The Missing Piece for Cyclists With Low Back Pain: A Professional Bike Fitting

When it comes to managing low back pain in our cycling athletes, it’s important to have all the tools in your back pocket (literally). Sometimes you’re putting out fires with spinal manipulation and dry needling. Sometimes you go straight to mobility drills, segmental loading, and progressive overload. And sometimes you break out the …. Wrenches?

We gotta admit, it’s our bias here at ICE to always focus on building a more resilient human; “All roads lead to load.” However, in the cycling community, sometimes just being strong and mobile isn’t enough. It’s hard to be comfortable and powerful on a fixed object in a suboptimal position. And for our cyclists with low back pain, thats often the case.

A Professional Bike Fit is essential for these athletes to get back to training pain free.

In this particular case, the saddle is going to be our most important focus. Here are a few tips for improving the position of your cyclist patients:

  • For starters, establishing adequate saddle height (knee roughly 30 degrees shy of straight at the bottom of the pedal stroke) will help clear some much needed hip flexion and allow the athlete to assume a more relative neutral pelvic tilt throughout the pedal stroke.
  • Speaking of tilt, ensuring that the saddle is at least level, if not slightly negative (1-2 degrees nose down) will allow, again, for a more neutral pelvic position.

There’s so much more that goes into the full bike fit process, but those two examples demonstrate one collective theme. Getting our athletes into a “relatively” neutral lumbar posture will ensure less pain, longer ride times, and better fitness gains. We saw this concept supported by Salai et al* in BJSM with their paper “Effect of changing the saddle angle on the incidence of low back pain in recreational bicyclists.”. They found that a negative saddle tilt resulted in decreased lumbar strain, increased relative anterior tilt, and when applied to cyclists with blowback pain, 70% saw improvements in symptoms.

It’s one of those scenarios where posture truly does make a difference. Helping these athletes get away from an end-range lumbar flexion position will make immediate changes that would
otherwise take weeks, months, or even years to build and adapt to.

Want to learn to make these quick changes and fill in the gaps for these folks?

Come join us for a weekend and get your hands dirty (literally). The ICE Professional Bike Fit Certification is a fully immersive weekend, unlike any other continuing education course. You’ll learn all about the most common conditions these athletes battle. You’ll get loads of lab time to learn and use tools of the trade, and build the confidence to fit bikes on Monday (Yes, even if you’ve never held a wrench before this weekend!). Furthermore, we dive deep day two into the strength training and programming principles for these folks to really give you the full “AND not OR” experience and ensure that you’re ready.


Check out for all our continuing education courses. We’ll see you on the road.



Salai M, Brosh T, Blankstein A, Oran, Chehik. Effect of changing the saddle angle on the
incidence of low back pain in recreational bicyclists. Br J Sports Med. 1999; 33:398-400.