Cycling and Back Pain – Rehab and PRI With Luke Worthington

Last week I popped up to London for a meeting and decided to tick a few things off a list of things I’ve been planning to do for a while.

One of the things I was most excited about was visiting Third Space to meet Luke Worthington, who I’m loathe to even refer to as a personal trainer because he’s so very more than that. I first came across Luke through my friend Sophie Everard’s Instagram where she mentioned Luke was helping with her some imbalances caused by snowboarding and surfing, and after following a little Instagram trail and reading Luke’s piece on Sophie’s blog ‘Mad To Live,’ I became convinced I needed to see him.



I’ve suffered from lower back pain for around five years now. It worsens and lessens but it never goes – sitting here typing this blog, it’s hurting me now and when I’m on the bike, it’s my back rather than my legs that inhibit my performance. When I get a bad flare up, I can’t actually stand up straight, let alone cycle.

I’ve seen doctors, chiropractors, physios and massage therapists. One physio told me it was in my head and I needed to ride around thinking ‘happy thoughts,’ which just made me furious. I swim, stretch, do yoga and devote a lot of time to strengthening my core and glutes. I’ve had X-Rays, though never an MRI (too expensive). I’ve had a bike fit and tried numerous different set ups. But despite the fact the pain is one-sided, I’d never considered that it could be related to something postural, or to the many years spent sliding sideways when I was a pro-snowboarder.

A former national athletics champion who went of to play rugby in the Premiership, Luke has a huge amount of experience of elite international sport and athletics. Luke specializes in biomechanical assessment, injury rehab and prevention and strength and conditioning for stability and is the only person outside the US trained in Postural Restoration through the Postural Restoration Institute. He’s basically a kind of super coach with a clinical approach.

So what exactly is Postural Restoration and why does it matter?

Put simply, there’s more to posture than just standing up, and whilst it might seem straight forward, the way we stand and move is the result of a complex arrangement of multiple systems, beginning with the obvious ones such as muscles, through to the breath and the mind.

With an asymmetry in place (as a result of standing sideways a lot, for instance) naturally movement becomes restricted and the resulting tightness makes it hard to move correctly. But that doesn’t mean you simply need to stretch the tight area – it’s pretty much impossible to isolate one movement from the kinetic chain, which is why Luke looks at the body as a whole and aims to create realignment, because otherwise you’re not actually dealing with the root of the problem.

So that’s the biomechanical side, but that’s just the beginning. In dealing with our imbalances and just with life in general, we can end up with an overactive sympathetic nervous system, which means we’re permanently ‘switched on’ and fired up, and in that state we’re unable to switch off active muscle chains or properly recover.

The sympathetic nervous system regulates some of the body’s unconscious actions, with something called the Sympathetic Ganglia delivering information to the body about stress and impending danger. Breathing very deeply with the diaphragm can help down-regulate the sympathetic nervous system, so breathe work is used with realignment exercises, meaning Luke might ask you to blow into a balloon whilst you’re balancing on your heels to work on your hamstring.


So what happened on my visit?

Well, first of all, Luke had me perform some exercises to asses my range of movement then I lay on a couch whilst he moved my limbs around to see where the were restricted. Pretty much straight away, it was obvious that there was an issue with the alignment of my pelvis and left leg.

What happened next was very odd. Luke explained to me that the body decides how it’s going to move in order to cope with the misalignment, which is why we need to look at the neurological side of movement and not just the physical, such as a tight or weak muscle. One way of tricking to body into not restricting movement in another area or moving in an odd way is by closing one eye, or putting a straw in one side of your mouth. Yes, I know, it sounds bonkers. But I tried a range of movements with and without and it was true.


So where does that leave my recovery?

Well, clearly I don’t want to go cycling with a straw in my mouth to stop my body behaving strangely, what I want to do is realign my pelvis. To do that, I need to reengage a small muscle in my glute that has stopped firing properly, strengthen my left hamstring and adductor, work with the breath to develop postural stabilization and control and down-regulate the sympathetic nervous system. In practice, that means working through a series of exercises that combine breath work, alignment and strength before every training session.

I’ll let you know how I get on, and I’ll be heading back to see Luke shortly for a follow up and to make a video.

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