In cycling, the shoulder doesn’t get challenged in many ways, apart from the load we bear as a result of leaning on the handlebars. Many of us have experienced shoulder pain while cycling, and it can be largely due to a number of factors, including the inadequate stimulation of all the tissues that surround, support, and move this complex joint.
(Image credit: anut21ng/Adobe Stock)
Shoulder injuries are one of the most common gradual onset injuries in recreational cyclists. This means that they develop slowly over time, usually as a result of the overuse of some muscles to the neglect of others. It often starts as a dull, aching sensation that gets worse with further use, as opposed to a sharp, acute pain that we really only see as a result of falls and accidents.
It’s important to know that the most mobile joint in the human body is the shoulder joint. Several bones, muscles and other tissues have influence on its structural integrity and movement capacity, which can make the causes of non-specific shoulder pain from cycling hard to identify. However, there are some common issues cyclists face simply due to the nature of the sport.
Poor Bike Fit & Prolonged Riding
Making sure your bike is fitted properly to your body is always one of the first things you should check when addressing pain. This is because as cyclists we stay more or less in the same positions for long periods of time, making us incredibly susceptible to overuse injuries and muscle imbalances.
If your handlebars are too low or too far away from you, it will force you to lean more forward, and you’ll resultantly have to support more of your bodyweight over the handlebars than you would otherwise. Think of an incline pushup (where your hands are elevated on something), and how the pushup gets harder as you move your hands lower towards the floor.
The constant weight bearing on the arms has a significant effect on the shoulder, and can often result in something called shoulder impingement syndrome. Pain when lifting the arms, pain while trying to reach overhead or behind you, pain in the front/side of the shoulder, arm weakness and stiffness are all symptoms of shoulder impingement syndrome.
Two of your four rotator cuff muscles (infraspinatus, supraspinatus) have tissues that pass between the humerus (upper arm bone) and acromion (top outer part of the shoulder blade). Constant load bearing on the arms, like you see in cycling, can compress, rub against, pinch or otherwise impinge upon these tissues, resulting in the symptoms previously listed.
(Image credit: VectorMine/Adobe Stock)
How to Fix It
- Get a professional bike fitting: Find a local shop that can do it in person or use an AI app like MyVeloFit to do it yourself at home. Either way, ensuring your bike is fitted to your body will immediately reduce your likelihood of injury and increase comfort while riding.
- Reduce cycling intensity: If you are dealing with some sort of shoulder impingement syndrome, you can see, just by its nature, how it’s not a problem you can simply work through. The body needs time to let this irritating condition settle while you work on creating more balance throughout the joint (next step).
- Strengthen the rotator cuff muscles: Cycling doesn’t challenge the shoulder in many ways, which is a disaster for shoulder health. It needs complex stimulation from a variety of exercises. Having a well-balanced program that trains the shoulder from all angles and in all positions is key to avoiding shoulder pain from cycling.
Faulty Breathing, Tense Neck & Shoulders
These three things are all related, and commonly found in the average cyclist. Because of the intimate and complex relationship between the humerus (upper arm), clavicle (collarbone), scapula (shoulder blade) and all their attaching tissues (which collectively form the shoulder joint), compromising any one of them can negatively influence the others.
This x-ray shows the complex arrangement of bones that meet to form the shoulder joint. (Image credit: Nut/Adobe Stock)
Cyclists are prone to inefficient breathing and excessive stress on the neck through their positioning on the bike. The head juts forward and back the more you bend over on the bike, this can place a load of 60+ pounds on your cervical (neck) spine, because the head’s weight gets multiplied every inch it moves forward in front of the body.
A forward folded position can also inhibit movement of the diaphragm, your primary respiratory muscle. This encourages you to breathe through the chest, which strains small secondary respiratory muscles in your neck responsible for lifting the ribs. Because cycling is such a cardio-intensive activity, this type of breathing can cause significant irritation.
Both of these things can carry over into daily life, and both can contribute to shoulder pain while cycling. By compromising the head, neck and upper back through poor breathing and positioning, the shoulder will have no choice but to try and compensate. This is one example of how shoulder pain is not always directly linked to the shoulder itself, but its surrounding parts.
How to Fix It
- Strengthen the neck extensors & upper back: The muscles that pull your head back, as well as extend (flatten) your upper back, tend to get very weak if all you do is cycle. This is because they are constantly being stretched out on the bike. This article will show you what exercises to do and why they work for less neck and shoulder pain while riding.
- Practice diaphragmatic breathing: This means breathing into your belly. Most neck and head pain in cyclists can be attributed to faulty chest/neck breathing patterns. A good exercise is lying back over an exercise ball and taking long deep breaths. This stretches the abdominals while stimulating the diaphragm and forcing it to be more active.
- Relax the neck: Stretching the neck muscles prior to and even during your ride can force them to relax while you focus on breathing more into your belly. Being conscious of how much tension you’re holding in your shoulders will also be beneficial. Try to catch yourself while riding if your shoulders get shrugged up close to the ears.
Note on Nutrition & Cycling Shoulder Pain
Many people fail to consider the role of the organs when it comes to shoulder pain in cyclists. The phrenic nerve is a major nerve that originates from the third to fifth cervical spine nerves (C3-C5) in the neck. It descends through the thorax (chest cavity) and travels between the lungs, in front of the heart and along the surface of the diaphragm.
You have two phrenic nerves, one going down the left and right side of the body. If the stomach, which is on the left side of the body, gets too distended or inflamed, it can press on the diaphragm and irritate the left phrenic nerve. Similarly on the right side, if the liver becomes enlarged, it can press on the right phrenic nerve via the diaphragm.
When these tissues become irritated or inflamed, they can send pain signals to the spinal cord through the sensory fibers of the phrenic nerve. In the spinal cord, the incoming pain signals from the phrenic nerve can activate nerve cells (neurons) that also receive sensory input from other areas of the body, including the shoulder. This is called referred pain.
Attention should be paid to the diet of a cyclist who is experiencing shoulder pain, especially if physio/massage interventions are proving ineffective. Stomach problems can contribute to left shoulder pain/weakness, and liver problems can do the same for the right shoulder. Common irritants like dairy, gluten and alcohol should be looked at as initial culprits.
Phrenic nerve, highlighted in yellow. This is a frontal view. The diaphragm is the large dome-shaped muscle at the bottom. Under the elevated right side would sit the liver, and under the left side would sit the stomach. (Image credit: vesalii/Adobe Stock)
Eliminate Cycling Shoulder Pain!
By incorporating a well-rounded strength, mobility, flexibility and injury-prevention plan into your training, you can greatly reduce the risk of injury to your shoulders and every other part of your body. That is exactly what the programming at Dynamic Cyclist is designed to do. Try us out for 7-days FREE by clicking here!