the traumatic and overuse injuries experienced by cyclists. The modern bicycle consists of a frame with various components, including handlebars, brakes, wheels, pedals, and gears, in various configurations for the various modes of cycling. For high performance cycling the proper fit of the bicycle is critical. The most efficient method to provide an accurate fit is the Fitkit, but proper frame selection and adjustment can be made by following simple guidelines for frame size, seat height, fore and aft saddle position, saddle angle, reach and handlebar height. The human body functions most effectively in a narrow range of pedal resistance to effort. Riding at too much pedal resistance is a major cause of overuse problems in cyclists. Overuse injuries are lower using lower gear ratios at a higher cadence. Cycling injuries account for 500,000 visits per year to emergency rooms in the US. Over half the accidents involve motor vehicles, and road surface and mechanical problems with the bicycle are also common causes of accidents. Head injuries are common in cyclists and account for most of the fatal accidents. Despite good evidence of their effectiveness, victims with head injuries have rarely worn helmets. Contusions, sprains and fractures may occur throughout the body, most commonly to the hand, wrist, lower arm, shoulder, ankle and lower leg. The handlebar and seat have been implicated in a wide variety of abdominal and genital injuries. Abrasions, lacerations and bruises of the skin are the most common traumatic injuries. Trauma may be prevented or reduced by proper protective safety equipment and keeping the bike in top mechanical condition. Anticipation of the errors of others and practising and adopting specific riding strategies also help to prevent traumatic injuries. Management of overuse injuries in cycling generally involves mechanical adjustment as well as medical management. Neck and back pain are extremely common in cyclists, occurring in up to 60% of riders. Ulnar neuropathy, characterised by tingling, numbness and weakness in the hands is common in serious cyclists after several days of riding. Managing saddle-related injuries or irritations may also involve adjusting seat height, angle and fore and aft position in addition to changing the saddle. Padding in the saddle and shorts play an important part in saddle problems. Saddle-related problems include chafing, perineal folliculitis and furuncles, subcutaneous perineal nodules, pudendal neuropathy, male impotence, traumatic urethritis and a variety of vulva trauma.(ABSTRACT TRUNCATED AT 400 WORDS)
Article
All 132 participants in a 500 mile, 8 day bicycle tour were surveyed by questionnaire to characterize the demographics and bicycling experience of the riders, and to determine the frequency and severity of non traumatic injuries they experienced. Riders who devel oped significant symptoms were interviewed and/or examined. Eighty-six percent of ride participants re sponded to the survey. The average age of the riders was 41.4 years (±11.7 years). They rode an average of 95.8 miles per week on a routine basis, but the majority were new to long distance touring. Most were healthy, but 5% had seri ous cardiovascular disease and bicycled as part of a rehabilitation program. The most common nontraumatic injury was buttocks pain (experienced by 32.8% of riders); four had skin ulceration of the buttocks. Knee problems occurred in 20.7% of riders; patellar pain syndromes and lateral knee complaints were the most common knee prob lems. One cyclist withdrew from the tour because of knee pain. Neck-shoulder pain occurred in 20.4% of the riders. Groin numbness and palmar pain or paresthesias each occurred in approximately 10%. Other less common problems were foot and ankle symptoms and sunburn.
Article
Two-hundred and ninety-four male and 224 female randomly selected recreational cyclists responded to a mail questionnaire. Significant differences were observed between male and female cyclists' training characteristics. Overall, 85% of the cyclists reported one or more overuse injury, with 36% requiring medical treatment. The most common anatomical sites for overuse injury/complaints reported by the male and female cyclists combined were the neck (48.8%), followed by the knees (41.7%), groin/buttocks (36.1%), hands (31.1%), and back (30.3%). For the male cyclists, effect upon back and groin/buttocks overuse injuries/complaints were miles/week, lower number of gears, and less years of cycling. For female cyclists, training characteristics which had the most significant effect upon groin/buttocks overuse injury/complaints were more non-competitive events/year and less stretching before cycling. The odds of female cyclists developing neck and shoulder overuse injury/complaints were 1.5 and 2.0 times more, respectively than their male counterparts.
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Back and neck problems in bicyclists should be managed by a combination of bicycle adjustment or modification, technique change, and medical treatment. The bicycle should be checked for proper fit. Often it is necessary to relieve the rider's extended position by using handlebars with less drop, using a stem with a shorter extension, raising the stem, or moving the seat forward. Changing hand positions on the handlebars frequently, riding with the elbows "unlocked," varying head position, using padded gloves and handlebars, and riding on wider tires all reduce the effects of road shock. Initial medical management includes ice, massage stretching, and nonsteroidal anti-inflammatory drugs or acetaminophen. Definitive treatment is neck and back rehabilitation based on dynamic muscular stabilization. It involves three progressive and overlapping parts: (1) establishing range of motion, (2) finding and stabilizing the neutral position, and (3) adapting the neutral position to exercise.
Article
To assess the incidence of and risk factors for injuries in a group of bicyclists with a well-defined exposure to bicycling, we conducted a prospective study of 1638 recreational bicyclists who rode in the 6-day 339-mile Cycle Across Maryland tour in 1994. The mean age of participants was 39 years (range, 7 to 79), and two-thirds were male. All riders wore helmets. During the tour there were 85 acute traumatic injuries (15.4 per 100,000 person-miles), 76 overuse injuries (13.7 per 100,000 person-miles), and 37 other medical problems (6.7 per 100,000 person-miles). Acute traumatic injuries were associated with a history of racing versus none (relative risk = 2.2, 95% confidence limits = 1.3, 3.7) and with inexperience, no previous Cycle Across Maryland tours versus one or more (relative risk = 1.7, 95% confidence limits = 1.04, 2.8), but not with sex, training, or prior injuries. Inexperience and lack of preride conditioning were risk factors for overuse injuries. The most common overuse injuries and medical problems were knee pain, hand or wrist numbness, foot blisters, insect stings and bites, and heat and dehydration. Study results provide exposure-based incidence rates of bicyclist injuries and suggest overuse injuries may be reduced by increased preride conditioning.
Article
The prevalence of lumbar disc degeneration in subjects suffering from low-back pain (n = 207; age range 10-49 years) and in age-matched asymptomatic controls (n = 216) was investigated by magnetic resonance imaging. The percentage of subjects with degenerated discs increased with age; starting from the age of 15 years, this increase was more rapid in subjects with low-back pain. Concurrently, the number of degenerated discs was higher in the pain group than in controls. Lumbar disc degeneration manifests earlier and in a greater percentage of subjects with low-back pain than in asymptomatic controls.
Article
A systematic review of the epidemiologic literature on smoking and low back pain. To establish whether smoking causes low back pain and whether cessation of smoking reduces the incidence and/or prevalence of low back pain. It seems to have become increasingly commonly accepted that smoking causes low back pain and that abstinence from smoking is an effective means for its prevention and treatment. Does the evidence in the epidemiologic literature support this concept? Forty-one original research reports reporting 47 studies, published between 1974 and 1996, were systematically reviewed for strength of association, dose-response correlation, temporality, reduction of symptoms with smoke cessation, and consistency of findings. In addition, the presence of positive findings was viewed in light of definition of low back pain, representativeness of the study sample, sample size, and in relation to whether the prime objective had been to study the smoking-low back pain issue. Two reviews were performed by the author, blindly and separated by a 2-month interval. There was no consistency of statistically significant positive associations between smoking and low back pain. The association, when present, was usually weak and clearly apparent only in large study samples. No other study characteristics had an effect on the frequency of positive associations. Additional analyses were therefore performed only on studies with large samples. In general, these did not contain consistent positive findings in relation to dose-response, temporality, or reversibility. Signs of causality were consistently evident only in the study with the largest sample (n > 30,000). Presently, smoking should be considered a weak risk indicator and not a cause of low back pain.