The final chapter – part three
In the final part of this blog series we are going to talk neck pain.
When all the power is being exerted through the legs, why, as a cyclist, would you experience neck pain? Let’s start with anatomy.
Attaching to the base of the skull, into the shoulders and down into the lower part of the spine, is the trapezius muscle (pictured below) which often causes a lot of discomfort for cyclists, but why?
In 1979 Dr Janda, a Czech physician, divided muscles into two groups; tonic and phasic muscles. The idea being that phasic muscles typically work eccentrically against gravity and are prone to becoming weak and inhibited by pain, stress, positioning, whereas tonic muscles are prone to becoming shortened and tight. An imbalance between these tonic and phasic muscles can lead to pain and instability in the body. Janda went on the classify certain predictable patterns of muscle imbalance. The ‘upper cross syndrome’ is an example of when tonic and phasic muscles become imbalanced with the facilitation of the levator scapula, upper fibres of trapezius, sternocleidomastoid and pectoral muscles and the inhibition of the deep neck flexors, serratus anterior and lower fibres of trapezius. These imbalances often lead to rounded shoulders and a forward head posture resulting in neck pain and often associated headaches.
Again, it’s a multifactorial picture and accounts for a lot more than just what’s happening when you cycle. What we do with the rest of our day when we are not cycling has a huge impact on our mechanics when we get on the bike. Those with desk-based jobs are more prone to developing this type of postural pattern and with the rise of technology, we spend more of our time looking down at our phones or typing on laptops. After 8-10 hours of working in a poor desk-based posture, many will then get onto their bikes which can exacerbate the shortening of the tonic muscles including the upper fibres of the trapezius and the lengthening and weakening of the phasic muscles such as the lower fibres of the trapezius. No wonder so many of us suffer from neck pain. So, what can you do to prevent developing this posture and self-treat accordingly?
Stretch and strengthen (Brugger exercise)
Stretch out those tonic muscles and strengthen those phasic muscles!
Upper trapezius and levator scapula stretch
Latissimus dorsi stretch
During your working day this simple stretch and strengthen routine can really help to open up the chest and exercise the back. It’s named the Brugger Exercise and is shown in the video below here.
TheraBand pull backs for the lower trapezius and rhomboids (remember to squeeze the shoulder blades together at end range)
Thoracic mobility and foam rolling
Often the trapezius and erector spinae muscles that run up the back can become tense if the joints in the back don’t move to their optimum range. In the cycling position, the thoracic spine (mid back) is often locked in a flexed position and this can cause stress and fatigue on the muscles running up into the neck. This is then exacerbated if someone also has a desk job where, for the most of their day, they remain relatively immobile in the thoracic spine. Below is attached a video from British cycling used in the previous blog to demonstrate some ways to mobilise your upper back. Running a foam roller up and down the mid back can also help to open up the chest and mobilise the thoracic spine.
Mobility Video here.
Ergonomics and desk position
Make sure if you are desked based that you have had an ergonomics check, it could just be a bad chair or desk position causing your neck pain! Try to take regular breaks from the desk position, even just rolling your shoulder backwards regularly can help keep muscles looser. If you find this hard to remember just put a post-it note on your laptop or a reminder on your phone to keep moving.
Bike fit errors can cause issues with the neck, for example having a reach too long or a handlebar position too low can force your neck into extension and lead to irritation of the joints in your lower neck. If you haven’t already it may be worth looking into a bike fit, very small adjustments can make a huge impact on the body when cycling.
As Osteopaths we are very good at taking a global approach to treatment. We won’t just look at your neck pain, but we will look at it in relation to the rest of your body. Look at any muscle imbalances that may exist between the tonic and phasic muscles, look at your spinal mobility whilst taking into consideration all the factors above that may be linking into the persistence of your neck pain. We are also very good at tailor making home care advice to suit the individual requirements from what has been flagged up in the consultation/treatment. Thinking about sorting out that neck pain that has been bothering you? Find osteopathy at The Good Health Centre Leeds, why wait?
Brit Tate (Osteopath at The Good Health Centre Leeds. Ex-cyclist now triathlete.)