Neck Pain and Cycling

neck pain cyclingDo you cycle to work each day? Is that pain in your neck and shoulders starting to make you look longingly at the car? With the rain, cold weather, and windy conditions setting in, neck pain from cycling might just be the final straw for your healthy planet, healthy you resolution. It need not be that way however as most neck and shoulder problems in cyclists are connected to poor cycling posture, bad habits, or the bike itself , sometimes neck pain is actually connected to an ill-fitting helmet of all things! Below are some common problems that cyclists encounter that can cause neck pain, shoulder pain, and even back pain, and banishing their eco-friendly lifestyle choice to the trunk of the car.


Cycling Posture and Neck Pain

Check your helmet, as simple as it seems having your helmet too low in front can cause you to strain your head upwards in order to actually see the road ahead. Aggressive, and speedy riders are more liable to this problem, as are those with racing-style bikes rather than upright riding styles. Glasses are another common cause of cycling neck pain that is often overlooked as your specs can easily slide down your nose when you are cycling, causing you to hold your head upwards to correct the problem. A simple strap to keep your glasses in place, or, if you’re feeling indulgent, some properly fitted cycling glasses, can save you from this common cause of neck pain from cycling.

cycling neck pain bike fitting

Seek professional help to ensure your bike fits you properly.

General cycling posture is quite different from a normal sitting position and those trying to keep their back straight whilst cycling will quickly, if not literally, run into problems. Cycling posture needs to help the pedalling action which, whilst it might sound obvious, is often not as smooth as it could be because of poor cycling habits. In addition to helping keep the pedalling action smooth, the cyclists’ posture needs to be able to withstand the inevitable jolts and bumps from the road surface. These potholes make for a jumpy and painful ride for many inexperienced cyclists who are keeping their upper body fully supported by their bones rather than their muscles. Shocks through these rigid bones are much more painful than when the body is supported by muscular effort, but many cyclists adopt a posture requiring little muscular effort and then suffer higher levels of pain in the wrists, back, shoulders, and the neck.

Correct Cycling Posture

Cyclists should aim to have an arched back, bridge-like rather than sunken between the hips and shoulders. This allows the shocks of the road to flex the back further rather than causing a greater extended arch in the swayback position. Where the back is dipped and a jolt in the road causes further extension this can cause problems, both acute and chronic, including lumbar pain and even severe injury.

When cycling, your elbows should be slightly bent but not locked as this means that your arm muscles are doing the work in absorbing any jolts from the road. Although many people try to keep their shoulders back, as when sitting down in a chair, the correct cycling posture is to actually have the shoulders rolled forwards so that the chest muscles are supporting the weight of the upper body, rather than all that weight being put on the collar bones.

Making these changes to your cycling position will likely be taxing at first as they require your muscles to do some work rather then simply resting your weight on your poor old bones. The easiest thing to do is to cycle harder! Really. The extra pressure pushing downwards means that your body weight is better supported by the resistance to the pedalling. Try doing this for short distances at first so as to not fatigue your muscles and accidentally return to old habits of poor posture. Cycling badly for short distances is easy enough to do, cycling well for that same distance might prove rather hard when changing to a better posture to avoid neck pain and back pain. Go for just two or three miles at first, then increase the distance gradually.


Is Your Bike Causing Your Neck Pain?

Some people will suffer from neck pain after cycling because of their bike rather than it just being down to poor posture. Having a bike that does not fit you is a surefire way of incurring acute or chronic problems with your neck, back, wrists, knees, and pretty much everything else, not to mention being inefficient and unlikely to keep you cycling day after day. Do not just buy any old bike from a department store if you intend cycling it either long distances or on a daily basis. It might seem cheaper in the short term but just think about the cost of hours of physio, acupuncture, and massage, not to mention the painkillers you’ll be buying and the time off work due to neck pain.

Top-Tubes and Trigger Points

Go to an actual bike shop and get them to measure you for a bike. This is not just for pro-cyclists and should involve a bit more than simply measuring your legs. Getting the right size frame is important, not just the wheel size but the top-tube distance too. Where the virtual top-tube length (the top-tube plus the stem length) is too long the neck becomes hyperextended leading to muscle strain and the development of trigger points in the neck and upper back. These trigger points formed in the muscle and muscle fascia can spasm and cause pain causing further spasms in a horrible cycle familiar to many with conditions such as fibromyalgia.

Having the right style of bike for the cycling you plan on doing also makes a big difference to the likelihood of you developing neck pain from cycling. A racing-style bike ridden in a lazy Sunday cycling fashion probably means that your handlebars will be too low and lead to you getting wrist pain, as well as shoulder and neck pain.
Shoulder pain is usually a postural issue in cyclists and can be due not only to low handlebars but also to the wrong angle of the seat, usually too low in front forcing your hands and wrists to bear your weight and keep you on your seat. Some people actually have asymmetrical arms, one longer than the other, or even a muscular disparity that causes them to hold one shoulder higher than the other. Both of these issues can cause shoulder pain in just one shoulder from cycling and may mean that it makes sense to set the handlebars slightly off-center to compensate for the difference.

chronic-pain-and-exercise-spin-class

Even spin-class can cause neck pain if your posture is poor.

An Epidemic of Neck Pain from Cycling

More than 49 million Americans are thought to ride their bikes at least once a month, with more than 5 million regular commuters or daily cyclists. Cycling can be a great aerobic activity and is both low-impact and relatively accessible to most people. However, the health benefits of cycling diminish rapidly when the bike is improperly fitted to the cyclist, when there is poor cycling technique, or when training patterns are suboptimal (binge-cycling at the weekend and doing nothing during the week!).

Neck and Back Pain Common in Cyclists

Distance cyclists often complain of neck and back injuries with 44% of male, and 55% of female recreational cyclists presenting for neck pain treatment (Wilber, et al, ). Bike tours of eight days resulted in 66.4% of recreational cyclists reporting neck and shoulder pain (Weiss, ) pointing to a need for better education of cyclists prior to such undertakings. Even commuters cycling to work and back each day can suffer from chronic microtrauma leading fatigue of specific structures such as the bones or tendons. Inflammation from such microtrauma can cause long-term problems if the tissue has no chance to recover. Stiffness, weakness, and chronic pain may then occur from degeneration rather than acute inflammation and the incipient nature of the chronic pain often means that the damage is done before the problems is fully appreciated and corrected.

Avoiding Common Neck Pain Triggers for Cyclists

Other common triggers for neck and shoulder pain in cyclists include looking over the shoulder for oncoming traffic, leading to left levator scapula pain, as well as radicular pain in older cyclists where comorbidities exist in the spine. Sufferers of thoracic outlet syndrome are also at increased risk of neck pain from cycling although the symptoms may be overlooked or not connected; tingling in the hands, neck pain, shoulder pain, arm pain, and headaches, along with coldness in one or both hands and weakness in the upper limbs can all indicate this condition. Hyperextension of the neck usually worsens these symptoms, as does any activity involving arm elevation for any period of time (such as driving or drying one’s hair).

Quick tips for cyclists suffering from neck pain: check your bike fits you, get assessed for proper cycling posture, don’t overdo it after months off your bike, and try to incorporate gentle neck stretches into the slower parts of your bike ride or when stopped at lights. Also, check your glasses and the angle of your seat and helmet, consider the length of your arms, the ease of the gear-change action, and the height of your handlebars. Cycling and neck pain need not go hand in hand and these simple steps can mean the difference between a happy daily commute and a dusty bike stored under the porch.


References

Wilber CA, Holland GJ, Madison RE, et al. An epidemiologic analysis of overuse injuries among recreational cyclists. Int J Sports Med 1995: 16: 201-6.

Weiss BD. Nontraumatic injuries in amateur long distance bicyclists. Am J Sports Med 1985; 13(3): 187-192.

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