Backache? - Road Cycling UK

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There is an interesting picture in the pages of CycleSport’s tribute to Lance Armstrong (a month or so ago). It’s of him and his Chiropractor, he’s being wrestled into a tangle of limbs on top of a massage table after another long day in the saddle. Armstrong would have his Chiropractor travel on the major stage races with him, so whatever the ache or twinge he could get instant treatment. Part of his winning formula was preparation and control, so it’s no surprise that he reacted immediately to any discomfort with a visit to the ‘bone doctor’.

We spend ages (and loads of money) on our bike preparation and training but still seem to spend very little time and money considering our physical well being. It’s always amusing to see riders spending thousands on lightweight gear but still stay 10 kilos overweight, it’s a similar thing when it comes to bike comfort – we think we know what fits right but yet we still base most of our judgement on ‘feel’.

So when riders like Armstrong weighs every ounce of food, considers every element of aerodynamics and has special modifications made to his clothing and bike, it’s no surprise he’s a bit concerned about his physical well being too.

Backache costs the country an estimated £1.6 billion a year, so no surprise either that most people will get some trouble in their lives. But a trip to the Doctor will often result in a lay off from cycling, a lie down and some Nurofen. Hardly a cure.

Crack or Quack?

Popular conceptions of Chiropractors are misleading though. It’s not all about bone crunching and quick fixes. Cycling places unusual demands on your body and specifically your spine. Hours of training can result in back pain and so it is a constant cause for complaint from cyclists. You are asking your back to hold your body in a very static position for hour after hour, so no surprises that it starts to complain after a couple of hours, less in some cases. But extreme discomfort shouldn’t be ignored and can be identified and treated. The Cyclist’s bad back can come on for a variety of reasons, the main ones are:

• Bike position
• Poor flexibility
• Muscle weakness or injury
• Previous injuries
• Sudden damage (due to crashes or accidents)
• Congenital ‘issues’
• Postural problems

Dr. Michael Lanning
Has treated some of the UK’s leading road riders including Warrick Spence and Simon Cope. He has seen several hundred cyclists over the past few years so he has seen many problems and more importantly, as a cyclist himself, he really understands what your body goes through on the bike. So you don’t have to explain to him what a time trial is or a 100 mile ride in the hills, or why you’d want to do them. He’s very friendly and spends a considerable time talking you through the Chiropratic process and what you can expect from him and what he expects from you. Actually he doesn’t stop talking the whole time, and explains each pain and ache in clear and simple terms. Unlike many specialists he has recognised that cycling requires influence from a variety of specialists, from bike fit through to podiatry and muscle damage – so he will refer you if he thinks it’s necessary and it usually is. Once we’ve agreed a time frame and arranged some appointments it’s down to business.

My problems started early in my cycling career, so I have a pretty good idea what will bring on pain. Riding hard in the hills or long time trials are the usual problem events for me. Some days it’s worse than others. Stretching can help (I’m not very disciplined!) and my posture is terrible too (even now as I type I’m making pathetic attempts to sit upright). I also played a bit of rugby as a child (why did they let us?) and seem to remember several bone crunching tackles that would have had Martin Johnson wincing.

The pain in my back got a lot worse a couple of years ago and twinges of pain turned into short term flare-ups where my back became very stiff for days on end. What was unusual is that it wasn’t always brought on by cycling. The potential root of the problem was identified on a trip to Cyclefit earlier this year. A leg length discrepancy was spotted which has been steadily increasing over the years, could be the reason for the pain and there is also a lack of support, partly due to a lack of core strength but also down to flexibility. I’ve had custom foot beds made to stabilise my feet and had the full Cyclefit experience. Also I stopped using a courier bag and have opted for a rucksac instead. But they also suggested a visit to the Gonstead Clinic.


On arrival at the Harley Street Clinic an initial consultation with Dr. Michael Lanning runs him over my history. An X-Ray is done, as it can confirm the level of damage, to a point. Within ten minutes my inner secrets are on the lightbox. Michael gets out a ruler and a pencil and starts making parallel marks on the negative. Before too long the problem is self evident. There is a slight sway in my spine and this is causing the hips to rotate, in turn providing that leg length discrepancy and, presumably, much of the pain. On the sectional X-Ray it’s also clear that some of the vertebrae are closing up and this could also be a causal factor – there are some uneven spaces between vertebrae at the base of my spine and a little damage to a few further up (Rugby and falling out of a loft opening as a child probably…). Everyone is different and this is a visual reference point from which Michael can base his treatment.


At every appointment Michael uses a specialist thermometer on my spine to help him find the joints which may be inflamed, this runs down your spine with two probes either side which are designed to pick up any slight increase in temperature which could signify a problem. In my case the problem is towards the base of the spine in the sacroiliac joint (I’ll spare you the detail) this is pretty common for cyclists as it tends to be the hinge that bends as we stoop over the bike. The lack of support to this slightly stiff hinge creates the pain, so what Michael is trying to do is free it up. Well that’s the simple version at any rate…

As the Gonstead Clinic’s website states:“By administering specific adjustments, we are able to stimulate the joint movement receptors (the body’s position sensors which tell the brain where the body is in space) by increasing specific joint motion, relieving the muscular compensatory spasm, and specifically rehabilitating the misaligned vertebrae or joint into the correct position. The body is then able to function in a normal manner.”

I’d been to Osteopaths recently too, so I was expecting a fair bit of wrestling and struggling, but far from it. The joint that requires treatment on me is low down the back and so is tricky to manipulate. Michael finds a few positions that can ‘adjust’ this joint. He’s very strong so no problems twisting me back into shape, he recommends Icing the joint that evening and suggests not riding for a few days, I did the former but the latter is always hard. The next day I felt OK, no signs of stiffness and after a couple of days I was back on the bike.

Michael is clear that there is no quick fix to back problems like mine and much of the treatment has to be supplemented by soft tissue work (massage in my case), posture, bike fit and stretching. Each visit takes twenty or so minutes and during the meeting Michael fires questions at you like a machine gun. My appointments are early, before Michael’s clinic is in full swing, but there is no doubt he enjoys what he does, whilst I’m in desperate need of a caffeine boost, he’s bouncing off the walls…

Such enthusiasm for my back problem is reassuring and I feel like I’m making progress, OK I’m not a model patient as my stretching routine is erratic but after 4 or so visits the acute twinges of pain followed by days of loss of mobility are over, yes there is still some pain after a few hours of racing but it’s less likely to flare up and the recovery time is much improved. The ‘adjustments’ being made are small, there is a bit of clicking and crunching but it’s done gradually and consistently. It doesn’t hurt either.

The muscles may also need to be treated, perhaps by a sports masseur and you will need to consider some remedial stretching, icing and general care over your spine, you look after your legs because you can see them and they can easily be rubbed and fussed over. But if your back will give up the effort before they do, then I suggest you consider a visit to a specialist like Michael.

Out on the bike, three months down the line, and the power has equalled up a bit, it’s a tricky thing to gauge accurately but I certainly have the feeling that my legs can work together again. I rode the Etape pain free (apart from cramp, but that’s another story) and managed a week in the Pyrenees without the previous levels of pain – I’m enjoying riding again without worrying so much about my backache. It still hurts sometimes but I do feel reassured that it’s not going to stop me from riding forever.


Unlike a trip to the Doctors you are going to have to pay. It’s £110 for the initial consultation and X-Rays and then £40 per visit thereafter. I had six or so visits but it can be as little as four – it all depends on your progress. But weigh up the cost next to a new set of wheels or a frame, I think it’s money well spent. If you want to know any more give Michael a call he’ll be happy to take you through the process and talk about specific requirements – and remember he’s a cyclist too, so he certainly won’t tell you to stop riding!
• Tel: 020 7637 2920


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