Neck pain in cycling is common especially with the use of racing bikes and with long distances. Racing bikes a lot of times cause people to ride with a bad posture, meaning flexed lower and upper spine causing hyper-extension in the neck. The neck as any part of the spine has joints that if they are fixated in a specific position for long time, such as long-distance cycling, can result into mechanical neck pain. However, as the body degenerates in the aging population, these symptoms may come sooner and persist longer.
The symptoms of neck discomfort include pain with prolonged cycling that worsens as you continue your activity. These may be accompanied with stiffness around the neck and shoulder muscles as the body attempt to protect an irritated area. As this worsens, headaches and inability to find comfortable positions in your day are not uncommon. Sleeping is not normally affected, however in the presence of stiff muscles it may be difficult to find a comfortable position for your head. During the morning the feeling of stiffness may be experienced as more severe and a hot shower may give temporary relieve. The pain may range from mild ache to severe discomfort depending on the irritation of the underlying structures and your daily activities. Desk job is associated with the protracted extended position in the neck that will result in pain at work. Feelings of clicking and grinding of the neck or radiating pain in the arm or fingers are due to underlying pathologies such as degenerative changes in the disks or from nerve irritation respectively.
Examination will commonly reveal a protracted neck posture with weakness in the deep stabilizing muscles of the neck as a result of persistent hyper-extension. In addition, there is commonly provocation of symptoms with specific neck positions and total range of movement may be limited, especially in rotation or tilting of your head. Stiffness of the surrounding muscles as explained before is not uncommon and is secondary causing the reduced range of movement. Strength in the shoulders is unlikely to be affected but can result in a case of secondary nerve irritation.
Management:
The management of the cyclist’s neck is with conservative management and may include analgesia or heat application in the initial stages of rehabilitation. In addition, instruction of correcting posture in activities of daily life and in cycling will allow for gradual resolution of the underlying irritation. In order to maintain a correct posture, exercises for the neck and upper back muscles will be initiated and will be combined with a variety of manual techniques. These include a combination of soft tissue work on the surrounding stiff muscles and mobilization of the spine to increase mobility of the affected segments in your spine. This will allow you to progress to returning to your previous levels of activity without discomfort.
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