Abstract
Cycling is widely practiced as a mode of transportation, a leisurely pursuit, and a competitive sport. Approximately half of cyclists experience low back pain. Yet, there has been limited study of spine tissue adaptations due to cycling. To investigate potential risk factors for spinal pain, we compared 18 high-volume cyclists (>150 km·wk for ≥5 yr) to 18 height-matched nonsporting referents. Participants had no history of spinal pathology. Magnetic resonance imaging was used to quantify intervertebral disc (IVD) morphology and hydration, and psoas, erector spinae, quadratus lumborum, and multifidus muscle size and fat content. Endurance of trunk muscles (flexors and extensors) was measured, and physical activity levels were assessed objectively using accelerometry. Cyclists' IVD showed prolonged T2 time (+10.0% ± 17.3%; P = 0.021), implying better IVD hydration and glycosaminoglycan content, compared with referents. Lower thoracic and upper lumbar IVD T2 time were longer in cyclists (P ≤ 0.029) but not at the lower lumbar spine. T2 time differences were larger in the nucleus pulposus compared with the annulus fibrosus. Cyclists showed larger psoas muscles with less fat content compared with referents. Cyclists also exhibited longer isometric trunk endurance times (P ≤ 0.036) and higher physical activity levels (osteogenic index, P = 0.038). Despite previous studies reporting higher than average prevalence of back pain in cyclists, the high-volume road cyclists in our cohort showed no anatomical or functional deficiency in spinal structures. By contrast, we found evidence for beneficial adaptations to the IVD and psoas muscles in high-volume cyclists compared with referents. These data support the notion that cycling is not detrimental to the spine, rather, by contrast, may be associated with beneficial changes at the spine.
Highlights
2 3 Cycling is globally practiced as a mode of transportation, a leisurely pursuit, for cross-training 4 and as competitive sport
Cyclists showed a 10.5(18.3) ms longer average lumbar intervertebral disc T2-time compared to referents (p=0.021; Table 2)
No significant group*gender interactions were observed. 172 Cyclists’ average spinal psoas muscle size was greater +118(365) mm2 and psoas muscle cross173 sectional area at L5 was greater +304(581) mm2 compared to controls (NS and p=0.034, 174 respectively; Table 3)
Summary
2 3 Cycling is globally practiced as a mode of transportation, a leisurely pursuit, for cross-training 4 and as competitive sport. There is limited data on the point prevalence of back pain in cyclists, with a narrative review of the literature estimating this to be 10-60% in cyclists [7]. This compares to similar estimates of 114 60% in the wider community [8]. We tested the hypotheses that high-volume road cyclists would show (a) subclinical signs of intervertebral disc degeneration (reduced height and hydration) on magnetic resonance imaging (MRI) [15], (b) smaller core muscles (psoas, erector spinae, quadratus lumborum and multifidus) on MRI, (c) increased core muscle fat content on MRI and 4) trunk extensor muscle fatigue or imbalance with trunk flexor muscles measured by isometric endurance
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