The Cyclist’s Neck

What is it?

Cycling completely changes the weight distribution through your muscles and spine, but also bends the back and neck into an unnatural position.

The neck, in particular, must compensate so that you can see where you are going. In a poor riding position this can be quite extreme; like standing and staring up into space for hours on end; it’s no wonder neck muscles can get tired and irritated.

This is generally caused by poor posture in the saddle or too much time spent in a bad position, reduced flexibility in the upper back, or a fault with the set-up of the bike itself that can exacerbate the problem.

The pain can spread around the region and sometimes can also lead to numbness or tingling in the arms.

This neck position places prolonged stresses through the joints and soft tissues, not only within and around the neck, but also across the tops of the shoulders, which means it is no wonder that many cyclists complain of neck pain when riding. It is so common amongst cyclists that it’s often dismissed as simply an accepted consequence of the sport.

However, no persistent ache/pain should be viewed as normal, rather a warning sign that your posture is compromised and your position on your bike is harming your body through repetitive microtrauma to the joints and soft tissues.

Problems arising from the stresses placed on the neck can include pain, not only within the neck itself but referred aching into the areas adjacent to the neck, i.e. the shoulder blades and upper trapezius muscles across the tops of the shoulders. In some cases, where poor neck positioning has started to irritate the nerve roots in that area, pain can be experienced at any point across the neck and shoulders, and even down the arm into the hand, possibly with associated pins and needles and/or numbness. Sometimes headaches can also occur, which can be referred from the neck itself.

Neck pain from cycling stems from 3 main causes:

• Poor posture
• Incorrect bike-fit / set-up
• Overtraining

How does physiotherapy treat neck pain?

A physiotherapist will assess the neck to produce a diagnosis and once this has been determined, a programme of rehabilitation involving manual therapy, stretching and strengthening exercises will be developed to alleviate the symptoms and enable the cyclist to hold a better posture in the saddle.

The physio will also look at the position of the cyclist when riding to determine the root cause of the problem.

If the position on the bike is causing the issue, then changes to such things as the saddle height or the handlebar position may be suggested.

Tips to help combat neck pain when riding:

Aside from making any necessary alterations to your bike-fit, there are some exercises, stretches and strategies when riding that can help combat this problem:

• Each time you come to a natural stop (e.g. at traffic lights), sit up from your bike and allow your spine to extend. Tuck your chin into your neck (backwards and downwards slightly) in order to reverse the position of strain.
• Relax your shoulders periodically whilst on your bike – tension in the upper trapezius muscles can build up slowly in a hunched position and cause aching. Imagine creating as much space between your ears and your shoulders as possible, lengthening your neck and stretching your trapezius muscles.
• Don’t lock out your elbows when cycling – a slightly flexed elbow can help with shock absorption through the upper limbs, taking pressure away from the muscles and joints around the shoulders and neck.
• Vary your hand position on the bike to alter the loading and position of the upper limbs whilst cycling.
• Continue your chin tucks and trapezius lengthening exercises when at your desk, when driving and whilst watching T.V at home – the more you do this throughout the day, and the better your overall posture, both on and off the bike, the more you will reduce your symptoms and the chance of developing a neck-related problem.
• It is also worth mentioning that the stronger your core muscles are, through specific conditioning exercises, the better posture you will adopt when on a bike (and indeed at your desk!), thus minimizing the risk of cycling-related aches and pains.