Is there any relation between the position of cycling and the appearance of lower pain? A systematized Review
DOI:
https://doi.org/10.47197/retos.v43i0.89363Keywords:
bicycling, biomechanics, spine, low back painAbstract
This article analyzed the relationship between the flexion position maintained during cycling and the possible relationship with low back pain. A systematic review was carried out through the PRISMA process between 2015-2020, in the PubMed, PEDro, Scopus and Web of Science databases, using the terms; "cycling", "cyclist", "position", "positioning", "injury from overuse", "biomechanics of the spine", "lumbar region", "low back pain". Five articles were selected that met all the inclusion criteria. Selected articles showed changes in pelvic tilt, torso flexion angles in medium and low strokes of the handlebars of the road bike and mountain bike, variations of the highest seat or the appropriate backrest according to the groin length, knee position 40 and trunk 35º simultaneously when the pedal is at 180º, while in anatomical position they have been described; The maximum angle of pelvic tilt in anteversion, the maximum angle of pelvic tilt in retroversion and the maximum angle of lumbar flexion are associated with pain or discomfort in the lumbar region. However, it is possible to establish that the association between cycling and low back pain has not been sufficiently studied, which leads us to infer that there is a need to update the information in order to prevent this type of injury associated with the position in cycling.
References
Ab Rahman, J. (2013). Sample size in research. When can you break the rule? International Medical Journal Malaysia, 12(2), 1–2. https://doi.org/10.31436/imjm.v12i2.501
Asplund, C., & St Pierre, P. (2004). Knee pain and bicycling: fitting concepts for clinicians. The Physician and Sportsmedicine, 32(4), 23–30. https://doi.org/10.3810/psm.2004.04.201
Balasubramanian, V., Jagannath, M., & Adalarasu, K. (2014). Muscle fatigue based evaluation of bicycle design. Applied Ergonomics, 45(2), 339–345. https://doi.org/10.1016/j.apergo.2013.04.013
Barrios, C., de Bernardo, N., Vera, P., Laíz, C., & Hadala, M. (2011). Clinical patterns and injury exposure rates in elite road cycling are changing over the last decade. British Journal of Sports Medicine, 45(4), 341 LP – 341. https://doi.org/10.1136/bjsm.2011.084038.89
Beach, T. A. C., Parkinson, R. J., Stothart, J. P., & Callaghan, J. P. (2005). Effects of prolonged sitting on the passive flexion stiffness of the in vivo lumbar spine. The Spine Journal : Official Journal of the North American Spine Society, 5(2), 145–154. https://doi.org/10.1016/j.spinee.2004.07.036
Bini, R., & Carpes, F. (2014). utilizaron. In Biomechanis of Cycling (pp. 23–32). London: Springer. https://doi.org/10.1007/978-3-319-05539-8
Bini, R., Hume, P. A., & Croft, J. L. (2011). Effects of Bicycle Saddle Height on Knee Injury risk and cycling performance. Sports Medicine, 41(6), 463–476. https://doi.org/10.2165/11588740-000000000-00000
Bini, R., & Diefenthaeler, F. (2010). Kinetics and kinematics analysis of incremental cycling to exhaustion. Sports Biomechanics, 9(4), 223–235. https://doi.org/10.1080/14763141.2010.540672
Bini, R., & Hume, P. A. (2013). Effects of workload and pedalling cadence on knee forces in competitive cyclists. Sports Biomechanics, 12(2), 93–107. https://doi.org/10.1080/14763141.2012.731428
Bini, R., & Rossato, M. (2014). Kinetics and Pedaling Technique. In Biomechanics of Cycling (Springer, pp. 43–53). London: Springer Berlin Heidelberg. https://doi.org/https://doi.org/10.1007/978-3-319-05539-8
Blocken, B., Defraeye, T., Koninckx, E., Carmeliet, J., & Hespel, P. (2013). CFD simulations of the aerodynamic drag of two drafting cyclists. Computers & Fluids, 71, 435–445. https://doi.org/https://doi.org/10.1016/j.compfluid.2012.11.012
Blocken, B., van Druenen, T., Toparlar, Y., & Andrianne, T. (2018). Aerodynamic analysis of different cyclist hill descent positions. Journal of Wind Engineering and Industrial Aerodynamics, 181, 27–45. https://doi.org/https://doi.org/10.1016/j.jweia.2018.08.010
Borg, G. (1990). Psychophysical scaling with applications in physical work and the perception of exertion. Scandinavian Journal of Work, Environment & Health, 16 Suppl 1, 55–58. https://doi.org/10.5271/sjweh.1815
Brand, A., Sepp, T., Klöpfer-Krämer, I., Müßig, J. A., Kröger, I., Wackerle, H., & Augat, P. (2020). Upper Body Posture and Muscle Activation in Recreational Cyclists: Immediate Effects of Variable Cycling Setups. Research Quarterly for Exercise and Sport, 91(2), 298–308. https://doi.org/10.1080/02701367.2019.1665620
Burnett, A. F., Cornelius, M. W., Dankaerts, W., & O’sullivan, P. B. (2004). Spinal kinematics and trunk muscle activity in cyclists: a comparison between healthy controls and non-specific chronic low back pain subjects-a pilot investigation. Manual Therapy, 9(4), 211–219. https://doi.org/10.1016/j.math.2004.06.002
Caldwell, J. S., McNair, P. J., & Williams, M. (2003). The effects of repetitive motion on lumbar flexion and erector spinae muscle activity in rowers. Clinical Biomechanics (Bristol, Avon), 18(8), 704–711. https://doi.org/10.1016/s0268-0033(03)00117-7
Clarsen, B, Bahr, R., Heymans, M. W., Engedahl, M., Midtsundstad, G., Rosenlund, L., Thorsen, G., & Myklebust, G. (2015). The prevalence and impact of overuse injuries in five Norwegian sports: Application of a new surveillance method. Scandinavian Journal of Medicine & Science in Sports, 25(3), 323–330. https://doi.org/10.1111/sms.12223
Clarsen, Benjamin, Krosshaug, T., & Bahr, R. (2010). Overuse injuries in professional road cyclists. American Journal of Sports Medicine, 38(12), 2494–2501. https://doi.org/10.1177/0363546510376816
De Vey Mestdagh, K. (1998). Personal perspective: in search of an optimum cycling posture. Applied Ergonomics, 29(5), 325–334. https://doi.org/10.1016/S0003-6870(97)00080-X
Deakon, R. T. (2012). Chronic musculoskeletal conditions associated with the cycling segment of the triathlon; prevention and treatment with an emphasis on proper bicycle fitting. Sports Medicine and Arthroscopy Review, 20(4), 200–205. https://doi.org/10.1097/JSA.0b013e3182688fa0
Debraux, P., Grappe, F., Manolova, A. V., & Bertucci, W. (2011). Aerodynamic drag in cycling: Methods of assessment. Sports Biomechanics, 10(3), 197–218. https://doi.org/10.1080/14763141.2011.592209
Dedering, A., Roos af Hjelmsäter, M., Elfving, B., Harms-Ringdahl, K., & Németh, G. (2000). Between-days reliability of subjective and objective assessments of back extensor muscle fatigue in subjects without lower-back pain. Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology, 10(3), 151–158. https://doi.org/10.1016/s1050-6411(00)00009-2
Dettori, N. J., & Norvell, D. C. (2006). Non-traumatic bicycle injuries : a review of the literature. Sports Medicine (Auckland, N.Z.), 36(1), 7–18. https://doi.org/10.2165/00007256-200636010-00002
Dorel, S., Couturier, A., & Hug, F. (2009). Influence of different racing positions on mechanical and electromyographic patterns during pedalling. Scandinavian Journal of Medicine and Science in Sports, 19(1), 44–54. https://doi.org/10.1111/j.1600-0838.2007.00765.x
Downs, S. H., & Black, N. (1998). The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. Journal of Epidemiology & Community Health, 52(6), 377–384. https://doi.org/10.1136/jech.52.6.377
Edwards, R. H. (1981). Human muscle function and fatigue. Ciba Foundation Symposium, 82, 1–18. https://doi.org/10.1002/9780470715420.ch1
Fintelman, D. M., Sterling, M., Hemida, H., & Li, F.-X. (2014). Optimal cycling time trial position models: aerodynamics versus power output and metabolic energy. Journal of Biomechanics, 47(8), 1894–1898. https://doi.org/10.1016/j.jbiomech.2014.02.029
Fonda, B., & Sarabon, N. (2010). Biomechanics of Cycling. Sport Science Review, 19(1–2), 187–210. https://doi.org/10.2478/v10237-011-0012-0
Gajdosik, R. L., Albert, C. R., & Mitman, J. J. (1994). Influence of hamstring length on the standing position and flexion range of motion of the pelvic angle, lumbar angle, and thoracic angle. The Journal of Orthopaedic and Sports Physical Therapy, 20(4), 213–219. https://doi.org/10.2519/jospt.1994.20.4.213
García-López, J., Rodríguez-Marroyo, J. A., Juneau, C.-E., Peleteiro, J., Martínez, A. C., & Villa, J. G. (2008). Reference values and improvement of aerodynamic drag in professional cyclists. Journal of Sports Sciences, 26(3), 277–286. https://doi.org/10.1080/02640410701501697
García-Ruiz, S., Díaz-Hernández, T., Rozo-Lesmes, P., & Espinosa de Gutiérrez, G. (2010). El enfoque poblacional: las personas como centro de las políticas. Revista de Investigaciones En Seguridad Social y Salud, 12, 129–142. Retrieved from http://uvsalud.univalle.edu.co/escuelas/rehabilitacion/Logros/Publicaciones/523_11._el_enfoque_poblacional_las_personas%5B1%5D.pdf
Grant, M. J., & Booth, A. (2009). A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information and Libraries Journal, 26(1), 91–108. https://doi.org/10.1111/j.1471-1842.2009.00848.x
Hagberg, J. M., Mullin, J. P., Giese, M. D., & Spitznagel, E. (1981). Effect of pedaling rate on submaximal exercise responses of competitive cyclists. Journal of Applied Physiology, 51(2), 447–451. https://doi.org/10.1152/jappl.1981.51.2.447
Harrison, D. E., Colloca, C. J., Harrison, D. D., Janik, T. J., Haas, J. W., & Keller, T. S. (2005). Anterior thoracic posture increases thoracolumbar disc loading. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 14(3), 234–242. https://doi.org/10.1007/s00586-004-0734-0
Holmes, J. C., Pruitt, A. L., & Whalen, N. J. (1993). Iliotibial band syndrome in cyclists. The American Journal of Sports Medicine, 21(3), 419–424. https://doi.org/10.1177/036354659302100316
Izquierdo, M., Echeverría, J. M., & Morante, J. C. (2008). Estructura y análisis del movimiento. In Biomecánica y bases neuromusculares de la actividad física y el deporte (Medica Pan, p. 770).
Kapandji, A. I., & Lacomba, M. T. (2007). Fisiología articular: dibujos comentados de mecánica humana. Raquis, cintura pélvica, raquis lumbar, raquis torácico y tórax, raquis cervical, cabeza. Madrid: Editorial Médica Panamericana.
Laplaud, D., Hug, F., & Grélot, L. (2006). Reproducibility of eight lower limb muscles activity level in the course of an incremental pedaling exercise. Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology, 16(2), 158–166. https://doi.org/10.1016/j.jelekin.2005.04.002
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ., 339(2700), doi:10.1136/bmj.b2700.
Little, J. S., & Khalsa, P. S. (2005). Human lumbar spine creep during cyclic and static flexion: creep rate, biomechanics, and facet joint capsule strain. Annals of Biomedical Engineering, 33(3), 391–401. https://doi.org/10.1007/s10439-005-1742-x
Lucía, A., Hoyos, J., & Chicharro, J. L. (2001). Preferred pedalling cadence in professional cycling. Medicine and Science in Sports and Exercise, 33(8), 1361–1366. https://doi.org/10.1097/00005768-200108000-00018
Marsh, A. P., & Martin, P. E. (1997). Effect of cycling experience, aerobic power, and power output on preferred and most economical cycling cadences. Medicine and Science in Sports and Exercise, 29(9), 1225–1232. https://doi.org/10.1097/00005768-199709000-00016
Mayo, Xián, Iglesias-Soler, E., & Fernández-Del-Olmo, M. (2014). Effects of set configuration of resistance exercise on perceived exertion. Perceptual and Motor Skills, 119(3), 825–837. https://doi.org/10.2466/25.29.PMS.119c30z3
Mayo, Xian, Iglesias-Soler, E., & Kingsley, J. D. (2019). Perceived Exertion Is Affected by the Submaximal Set Configuration Used in Resistance Exercise. The Journal of Strength & Conditioning Research, 33(2), 426–432. https://doi.org/10.1519/JSC.0000000000001886
Mellion, M. B. (1991). Common cycling injuries. Management and prevention. Sports Medicine (Auckland, N.Z.), 11(1), 52–70. https://doi.org/10.2165/00007256-199111010-00004
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., Altman, D., Antes, G., … Tugwell, P. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6(7). https://doi.org/10.1371/journal.pmed.1000097
Momeni, K., Faghri, P. D., & Evans, M. (2014). Lower-extremity joint kinematics and muscle activations during semi-reclined cycling at different workloads in healthy individuals. Journal of Neuroengineering and Rehabilitation, 11, 146. https://doi.org/10.1186/1743-0003-11-146
Muyor, J. M., & Zabala, M. (2015). Road Cycling and Mountain Biking Produces Adaptations on the Spine and Hamstring Extensibility. International Journal of Sports Medicine, 37(1), 43–49. https://doi.org/10.1055/s-0035-1555861
Muyor, José M, López-Miñarro, P. A., & Alacid, F. (2013). The Relationship Between Hamstring Muscle Extensibility and Spinal Postures Varies with the Degree of Knee Extension. Journal of Applied Biomechanics, 29(6), 678–686. https://doi.org/10.1123/jab.29.6.678
Muyor, José Manuel, Alacid, F., López-Miñarro, P., & Casimiro, A. (2012). Evolución de la Morfología del Raquis e Inclinación Pélvica en Ciclistas de Diferentes Edades: Un Estudio Transversal. International Journal of Morphology, 30, 199–204. https://doi.org/10.4067/S0717-95022012000100036
Nogueira Mendes, R., Farías Torbidoni, E., & Pereira da Silva, C. (2021). Eventos de bicicleta de montanha em Portugal: características, distribuição temporal e espacial e ocorrência sobre a rede nacional de áreas protegidas e classificadas. RETOS. Nuevas Tendencias En Educación Física, Deporte y Recreación, 2041(39), 216–223. https://doi.org/https://doi.org/10.47197/retos.v0i39.78368
O’Sullivan, P. B., Mitchell, T., Bulich, P., Waller, R., & Holte, J. (2006). The relationship beween posture and back muscle endurance in industrial workers with flexion-related low back pain. Manual Therapy, 11(4), 264–271. https://doi.org/10.1016/j.math.2005.04.004
Pineau, C. (1982). The psychological meaning of comfort. Applied Psychology, 31(2), 271–282. https://doi.org/https://doi.org/10.1111/j.1464-0597.1982.tb00097.x
Polga, D. J., Beaubien, B. P., Kallemeier, P. M., Schellhas, K. P., Lew, W. D., Buttermann, G. R., & Wood, K. B. (2004). Measurement of in vivo intradiscal pressure in healthy thoracic intervertebral discs. Spine, 29(12), 1320–1324. https://doi.org/10.1097/01.brs.0000127179.13271.78
Priego Quesada, J. I., Pérez-Soriano, P., Lucas-Cuevas, A. G., Salvador Palmer, R., & Cibrián Ortiz de Anda, R. M. (2017). Effect of bike-fit in the perception of comfort, fatigue and pain. Journal of Sports Sciences, 35(14), 1459–1465. https://doi.org/10.1080/02640414.2016.1215496
Sanderson, D. J., Martin, P. E., Honeyman, G., & Keefer, J. (2006). Gastrocnemius and soleus muscle length, velocity, and EMG responses to changes in pedalling cadence. Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology, 16(6), 642–649. https://doi.org/10.1016/j.jelekin.2005.11.003
Schwellnus, M. P., & Derman, E. W. (2005). Common injuries in cycling: Prevention, diagnosis and management. South African Family Practice, 47(7), 14–19. https://doi.org/10.1080/20786204.2005.10873255
Solomonow, M, Zhou, B.-H., Baratta, R. V, & Burger, E. (2003). Biomechanics and electromyography of a cumulative lumbar disorder: response to static flexion. Clinical Biomechanics (Bristol, Avon), 18(10), 890–898. https://doi.org/10.1016/s0268-0033(03)00173-6
Solomonow, Moshe, Baratta, R. V, Banks, A., Freudenberger, C., & Zhou, B. H. (2003). Flexion-relaxation response to static lumbar flexion in males and females. Clinical Biomechanics (Bristol, Avon), 18(4), 273–279. https://doi.org/10.1016/s0268-0033(03)00024-x
Staszkiewicz, R., Kawulak, M., Nosiadek, L., Omorczyk, J., & Nosiadek, A. (2017). Effect of Changes in Cycle Ergometer Settings on Bioelectrical Activity in Selected Muscles of the Lower Limbs. Polish Journal of Sport and Tourism, 24(4), 228–234. https://doi.org/10.1515/pjst-2017-0022
Troncoso, L., Troncoso Robles Dri Manfiolete, S., & Toro-Arévalo, S. (2020). Procesos educativos vivenciados en la práctica social mecánica de bicicleta. Retos, 38, 102–108. https://doi.org/https://doi.org/10.47197/retos.v38i38.74280
Van Hoof, W., Volkaerts, K., O’Sullivan, K., Verschueren, S., & Dankaerts, W. (2012). Comparing lower lumbar kinematics in cyclists with low back pain (flexion pattern) versus asymptomatic controls--field study using a wireless posture monitoring system. Manual Therapy, 17(4), 312–317. https://doi.org/10.1016/j.math.2012.02.012
Verma, R., Hansen, E. A., de Zee, M., & Madeleine, P. (2016). Effect of seat positions on discomfort, muscle activation, pressure distribution and pedal force during cycling. Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology, 27, 78–86. https://doi.org/10.1016/j.jelekin.2016.02.003
Wanich, T., Hodgkins, C., Columbier, J.-A., Muraski, E., & Kennedy, J. G. (2007). Cycling injuries of the lower extremity. The Journal of the American Academy of Orthopaedic Surgeons, 15(12), 748–756. https://doi.org/10.5435/00124635-200712000-00008
Zamiri, S., Yazdi, M., Mehravar, M., Takamjani, I. E., Ahmadi, A., & Maroufi, N. (2017). The relationship between prolonged sitting position and adaptive alterations in lumbar spine and pelvic range of motion in cyclists with chronic low back pain. Journal of Family Medicine, 15(10), 23–27. https://doi.org/10.5742/MEWFM.2017.93132
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