Neck Pain with Cycling
Cycling requires the rider to maintain the back in a flexed positioned whilst the neck is forced to bend in the opposite direction and sustain an extended position in order for the rider to be able to see the road ahead. Whilst the degree of flexion of the back and extension of the neck may vary depending on the type of bike your riding, this sustained posture is for the most part inescapable (unless of course you somehow managed to grow a set of eyes on the top of your head, in which case please let me know…). What’s more, the modern road bike has seen the adoption of ‘tighter’ geometry comprised largely of a shorter wheelbase and lower drop from seat to handlebars, meaning that the rider has to contort their body like that of a circus performer in order to ride the thing.
Hence, it’s probably not surprising that the highest reported injury amongst cyclists is neck and back pain. Having to forcibly extend the neck over a long period of time can increased loading of the joints of the vertebrae that make up the neck. This position can also lead to tight, angry muscles around the neck that have to work overtime to maintain this position. Taught bands of muscles fibres known as trigger points can develop in these muscle causing both localised and referred pain to other parts of the body and further increase loading on the joints of the neck. If left untreated these symptoms can snowball into long-term joint changes, headaches/migraines, negatively impact on sleep and work and may ultimately mean more time off the bike. Neck pain can be avoided by firstly ensuring your bike is setup correctly for YOU, not for Bradley Wiggins or Cadel Evans. Each individual is different and height, body proportion, flexibility, trunk/pelvic stability, muscle strength/weakness and pedalling technique will all influence your ability to adopt and sustain a particular posture.
Riding with arms fully extended/straight can force the shoulder blades to drop downward, increasing the stretch placed on the nerves which pass through the vertebrae of the neck and down the neck and arms. These nerves are what provide you with sensation/feeling and act as the relay network to the muscles. Nerves are highly irritable if stretched or crushed by narrowing of the space they travel through such as the spine. Hence, this position can also be a huge contributor to neck pain. This position can be avoided by actively shrugging your shoulders at regular intervals during a ride and riding with elbows slightly bent. Particularly if you’re someone that spends allot of time on the drops and your experiencing neck pain, you should consider switching hand position from drops to brake hoods and top of bars regularly. If you are unable to achieve a slight bend in the elbows regardless of hand position clearly your handlebars are too low and need to be raised.
Lastly, neck pain commonly occurs in cyclist when all the extension at the neck is happening at one level/joint of the spine. This is what’s known as ‘hinging’ and can occur if the rest of the joints/vertebrae that make up the neck have become stiff and the muscles that support the head called ‘deep neck flexors’ are weakened.
Riders should perform regular flexion (looking down/binging chin to chest) and side flexion (looking forwards bringing each ear to shoulder) movements whilst on the bike. When stopped or at traffic lights getting off the seat standing over the bike and extending through the back and flexing the neck is also helpful to reverse the position you’re stuck in on the bike.
If you’re a cyclist suffering with neck pain get on top of it and get help before it becomes a chronic issue that prevents you from getting on your bike! Your physiotherapist can help identify the cause, help treat tight muscles and trigger points, loosen stiff joints, offer advice on bike setup and prescribe a rehab program to get you on your way to staying pain free.