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.
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.
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.
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.
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 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 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.
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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Semi-retired as owner and director of his private Orthopedic Physical Therapy practice after over 20 years, Chris is blessed with the freedom to pursue his passion for virtual cycling and writing. On a continual quest to give back to his bike for all the rewarding experiences and relationships it has provided him, he created a non-profit. Chris is committed to helping others with his bike through its work and the pages of his site.
In the summer of 2022, he rode 3,900 miles from San Francisco to New York to support the charity he founded, TheDIRTDadFund. His “Gain Cave” resides on the North Fork of Long Island, where he lives with his beautiful wife and is proud of his two independent children.
You will read him promoting his passion on the pages of Cycling Weekly, Cycling News, road.cc, Zwift Insider, Endurance.biz, and Bicycling. Chris is co-host of The Virtual Velo Podcast, too!
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.
Well said, Sir!