Cyclists frequently present to SPC with a complaint of pain, typically in their knees or back during long rides. For some, the solution is as simple as an appropriate bike fit. For others, resolution of the problem may take a little more work.
Core Strengthening has been adopted by the athletic community and health professionals for both injury prevention and performance enhancement. It has become an accepted fact in the literature that decreased strength in the pelvic stabilizers, specifically the rotators of the hip, can lead to altered alignment of the lower limb during activities like cycling or running and subsequently result in overuse injury. The core not only provides stability to the back, but it also affords more leverage to the lower extremity for force production.
The repetitive motion of cycling requires efficient movement patterns to avoid excessive stresses being applied to the structures of the lower extremity. A proper bike fit will give you a consistent lower extremity alignment throughout the pedal stroke. Decreased core strength, however, may artificially induce a malalignment in an effort to maintain your power output. When you add this malailgnment with excessive cadence and increase volume or intensity together, your chance of injury is amplified.
Unfortunately, a universal core program does not exist. Each individual athlete will have their own deficits to address. Asking your coach to provide feedback on your position in the saddle, and having a sports specialist analyze your mechanics, will provide the necessary details to design a personalized program. The majority of mechanical faults only present in times of fatigue. Conducting a spin scan during a lactate balance point test is an ideal way to identify mechanical faults. This will also provide an in depth look at your power output, pedaling efficiency and identify dead spots in your pedal stroke.
Frequently we see patients who present with mechanical faults and claim that their stability can not be the problem because they work on their core muscles all the time. Many times the core exercises they have been working on consist mainly of sit-ups or variations of traditional abdominal exercises. These patients are often surprised to hear that core stability has very little to do with how many sit-ups they perform each day.
A basic way to test the strength of your core is to attempt a single leg squat in front of a mirror. Does your pelvis drop to one side? Does your knee roll inwards? Does your foot pronate or flatten? If the answer is yes to any of the above questions there may be an issue with strength, control, activation or timing with the muscles around the lumber spine, hip and pelvis. (see example to the right of a faulty pattern)
A core program must begin with an understanding of how to activate the appropriate muscles involved with stability. By consciously contracting the “core” muscles, you can create a muscular corset around the spine. Learning to contract or brace all the muscles around the spine at once will support the spine from all sides and give it the stability it needs. When this is done properly, it will feel as though your pelvis is locked to your rib cage. Research has shown bracing imparts more stability to the spine than the more popular “hollowing” method of drawing the belly inward. Once this is achieved, movement can be attained both above and below the core without altering the position of the spine and pelvis. (see pictures for examples)
-Spinal and pelvic position remain constant despite hip or leg movement.
How to Brace:
Start by standing up straight in a comfortable position (spinal neutral). Concentrate on tightening all the muscles in your abdomen without altering your body posture and hold this contraction. The key to a good brace is to keep the spine neutral and breathe naturally. Do not hold your breath. Have your local sports medicine professional teach you to brace properly.
Once muscle strength and activation patterns are in place to allow force transfer through the pelvis without compromise of your lower limb alignment, linking these activities into riding can take place. You must be able to transfer what you learn in the gym onto the bike. Everyone is different and each person will require different cues to help transfer stability learned off the bike to being stable on the bike. With video assessment we have had success teaching people what is happening to their position in the saddle with each pedal stroke. This allows them to concentrate on their weakness when they ride.
A properly designed, year round core program and soft tissue techniques like ART®, both aimed at correcting mechanical faults in the pedal stroke, combined with your regular training will increase your chance of a successful pain-free season.
By Dr. Ian MacIntyre