Bicycling is a great non-impact sport that can be enjoyed by many, no matter the age. I have been an avid bicyclist since I was a resident physician at the University of Utah. When I started commuting to work, my low back pain improved, as did my overall health and endurance. I loved the alone time and the beautiful scenery I would otherwise miss if I drove to work.
After a few years I developed neck pain. I tried switching bikes and used a bike rack instead of a backpack, but to no avail. Neck pain is a common complaint
for bicyclists and affects up to 50% of regular cyclists.
When you ride a traditional bike, the rider leans forward to grasp the handlebars and this increases the kyphosis (or flexion) of lumbar and thoracic spine and hyperextends the neck. This results in overloading of the small joints in the neck and the paraspinal muscles that hold the head up. Hyperextension of the neck can also cause pinching of the nerves from the neck to the arms, thereby causing arm pain, numbness, and tingling. If a rider has poor midback flexibility and strength, then the upper neck muscles (upper trapezius, levator scapulae, scalenes, sternocleidomastoid) can become overactive and put additional stress on the neck. Dr. Janda, a renowned neurologist, referred to this as “upper crossed syndrome”.
Treatment must address appropriate exercise and proper bike fitting. Cross-training is essential to work on antagonistic muscles and movements to oppose the sustained posture of bicycling. In my case, I should have strengthened my deep neck flexors and mid-back muscles and worked on flexibility of the anterior and upper neck muscles.
I recently took advantage of a professional bike fitting service at a local bike shop, East Coasters. I saw a dramatic difference in my posture and neck pain while on my bike immediately after the fitting. At East Coasters, the athlete is carefully measured and examined while on a bike in order to ensure proper seat height, arm elevation and reach, and other factors.
Neck pain that lasts more than a month or results from trauma should be a red flag to go see a doctor for further evaluation. Severe cases may require a neck injection, manipulation, or even surgical consultation.
Valley Sports & Spine Clinic
Giving you Back your Life
Dr. Ethan Colliver