Back pain and sports

Although bicycling strengthens the muscles of your legs, it does not do much for the muscles around your spine. Bending your lower spine forward while arching your upper back for long periods can strain your back and neck muscles. Mountain biking on uneven surfaces can cause jarring and sudden compressions (squeezing) on the spine.

Tips to help make bicycling easier on your back include:

• Avoid mountain biking.
• Ride a bike that fits you properly. Staff at a good bike shop can help you get fitted.
• Remember not only to push down on the pedals, but also to pull up on them.
• Wear biking gloves and use a handlebar cover to reduce jarring in your upper body.
• Put shock absorbers on the front wheel.
• A more upright bike can have less pressure on your lower back and neck.
• Recumbent bikes place less stress on your back and neck.

The muscles that bring your leg up toward your abdomen are called flexors. They are used a lot when you ride a bicycle. Keeping these muscles stretched out is important because it will help keep the proper balance in the muscles around your spine and hips.

Weightlifting can put a lot of stress on the spine. This is particularly true for people who are middle-aged and older because their spinal disks may dry out and become thinner and more brittle with age. Disks are the "cushions" between the bones (vertebrae) of your spine.

Along with muscle and ligament injuries, weightlifters are also at risk for a type of stress fracture in the back called spondylolysis.

To prevent injuries when weightlifting:

• Do some aerobic exercise and stretch well before lifting to warm up your muscles.
• Use training machines rather than free weights. These machines place less stress on your spine and do not require a spotter. Training machines are also easier to learn how to use compared to free weights.
• Do more repetitions instead of adding more weight when you are trying to build strength.
• Lift only as much as you can safely lift. Don't add too much weight.
• Learn the proper lifting techniques from someone who is well trained. Technique is important.
• Avoid certain weightlifting exercises that are more stressful on your spine. Some of these are squats, clean-and-jerks, snatches, and deadlifts.
• Ask your provider or trainer whether a weightlifting belt would be helpful for you.

The golf swing requires forceful rotation of your spine, and this puts stress on your spinal muscles, ligaments, joints, and disks.

Tips to take the stress off your back include:

• Ask your physical therapist about the best posture and technique for your swing.
• Warm up and stretch your muscles in your back and upper legs before starting a round.
• Bend with your knees when picking up the golf ball.
• On the course, use a push cart (trolley) to wheel your golf bag. You can also drive a golf cart.

The disks and the small joints in the back are called facet joints. Running causes repeated jarring and compression on these areas of your lumbar spine.

Tips to help reduce the stress on your spine include:

• Avoid running on concrete and uneven surfaces. Instead run on a padded track or soft, even grassy surfaces.
• Wear high-quality running shoes with good cushioning. Replace them when they become worn.
• Ask your physical therapist about the best running form and motion. Most experts suggest a forward motion, leading with your chest and keeping your head balanced over your chest.
• Before taking off on a longer run, warm up and stretch the muscles in your legs and lower back. Learn exercises that strengthen the core muscles deep inside your abdomen and pelvis that support your spine.

Motions that place stress on your spine while playing tennis include overextending (arching) your back when serving, constant stopping and starting motions, and forceful twisting of your spine when taking shots.

A tennis coach or your physical therapist can show you different techniques that can help reduce the stress on your back. For example:

• Bending your knees.
• Keeping your abdominal muscles tighter will reduce stress on your spine. Ask about the best ways to serve to avoid overextending your lower back.

Before playing, always warm up and stretch the muscles in your legs and lower back. Learn exercises that strengthen the core muscles deep inside your abdomen and pelvis, which support your spine.

Before skiing again after a back injury, learn exercises that strengthen the core muscles deep inside your spine and pelvis. A physical therapist may also help you to build strength and flexibility in the muscles that you use when you twist and turn while skiing.

Before you start skiing, warm up and stretch the muscles in your legs and lower back. Make sure you only ski down slopes that match your skill level.

Although swimming can strengthen the muscles and ligaments in your spine and legs, it can also stress your spine by:

• Keeping your lower back extended (arched) when doing strokes on your stomach, such as the crawl or the breaststroke
• Turning your neck back every time you take a breath

Swimming on your side or back can avoid these movements. Using a snorkel and mask may help decrease the neck turning when you breathe.

Proper technique when swimming is also important. This includes keeping your body level in the water, tightening your abdominal muscles somewhat, and keeping your head on the surface of the water and not holding it in a lifted position.

Bicycling - back pain; Golf - back pain; Tennis - back pain; Running - back pain; Weightlifting - back pain; Lumbar pain - sports; Sciatica - sports; Low back pain - sports

Ali N, Singla A. Traumatic injuries of the thoracolumbar spine in the athlete. In: Miller MD, Thompson SR. eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 129.

El Abd OH, Amadera JED. Low back strain or sprain. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 48.

Hertel J, Onate J, Kaminski TW. Injury prevention. In: Miller MD, Thompson SR. eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 34.

Updated by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.