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Cycling... It Doesn't Have To Be a Pain In The Neck (and Shoulders and Arms) - Ron Fritzek, D.C.
12/24/09
Cycling... It Doesn't Have To Be a Pain In The Neck (and Shoulders and Arms) - Ron Fritzek, D.C.
Whether you're a novice or someone who has been riding a long time, chances are you've gone on a long ride only to finish up with pain in your shoulders and a very tight neck. What exactly is going on? Do cyclists have to just grin and bare it? The answer is, 'No, you don't have to put up with it'. Cyclists tend to have neck and upper back problems for several reasons which we'll cover in this article. In addition, we'll look at preventative measures when it comes to cycling and neck, shoulder, and arm pain.
Aches, Pains, and A Proper Bike Fit
Whether you are riding to a friend's house around the block or across the country, you should be comfortable on your bike. If you have pain in your upper back or neck, your bicycle may not fit you properly.
You can eliminate a lot of discomfort by making adjustments. A good bike fit can also improve your pedaling efficiency and aerodynamics, and actually make you faster. I encourage you to visit your local bike shop. They should have someone there who knows a lot about proper bike fitting. Make good use of their expert knowledge.
For now, let's get an understanding of what's happening. Cyclists ride in a hunched over position which is a very awkward posture that can be very hard on the upper back and neck. If the ride is long and there is a prolonged hyper-extension of the neck, a searing pain can develop.
Neck pain is a very common cycling complaint and it is usually the result of bending the neck up to see where we are going. If this is the case, you may be riding a bike that is too long and/or have handlebars that are too low. Make sure you aren't too ëlaid outí on the bike. This creates the need to bend the neck further up. If this is the case, there are a few common sense changes that can be made:
1. Raise the handle bars so that youíre riding more upright.
2. Make sure the bike you are riding isn't too long
3. If the bike is too long and a new frame or bike is out of the question, shorten the reach by getting a shorter stem. Don't go much shorter than 100 mm or your bike may ride squirrelly and give you problems.
4. When you're in your handlebar drops, choose a bar with a shallower drop.
Another equipment consideration is the helmet. Proper placement of the helmet is equally important to a good bike fit. If the helmet is worn too far forward, neck problems can occur because you'll have to bend your head too far up to be able to see where you're going. Not only are we causing ourselves unnecessary pain but having the helmet too far forward defeats the safety benefits of a bike helmet.
Again, most bike shops can check a bike's fit and helmet position, often at no charge.
I Have a Near Perfect Fit and I Still Have Neck Pain
This boils down to an overuse injury. When a cyclist logs many hours of riding, there is repetitive sub-maximal loading on the upper back and neck which leads to damage.
Let's take a look at what is occurring when the neck is bent in an upward position for a prolonged period of time. We'll also review some ways to combat the problem (or avoid the problem in the first place).
When a muscle has a sustained contraction for a long period of time, the circulation of blood into that muscle becomes compromised. This is because the muscle contraction puts pressure on the blood vessels, essentially clamping it nearly shut, and the blood supply is greatly reduced. As if this isn't bad enough, these muscles are being asked to perform a continual workload while being deprived of adequate oxygen and nutrients. Keep the upper back and neck muscles under duress for too long and you could have painful muscle spasms and trigger points.
Trigger points are discrete, hyper-irritable spots located in a taut band of skeletal muscle. They can produce a local tenderness that can be very painful. They can even elicit a local twitch response, although it is not the same as a muscle spasm. Cyclists can be susceptible to trigger points in the upper back and neck region, especially if they ride often and travel long distances.
In a nutshell, a knot in the muscle develops, followed by lots of local pain and twitching. There are effective treatments for trigger points but they're outside the scope of this article. Instead, let's discuss what can be done so trigger points never become a concern.
Get Those Muscles Moving
I believe it is important to understand trigger points and their origin. With a basic understanding of trigger points and the problems they cause, you're more likely to follow a prescribed regiment of stretches and exercises. If you don't understand why you're doing your exercises, the likelihood of staying with the program diminishes.
Most cyclists tend to have a sustained contraction in their upper back/neck region while riding. This means inadequate circulation (and oxygen and nutrients) to the upper back and neck region. A sustained contraction means your muscles are under continuous load and not moving (not alternating between a contracted and relaxed state which is desirable).
So what types of things can be done to help? You probably already know that stretching is advantageous to avoiding muscle related injuries. In addition to stretching the neck and upper back muscles, you can also benefit from these two exercises: elbow presses and reverse shoulder shrugs.
Elbow presses are a great blood pumping exercise that helps an ample blood supply reach the upper back and neck region. This will counter the sustained sub-maximal contraction that cinches down on the muscle's small arteries which occur with long bike rides.
To perform elbow presses, bring your elbows out away from the body at the shoulder level. Then pull your elbows back as far as you can, causing the muscles around your shoulder blades and upper back to contract before you bring the elbows back to the starting point. Continue performing reps until you get a mild burning sensation in the muscles of the upper back and neck.
Reverse shoulder shrugs are also great because they make the muscles in the neck and upper back region alternate between full contraction and full relaxation.
Reverse shoulder shrugs are performed by shrugging your shoulders upward toward your ears and then back down toward the ground and behind you. It is important to do reverse shoulder shrugs (shrugging up and back) rather than regular forward shoulder shrugs. Forward shoulder shrugs have a forward rotation which makes the back hunch forward into a chimp-like posture.
This prevents the muscles of the upper back from contracting enough to accomplish the desired "contract, relax, contract, relax" movement pattern. Doing this exercise properly will get the muscles in the upper back and neck pumping periodically and cyclists will notice a positive difference within a few times of performing the exercise.
As an avid cyclist, I've added both of these exercises to my workout routine and my riding comfort and performance have improved. I do however, recommend that you use common sense when planning any shoulder exercises, especially if you have shoulder issues such as a rotator cuff injury.
There are also some basic neck movements that may help neck range of motion and circulation in the neck. Here are the ones that I recommend:
1. Flexion (chin to chest)
2. Extension (head up)
3. Right and left rotation (chin pointing toward the point of the shoulder)
4. Right and left lateral flexion (ear to the shoulder).
Cyclists can also fall prey to another common problem that occurs in the upper back and neck area known as Thoracic Outlet Syndrome or TOS for short. T.O.S. is a condition in which blood vessels or nerves are compressed, usually by overlying muscles, as they pass from the neck region into the arm. This can cause pain, numbness, and weakness in the arms and hands. Typically, athletes in strength sports like football and baseball are most susceptible, but cyclists may also experience thoracic outlet syndrome-type symptoms.
The difference is that cyclists are more likely to suffer because of muscle tightness or spasm at the base of the neck. Again, muscle movement and stretching are effective in relieving TOS related discomfort.
Let's Ride!
As cyclists, we need to be diligent and take care of our bodies. The form of our bike puts our body in a posture that is unnatural and susceptible to injury. Without care, we are likely to face neck, upper back, and arm problems. First, it is important to get a properly fitted bike that gives as comfortable a ride as possible.
It is also imperative to keep our muscles in the upper back and neck region limber and with a full range of motion. By stretching and following the exercises and maneuvers in this article, you can help keep your upper back and neck muscles loose, relaxed, and ensure that they recieve good blood circulation.
This will translate into better performance, and rides that are comfortably enjoyable for the foreseeable future.
About the Author
A former distance runner with a personal best of 2:17 in the marathon, Ron Fritzke, D.C. currently races his bike in California. He's been helping patients with their back problems for the last 22 years in Mount Shasta, California. In addition to serving on the sports medicine team at the College of the Siskiyous, Ron spends time writing about cycling apparel such as cycling jerseys, and cycling bib shorts on his website. He also reviews items like Sidi bike shoes at www.cycling-review.com.
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