British Cycling and the UKSI reduce lower back pain in female sprinters
British Cycling and the UK Sports Institute (UKSI) Athlete Heath Team has collaborated to reduce training days lost to back pain in the women’s sprint squad from 458 to just one over the past four years.
In 2019, lower back pain and associated injuries caused a total of 458 missed training days, a contributing factor to the women’s sprint team not qualifying for the Tokyo 2020 Olympic Games. In 2024, the impact of this performance project has been so significant that it has been credited with helping the team qualify a slot at the Olympic Games for the first time since London 2012.
Head of Physiotherapy at British Cycling Katie Flatters explained: “We reached out to the UKSI to see if there was any help they could give us to work out why this problem was occurring and how we could look to manage it differently.”
Athlete Health Lead at the UK Sports Institute Steve McCaig explained how the team supported: “Many different parts of the Athlete Health Team contributed to this project and worked collaboratively with British Cycling. Insight obtained from our PDMS medical records system was able to identify that lower back pain was a significant cause of injury burden within cycling. Follow up analysis identified that lower back pain was specifically an issue with female cyclists.
“Our experts facilitated a workshop with British Cycling to understand the causes contributing to the problem, we were then able to work together to identify the measures we were going to implement to address these causes.”
Some of the themes identified included training load, lifestyle factors, female athlete health. Each of the themes was mapped onto an impact-effort graph to identify how easy it would be to address and what the impact would be on lower back pain in the sport.
By 2021, there was a reduction in injuries, but there were still 300 days lost to lower back pain. The initial themes were revisited and ‘pain beliefs’ was focused on, looking at how riders perceive different kinds of pain and how they react to it. This led to a range of changes including how pain, scans and results were communicated, in an attempt to remove fear and negativity. There has also been an increased focus on data to support communication around pain and injuries.”
British Cycling Track Sprinter Sophie Capewell said: “Psychological support has helped changed our perception on what pain is.
“Through this project, we’ve realised that the more we can communicate, the better, because the better your understanding is the more aware you are of what’s going on and your body’s got a better chance of adjusting to that, if there is something that needs to change.”
In 2023, just one day of training was missed to lower back pain and the women’s sprint squad won the silver medal at the world championships in Glasgow, having not medalled in the event at the world championships since 2014.
Capewell, who was part of the silver-medal winning team sprint squad, continued: “Overall training days lost to back pain has substantially reduced, and it shows in our results. The last few years, the women’s sprint team has made a massive step forward, and part of that has to be to do with the fact that we’ve missed a lot less training.”
For Flatters, the impact goes far wider and has influenced the entire programme.
She explained: “The UKSI have been invaluable to me throughout this project. As a medical team and a wider performance team, we’ve learnt a lot from this project and those practices are embedded in what we do now, not just for lower back pain, but how we manage injuries and pain across the programme, which will also filter down through our pathways.”
Steve McCaig concluded: “This project is a great example of how the UKSI has worked collaboratively with a sport to address one of their priority health problems that was significantly affecting performance.”
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