As a keen cyclist, my bike riding has always associated with a lower back pain. When I started to be serious with bike riding 5 years ago, I became a member of a cycling club that holds a road race weekly. During one of the training sessions, an A grade rider suggested: “Hey mate, here is a trick for you to ride faster quickly.” Of course, I am all for it, because speed was all I was looking for. “The trick is while you are riding up a hill use a higher gear. As most riders use lower gears for climbing, you will be climb faster with your bigger gear.” That sounded like a good moment to launch an attack in group rides/races. Thus, I started. I remembered in the first two weeks, I was really satisfied with the noticeable improvement of my speed. Two weeks later, this happiness came with a shadow – I started to feel some minor lower back pain on my right side when I was on the bike. As “Pain and Glory” is the mojo for many serious bike riders, I soldiered on with the high gear climbing the hills. Another 2 or 3 weeks later, I felt the back pain not only during the bike ride and while sitting at home, as it constantly aches on my lower back.

That was the time I realized that my back pain has become a problem, but not only a byproduct of my hobby. I was forced to shift my perspectives from an amateur cyclist to what I do for life – an acupuncturist.

The back pain I experienced has a few interesting features:
• The pain can be felt on the lower back, but cannot be found at an exact spot.
• The discomfort is more of a constant aching and stiffness on the back, rather than a sharp pain or a total lockout.
• It can be started as a mild condition that only happens during or after a long ride. Over time, this stiffness in the lower back can get worse – it happens when I get out of bed or after I sat on a chair for a while.
• At its worse, it can be difficult for me to straighten my back. My body somehow stays in a leaning forward posture.

These symptoms are caused by the tightness of the Psoas muscle (see Picture 1). Funny enough, Psoas muscle is not located at the lower back (that is why you cannot find the exact pain located on your back). It is located behind the guts and in front of the spine that forms part of the wall behind the stomach. In a layman’s term, this muscle is a part of our body’s “core muscles”. It begins with the height of the kidney and runs down your body until it reaches the inner thighs. As it is located across the hip joint, all upper leg movements are engaged with this muscle. Most of the paddling is uses the thighs and calf muscles for the power. In my case, when I paddle tremendous effort, the Psoas kicks in with the rest of the muscles from the inner thigh. Once the Psoas is overworked and becomes fixed, it can be difficult to stretch/relax it as the psoas is so deep. To make things worse, during the hours of cycling training, Psoas stays in a rigid and shorten state for a long time. (see Picture 2) It pulls the spine forward and consequently, the back muscles get tighter when staying upright. That is when I start noticing the backaches and stiffness. Treating this type of lower back pain almost like fixing a crack on an archery bow that is caused by a tight string. By loosening the string, the crack can be repaired easier instead of fixing the crack by wrapping around it with materials to reinforce the bow. Any therapies that focused on the lower back (“the bow”) alone, i.e. massages, heat packs and stretches, only relief the time for a short term. Usually a few hours or couple of days later, the back pain comes back. So, to counter this issue I used acupuncture to relax the Psoas muscle (“the string”) from my groin. The pain relief almost happens immediately and I noticed that my back getting a lot looser.

Of course, I have done acupuncture on myself for this lower back pain, like all acupuncturists can be. I am happy to report that I have not felt the back pain in last four years while riding after a few acupuncture sessions and learnt ways to strengthen my core muscles. One lesson learned that from riding – compete at the level your body can handle, train hard to reach your best but not by any harmful tricks or methods.