Shoulder/Neck Pain

[SayHey]

I'm looking from some suggestions on an issue I've had for a couple of years now -- shoulder/neck pain when riding. I know there's a tremendous amount of knowledge on this forum (likely dealing with this issue).

I don't know the names of different muscle groups, but the picture below shows where I get the discomfort (in my upper left shoulder near the base of my neck). My typical long weekly ride is about 55 - 60 miles, although the discomfort starts on my shorter rides after 10 miles or so. The pain never becomes so heavy that I say I've got to stop riding, but it's there and takes away from the pleasure of riding. Interestingly, the discomfort diminishes significantly when I'm off the bike for about 5 minutes.

I've been riding for over 20 years and in the past have done many longish rides (centuries, a few doubles, etc.). I'm interested in taking longer rides again and doing some tours, but I'd like to address this issue to make it more fun.

A few other pieces of information that might be useful ... I ride a number of different bikes (Serotta, Atlantis, Mtn Bike, and a road tandem). They all have positions that differ somewhat and it doesn't seem to make much difference. The Serotta has about 3 - 4 cm of drop, whereas my Atlantis has 0 - 1 cm but is a little more stretched out. (Those are the two bikes I've been on the most in the last 6 - 8 months).

I'm conscious of keeping my grip relaxed and elbows bent to avoid creating tension in my shoulder area. I used to sleep on my stomach, but stopped that about 7 months ago because I heard that could be a cause. It's possible that I have some built up shoulder/neck tension and no matter what bike I'm on, it gets triggered.

Interestingly, I broke my collar bone in early February (while riding) and had to stay off my bike for about 3 months (doctors orders!). When I resumed riding, the discomfort didn't come back right away but returned after a month or so of riding.

I'm searching for answers and am thinking stretching, strengthening exercises, physical therapy, and/or massage might be the next best step(s). Your thoughts and ideas are appreciated. Thanks ... Ray

[regularguy412]

From time to time, I have pain in the same area, too. I, too, broke my left collar bone (many years ago). I, too, often awaken in the mornings after having slept on my stomach.

I'm pretty sure my local pain stems from the collar bone break, as I think it probably didn't mend back precisely in its original geometry. My break was not plated ( no surgery performed to implant a plate and screws). I was in a figure-8 sling for eight weeks. You didn't mention if your break required surgery. I would think that a surgically repaired break would tend to heal in a more natural fashion.

When riding, I find it difficult to turn my head _ALL_ the way to look over my shoulder at traffic, if I try to turn to the left (injured) side. It's much easier to look over the right.

I've tried the neck pillows and towel rolls in the past, but those methods yielded only marginal relief. What has seems to work best for me includes a variety of therapies that include: making sure that the muscles in that area remain strong (light weight lifting such as upright rows 30 - 40 lbs, reverse lateral raises with dumbells 10-15 lbs each hand), and also chiropractic manipulation if things feel 'stuck'.

It sounds like you have a pretty good position on the bike, i.e., good fore/aft weight balance, such that not a lot of weight is being carried by your hands and arms. Something you may want to consider is a position issue I had to overcome when I first started racing. Early on, I wanted to subconsciously scrunch my shoulders up closer to my ears. I never realized it until my riding buddy told me about it. Now I purpousely 'shake out' my elbows and pull my shoulders down several times during a ride, just to be sure I'm not too tense.

I still have some pain, occasionlly, however it doesn't seem to come on 'during' the ride -- usually worse in the mornings if I sleep in an awkward position, or later at nite after using my back muscles a lot. Hot water and Ibuprofen are my friends.

Mike in AR

[andy mac]

1. stress can often pop up in that region.

2. have you looked into your working position and general posture?

3. also may be worth looking into muscle imbalances?

if any of the above apply maybe a getting on a bike is enough to tip you into the pain world??

i have been battling various back/leg/neck problems over the last four years and they all seem to stem from lower back issues (pretty locked up), poor posture, sleeping on my front, stress and muscle imblances. never a dull moment around me...

hope you get to the bottom of it!

:beer:

andy.

[andy mac]

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[SayHey]

Fortunately, my collar bone break didn't require surgery. The doctor said stay off the bike though until I was almost back to 100% because he said another fall while I was healing would likely mean surgery. I don't think the break is the cause of discomfort in my case because I was having the same kind of pain before the fall & break.

Your suggestion of some weight training is something I've been considering. Right now I do nothing to strengthen the muscles in my shoulder/neck area.

I think my fore/aft position is reasonably good, but I may be still carrying a little too much weight on my arms. I'm thinking I may need a little more core strength to help support my upper body and take just a little more weight off my hands/arms.

I've heard some say that you should be able to basically hover your hands over the brake hoods with minimal effort and not slide forward on your saddle while in that position. I can do that but it takes effort and concentration. I don't know if that's the 'gold standard' for determining if you have the right fore/aft position, saddle-to-bar drop, and core strength. Obviously, they're interdependent.

Thanks for your reply.

[SayHey]

1. stress can often pop up in that region.

2. have you looked into your working position and general posture?

3. also may be worth looking into muscle imbalances?

I recently had an ergo evaluation recently at work and think my position is reasonably good, although not perfect. I think the point about muscle imbalances is a very good one and may be a root cause.

Thanks ..... Ray

[rwsaunders]

Check with a Doc. Believe it or not, that's an area that sometimes can be related to a pinched nerve in your neck. Been there and PT solved the trick. Wait too long and you can have disc issues.

[Tailwinds]

Stress is often carried there, and a tendency for the shoulders to rise while riding (or stressed) can exacerbate the pain there, too.

Good, therapeutic massage can do wonders to release those muscles that you describe.

[Dekonick]

Check with a Doc. Believe it or not, that's an area that sometimes can be related to a pinched nerve in your neck. Been there and PT solved the trick. Wait too long and you can have disc issues.

+1

and consider checking out an atlas/orthogonal chiropractor (specialize in your upper neck area - not your typical chiropractor. You may not find any in Hi -)

make sure you are careful - you only get one neck in life. Take care of it.

side note - good pillows, and sleepnumber beds rock.

[eddief]

one of these things, while looking rather nasty, is remarkably efficient in working out knots in that exact spot:

http://www.bodybackbuddy.com/product.asp?specific=jnnphor8

of course i'm speaking of the tool not the tool holder. if you can get them both for $7.95 all the better.

this is a regular spot for cyclists to have pain. consider the "normal" riding position and having to hold up that heavy head while bouncing down the road.

he suggested strengthening those muscles, duh.

on your stomach, arms by sides, keep arms straight, raise arms above back, and pull shoulders together, hold ten seconds, do a bunch.

same thing but a little different--this time with arms out in a "t" at 90 degrees to your torso, lift arms, pull shoulders up, hold ten seconds.

when you can do it easily with no weight in hands---then add weights in hands.

i'm working on these to get rid of the pain I believe you are describing.

[SayHey]

Good suggestions, all.

rwsaunders -- I think it's time to see the Dr., which will then get me to the PT. I've seen a PT once about a year ago and they can work wonders not only in providing some immediate relief, but in helping educate and guide for long term health.

Tailwinds -- I will try to be more conscious of my shoulder position while riding. It's possible mine may be creeping up as I ride longer.

Dekonick -- I've never seen a chiropractor before and have heard a few stories including one from a friend that was injured from a visit; consequently, I'm hesitant. I've also heard many say they've gotten much relief from visiting a chiropractor. Don't know if there's a chiropractor in my area that has the special training you noted.

eddief -- that body back buddy looks like it would be a useful device; I think I'll order one of those. The exercises you noted seem interesting. I think I may have a muscle imbalance too and developing more strength in that area would likely help significantly.

One thing I've come to realize is there's likely no quick fix, but a combination of techniques and approaches are needed (through a little experimentation) to get lasting results.

Thanks again for your suggestions ... Ray

[Dekonick]

One must be careful in choosing any medical professional. A good chiropractor will work with your MD and PT. I also have heard horror stories, but from personal experience nothing helped me until I found an atlas/orthogonal chiropractor. I had a neurosurgeon who wanted to slice my neck and fuse several vertebrae. I had an orthopedic surgeon who wanted to do the same. A third neuro told me to deal with the pain until I could bear it no longer - and only then would he suggest a slice and dice...as he put it you only get one neck...

so I listend to him. Years later I finally found an atlas orthogonal DC who has made me pain free - and now my legs are the same length, I no longer have C-8 impingement, - and the best part - no more headaches/shoulder aches (exactly where you pointed out on that pic)

It isn't for everybody, and it won't work for you if you don't have a sublexation of your cervical spine. If you do, it can work and make you feel better.

For what it is worth, I always thought chiropractors were quacks - an image that the majority of the medical community perpetuates. I now have changed my opinion - after all, it is what 'fixed' me! :banana:

[imm]

Find a good MT experienced in real deep tissue and myofascial release techniques. It hurts like hell, but is very therapeutic. I'd also find a quality osteopath and get eval'd.

Best of luck!