NECK AND SHOULDER PAIN
Bike fit for neck and shoulder pain when cycling.
Your head weighs about as much as a bowling ball and you are holding it up against gravity, tilted back, for the whole ride.
THE SHORT ANSWER
Why does my neck hurt when I ride a road bike?
Because a road position asks you to bend forward and then tilt your head back to see where you are going, and hold that for hours. The muscles at the back of the neck work continuously to keep your head up. Three things usually make it worse: a reach that is too long or too low, so you have to extend the neck further; too much body weight going through your hands, which locks the shoulders and upper back; and never changing hand position, so the same muscles never get a break. Shortening the reach, raising the bars, correcting saddle tilt so you are not sliding forward, and improving upper back mobility all reduce the load.
15 to 20min
How often to change hand position, as a habit rather than when it hurts
90min
The initial fit, including the off-bike assessment and the written summary
2
Jobs the upper body does at once: holding you forward, and holding your head up
60min
The follow-up, once you have ridden the new position for a few weeks
Neck and shoulder pain is the complaint that most often makes riders sell a bike. It is also one of the more solvable ones, because the causes are usually mechanical and sit in the part of the setup that is easiest to change.
Two separate things are happening at once. Your upper body is being held forward, supported partly by your arms, and your head is being tilted back so your eyes are level with the road. Both are static jobs. Neither muscle group gets to rest until you stop.
How much of that job lands on your neck depends on how far forward you are, how much weight is on your hands, and whether anything above your hips moves during a ride. All three are things a fit can change.
AT A GLANCE
- Most common driver
- Reach and drop against your available range
- Second most common
- Too much body weight on the hands
- Where it is assessed
- New Westminster studio, by appointment
- Session length
- 90 minutes for the initial fit
THE NECK
Why the back of the neck fatigues
The lower and further forward your torso is, the further you have to tilt your head back to look up the road. That extension is held by a small group of muscles at the base of the skull and the back of the neck, and they were not built for hours of continuous work.
Riders usually describe a burning ache at the base of the skull or across the top of the shoulders that arrives at a fairly predictable point and gets worse from there. Some get a headache with it that starts at the back of the head and wraps forward, which is a well-recognised pattern where the neck refers pain into the head.
Reach too long or bars too low
The bigger the drop between saddle and bars, the more neck extension it takes to see ahead.
Helmet and glasses
A helmet that sits low at the front, or glasses you have to look over the top of, both make you extend the neck further than the bike position requires.
Riding one hand position all day
Staying on the hoods for four hours means the neck is at the same angle for four hours. Moving between tops, hoods and drops changes it.
A stiff upper back
If the thoracic spine does not bend, the neck bends more to make up for it. This is very common in desk workers.
SHOULDERS AND UPPER BACK
Aching between and around the shoulder blades
Pain between the shoulder blades or across the front of the shoulders is usually a weight-bearing problem. Your arms are meant to steady you on the bars, not hold you up. When too much of your body weight goes through your hands, the shoulders and upper back work continuously to stop you collapsing forward.
The giveaway is that it eases immediately when you sit up or take a hand off the bars. If unweighting your hands fixes it within seconds, the problem is how much load they were carrying.
Saddle tilted nose-down
You slide forward, then push back against the bars to stay put. A frequent and easily fixed cause.
Saddle too far forward
Shifts your centre of mass over the front of the bike so the arms carry more.
Locked elbows
Straight arms transmit every bump straight into the shoulders and neck. A soft bend acts as suspension.
Bars too narrow or too wide
Bar width that does not match your shoulders puts the joint at an angle it has to brace against rather than rest in.
Lever position
Brake levers rotated too far down or up change your wrist and shoulder angle for every hour you are on the hoods.
OFF THE BIKE
The desk connection
A lot of the riders we see with neck pain on the bike also have a neck that is not thrilled at their desk. The two positions are more similar than they look: head forward, upper back rounded, shoulders held. The bike then asks the same tissue to do a harder version of the same job.
That matters because it changes what actually fixes it. If your neck is already at its limit by Friday afternoon, a Saturday ride does not need much of a fit problem to tip it over. Working on upper back mobility and neck endurance often does more than another 10 millimetres of stem.
Upper back mobility
Extension and rotation through the thoracic spine, so the neck does not have to provide all of it.
Deep neck endurance
The ability to hold the head steady for a long time at low effort, which is exactly the demand of riding.
Shoulder blade control
Being able to support your weight through the arms without the shoulders creeping toward the ears.
Change something at the desk too
Screen height, chair, and how often you get up. If the week is loading the neck, the ride is not the only thing to change.
This is general information, not a personal assessment. Nothing here replaces having the joint looked at. Stop any change that increases your pain, and see a regulated clinician if the pain is sharp, swelling, giving way, or getting worse week to week.
ENQUIRE IN NEW WESTMINSTER
Book a fit if
- Your neck burns at a predictable point in every ride
- You get headaches that start at the base of the skull during or after riding
- Your hands go numb as well, which points at weight on the bars
- It eases the moment you sit up or take a hand off
- The pain arrived after a new bike, new stem or a lower position
- You also have a neck that struggles at a desk
LAUNCH REHAB NEW WESTMINSTER
Bike fitting runs from our New Westminster studio, by appointment. Tell us what happens on the bike and we will tell you whether you need a fit, a physiotherapy assessment, or both. It is a two-minute conversation and it saves booking the wrong thing.
- Address
- 219-800 Carnarvon St, New Westminster, BC V3M 0G3
- Getting here
- Inside Shops at New West, above New Westminster SkyTrain station
Bike fitting is by appointment only and books out during the spring and summer riding season. Enquire early if you have an event coming up. About the New Westminster studio.
FAQ
Common questions.
It is a reasonable first move and it helps many riders. Watch for two things. Raising the bars without shortening the reach can leave you stretched out at a new angle, which does not always feel better. And if you are sliding forward because the saddle is tilted nose-down, bar height will not stop that. If a bar change gave partial relief, the direction is right and something else is still contributing.
KEEP READING
More from the bike fitting guides.
- Pain and symptoms
Numb hands
Which fingers go numb tells us where the pressure is landing, and that points straight at the fix.
READ - Pain and symptoms
Lower back pain
If the hips cannot rotate far enough to reach the bars, the low back rotates instead and holds it all ride.
READ - By type of bike
Triathlon and TT
The hardest fit to get right. A low position held for hours, and in triathlon you still have to run after it.
READ
FROM THE JOURNAL
Related reading from our clinicians.
READY?
Book your bike fit in New Westminster.
By appointment at 219-800 Carnarvon St, New Westminster, BC V3M 0G3. Not sure which appointment you need? Call 604-519-0777 and describe what happens on the bike.