Cycling Training Articles - Do Neck Pain and Upper Back Pain Go Hand in Hand With Cycling?

Do Neck Pain and Upper Back Pain Go Hand in Hand With Cycling?

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By Ron Fritzke, D.C.

If you've been on enough long rides, I'll bet you've felt that burning in your shoulders, that tightness in your neck, or even the numbness that goes down into your arms, hands, and fingers. Neck and upper back problems in cyclists have their roots in several factors which we'll discuss throughout this article. I'll suggest some solutions too, so hang in there.

It's The Awkward Position

It's amusing to note that anthropologists attribute so many of our aches and pains to the audacity we display by walking upright. Just ask us cyclists: moving forward while hunched over on a bike isn't pain-free either, even though it satisfies the scientists' desire for us to look chimpanzee-ish.

But that's the position cyclists find themselves in. We're bent over at the waist and in order to see where weíre going, we have to bend our necks up for hours on end. Health care professionals call it cervical (neck) hyper-extension. It's this prolonged hyper-extension of the neck that leads to so much pain.

So What's Really Happening In The Neck...

Where to begin? Health care providers define an overuse injury, like what's experienced by cyclists in the neck and upper back, as the damage that occurs by repetitive sub-maximal loading.

I've spent over 20 years translating medical-speak into language understood by my patients, so let me give it my best shot in explaining what's happening when the neck is bent up for hours on end. I'll also give you some tips on how to combat the problem.

The circulation of blood into a muscle becomes vulnerable when the vessels enter the muscle, and a prolonged, sustained contraction of that muscle is occurring. When the muscle contracts, it is putting pressure on the arterioles and capillaries within itself. In a sense, it is reducing it's own blood supply.

This isn't a problem when a muscle is contracting and relaxing, like the muscles in the leg do when the cyclist is pedaling. But when the muscles on the back side of the neck and upper back stay contracted for hours on end, circulation is impaired. Various fibers of a muscle that is being asked to contract without adequate oxygen and nutrients often go into spasm. This commonly results in trigger points in that muscle.

Trigger points are 'knots' in various parts of a muscle which initiate a pain, spasm, then more pain response. Now you've got problems. There are effective treatments for trigger points but they're outside the scope of this article.

Let's talk about what can be done long before trigger points develop.

It's All About Movement!

There's a reason I took the effort to describe trigger points and their origin. If all I do is tell you a few stretches and maneuvers designed to combat neck and upper back tightness you're quite likely to forget them by the time you've surfed three waves down the world wide web. But if you have a basic understanding of the problem of sustained contraction and the lack of adequate circulation to that muscle when it's under a load, you should be able to reason out what needs to be done.

So what needs to be done? You probably already know that stretching out the muscle is beneficial. But in addition to the stretching, you'll do yourself a favor by making those muscles alternate between contracting at 100% and then relaxing. Reverse shoulder shrugs are great for this.

Reverse shoulder shrugs are performed by shrugging your shoulders up toward your ears, then back toward what ever's sneaking up behind you, then dropping back to the starting point. They're called reverse shoulder shrugs because forward rotating instead of reverse rotating not only serves to hunch the back even more into the chimp-like posture, it also doesn't force the muscles of the upper back to contract enough to accomplish the "contract, relax, contract, relax" movement pattern. Just remember that you'll benefit if you can get those muscles pumping periodically.

Elbow presses are also very good at forcing this pumping of the blood supply to the upper back. Remember, we're trying to combat the sustained sub-maximal contraction that cinches down on the muscle's small arteries.

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. Repeat this until you get a mild 'burn' in the muscles.

Of course you should use some common sense regarding doing any of these exercises if you have shoulder issues, like a rotator cuff injury.

How about some basic neck ranges of motion? Certainly don't compromise your ability to remain upright on the bike, but you may try putting your neck through its paces. Here's the cervical range-of-motion drill: flexion (chin to chest), extension (head up), right and left rotation (chin pointing toward the point of the shoulder), and right and left lateral flexion (ear to the shoulder).

Thoracic outlet syndrome accounts for much of the problem of nerve-like discomfort into the arms. A description of the symptoms includes the Who's Who of upper back and neck problems. Anything from muscle tension headaches, pain in the neck, pain in the shoulders, arm pain, and weakness or tingling in any of these areas can be attributed to thoracic outlet syndrome.

Essentially thoracic outlet syndrome is a compression of the bundle of nerves, arteries, and veins that go down into the arms. Over-development of the muscles in the area, such as the scalene muscles, contributes to this problem in strength sports like football and baseball pitching. Cyclists experiencing thoracic outlet syndrome-type symptoms, however, are more likely suffering from muscle tightness or spasm at the base of the neck. Once again, movement and stretching are effective in relieving discomfort.

Now On To Bike Fitting

Letís start by offering some solutions in the area of positioning ourselves on the bike. To begin with, most riders have access to a local bike shop that should know a lot about proper bike fitting. Make good use of their expertise.

Being too laid out on the bike creates the need to bend the neck further up, so there are a few common sense changes that can be made. Raising the handle bars so that youíre riding more upright, or making sure that your 'virtual top tube' length isnít too long are good places to start.

While it isn't practical to get a shorter top tube (youíd need a new frame), you can shorten the reach by getting a shorter stem. Just be sure you donít go much shorter than 100 mm or your bike may achieve levels of squirreliness you don't want to have to deal with.

I'm sure most of you know about the basic measurement of correct reach, but here it is anyway. When youíre in your handlebar drops, your front hub should be obscured by your handlebars when you look down.

Modern handlebars have a variety of degrees of drop so choosing a bar with shallow drops may be a good idea. Or you may not spend very much time in the drops at all, in which case it may be a mute point.

Another equipment consideration is the helmet. Road bikers don't often have visors on their helmets because it necessitates having to bend the neck too far up in order to see ahead. Proper placement of the helmet is also important. Having the helmet too far forward causes neck problems by forcing the rider to bend their head too far back. Having it too far back defeats the safety benefits.

In Summary...

As long as we've restricted ourselves to the constraints of our bikes, we'll need to be diligent to overcome the inherent problems such as neck, upper back, and arm problems caused by our abnormal posture while cycling. Proper bike fitting is essential since we don't want to make what is already a problematic position even worse by being too 'stretched out', necessitating exaggerated neck extension.

We also need to be diligent in keeping our muscles as loose as possible by stretching them out as well as causing them to contract, relax, and contract. These activities will go a long way toward keeping the musculature in the upper back and lower neck from getting too tight, causing problems in the muscles themselves, or in the sensitive tissues of the area.

It all translates into more efficient and comfortable riding.

About Ron

After 22 years in a Mount Shasta private practice, Ron Fritzke, D.C. is pleased to be the chiropractor for the sports medicine team at the College of the Siskiyous. As a former 2:17 marathoner, and current bike racer Ron Fritzke writes about cycling issues like road bike shoes, the fluid bike trainer, bicycle jerseys, and cycling apparel in general, on his website, cycling-review.com.

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