I’m a Cyclist and Physical Therapist, and This is What I Do For Shoulder Pain While Cycling

A ten-step approach to treating and preventing cycling-related shoulder pain from a PT with 25 years of experience and a few miles in the saddle.

Shoulder pain while cycling is a common cycling-related complaint. However, it’s often not because of cycling. Many recreational cyclists develop a love of riding after years of dabbling or competing in other sports. Throwing and overhead sports, like baseball, tennis, and volleyball, take a toll on our shoulders. 

If you’re a triathlete, the repetitive overhead swimming motion may contribute to shoulder pain while cycling. The damage to the shoulder joint’s muscles, tendons, and ligaments following repetitive overhead motion accumulates over time. 

It isn’t until later in life that the pain becomes a limiting factor when it often interferes with cycling enjoyment. Address the pain immediately to avoid the risk of more severe consequences, like rotator cuff muscle tears and frozen shoulders (adhesive capsulitis).

An October 2022 study published in The Physician and Sports Medicine asked almost 63,000 recreational riders over five years about their cycling-related pain history. It might be hard to believe, but shoulder pain is the second most common recreational cycling injury. The researchers found that 10.6 percent of the recreational cyclists studied with gradual-onset injuries experienced shoulder pain the previous year.

Shoulder pain while cycling occurs in moutain bikers
Photo: TLBVelo photography @TLBVelo.com

Causes of Shoulder Pain While Cycling

What is the rotator cuff?

Whether you experienced shoulder pain before you began riding or it developed over time, the rotator cuff is a likely cause. The rotator cuff is a group of four muscles, the supraspinatus, infraspinatus, teres minor, and subscapularis. 

 

The tendons combine to position the ball (head) of the upper arm bone (humerus) in the shoulder socket and hold it firmly. The rotator cuff muscles are also essential in proper shoulder joint movement.

What is rotator cuff tendinopathy?

Rotator cuff tendinopathy, also called tendinitis, impingement, or rotator cuff syndrome, is an irritation or inflammation of one or more of the tendons as they attach to the head of the humerus. Rotator cuff inflammation often results from repetitive overhead motion if the muscles are weak or joint movement is not biomechanically optimal.

How did I get Shoulder Pain While Cycling?

Athletes that engage in overhead and throwing sports, like baseball, tennis, volleyball, and swimming, often complain of shoulder pain and soreness related to the rotator cuff. However, there’s a postural component, and cyclists fall into this category.

 

The prolonged cycling “slump” posture with the trunk and shoulders bent forward and rounded places imbalanced strain on your shoulders. The excessive improper demand causes the shoulder blades (scapula) to slide forward (scapular protraction). In turn, the back of the shoulder becomes stiff, and the structures lose flexibility over time.

Man riding a bike in costume with shoulder pain while cycling
Photo: TLBVelo photography @ TLBVelo.com

Symptoms of Shoulder Pain While Cycling

When you raise your arm during household chores or for work, the shoulder joint doesn’t move properly. The rotator cuff muscles and tendons get pinched (impinged) and become irritated with repetitive movement, causing pain and range of motion limitations. 

In addition, previous injuries, like a dislocated shoulder or fractured clavicle (collar bone) or humerus, can cause improper shoulder joint movement.

Shoulder pain while cycling from rotator cuff tendinopathy is a gradual onset issue. The most common symptom is acute, often sharp pain when raising your arm to the side. The pain is most significant during the “painful arc” between 60 and 120 degrees of arm elevation. However, cyclists also experience pain during pressing movements, like opening a door, doing push-ups, or climbing out of the saddle.

If not addressed, rotator cuff ailments often progress to muscle tears and joints that become frozen (adhesive capsulitis or frozen shoulder). The good news is that rotator cuff-related shoulder pain while cycling is effectively prevented and treated. 

Follow these tips and the Ten-Step Shoulder Pain While Cycling Exercise Program.

Shoulder Pain While Cycling Bike Fit and Positioning Tips

There are several upper body pain prevention tips you can follow.

  • Position your hands shoulder-width apart.
  • Hold your wrists in a neutral position.
  • Don’t lock your elbows.
  • Use padded gloves and cushioned bar tape to absorb vibration and lessen the impact.
  • Use a relaxed grip on the handlebars.
  • Set your handlebar height for a slight elbow bend and decreased pressure on your shoulders.
  • Change your hand position every three to five minutes.
  • Limit the use of time trial or tri bars until the symptoms resolve.

Shoulder Pain While Cycling Exercise Program

Posterior Capsule Stretch

Gently pull on the elbow of the target arm with the other hand until a stretch is felt in the shoulder.

Shoulder pain while cycling posterior capsule stretch
Shoulder pain while cycling towel shoulder internal rotation stretch

Towel Shoulder Internal Rotation Stretch

Gently pull up your affected arm behind your back with the assistance of a towel. Hold this as a stretch, then lower back down and repeat.

Pec Corner Stretch

While standing at the corner of a wall, place your arms on the walls with elbows bent so that your upper arms are horizontal and your forearms are directed upwards as shown. Take one step forward towards the corner. 

 

Bend your front knee until a stretch is felt along the front of your chest and shoulders. Your arms should be pointed down towards the ground. Your legs control the stretch by bending or straightening your front knee.

pec corner stretch
wall shoulder external rotation stretch

Wall Shoulder External Rotation Stretch

Place your affected hand on the wall with the elbow bent. Gently turn your body in the opposite direction until a stretch is felt. Keep your arm close to your side.

Elastic Band Shoulder Extension

While holding an elastic band in front of you with your elbow straight, pull the band down and back towards your side.

elastic band shoulder extension
elastic band shoulder flexion

Elastic Band Shoulder Flexion

While holding an elastic band at your side, draw up your arm up and in front of you while keeping your elbow straight.

Elastic Band Shoulder External Rotation

While holding an elastic band at your side with your elbow bent, start with your hand near your stomach and then pull the band away. Keep your elbow at your side the entire time.

elastic band shoulder external rotation
elastic band shoulder internal rotation

Elastic Band Shoulder Internal Rotation

While holding an elastic band at your side with your elbow bent, start with your hand away from your stomach, then pull the band towards your stomach. Keep your elbow near your side the entire time.

Elastic Band Shoulder Diagonal Abduction

While holding an elastic band across the lower half of your body, pull the band upwards and outwards towards the opposite side. Your hand should start in the thumb-down position and end in the thumb-up position.

Elastic Band Shoulder Diagonal Extension

While holding an elastic band across the upper half of your body, pull the band downward and across towards your other side. Your hand should start in the thumb-up position and end in the thumb-down position.

Bird dog core strengthening program image

Core strength is essential to the prevention of shoulder pain while cycling. Follow this Bird Dog Trunk strength progression to improve spine and shoulder stability.

If you’re experiencing shoulder pain while cycling, don’t try to shrug it off! Follow these suggestions and the ten-step plan to prevent and treat shoulder pain while cycling.

For more ways to actively treat your cycling-related aches and pains, check out the Virtual Case Studies page of The ZOM!

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Hannan Ahmad
2 months ago

The intricacies of shoulder pain in cyclists reveal a layered interplay of past sports engagements, cycling postures, and the delicate biomechanics of the shoulder. The deep dive into the rotator cuff’s role, especially its vulnerabilities to repetitive strains and imbalances, is enlightening. Drawing from both the wisdom of a seasoned physical therapist and the personal lens of a cyclist, it offers a multifaceted view of the challenges and solutions surrounding cycling-induced shoulder issues. It underscores the need for a holistic approach to shoulder health, considering past injuries, current habits, and the sheer demands of cycling.

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