This stretch should be combined with the reverse shoulder-shrug. This involves shrugging the shoulders up and then drawing the shoulder blades together and down towards the ground. This helps draw your shoulder blades back to a correct shoulder position, and prevents prolonged stretching and overuse of the postural muscles.
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Masterclass: Thoracic Pain

Pain in your back? It’s time to get stretching!

Following on from my previous article on lower back pain in cyclists, I thought it would be a good time to look a bit deeper into upper back pain. I will follow on with an article on neck pain in the next issue.

The back can be divided into three segments from the bottom up – lumbar, thoracic and cervical. The lower back or lumbar segment is the classic area for sciatic type pain and disc bulges, and causes the majority of problems. However, it is important not to forget the contribution of your upper back (thoracic spine).

The thoracic spine is involved mainly in rotation of the spine and is held tightly in position by its attached ribs. When the thoracic spine is tight and loses some of its rotation, the lumbar spine tries to take over and perform a job it isn’t designed for – rotating. This frequently leads to breakdown, either where the lumbar spine joins the thoracic spine or where the lumbar spine joins the sacrum. Cyclists are prone to these issues for a number of reasons.

Cycling is not a natural position. You are spending long hours hunched over trying to stabilise your core to transmit all the power through your body and down to the pedals. This position is even more extreme when you are on a time trial bike, trying to flatten your back as much as possible. The other big factor affecting the thoracic spine is our work outside cycling. The main issue that causes problem is ‘screen time’. Be it at work or on the home computer.

Symptoms of thoracic back problems frequently present as pain and tightness in the upper back and can sometimes radiate to your chest, giving chest pain during or following a ride. It is also important not to ignore the thoracic spine’s involvement in lower back and neck pain. If your thoracic spine is tight and not rotating, your lower back will try to compensate. A healthy back requires treatment of all three segments, not just the area giving you pain.

A big cause of upper back pain is postural. It is vital to have a correct bike set up to avoid these issues. Having your handlebars too far away will cause you to reach and strain your back, and if they are too close you, you will be riding with an exaggerated crunch which can be equally troublesome.

Posture off the bike is equally important. It is rare for me to see someone with ‘good’ posture. The majority of us (myself included) roll our shoulders forward and slouch. This is an easy and lazy posture, which can cause significant thoracic tightness and pain.

Prevention of thoracic back pain is relatively easy. It comes down to correct bike and work station set up, frequent breaks and stretches. For correct bike set up I have already alluded to having the correct reach on your bike. Your local bike shop should be able to advise you well on set up but a basic guide for the correct reach is when you are down in the handlebar drops and you look down – your front hub should be obscured by the handlebars. If you are unsure, you should seek out a qualified bike position expert.

For correct work station set up it is important to have an ergonomic fit. You should be able to type or mouse with your elbows rested and all the work being done from the forearms down to your hands. You should be looking straight at the screen and not down to it, and you should have everything within arm’s reach with no prolonged straining or bending. Break wise, I go by the 20 minute rule. No one should be in the same position for over 20 minutes without a break. This rule applies whether you are working or cycling. At 20 minutes you should be moving around, having a bit of a stretch, and easing off any tight muscles.

I am also a great fan of the thoracic roll. This involves using one of those hard physio rolls or using a couple of towels rolled up and duct taped together. These should be placed vertically down your back lying on your thoracic spine with your bum on the floor. Gently ease back onto the roll and let your back stretch over the roll. Hold this position for 20-30 seconds.

You can also use the thoracic roll horizontally across the back rolling back onto it each segment down your back to ease the tightness around the vertebrae.

As cyclists we spend a lot of time in one position pursuing our various goals. It is very common for back pain to creep up on us and cause long-term problems. Making sure you have a correct bike set up, changing your position on the bike frequently and working on some gentle stretches and exercises can help you significantly in the long-run.

Stretching once you are off the bike consists of two main stretches. The thoracic stretch, detailed in my previous article – while sitting in a chair. With your bottom well back in the seat, gently rotate your shoulders around to 90 degrees, feeling a gentle stretch in your upper back.

This stretch should be combined with the reverse shoulder-shrug. This involves shrugging the shoulders up and then drawing the shoulder blades together and down towards the ground. This helps draw your shoulder blades back to a correct shoulder position, and prevents prolonged stretching and overuse of the postural muscles.

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Australian Custom Bicycle Show 2012